In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Some accounts of moral responsibility hold that an agent's responsibility is completely determined by some aspect of the agent's mental life at the time of action. For example, some hold that an agent is responsible if and only if there is an appropriate mesh among the agent's particular psychological elements. It is often objected that the particular features of the agent's mental life to which these theorists appeal (such as a particular structure or mesh) are not necessary for responsibility. This (...) is because there appear to be cases in which an agent acts at an earlier time which causes her to lack the appropriate psychological features at some later time and yet, intuitively, she is responsible at that later .. (shrink)

Many of us are inclined to accept something like the following principle: We can only be properly morally assessed for what is in our control. And yet our ordinary practices seem to frequently violate this principle. The resulting tension, and the attempt to resolve it, is the problem of moral luck. For example, we tend to punish and think worse of the negligent driver who kills a child than we do the equally negligent driver who was lucky there was no (...) child in his path. Thus, the lucky outcomes of our actions do seem to affect the extent to which we hold and are held responsible, but these are not things over which we exercise control. And, as Thomas Nagel famously illustrated in his response to Bernard Williams (the two of which papers form the founding documents of the moral luck debate), the influence of luck is not limited to outcomes. For the circumstances in which we find ourselves and, indeed, our very constitution are also shaped by luck. Since the publication of Williams's and Nagel's papers, the existence and breadth of moral luck has been hotly debated. This debate is not a mere intellectual trifle but, as the essays in this volume illustrate, a debate which lies at the heart of free will, responsibility, identity, causation, and self-creation. (shrink)

It typically taken for granted that agents can be morally responsible for such things as, for example, the death of the victim and the capture of the murderer in the sense that one may be blameworthy or praiseworthy for such things. The primary task of a theory of moral responsibility, it is thought, is to specify the appropriate relationship one must stand to such things in order to be morally responsible for them. I argue that this common approach is problematic (...) because it attempts to explain the way in which an agent can be morally responsible for something that is external to her, the agent. Since, I argue, everything that matters for moral responsibility is internal to the agent, the accounts that emerge from this approach are committed to a particular form of moral luck. Instead, we should reject this form of moral luck, and with it, the possibility of moral responsibility for objects external to the agent. We are, I argue, morally responsible only for our inner willings. Thus, a form of internalism about moral responsibility is defended. (shrink)

Many of those working on moral responsibility assume that "once blameworthy, always blameworthy." They believe that blameworthiness is like diamonds: it is forever. We argue that blameworthiness is not forever; rather, it can diminish through time. We begin by showing that the view that blameworthiness is forever is best understood as the claim that personal identity is sufficient for diachronic blameworthiness. We argue that this view should be rejected because it entails that blameworthiness for past action is completely divorced from (...) the distinctive psychological features of the person at the later time. This is because on none of the leading accounts of personal identity does identity require the preservation of any distinctive psychological features, but merely requires some form of continuity. The claim that blameworthiness is forever should therefore be rejected. We then sketch an account of blameworthiness over time, and consider two objections. (shrink)

This paper distinguishes between synchronic responsibility (SR) and diachronic responsibility (DR). SR concerns an agent’s responsibility for an act at the time of the action, while DR concerns an agent’s responsibility for an act at some later time. While most theorists implicitly assume that DR is a straightforward matter of personal identity, I argue instead that it is grounded in psychological connectedness. I discuss the implications this distinction has for the concepts of apology, forgiveness, and punishment as well as the (...) way in which this distinction can be used to defend quality of will accounts of responsibility against objections involving psychological manipulation. I argue that the intuition that a manipulated agent is not responsible can be explained by appeal to the conditions of DR and, as such, does not unproblematically shed light on the conditions of SR. (shrink)

Many theorists have found the notion of forgiveness to be paradoxical, for it is thought that only the blameworthy can be appropriately forgiven but that the blameworthy are appropriately blamed not forgiven. Some have appealed to the notion of repentance to resolve this tension. But others have objected that such a response is explanatorily inadequate in the sense that it merely stipulates and names a solution leaving the transformative power of repentance unexplained. Worse still, others have objected that such a (...) response cannot succeed because no amount of repentance can render the blameworthy not blameworthy. I argue that this latter objection is based on a mistaken assumption, the acknowledgement of which has the power to resolve the paradox in a way that meets the explanatory adequacy challenge, and, more generally, has significant implications with which any full theory of forgiveness must engage. (shrink)

