Ethical deficits in poor physician leadership: a deductive content analysis of virtue ethics, consequentialism and deontological ethics

Purpose This study aims to examine how virtue ethics, consequentialism and deontological ethics are violated in poor physician leadership. Design/methodology/approach Semi-structured interviews with 50 physicians across all career stages were analysed using deductive content analysis based on a normative ethical framework of virtue ethics, consequentialism and deontological ethics. Findings The results revealed leadership behaviours largely contradictory with all three normative ethical frameworks. Regarding virtue ethics, informants described deficits in honesty, fairness, compassion, integrity and responsibility. From a consequentialist perspective, leadership practices led harmful to outcomes, including psychological strain, reduced trust and well-being, impaired organizational functioning and negative implications for patient care. In terms of deontological ethics, informants noted violations of duties, moral rules and respect for persons, including inequitable treatment, discriminatory decisions, breaches of procedural justice and failures in supervisory responsibilities. Practical implications Across the normative ethical frameworks, the findings revealed an absence of conduct consistent with normative moral principles. These results highlight the ethical fragility of leadership practices within the studied health-care context and underscore the need for strengthened ethical grounding in leadership development and organizational governance. These findings can be used to learn and to improve ethical decision-making in physician leadership. Cultural or health-care contexts differences may limit the transferability of the findings. Originality/value No prior empirical research has specifically examined how normative ethics is violated in poor physician leadership.