**4. Ethical behaviour as a business asset in the healthcare industry**

The changes that have occurred in the economic context in recent times have been influenced by rapid technological processes and by an increased competitiveness, which has prompted the healthcare industry to review their own models of business conduct and of economic and financial communication, focusing on their investment choices of growing stocks of knowledge and innovation. This is how an economic activity characterized more and more by intangible elements, such as the exchange of ideas, information and advanced services between the enterprise and external society was asserted.

The ethical challenge for management consists, therefore, in trying to satisfy the legitimate demands put forward by a variety of stakeholders in the enterprise, obviously including the

The Institutional Aims of the Public Healthcare System and Its Ethical-Social Action

http://dx.doi.org/10.5772/intechopen.74965

93

The basic reason for this principle is traceable in a hypothetical "contract" between society and the healthcare system, though the first authorizes the second to structure itself as such in

Adopting this view implies, therefore, that favorable and mutually advantageous relationships between the stakeholders are considered elements of consolidation and growth for the healthcare system's value and represent, in this view, major assets, namely, goods that gener-

Long-term value of the healthcare system will depend, therefore, principally on the knowledge, the ability and the commitment of its employees and, consequently, on the relationships with its investors, consumers and all the other subjects that participate in various ways in the

The healthcare system's ability to establish positive relationships with all the affiliate members generates a competitive advantage in terms of risk reduction, innovation, reputation and the opening of new markets and opportunities. For this reason, then, managers, who by their

Their responsibility resides in the ability to establish, with all the stakeholders, relationships so as to combine the different interests in a united and coordinated framework that acts as a cooperative network in the production of wealth. Described like this, the role of the manager is a constituent element of trust, intended as social adhesive that permits all the relationships

It is something which allows the members of the organization unit to trust each other reciprocally and to collaborate without depending on detailed negotiations; it is underpinned by

*"Shared values are an important asset to the corporation; they are the communal foundation on which cooperation, collaboration and the solution to conflicts can be based on and the reciprocal benefits* 

Obviously, until the values can be shared, they must be acceptable by and objectively correct and well integrated in the vision and mission of the healthcare system. In such a context, the importance of an ethical profile of the people that together generate and give life to the business activity can be inserted [27]. Their moral behaviour presents itself as the ultimate results of the positive union between shared values and its correct application, between credo and action. The possibility to prosper and generate wealth derives more from the exponential synergy that is generated by the shared cooperation between those who invest more in value

The behaviour of the management must, in fact, model the organizational context by building, effectively, a feeling of trust in the ethical value with a simultaneous translation into the activity. Management is the true subject capable of setting an example of fairness and correctness

shared values, that is, cultural norms that contribute to defining the organization.

of activity, than by the pure application of economic principles.

activities represent the system as a third party, appear to play a key role.

owners as well.

exchange for the promotion of social well-being.

that cannot be fully defined in contractual terms.

ate new and greater wealth in the future.

activity of the enterprise.

*achieved"* [26]*.*

From the first definition of enterprise, the economic nature and the social role that the institute has had since its foundation have always been joined together [24].

The evolution of its role in the modern world is putting into play certain base characteristics. For decades, the healthcare industry has been considered the best economic and social institute to create and distribute welfare. Through its constant effort to increase profits, it has inevitably brought about social changes a consequence of the structure and activity that it has carried forward.

All those who, with different interests, have found themselves participating in production activities and the sale of goods are inextricably tied to its fate and decisions.

As the years go by, social change continues, but above all, the awareness on the part of the shareholders and management of the role of other stakeholders in the production has lead, inevitably, to a rigorous review of the entire organization of the enterprise; above all it has given rise to a new way of thinking about the people that gravitate around the enterprise, by broadening and putting together the different interests of all the participants for its success. The novelty of this approach in respect to the past was to include among the beneficiary of the business performance not only the shareholders or more in general the providers of capital but all those who, in various capacities, participate in the business activity and without whom the institute itself cannot exist nor prosper. For example, the worker is entitled to a productivity bonus at the end of the year for the results achieved.

