Ethical Climate and Associated Factors: Systematic Literature Review. Ethical Climate: Systematic Review

Abstract

An organization’s ethical climate reflects organizational practices, procedures, and policies with moral consequences and demonstrates the influence of the workplace on ethical practice. The aim of this article is to analyse ethical climate in health care facilities and the factors associated therewith. This is a systematic literature review. The searches were conducted in January 2023 in the Embase, Scopus, PUBMED, and BVS databases using the keyword ‘hospital ethical climate survey’. Studies that had administered the 26-item scale in its original, translated or adapted version to health care professionals and described their respective scores were included. Studies that used the HECS in a reduced form, as well as theoretical studies, reviews, theses, and dissertations, were excluded. Twenty-three studies published between 2009 and 2022 were selected. The mean score for organisational ethical climate was 3.51, and scores ranged from 3.19 to 3.82, with the less ethical climate scores for the ‘physicians’ subscale and the highest scores for the ‘peers’ subscale.The organizational ethical climate showed a statistically significant association with sociodemographic and work variables: a positive ethical climate reduces moral distress, burnout, mistakes, and intention to leave the job, while it increases job satisfaction, ethical leadership, perceptions of quality, competence, and empowerment. The organizational ethical climate can affect the decision-making and ethical behaviour of health care professionals, thus influencing workplace well-being and the quality of care delivered. Actions to promote a positive ethical climate should be implemented.