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Ethical Implications of Acceleration: Perspectives From Health Professionals

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Abstract

Time is a critical issue for organizations, especially for healthcare organizations. In the last three decades, concerns over the transformation of healthcare organizations have increasingly gained attention in the literature, indicating how task duration has been reduced to improve clinical-workflow efficiency. This article seeks to raise questions about the experience of acceleration and the ways in which this brings ethical implications to the fore for health professionals within healthcare organizations. Current approaches to acceleration fail to place ethical considerations as their central concern. This article, drawing on the theory of social acceleration and dynamic stabilization of Hartmut Rosa, offers a deeper analysis of ethical perspectives concerning acceleration. To do so, we draw on an in-depth case study, ethnographic immersion, and 48 semi-structured interviews with professionals within a French public hospital. We also carried out 20 telephonic interviews with directors in different hospitals of various sizes. We contribute to the literature by critically exploring the intersection between the experience of acceleration and ethics. We identify four broad categories of ethical implications for health professionals: the expected flexibility of directors facing uncertainty; the erosion of the ethics of care; the process of mechanistic dehumanization; and the adverse effects of speed on emotional work and workers’ well-being.

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References

  • Adam, B. (1990). Time and social theory, edited by Press, P.

  • Alacovska, A., & Bissonnette, J. (2021). Care-ful work: An ethics of care approach to contingent labour in the creative industries. Journal of Business Ethics, 169(1), 135–151.

    Article  Google Scholar 

  • Ancona, D. G., Goodman, P. S., Lawrence, B. S., & Tushman, M. L. (2001). Time: A new research lens. Academy of Management Review, 26(4), 645–663.

    Article  Google Scholar 

  • Bagdasarov, Z., & Connelly, S. (2013). Emotional labor among healthcare professionals: The effects are undeniable. Narrative Inquiry in Bioethics, 3(2), 125–129.

    Article  Google Scholar 

  • Becker, H. S. (1958). Problems of inference and proof in participant observation. American Sociological Review, 23(6), 652–660.

    Article  Google Scholar 

  • Blue, S. (2019). Institutional rhythms: Combining practice theory and rhythmanalysis to conceptualise processes of institutionalisation. Time and Society, 28(3), 922–950.

    Article  Google Scholar 

  • Broadbent, J., & Guthrie, J. (1992). Changes in the public sector: A review of recent ‘Alternative’ accounting research. Accounting, Auditing & Accountability Journal, 5(2), 3–31.

    Article  Google Scholar 

  • Broadbent, J., & Guthrie, J. (2007). Public sector to public services: 20 years of ‘contextual’ accounting research. Accounting, Auditing and Accountability Journal, 21(2), 129–169.

    Article  Google Scholar 

  • Burke, R. J. (2002). Work stress and women’s health: Occupational status effects. Journal of Business Ethics, 37(1), 91–102.

    Article  Google Scholar 

  • Butler, R. (1995). Time in organizations: Its experience, explanations and effects. Organization Studies, 16(6), 925–950.

    Article  Google Scholar 

  • Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5(7), 374–381.

    Article  Google Scholar 

  • Cornelissen, J. P., Durand, R., Fiss, P. C., Lammers, J. C., & Vaara, E. (2015). Putting communication front and center in insistutional theory and analysis. Academy of Management Review, 40(1), 10–27.

    Article  Google Scholar 

  • De Croon, E. M., Sluiter, J. K., Blonk, R. W. B., Broersen, J. P. J., & Frings-Dresen, M. H. W. (2004). Stressful work, psychological job strain, and turnover: A 2-year prospective cohort study of truck drivers. Journal of Applied Psychology, 89(3), 442–454.

    Article  Google Scholar 

  • DeGeorge, R. (2014), Business ethics, edited by Pearson, Seventh.

  • Demerouti, E., Bakker, A. B., & Bulters, A. J. (2004). The loss spiral of work pressure, work-home interference and exhaustion: Reciprocal relations in a three-wave study. Journal of Vocational Behavior, 64(1), 131–149.

    Article  Google Scholar 

  • Egede-Nissen, V., Jakobsen, R., Sellevold, G. S., & Sørlie, V. (2013). Time ethics for persons with dementia in care homes. Nursing Ethics, 20(1), 51–60.