In this model, the healthcare industry is depicted not as a place in which a series of market transactions occur, but as a cooperative effort that involves an ample number of individuals and organized groups in various ways.

This is totally different to the role of those who are called on to influence, with their decisions, the progress and success of the enterprise. One no longer speaks of only generating profits to remunerate the capital risk of the shareholders but of specific responsibilities towards all those who concretely contribute to the activity and the survival of the enterprise itself.

From these considerations comes another more relevant one: the relationship network between all the participants present in the enterprise which represents an element that is capable of creating value. Certain important studies have demonstrated a strong correlation between good relationships between the stakeholders and the success of the enterprise; the fact that such a relationships exists offers empirical proof of the existence of a link between social performance and financial performance [25].

In all healthcare systems, the comprehension of ethics, the fact that it is made up of shared values, gives full meaning to the system of business "values" and facilitates their translation into concrete behaviour.

The ethical challenge for management consists, therefore, in trying to satisfy the legitimate demands put forward by a variety of stakeholders in the enterprise, obviously including the owners as well.

the healthcare industry to review their own models of business conduct and of economic and financial communication, focusing on their investment choices of growing stocks of knowledge and innovation. This is how an economic activity characterized more and more by intangible elements, such as the exchange of ideas, information and advanced services between the

From the first definition of enterprise, the economic nature and the social role that the insti-

The evolution of its role in the modern world is putting into play certain base characteristics. For decades, the healthcare industry has been considered the best economic and social institute to create and distribute welfare. Through its constant effort to increase profits, it has inevitably brought about social changes a consequence of the structure and activity that it has

All those who, with different interests, have found themselves participating in production

As the years go by, social change continues, but above all, the awareness on the part of the shareholders and management of the role of other stakeholders in the production has lead, inevitably, to a rigorous review of the entire organization of the enterprise; above all it has given rise to a new way of thinking about the people that gravitate around the enterprise, by broadening and putting together the different interests of all the participants for its success. The novelty of this approach in respect to the past was to include among the beneficiary of the business performance not only the shareholders or more in general the providers of capital but all those who, in various capacities, participate in the business activity and without whom the institute itself cannot exist nor prosper. For example, the worker is entitled to a productiv-

In this model, the healthcare industry is depicted not as a place in which a series of market transactions occur, but as a cooperative effort that involves an ample number of individuals

This is totally different to the role of those who are called on to influence, with their decisions, the progress and success of the enterprise. One no longer speaks of only generating profits to remunerate the capital risk of the shareholders but of specific responsibilities towards all those who concretely contribute to the activity and the survival of the enterprise itself.

From these considerations comes another more relevant one: the relationship network between all the participants present in the enterprise which represents an element that is capable of creating value. Certain important studies have demonstrated a strong correlation between good relationships between the stakeholders and the success of the enterprise; the fact that such a relationships exists offers empirical proof of the existence of a link between social performance

In all healthcare systems, the comprehension of ethics, the fact that it is made up of shared values, gives full meaning to the system of business "values" and facilitates their translation

tute has had since its foundation have always been joined together [24].

activities and the sale of goods are inextricably tied to its fate and decisions.

ity bonus at the end of the year for the results achieved.

and organized groups in various ways.

and financial performance [25].

into concrete behaviour.

enterprise and external society was asserted.

carried forward.

92 Social Responsibility

The basic reason for this principle is traceable in a hypothetical "contract" between society and the healthcare system, though the first authorizes the second to structure itself as such in exchange for the promotion of social well-being.

Adopting this view implies, therefore, that favorable and mutually advantageous relationships between the stakeholders are considered elements of consolidation and growth for the healthcare system's value and represent, in this view, major assets, namely, goods that generate new and greater wealth in the future.

Long-term value of the healthcare system will depend, therefore, principally on the knowledge, the ability and the commitment of its employees and, consequently, on the relationships with its investors, consumers and all the other subjects that participate in various ways in the activity of the enterprise.

