title: Ethical climate in managed care organizations.
abstract: Managed care organizations employ nurses as medical utilization reviewers; however, little is known about the ethical climate of these organizations. This study describes different ethical climates in which utilization review nurses work and the implications of these differences for nurse administrators. The nurse participants, although demographically similar across three managed care organizations, perceived distinct ethical climates across the organizations. Nurses were employed to make complex decisions regarding medical care utilization; however, none of the organizations had an ethics committee to help nurse reviewers in this decision-making process. The need for such committees, as well as clarification of a consistent and deliberate ethical climate by nurse administrators, is discussed.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI 48202, USA.
authors.forename: Sue Ellen
authors.initials: SE
authors.lastname: Bell
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003659:Decision Making, Organizational; D017041:Ethics Committees / Q000458:organization & administration; D004991:Ethics, Institutional; D004993:Ethics, Nursing; D005163:Factor Analysis, Statistical; D005260:Female; D006279:Health Maintenance Organizations / Q000145:classification / Q000941:ethics* / Q000458:organization & administration; D006801:Humans; D008297:Male; D008330:Management Audit / Q000941:ethics; D008875:Middle Aged; D009718:Nurse Administrators / Q000941:ethics / Q000523:psychology*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D015279:Organizational Culture; D010067:Ownership / Q000941:ethics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States; D014600:Utilization Review / Q000941:ethics* / Q000458:organization & administration