    Article  Google Scholar 

  • Eisenhardt, K. M. (1989). Building theories from case study research. Academy of Management Review, 14(4), 532–550.

    Article  Google Scholar 

  • Gilligan. (1982). In a different voice. Harvard Un.

    Google Scholar 

  • Gross, D. A., Zyzanski, S. J., Borawski, E. A., Cebul, R. D., & Stange, K. C. (1998). Patient satisfaction with time spent with their physician. Journal of Family Practice, 47(2), 133–137.

    Google Scholar 

  • Hallett, T. (2010). The myth incarnate: recoupling processes, turmoil, and inhabited institutions in an urban elementary school. American Sociological Review, 75(1), 52–74.

    Article  Google Scholar 

  • Hallett, T., & Ventresca, M. J. (2006). Inhabited institutions: Social interactions and organizational forms in Gouldner’s Patterns of Industrial Bureaucracy. Theory and Society, 35(2), 213–236.

    Article  Google Scholar 

  • Hammersley, M. (2006). Ethnography: Problems and prospects. Ethnography and Education, 1(1), 3–14.

    Article  Google Scholar 

  • Hassard, J. (1990). Introduction: The sociological study of time. The Sociology of Time. https://doi.org/10.1007/978-1-349-20869-2_1

    Article  Google Scholar 

  • Hassard, J. (2001). Commodification, construction and compression: A review of time metaphors in organizational analysis. International Journal of Management Reviews, 3(2), 131–140.

    Article  Google Scholar 

  • Held. (2006). The ethics of care: Personal, political and global. Oxford University.

    Google Scholar 

  • Henderson, A. (2001). Emotional labor and nursing: An under-appreciated aspect of caring work. Nursing Inquiry, 8(2), 130–138.

    Article  Google Scholar 

  • Henderson, J., Willis, E., Walter, B., & Toffoli, L. (2008). Community mental health nursing: Keeping pace with care delivery? International Journal of Mental Health Nursing, 17, 162–170.

    Article  Google Scholar 

  • Hochschild, A. R. (1983). Social Constructionist and positivist approaches to the sociology of emotions—Comment. American Journal of Sociology, 89(2), 432–434.

    Article  Google Scholar 

  • Holmer-Nadesan, M. (1997). Essai: Dislocating (instrumental) organizational time. Organization Studies, 18(3), 481–510.

    Article  Google Scholar 

  • Holt, R., & Johnsen, R. (2019). Time and organization studies. Organization Studies, 40(10), 1557–1572.

    Article  Google Scholar 

  • Hood, C. (1991). A public management for all seasons? Public Administration, 69(1), 3–19.

    Article  Google Scholar 

  • Hood, C. (1995). The ‘New Public Management’ in the 1980s: Variations on a theme. Accounting, Organizations and Society, 20(2–3), 93–109.

    Article  Google Scholar 

  • Hutter, M. M., Kellogg, K. C., Ferguson, C. M., Abbott, W. M., & Warshaw, A. L. (2006). The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Annals of Surgery, 243(6), 864–871.

    Article  Google Scholar 

  • Jeffrey, B., & Troman, G. (2004). Time for ethnography. British Educational Research Journal, 30(4), 535–548.

    Article  Google Scholar 

  • Kälvemark, S., Höglund, A. T., Hansson, M. G., Westerholm, P., & Arnetz, B. (2004). Living with conflicts-ethical dilemmas and moral distress in the health care system. Social Science & Medicine, 58(6), 1075–1084.

    Article  Google Scholar 

  • Karimi, L., Leggat, S. G., Donohue, L., Farrell, G., & Couper, G. E. (2014). Emotional rescue: The role of emotional intelligence and emotional labour on well-being and job-stress among community nurses. Journal of Advanced Nursing, 70(1), 176–186.

    Article  Google Scholar 

  • Kellogg, K. C., Breen, E., Ferzoco, S. J., Zinner, M. J., & Ashley, S. W. (2006). Resistance to change in surgical residency: An ethnographic study of work hours reform. Journal of the American College of Surgeons, 202(4), 630–636.