Abstract:The term stakeholder is a powerful one. This is due, to a significant degree, to its conceptual breadth. The term means different things to different people and hence evokes praise or scorn from a wide variety of scholars and practitioners. Such breadth of interpretation, though one of stakeholder theory’s greatest strengths, is also one of its most prominent theoretical liabilities. The goal of the current paper is like that of a controlled burn that clears away some of the underbrush of (...) misinterpretation in the hope of denying easy fuel to the critical conflagration that would raze the theory. We aim to narrow its technical meaning for greater facility of use in management and organizational studies. By elaborating a number of common misinterpretations – critical and friendly – of the theory, we hope to render a stronger and more convincing theory as a starting place for future research. (shrink)

The problem of moral luck arises due to a particular tension in our thought. On the one hand, we seem readily inclined to endorse the principle that moral responsibility, that is, one’s praiseworthiness or blameworthiness, cannot be affected by luck, that is, by factors over which one lacks control. But, when we examine our actual practices, we find that our moral judgments are highly sensitive to luck. This resulting tension between principle and practice is the problem of moral luck, and (...) an attempt to solve this problem is an attempt to resolve this tension. The article first explains the traditional characterization of the problem and reviews three general strategies in responding to it. It is then argued that we should characterize the problem in a slightly broader way. This refocusing turns out to have significant methodological implications. (shrink)

Building on Peter French’s important work, this chapter draws three distinctions that arise in the context of attributions of moral responsibility, understood as the extent to which an agent is blameworthy or praiseworthy. First, the subject of an attribution of responsibility may be an individual agent or a collective agent. Second, the object of the responsibility attribution may be an individual action (or consequence) or a collective action (or consequence). The third distinction concerns the temporal dimension of the responsibility attribution. (...) Sometimes responsibility for an action is attributed to an agent at the time of the action. At other times responsibility for an action is attributed to an agent sometime after the action has taken place. Taken together, these three binary distinctions yield eight types of responsibility attribution. It is argued that a collective agent’s responsibility for a past collective act is properly understood on the same theoretical model as is an individual’s responsibility for a past individual act. While most assume that responsibility over time is a straightforward matter of identity over time, it is argued that instead this is a matter of psychological or attitudinal connectedness. The possibility is considered that this relation also grounds attributions involving an asymmetry between subject and object, such as individual responsibility for past collective action, but a skeptical worry is raised that such attributions entail an unpalatable form of moral luck and should therefore be rejected. (shrink)

Manipulation arguments are commonly deployed to raise problems for compatibilist theories of responsibility. These arguments proceed by asking us to reflect on an agent who has been manipulated to perform some (typically bad) action but who still meets the compatibilist conditions of responsibility. The incompatibilist argues that it is intuitive that the agent in such a case is not responsible even though she met the compatibilist conditions. Thus, it is argued, the compatibilist has not provided conditions sufficient for responsibility. Patrick (...) Todd has recently argued that incompatibilists have taken on a heavier dialectical burden than is necessary. Todd argues that incompatibilists need not argue that an agent in a manipulation case is not at all responsible, but only that her responsibility is mitigated in order to refute compatibilism. Hannah Tierney has responded to Todd’s argument by arguing that a compatibilist can admit that manipulation mitigates responsibility without eliminating it. I argue that Tierney’s response is unsuccessful on its own terms. But, I argue, Todd’s argument can be resisted by way of a parallel counter-argument for compatibilism. I argue that Todd’s argument for incompatibilism is no more powerful than my argument for compatibilism. And since Todd’s manipulation argument is offered as an objection to compatibilism, this amounts to a victory for the compatibilist; the objection is defused. (shrink)

In this article we revisit the notion of stakeholder responsibility as a way to highlight the role that stakeholders have in creating anethical business context. We argue for modifying the prevailing focus on corporate responsibility to stakeholders, and giving more serious attention to the importance of stakeholder responsibility—to firms, and to other stakeholders who are part of the collective enterprise. We elaborate why stakeholder responsibility matters, and suggest how making stakeholder responsibility a central focus of academics and practitioners can redefine (...) the interaction between firms and stakeholders and ultimately enhance business excellence. (shrink)

