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National Center for Ethics in Health Care

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Ethical Leadership



Fostering an Ethical Environment and Culture

Leaders strongly influence the ethical environment and culture of health care organizations, which, in turn, influence employee behavior. The Ethical Leadership component of IntegratedEthics® (IE) provides health care leaders with the practical tools and training they need to foster an ethical environment and culture that will make it easier for employees to "do the right thing."

The IntegratedEthics model of ethical leadership is organized around four compass points:


1. Demonstrate that ethics is a priority

2. Communicate clear expectations for ethical practice

3. Practice ethical decision making

4. Support your local ethics program 


Ethical Leadership: Fostering an Ethical Environment and Culture - The primer explains the role leaders play in creating and sustaining an ethical culture in health care organizations, critical factors for success, and the specific behaviors leaders use to foster an ethical environment and culture. Intended for health care leaders at the executive and mid-manager levels.

Foglia MB, Cohen JH, Pearlman RA, Bottrell MM, Fox E. Perceptions of Ethical Leadership and the Ethical Environment and Culture: IntegratedEthics Staff Survey Data from the VA Health Care System. AJOB Primary Research, 2013. 4(1) 44-58.

Bottrell MM. Ethics Quality Helps Build Healthy Organizations. Organizational Health, 19 (Summer 2013).

IntegratedEthics Policy (VHA Handbook 1004.06)



Ethical Leadership: Fostering an Ethical Environment and Culture Video - 44-minute, interactive training video to teach viewers leadership behaviors that will help foster an ethical leadership and culture. 


Tools to explain the role of the Ethical Leadership Coordinator:

Tools to support the development of ethical leadership skills:

Talk About Ethics - an activity and activity guide for all staff members to help them consider how they "talk about ethics" and to encourage discussion with their colleagues

Ethics Discussion Activities - using journal articles and media examples, activities prompt group discussion of ethical leadership concepts

Tear Sheets on Ethical Leadership from IntegratedEthics in Action – Articles highlight decisions, processes, and activities to help leaders of health care organizations foster an ethical environment and culture. Tear sheets can be used as educational emails, reprints in local or facility newsletters, or discussion topics for meetings.

Tools to improve plans to strengthen an organization's environment and culture:


IE Archive: Materials used in initial launch of VA IE program


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