Ethical Healthcare Leadership: The Role of Moral Courage

This essay critically analyzes the concept of courage in leadership within the context of an ethical healthcare environment. It defines moral courage and explores its necessity for leaders, emphasizing the challenges faced by nurse leaders in complex settings. The essay highlights the importance of moral courage in decision-making, particularly when addressing intractable problems, and its role in maintaining ethical standards and promoting patient well-being. It discusses frameworks that enable leaders to apply moral courage, including moral imagination and cognitive processes, and the need for open reflection and transparency. Furthermore, the essay examines how courageous leadership can transform individuals, engage others, and establish ethical standards, ultimately improving patient care and organizational reputation. The essay is supported by recent peer-reviewed journal articles and emphasizes the significance of ethical programs and the development of moral courage as a critical competency for healthcare leaders.

Courage in Leadership

In the current healthcare sector, the nurse leaders have to practice in a highly complex
environment, which leads to value conflicts and moral distress (Hutchinson, Daly, Usher, &
Jackson, 2015). The cause behind moral distress is, when an individual knows the morally
correct act, but cannot perform it due to constraints (Musto, Rodney, & Vanderheide, 2015).
The nursing profession is considered as the moral centre of healthcare which inspires ethical
care and compassion (Musto, Rodney, & Vanderheide, 2015). The nurse leaders have to
remain focused during crises times and should take command in order to reduce uncertainty
by taking essential decisions (Hutchinson, Daly, Usher, & Jackson, 2015). Sometimes,
leaders face intractable problems and become unable to find solutions to them. In such a
situation, a proactive and adaptive approach for leaders is to exercise moral courage
(Hutchinson, Daly, Usher, & Jackson, 2015). Through this approach, leaders maintain
fundamental values in decision-making and at the same time guide and influence others to
achieve ethical standards (Musto, Rodney, & Vanderheide, 2015). They also need sufficient
moral imagination and courage to articulate moral choices and actions. The complications of
moral leadership and taking moral decisions provides a framework that includes
comprehensive understanding of individual as well as contextual factors which obstruct as
well as enable moral actions to be taken by leaders and suggests factors to be fostered by
them to display moral courage (Kobuck, 2015). Two domains of the framework i.e. moral
imagination and cognitive processes, exhibits how leaders can apply moral courage to the
problems which are complex, intractable, and do not have clear solutions (Hutchinson, Daly,
Usher, & Jackson, 2015). Such problems can be resolved through open reflection, for which
leaders require transparency, determination and courage to risk the failure in the process of
resolving the problems (Hutchinson, Daly, Usher, & Jackson, 2015). In addition to it, moral
leader courage also needs the capacity to openly discuss about the volatile or difficult nature
of the problem (Quinn, 2017).

In healthcare environment, the situations of ethical dilemmas arise in front of the nurse
leaders (Kobuck, 2015). However, rapid changes and increasing demands do not allow for
occasional situations to arise and requires difficult decisions on immediate basis (Kobuck,
2015). It has become a norm for daily operations for care delivery and nurse leaders must
have the ability to act courageously to give support to the patients and residents within
available resources (Kobuck, 2015).
As nurses act as moral agents in the healthcare system, the acts of moral courage of nurses
benefits the patients, nurses as well as the organization (Musto, Rodney, & Vanderheide,
2015). The acts of moral courage have the potential to increase nurse retention, promote
patient comfort, release patient suffering as well as enhance the repute of an organization
(Musto, Rodney, & Vanderheide, 2015). The ethical thinking requires specific education and
skill development if it does not exist intrinsically among nurse leaders. The ethical actions
must be followed by the decision-making process and moral courage is considered as the
channel for ethical leadership for nurse leaders (Musto, Rodney, & Vanderheide, 2015).
The actions and decisions taken by the leadership defines the ethical climate in the healthcare
environment and morally courageous decisions establish the standards for the entire
organization to follow them (Kobuck, 2015). Such a combination of leadership actions and
guidelines of the organization develops a level of trust and the ethical climate becomes
evident internally as well as externally (Kobuck, 2015). The ethical programs ensure
maintaining an environment which promotes moral courage throughout an organization. The
barriers for the leaders to become effective in taking decisions require moral courage, which
is considered as the need to understand and develop a level of competency (Hutchinson,
Daly, Usher, & Jackson, 2015). That is why, moral courage has become a requirement in
executive leadership for ethical decision-making to provide best possible patient care in the
healthcare sector (Hutchinson, Daly, Usher, & Jackson, 2015).

References
Hutchinson, M., Daly, J., Usher, K., & Jackson, D. (2015). Editorial: Leadership when there
are no easy answers: applying leader moral courage to wicked problems. Journal of
Clinical Nursing, 24(21-22), 3021-3023.
Kobuck, S. (2015). Moral Courage: A Requirement for Ethical Decision Making in Nursing
Home Leadership. Retrieved from Duq.edu: https://dsc.duq.edu/etd/761/
Musto, L., Rodney, P., & Vanderheide, R. (2015). Towards interventions to address moral
distress: Navigating structure and agency. Nursing Ethics, 22(1), 91-102.
Quinn, B. (2017). Role of nursing leadership in providing compassionate care. Nursing
Standard, 32(16-19), 53-63.