Between bureaucracy and moral truth: reclaiming ethical authenticity in contemporary institutional ethics: clinical and AI ethics as emblematic cases

Purpose This study aims to diagnose the transformation of ethics into procedural compliance within institutional contexts and to propose a practice-oriented reconstruction termed “Real Ethics,” which preserves moral deliberation while maintaining essential safeguards, using clinical and AI ethics as emblematic cases within a broader institutional analysis. Design/methodology/approach The research employs a conceptual analysis informed by the works of Weber, Habermas, MacIntyre, Taylor, Tronto and Foucault, in conjunction with selected literature from clinical ethics, Institutional Review Boards, public health and artificial intelligence (AI) governance. Findings The findings indicate that institutional ethics frequently transitions from reasoned judgment to a focus on auditability and risk management, resulting in moral outsourcing, epistemic exclusion and moral distress. While procedural tools are crucial, they must serve as adaptable scaffolds firmly rooted in deliberative processes. Originality/value This study offers a unified institutional diagnosis of the proceduralization of ethics across multiple professional fields drawing on clinical and AI ethics as paradigmatic cases and presents actionable design principles for sustaining ethical agency across diverse institutional contexts.