The healthcare system's ability to establish positive relationships with all the affiliate members generates a competitive advantage in terms of risk reduction, innovation, reputation and the opening of new markets and opportunities. For this reason, then, managers, who by their activities represent the system as a third party, appear to play a key role.

Their responsibility resides in the ability to establish, with all the stakeholders, relationships so as to combine the different interests in a united and coordinated framework that acts as a cooperative network in the production of wealth. Described like this, the role of the manager is a constituent element of trust, intended as social adhesive that permits all the relationships that cannot be fully defined in contractual terms.

It is something which allows the members of the organization unit to trust each other reciprocally and to collaborate without depending on detailed negotiations; it is underpinned by shared values, that is, cultural norms that contribute to defining the organization.

*"Shared values are an important asset to the corporation; they are the communal foundation on which cooperation, collaboration and the solution to conflicts can be based on and the reciprocal benefits achieved"* [26]*.*

Obviously, until the values can be shared, they must be acceptable by and objectively correct and well integrated in the vision and mission of the healthcare system. In such a context, the importance of an ethical profile of the people that together generate and give life to the business activity can be inserted [27]. Their moral behaviour presents itself as the ultimate results of the positive union between shared values and its correct application, between credo and action. The possibility to prosper and generate wealth derives more from the exponential synergy that is generated by the shared cooperation between those who invest more in value of activity, than by the pure application of economic principles.

The behaviour of the management must, in fact, model the organizational context by building, effectively, a feeling of trust in the ethical value with a simultaneous translation into the activity. Management is the true subject capable of setting an example of fairness and correctness of the basic values of the business culture. Its leadership is based on the reputation that it has towards employees, clients and suppliers. Behaviour is therefore that which, effectively, can modify the values of the healthcare system, affecting the modes of perception themselves. The link with business performance is undeniable.

manner, the wider consumer market sees this effort of business clarity positively, recognizing not only the ability to manage the system correctly and truthfully but above all the greater value tied to the security of facing a person with whom to negotiate, reducing discussions to a minimum of informative asymmetries. Transparency is not only external to the enterprise but also internal to it, so much so that there are many cases of change in governance in order to simplify and clarify the relationships between the various people that operate within the

The Institutional Aims of the Public Healthcare System and Its Ethical-Social Action

http://dx.doi.org/10.5772/intechopen.74965

95

The fundamental principles of economic-business analysis confer upon time and the systematic vision an essential importance to analyze the vital processes of the healthcare system.

In this context, ethical values are basic, as, on one hand, they introduce the trust and fairness necessary to cement any relationship into the long term and, on the other hand, they determine indispensable conditions so that the processes of accumulation of technological knowhow and organizational abilities are produced in the enterprise, which transform, with time,

The healthcare company is then ethical when it pursues the aim of creating long-lasting value,

In this way, the enterprise carries out its instrumental function of creating economic goods that are able to satisfy the material necessities of society while at the same time respecting the

Obviously, the modern healthcare system is not asked to do charity work but to face a new challenge: combining profit, which is, in fact, its *raison d'être* with respect and the safeguard of certain fundamental ethical values, contributing, in a decisive manner, to the economic, social

[2] Baldarelli MG. Responsabilità sociale e dottrina sociale della Chiesa: il ruolo dell'accountability etica, sociale e ambientale. Paper presented at the 5th Conference on

organization and all other stakeholders.

into economic and social capital.

**Author details**

Ubaldo Comite

**References**

acting with fairness, reciprocity and transparency.

entirety of the ethical values embedded in social behaviours.

and sanitary development of the entire associated community.

Address all correspondence to: ubaldo.comite@libero.it

[1] Farneti G. Economia d'Azienda. Milano: F. Angeli; 2007

Social and Environmental Accounting Research, Barcellona; 2005

University "Giustino Fortunato", Benevento, Italy

The virtuous processes put in place in respect to moral behaviour can be interpreted and then, as fundamental elements of business assets, valid for the creation of value.
