Leadership under ethical constraint in health, disability and social care

Purpose Leadership scholarship often assumes that leadership experience can be made visible through articulation, reflection and representational accounts. In health, disability and social care contexts, these assumptions may fail where naming events, actors or relational dynamics risks harm. This paper aims to examine how fictomorphosis can support ethical sensemaking under such conditions and presents six situated ethical-relational orientations as a reflective heuristic for leadership practice. Design/methodology/approach The paper draws on a post-qualitative, practice-led inquiry grounded in autoethnographic field notes and ethical fictionalisation. Through fictomorphosis, ethically constrained practitioner experiences were distilled into Nuggets and transformed through multiple genre-based retellings. The resulting stories were treated as generative texts rather than factual reconstructions. Recurring ethical and relational possibilities, termed fictomorphs, were identified across the transformed narratives and provisionally grouped into six broader interpretive orientations through reflexive comparison with the stories, field notes and practice. Findings The inquiry generated six interconnected orientations: inclusivity, autonomy, collaboration, transformation, diversity and communication. These orientations are presented not as universal dimensions, validated competencies or a general theory of leadership, but as a situated reflective heuristic. They support leaders in examining how power, silence, care, agency, difference and responsibility interact in ethically constrained situations. The findings also show how leadership practice may be reshaped through restraint, attentiveness, reflexive questioning and the careful calibration of what can and cannot be said. Originality/value The paper’s primary contribution is methodological. It demonstrates how leadership inquiry and ethical sensemaking may proceed when direct disclosure or representation of sensitive experience is neither necessary nor defensible. Its secondary contribution is a practice-facing heuristic that can support reflection, supervision, leadership development and organisational learning in health, disability and social care settings. The paper also extends leadership scholarship by treating ethical constraint, non-disclosure and limits on speakability as constitutive conditions of practice rather than merely obstacles to research.