    Article  Google Scholar 

  • Kivimäki, M., & Steptoe, A. (2018). Effects of stress on the development and progression of cardiovascular disease. Nature Reviews Cardiology, 15(4), 215–229.

    Article  Google Scholar 

  • Kostera, M., & Pirson, M. (2016). Dignity and the organization. Palgrave McMillan.

    Google Scholar 

  • Kubicek, B., Korunka, C., & Ulferts, H. (2013). Acceleration in the care of older adults: New demands as predictors of employee burnout and engagement. Journal of Advanced Nursing, 69(7), 1525–1538.

    Article  Google Scholar 

  • Langley, A. (1999). Strategies for theorizing from process data. Academy of Management Review, 24(4), 691–710.

    Article  Google Scholar 

  • Lapsley, I. (1988). Research in public sector accounting: An appraisal. Accounting, Auditing & Accountability Journal, 1(1), 21–33.

    Article  Google Scholar 

  • Lapsley, I. (2008). The NPM Agenda: Back to the future. Financial Accountability & Management, 24(1), 77–96.

    Article  Google Scholar 

  • Lee, H., & Liebenau, J. (1999). Time in organizational studies: Towards a new research direction. Organization Studies, 20(6), 1035–1058.

    Article  Google Scholar 

  • Linsley, P. M., & Slack, R. E. (2013). Crisis management and an ethic of care: The case of Northern Rock Bank. Journal of Business Ethics, 113(2), 285–295.

    Article  Google Scholar 

  • Lopetegui, M., Yen, P. Y., Lai, A., Jeffries, J., Embi, P., & Payne, P. (2014). Time motion studies in healthcare: What are we talking about? Journal of Biomedical Informatics, 49, 292–299.

    Article  Google Scholar 

  • Loscher, G. J., & Kaiser, S. (2020). The management of accounting firms: Time as an object of professional and commercial goals. Journal of Accounting and Organizational Change, 16(1), 71–92.

    Article  Google Scholar 

  • Van Maanen, J. (1979). The fact of fiction in organizational ethnography. Administrative Science Quarterly, 24(4), 539–550.

    Article  Google Scholar 

  • MacBeth, D. (2001). On ‘Reflexivity’ in qualitative research: Two readings, and a third. Qualitative Inquiry, 7(1), 35–68.

    Article  Google Scholar 

  • Mariappanadar, S., & Aust, I. (2017). The dark side of overwork: An empirical evidence of social harm of work from a sustainable HRM perspective. International Studies of Management and Organization, 47(4), 372–387.

    Article  Google Scholar 

  • Maurya, P. K., Noto, C., Rizzo, L. B., Rios, A. C., Nunes, S. O. V., Barbosa, D. S., Sethi, S., et al. (2016). The role of oxidative and nitrosative stress in accelerated aging and major depressive disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 65, 134–144.

    Article  Google Scholar 

  • Mauthner, N. S., & Doucet, A. (2003). Reflexive accounts and accounts of reflexivity in qualitative data analysis. Sociology, 37(3), 413–431.

    Article  Google Scholar 

  • McGivern, G., Dopson, S., Ferlie, E., Fischer, M., Fitzgerald, L., Ledger, J., & Bennett, C. (2018). The silent politics of temporal work: A case study of a management consultancy project to redesign public health care. Organization Studies, 39(8), 1007–1030.

    Article  Google Scholar 

  • McNair, C. J. (1991). Proper compromises: The management control dilemma in public accounting and its impact on auditor behavior. Accounting, Organizations and Society, 16(7), 635–653.

    Article  Google Scholar 

  • Michel, A. (2011). Transcending socialization: A nine-year ethnography of the body’s role in organizational control and knowledge workers’ transformation. Administrative Science Quarterly, 56(3), 325–368.

    Article  Google Scholar 

  • Mitchell, M. S., Greenbaum, R. L., Vogel, R. M., Mawritz, M. B., & Keating, D. J. (2019). Can you handle the pressure? The effect of performance pressure on stress appraisals, self-regulation, and behavior. Academy of Management Journal, 62(2), 531–552.

    Article  Google Scholar 

  • Molterer, K., Hoyer, P., & Steyaert, C. (2020). A practical ethics of care: Tinkering with different ‘Goods’ in residential nursing homes. Journal of Business Ethics, 165(1), 95–111.

