The Ethical Obligations of Health-Care Delivery Organizations: a dynamic view

The ethical obligations of health-care delivery organizations are complex, often generating deep disagreements about what justice requires of organizations operating within unjust social conditions. This article maps such disagreements onto the implicit tension between ideal and nonideal perspectives on justice and offers a dynamic way of bridging them. The ideal-nonideal tension and its potential resolution are illustrated with an organizational ethics case on social and medical care integration. By identifying and relating ideal and nonideal perspectives in a dynamic framework, the authors offer a new set of analytic and pragmatic tools by which health-care managers can navigate a broad range of complex questions of organizational ethics and health justice.