**5. Conclusion**

The considerations proposed, even if remaining on an abstract level, permit the emphasis of some of the critical points related to the links between the mostly economic function carried out by the healthcare system and the problems of ethical and social relevance that emerge as a consequence of decisions made by corporate governance.

Ethics, in reality, is neither a norm nor a precept but, as opposed to an abstract idea, emerges from the ability to recognize value and to not confuse it with price.

Reality, therefore, by now demonstrates how ethics and profit, in the long term, are fundamental elements for the success of an enterprise, two concepts inextricably linked by a single complex civil and economic merit.

The term "business ethics" is often spoken about as if to indicate a series of behaviour within a closed system. The enterprise is not, though, a closed system. Rather, it is open to the environment in which it exists and with which it interacts continuously. For this reason, the level of ethics that it can reach is directly correlated to that of the environment in which it operates. It is precisely by the continuous exchange between environment and enterprise that an "ethical model" can be created [28].

Since economic institutions consist of individuals organized among themselves, enterprises bring in requests, culture, morality and the values of the people involved. Rightly so, one speaks of ssthe relativity of ethical behaviour in both space and time" [29]. In fact, culture and requests are from different areas and countries with consequential diversity in the behaviour of individuals. Ethics present in the healthcare system cannot be the same as that found in the socio-economic contexts external to it. As the markets have expanded until they have merged into a single scenario in which nations or continents represent only a geographical declination, they have consequently reversed the relationships between production and consumption, passing from productive logic to that of satisfying clients in terms of greater services offered, correctness and transparency but, above all, the importance of image provided by the health system regarding the satisfaction of health needs.

The healthcare system is no longer capable of carrying out its activity without taking into consideration its own behaviour. Its outward image has become more and more important, even being, in some cases, a factor of success or failure. Just as analysts require clearer technical information in order to correctly evaluate the assets and financial situation, in the same 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 organization and all other stakeholders.

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, into economic and social capital.

The healthcare company is then ethical when it pursues the aim of creating long-lasting value, acting with fairness, reciprocity and transparency.

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 entirety of the ethical values embedded in social behaviours.

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 and sanitary development of the entire associated community.