In most penal systems, success is punished more than failure. For example, murder is punished more severely than attempted murder. But success or failure is often determined by luck. It thus appears that punishment is allotted on the basis of arbitrary factors. The problem of criminal attempts is the question of how to best resolve this apparent tension. One particularly sophisticated attempt at resolution, first developed by David Lewis, holds that such differential punishment is not unjust when understood as a (...) natural penal lottery. What is most interesting about this view is that it does not appear to involve a commitment to resultant moral luck. I argue that the natural penal lottery fails to deliver justice. Upon analysis, it carries the same implication that it sought to avoid—namely, a commitment to resultant moral luck. I then argue that there can be, in principle, no penal lottery that delivers justice, natural or otherwise. (shrink)

We conduct an experiment with 459 nonprofessional investors to examine whether they evaluate companies differently based on management’s stated purpose for undertaking corporate social responsibility activities in the presence versus absence of a company-specific negative event. Specifically, we vary whether or not management intends to achieve financial returns from CSR activities in addition to promoting social good. We address investors’ decision processes by investigating whether their judgments are mediated by perceptions of future cash flows and/or the underlying ethical culture of (...) the company. Results show that absent a negative event, investment judgments are stronger when CSR activities are intended to achieve financial returns, through expectations of higher future cash flows. However, when a negative event occurs, we find a moderating effect of independent assurance of CSR disclosures. When disclosures are not assured, investors prefer CSR undertaken only for societal benefit, mediated by perceptions of a stronger ethical culture. However, when disclosures are assured, ethical culture is viewed similarly regardless of management’s intention to achieve financial returns from CSR activities. This suggests that management’s willingness to obtain independent assurance on disclosures is viewed as a positive ethical signal. Thus, assurance complements disclosure of CSR activities by contributing to protection against the impact of negative events. (shrink)

It is commonly held that agents can be blameworthy only for acts that are morally wrong. But the claim, when combined with a plausible assumption about wrongness, leads to an implausible view about blameworthiness. The claim should be rejected. Agents can be blameworthy for acts that are not morally wrong. We will take up the claim in terms of three initially appealing, but jointly inconsistent propositions. The significance of noting the inconsistency is motivated by a consideration of a number of (...) theorists who have held, or at least flirted with, all three propositions. The best way to resolve the inconsistency is to reject the claim that blameworthiness requires wrongness. There are good reasons to conclude that a different relation between blameworthiness and wrongness can garner more intuitive support than the alternatives. (shrink)

Intersectional feminist scholars emphasize how overlapping systems of oppression structure gender inequality, but in focusing on the gendered, classed, and racialized bases of stratification, many often overlook disability as an important social category in determining economic outcomes. This is a significant omission given that disability severely limits opportunities and contributes to cumulative disadvantage. We draw from feminist disability and intersectional theories to account for how disability intersects with gender, race, and education to produce economic insecurity. The findings from our analyses (...) of 2015 American Community Survey data provide strong empirical support for hierarchies of disadvantage, where women and racial minority groups with disabilities and less education experience the highest poverty levels, report the lowest total income, and have a greater reliance on sources outside the labor market for economic security. By taking disability into account, our study demonstrates how these multiple characteristics lead to overlapping oppressions that become embedded and reproduced within the larger social structure. (shrink)

Scant research has examined the effects of an organization’s stakeholder orientation on the cognition and attitudes of employees. Our study focuses on how one aspect of an organization’s objective, its stakeholder orientation, affects employee job satisfaction. Through seven studies utilizing different samples and measures, we theorize and demonstrate that employees with a higher perceived stakeholder orientation experience enhanced job satisfaction. We provide correlational field data and causal experimental evidence to show that increased employee perspective-taking is one potential mediator of this (...) effect. These results contribute to our understanding of job satisfaction and perspective-taking by showing how employee orientation toward other stakeholders affects their attitude toward their job and social cognition. We also expand the focus of stakeholder orientation beyond normative philosophy and toward understanding its effects on the cognitions and attitudes of organizational members to provide a basis for examining the behavioral implications of different stakeholder orientations. (shrink)

Glucocorticoid hormones are effective in controlling inflammation, but the mechanisms that confer this action are largely unknown. Recent advances in this field have shown that both positive and negative regulation of gene expression are necessary for this process. The genes whose activity are modulated in the anti‐inflammatory process code for several cytokines, adhesion molecules and enzymes. Most of them do not carry a classical binding site for regulation by a glucocorticoid receptor, but have instead regulatory sequences for transcription factors such (...) as AP‐1 or NF‐κ. This makes them unusual targets for glucocorticoid action and emphasizes the need for novel regulatory mechanisms. Recent studies describe an important contribution by protein‐protein interactions, in which several domains of the receptor participate; these studies provide a better understanding of the action of the receptor and offer opportunities for the design of steroidal compounds that could function more effectively as anti‐inflammatory drugs. (shrink)