    Article  Google Scholar 

  • Morinière, A., & Georgescu, I. (2021). Hybridity and the use of performance measurement: facilitating compromises or creating moral struggles? Insights from healthcare organizations. Accounting Auditing and Accountability Journal. https://doi.org/10.1108/AAAJ[1]12-2019-4303

    Article  Google Scholar 

  • Nortvedt, P., Hem, M. H., & Skirbekk, H. (2011). The ethics of care: Role obligations and moderate partiality in health care. Nursing Ethics, 18(2), 192–200.

    Article  Google Scholar 

  • Nussbaum, M. (2002). Capabilities and social justice. International Studies Review, 4(2), 123–135.

    Article  Google Scholar 

  • Orlikowski, W. J., & Yates, J. A. (2002). It’s about time: Temporal structuring organizations. Organization Science, 13(6), 684–700.

    Article  Google Scholar 

  • Padgett, D. K. (1998). Qualitative methods in social work research: Challenges and rewards. Sage.

    Google Scholar 

  • Picard, C. F., Durocher, S., & Gendron, Y. (2014). From meticulous professionals to superheroes of the business world: A historical portrait of a cultural change in the field of accountancy. Accounting, Auditing and Accountability Journal, 27(1), 73–118.

    Article  Google Scholar 

  • Pirson, M. (2017). A humanistic perspective for management theory: Protecting dignity and promoting well-being. Journal of Business Ethics, 159(1), 39–57.

    Article  Google Scholar 

  • Pirson, M. (2021). Leading for well being—Dignity as cornerstone. Humanistic Management Journal, 6(2), 147–150.

    Article  Google Scholar 

  • Preshaw, D. H. L., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes: Literature review. Nursing Ethics, 23(5), 490–506.

    Article  Google Scholar 

  • Reinecke, J., & Ansari, S. (2014). When times collide. Temporal brokerage at the intersection of markets and development. 74th Annual Meeting of the Academy of Management, AOM 2014 (Vol. 58, No. 2, pp. 250–255).

  • Rosa, H. (2003). Social acceleration: Ethical and political consequences of a desynchronized high-speed society. Constellations, 10(1), 3–33.

    Article  Google Scholar 

  • Rosa, H. (2008). Social acceleration, power, and modernity. Penn State Press.

    Google Scholar 

  • Rosa, H. (2010). Alienation and acceleration: Towards a critical theory of late-modern temporality. NSU Press.

    Google Scholar 

  • Rosa, H. (2015). Social acceleration: A new theory of modernity. Columbia University.

    Google Scholar 

  • Rosa, H., Dörre, K., & Lessenich, S. (2017). Appropriation, activation and acceleration: The escalatory logics of capitalist modernity and the crises of dynamic stabilization. Theory, Culture & Society, 34(1), 53–73.

    Article  Google Scholar 

  • Rostami, A., Gabler, C., & Agnihotri, R. (2019). Under pressure: The pros and cons of putting time pressure on your salesforce. Journal of Business Research, 103(June), 153–162.

    Article  Google Scholar 

  • Sanday, P. R. (1979). The ethnographic paradigm(s). Adminstrative Science Quarterly, 24(4), 527–538.

    Article  Google Scholar 

  • Sellevold, G. S., Egede-Nissen, V., Jakobsen, R., & Sørlie, V. (2013). Quality care for persons experiencing dementia: The significance of relational ethics. Nursing Ethics, 20(3), 263–272.

    Article  Google Scholar 

  • Sen, A. (2005). Human rights and capabilities. Journal of Human Development, 6(2), 151–166.

    Article  Google Scholar 

  • Simonet, D. (2015). Post-NPM reforms or administrative hybridization in the French health care system? International Journal of Public Administration, 38(9), 672–681.

    Article  Google Scholar 

  • Smith, P. (2012). The emotional labour of nursing revisited (2nd ed.). Palgrave Macmillan.

    Book  Google Scholar 

  • Spiller, C., Erakovic, L., Henare, M., & Pio, E. (2011). Relational well-being and wealth: Māori businesses and an ethic of care. Journal of Business Ethics, 98(1), 153–169.

