What Critical Ethical Values Guide Strategic Planning Processes in Health Care Organizations?

AMA J Ethics. 2017 Nov 1;19(11):1073-1080. doi: 10.1001/journalofethics.2017.19.11.ecas1-1711.


This case explores a fictitious hospital's use of co-creation to make a decision about redesign of inpatient units as a first step in incorporating stakeholder input into creation of governing policies. We apply a "procedural fairness" framework to reveal that conditions required for an ethical decision about space redesign were not met by using clinician and patient focus groups to obtain stakeholder input. In this article, we identify epistemic injustices resulting from this process that could undermine confidence in leadership decisions. Suggestions are offered for incorporating stakeholder input going forward that address prior shortcomings. The result should be conditions that are perceived as procedurally fair and decisions that engender confidence in institutional leadership.

MeSH terms

  • Attitude
  • Decision Making / ethics*
  • Environment Design*
  • Focus Groups
  • Hospitalization
  • Hospitals*
  • Humans
  • Leadership
  • Morals
  • Organizations
  • Social Justice*
  • Stakeholder Participation*
  • Strategic Planning*