Managing responsible innovation in European healthcare living labs: aligning ethical goals with operational realities

Purpose This paper investigates how European Healthcare Living Labs (HLLs) operationalize principles of Responsible Research and Innovation (RRI) within their innovation management practices. Rather than adopting RRI as a fixed framework, HLLs use it as a flexible, guiding orientation to navigate complex organizational and institutional environments. Design/methodology/approach The study combines a systematic mapping of 89 HLLs across Europe and a thematic analysis of 16 in-depth interviews with HLLs project managers and stakeholders. Findings HLLs enact RRI as a dynamic process, aligning innovation goals with ethical and inclusive values. They develop reflexive management practices that reconcile normative commitments with innovation imperatives, fostering collaboration and inclusiveness. The study contributes to understanding RRI as a situated practice rather than a fixed protocol. Research limitations/implications Findings are context-specific to European HLLs. Future research could examine similar dynamics in other innovation ecosystems or regions, or outside the healthcare sector. Practical implications We identify and describe tools and strategies, such as stakeholder co-creation, iterative evaluation, and adaptive governance, that help innovation managers integrate societal values into innovation processes. Social implications By embedding RRI principles, HLLs promote inclusive, ethically aware innovation in healthcare, enhancing responsiveness to societal needs and trust in innovation systems. Originality/value The study offers a perspective on how RRI can be strategically embedded in Healthcare living labs, linking normative ambitions with operational realities in innovation management.