    Article  Google Scholar 

  • Steccolini, I. (2018). Accounting and the post-new public management: Re-considering publicness in accounting research. Accounting, Auditing and Accountability Journal, 32(1), 255–279.

    Article  Google Scholar 

  • Sterponi, L., Zucchermaglio, C., Fatigante, M., & Alby, F. (2019). Structuring times and activities in the oncology visit. Social Science and Medicine, 228(August 2018), 211–222.

    Article  Google Scholar 

  • Tronto, J.-C. (1993). Moral boundaries: A political argument for an ethic of care. Routledge.

    Google Scholar 

  • Ulferts, H., Korunka, C., & Kubicek, B. (2013). Acceleration in working life: An empirical test of a sociological framework. Time & Society, 22(2), 161–185.

    Article  Google Scholar 

  • Van Der Lippe, T. (2007). Dutch workers and time pressure: Household and workplace characteristics. Work, Employment and Society, 21(4), 693–711.

    Article  Google Scholar 

  • Vijayasingham, L., Jogulu, U., & Allotey, P. (2018). Enriching the organizational context of chronic illness experience through an ethics of care perspective. Journal of Business Ethics, 153(1), 29–40.

    Article  Google Scholar 

  • Vincent, S. (2011). The emotional labour process: An essay on the economy of feelings. Human Relations, 64(10), 1369–1392.

    Article  Google Scholar 

  • Vostal, F. (2013). Thematizing speed: Between critical theory and cultural analysis. European Journal of Social Theory, 17(1), 95–114.

    Article  Google Scholar 

  • Vostal, F. (2015). Academic life in the fast lane: The experience of time and speed in British academia. Time & Society, 24(1), 71–95.

    Article  Google Scholar 

  • Vostal, F. (2016). Accelerating academia. Palgrave Macmillan UK. https://doi.org/10.1057/9781137473608

    Book  Google Scholar 

  • Waterworth, S. (2003). Temporal reference frameworks and nurses’ Work Organization. Time, 12(1), 41–54.

    Article  Google Scholar 

  • Watson, T. J. (2011). Ethnography, reality, and truth: The vital need for studies of ‘How Things Work’ in organizations and management. Journal of Management Studies, 48(1), 202–217.

    Article  Google Scholar 

  • Yin, R. K. (2008). Case study research. Design and methods (4th ed.). Sage.

    Google Scholar 

  • Yin, R. K. (2012). Applications of case study research (3rd ed.). Sage.

    Google Scholar 

  • Ylijoki, O. H. (2013). Boundary-work between work and life in the high-speed university. Studies in Higher Education, 38(2), 242–255.

    Article  Google Scholar 

  • Zapf, D. (2002). Emotion work and psychological well-being. A review of the literature and some conceptual considerations. Human Resource Management Review, 12(2), 237–268.

    Article  Google Scholar 

  • Zapf, D., & Holz, M. (2006). On the positive and negative effects of emotion work in organizations. European Journal of Work and Organizational Psychology, 15(1), 1–28.

    Article  Google Scholar 

  • Zerubavel, E. (1979). Patterns of time in hospital life. University of Chicago Press.

    Google Scholar 

  • Zilber, T. B. (2016). How institutional logics matter: A bottom-up exploration. Emerald Group Publishing LimitedIn J. Gehman, M. Lounsbury, & R. Greenwood (Eds.), How institutions matter! research in the sociology of organizations (Vol. 48A, pp. 137–155)

    Chapter  Google Scholar 

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Acknowledgements

We are grateful to Irène Georgescu and Ann Langley for their reading and thoughtful comments on earlier versions of this research.

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Correspondence to Agathe Morinière.

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Appendix

Appendix

See Tables 2, 3, 4 and 5.

Table 2 Interviews (2019–2021)
Table 3 Themes addressed in the research process and the interview guide (2019–2021)
Table 4 Interviews (2017–2018)
Table 5 Themes addressed in the research process and the interview guide (2017–2018)

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Morinière, A. Ethical Implications of Acceleration: Perspectives From Health Professionals. J Bus Ethics 188, 741–758 (2023). https://doi.org/10.1007/s10551-023-05499-6

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