Ethical Dilemmas among Healthcare Workers in Private Hospitals and Their Implications for Organizational Governance and Well-Being: Evidence from Sarawak, Malaysia

This study explores the ethical challenges that healthcare professionals experience in private hospitals in Sarawak, Malaysia, and the consequences of these challenges on the professionals' well-being and on the administrative structure of the hospitals. The central focus of this study is to capture the scope and type of ethical challenges that healthcare staff experience in private hospitals, the negative effects of these challenges on personal well-being and the administrative structure of an organization, and the impact of ethical standards and institutional frameworks on the challenges and issues that arise within these complexities.
A cross-sectional, descriptive research design was utilized. Data were collected via an online survey that included a structured questionnaire targeting private hospital workers across Sarawak, Malaysia, including physicians, nurses, allied health professionals, administrators, and support staff. The participants were selected through convenience sampling, and their participation was voluntary and anonymous. Statistical analyses (mainly descriptive and inferential statistics) were conducted to study the interrelationships of ethical challenges, the well-being of healthcare employees, and administrative outcomes.
The analysis shows the frequency of ethical dilemmas being encountered in the daily grind of the individual. Most acts of daily ethical dilemmas in the medical profession include informing a patient to consent to the treatment, how a doctor decides to allocate his services to his patients; is the action of a doctor in the best interests of the patient and does he keep the patients ethical dilemma, and what are the religious beliefs of a patient. Statistically, the more ethical dilemmas a person encounters, the more likely he or she is to experience negative outcomes, a decline in morale, and leaves a job because of lack of satisfaction and professional well-being. In the organizational world, the more ethical dilemmas a person encounters, the weaker the organization's governance is and the more the organization's ethical accountability and the more difficulty the organization has in applying standards to unethical behavior. On the contrary, governance and ethical behavior improves in the presence of ethically clear and unambiguous organizational criteria, social relations and a more ethical presence of organizational systems such as ethical committees and ethical consultations.
In private hospitals, ethical dilemmas are a challenge to the individual professional, and a problem of governance. Strengthening ethical governance to institutional ethical support systems and organizational and regulatory frameworks is a means of maintaining the professional's honor, increasing accountability, and ensuring that private health care is sustainable.

healthcare ethics, ethical governance, moral distress

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