Michael Walzer is one of the most distinguished political philosophers and social critics of this century. His ideas have had great import and influence in political philosophy and political discussion, yet very few of his ideas have been incorporated explicitly into the business ethics literature. We argue that Walzer’s work provides an important conceptual canvas for business ethics scholars that has not been adequately explored. Scholars in business ethics often borrow from political theory and philosophy to generate new insights and (...) develop new substantive contributions. Many valuable theoretical resources are already used extensively—particularly Aristotle, Kant, Marx and a variety of utilitarian philosophers. Walzer offers another set of resources to bring to the conversation of what business ethics is and how business ethicists add value. This paper provides an opportunity to delve further into Walzer’s writings, particularly themes that are tied to business ethics, and to illustrate how his ideas can be extended to reshape our understanding of the field and develop new perspectives on ethical issues in commerce. (shrink)

Although separated by the centuries, Anselm and Hegel represent two different developments of the ontological proof. This book guides the reader through an exploration of the perplexing ontological argument from a well-balanced analysis of the works of two significant, yet polar opposite thinkers, Anselm and Hegel.

There is a long and distinguished history of ethical thought in both business and medicine dating back to ancient times. Yet, the emergence of distinct academic disciplines ("business ethics" and "bioethics") which are also tied to broader social movements is a very recent phenomenon. In spite of the apparent affinities that would seem to emerge from this connection, many have argued that the differences between business and medicine make any constructive interaction between business ethics and bioethics minimal. Indeed, little has (...) been done to specifically examine the potential for collaboration and interdisciplinary research. This paper argues that there is considerable potential for constructive interaction between these two movements based on three major arguments: that the differences between medicine and business have been exaggerated, that both the fields face a number of urgent problems that are common to each, and that the model of bioethics can serve as a useful guide for business ethicists. (shrink)

Although a great deal of literature has looked at how individuals respond to stigma, far less has been written about how professional groups address challenges to their self-perception as abiding by clear moral standards. In this paper, we ask how professional group members maintain a positive self-perception in the face of moral stigma. Drawing on pragmatic and cultural sociology, we claim that professional communities hold narratives that link various aspects of the work their members perform with specific understanding of the (...) common good. These narratives allow professionals to maintain a shared view of their work as benefitting society and to perceive themselves as moral individuals. As a case study, we focus on the advertising industry, which has long been stigmatized as complicit in exploitative capitalist mechanisms and cultural degradation. We draw on nine total months of fieldwork and seventy-four interviews across three US advertising agencies. We find that advertising practitioners use narratives to present their work as contributing to the common good, depicting themselves as moral individuals who care about others in the process. We analyze three prevalent narratives: the account-driven narrative, which links moral virtue to caring for clients; the creative-driven narrative, which ties caring to the production of meaningful advertisements; and the strategic-driven narrative, which sees caring in finding meaningful relationships for consumers and brands. (shrink)

There is a long and distinguished history of ethical thought in both business and medicine dating back to ancient times. Yet, the emergence of distinct academic disciplines [“business ethics” and “bioethics”) which are also tied to broader social movements is a very recent phenomenon. In spite of the apparent affinities that would seem to emerge from this connection, many have argued that the differences between business and medicine make any constructive interaction between business ethics and bioethics minimal. Indeed, little has (...) been done to specifically examine the potential for collaboration and interdisciplinary research. This paper argues that there is considerable potential for constructive interaction between these two movements based on three major arguments: that the differences between medicine and business have been exaggerated, that both fields face a number of urgent problems that are common to each, and that the model of bioethics can serve as a useful guide for business ethicists. (shrink)

For undergraduate business ethics courses. The ethical training business students need to be successful in today's challenging business world. Recent scandals have created a mistrust that has spread through the entire business sector, jeopardizing public confidence in the stock market and economy. Now more than ever, it's important for students to understand the moral foundations, rules, and implications that are vital to the core of business. Business Ethics 1e presents an in-depth introduction of business ethics that emphasizes the role of (...) ethics as a critical part to management success. (shrink)

Since at least the 1938 publication of Hans Reichenbach’s Experience and Predication , there has been widespread agreement that, when discussing the beliefs that people have, it is important to distinguish contexts of discovery and contexts of justification. Traditionally, when one conflates the two contexts, the result is a “genetic fallacy”. This paper examines genealogical critiques and addresses the question of whether such critiques are fallacious and, if so, whether this vitiates their usefulness. The paper concludes that while there may (...) be one or more senses in which genealogical critiques are fallacious, this does not vitiate their value. (shrink)

Abstract:Recent work on the subject speaks to the importance trust has for firm performance (e.g., Hagen and Choe, 1999; Hill, 1995). Yet little work has been done to show how context affects the ability of firms to create trust in relationships with key stakeholders. This paper looks at how the institutional environment may affect the performance of different strategies for managing firm-stakeholder relationships, and in turn, how this affects firm performance. The authors put forward propositions that build on these theoretical (...) insights and offer prospects for future empirical work. (shrink)

There is growing appreciation of the challenges posed by our current economic activity in terms of the natural environment. Increasingly, people have come to appreciate that business must not only be more aware of its environmental impact, but also must be more environmentally sustainable in its core operations. Academic theories of management influence managerial practice. They clarify what is important to the corporation, and where managers and employees should direct their attention. The focus of this paper is to explore the (...) extent to which three possible managerial mindsets—shareholder value maximization, stakeholder value maximization, and the triple bottom line—may either enhance or inhibit the ability of corporations to manage in an environmentally sustainable way. We discuss the implications of each of these mindsets and highlight their relative strengths and weaknesses, noting that all three hold promise, but each has limitations in enabling managers to operate sustainably. (shrink)

The subject of journal quality has received little attention in the business ethics literature. While there are reasons for this past neglect, there are important new considerations which make it vital that researchers now address this topic. First, virtually all business school departments use evaluations of journal quality as an important indicator of scholarly achievement, yet business ethics has no such studies. Second, as many schools are beginning to ask ethicists to publish in the wider management literature, it is important (...) to find a way to compare journal quality across these domains. In the absence of such studies, performance review committees (including tenure decisions) may well make incorrect inferences about journal quality within business ethics or assume that ethics journals are not prestigious unless a candidate can provide evidence to the contrary (i.e. as in a study like this one). This study addresses these two issues. It relies on an opinion-based survey to establish journal quality by incorporating a list of journals within business ethics and the wider management literature. The target population is active business ethics researchers within the Society for Business Ethics (SBE). We present the results of the study and discuss their implications. (shrink)

The essays in this volume are illustrative of the variety of issues that arise when thinking about moral responsibility. From metaphysical concerns about free will and determinism to normative interest in the nature of our social practices, the philosophy of moral responsibility seems to have something to offer philosophers of nearly any taste or temperament. It is, in part, this pervasive and diverse significance that sparked and has sustained my own interest in the topic. I hope the essays in this (...) volume have similar effects on readers.The volume begins with an essay by Justin Capes, examining blameworthiness in the context of tragic choices. It is natural to think that freely and knowingly doing wrong, despite the awareness that one could do right, is a sufficient condition of blameworthiness. But some have recently argued that there are counterexamples to this claim. Suppose that Ann is faced with the difficult choice of saving a few strangers from certain death or preventing her c .. (shrink)

Several critics have maintained that there are some critical differences between the ethics of medicine and the ethics of business such that health care should remain as free as possible from the influence of business. In particular, it has been suggested that the core moral identity of those in medical practice, and their accompanying institutions, are not only antagonistic, but effectively opposed to their counterparts in business. This paper attempts to challenge such a sharp contrast and suggests that a reformulation, (...) where the two are seen as fundamentally similar is both appropriate and compelling. Indeed, as we contemplate the direction of proposed comprehensive reforms in health care, such an understanding of the moral framework of medicine and business is essential. (shrink)

Abstract:Total Quality Management (TQM) has been the object of extensive discussion within the popular literature and is increasingly of interest among management scholars. Recent scholarship has focused on the theoretical foundations of TQM, particularly what makes it work, why so many firms have had problems implementing it, and under what circumstances it may create a sustainable advantage for individual firms. This paper extends the work in theory development regarding TQM and offers an empirically testable theoretical model of its function. The (...) central claim of the paper is that embedded within TQM there are a set of moral values (“value dynamics”) that must be developed and maintained if it is to work, and that seeing them as moral values has significant theoretical and practical implications. That is, how TQM is understood and “enacted” (Weick 1979) by managers plays a significant role in determining its success. The discussion is linked to the ethics literature, normative implications of the model are explored, and directions for future research are outlined. (shrink)