The Ethics of Hospital Trustees

Bruce Jennings, Bradford H. Gray, Virginia A. Sharpe, and Alan R. Fleischman, Editors

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All manner of medical practitioners have had their scruples dissected ad infinitum. In spite of the attention paid to medical ethics and bioethics, little has been paid to the ethical roles and responsibilities of those who are ultimately in charge of hospital governance: hospital trustees.

Deriving from a Hastings Center research project involving meetings with a national task force of experts and extensive interviews with 98 nonprofit hospital trustees and CEOs over a two-year period, The Ethics of Hospital Trustees shows that the decisions made by these often overlooked members of the health community do raise important ethical issues, and that ethical dimensions of trustee service should be more explicitly recognized and discussed.

Practical as well as theoretical, The Ethics of Hospital Trustees uncovers four basic principles: 1. Fidelity to mission; 2. Service to patients; 3. Service to the community; and 4. Institutional stewardship. In delineating the extremely important functions of hospital trustees, from patient safety to financial responsibility, the contributors outline not only how hospital trustees do perform—they give a fresh understanding to how they should perform as well.

Table of Contents

Introduction: A Framework for the Ethics of Trusteeship
Bruce Jennings, Bradford H. Gray, Virginia A. Sharpe, and Alan R. Fleischman

Part I: Hospital Trusteeship in Legal and Social Context

1. The Trustee's Dilemma: Hospitals as Benevolence or Business - Looking Back a Century
Elizabeth Robilotti and David Rosner

2. The Legal Responsibilities of Voluntary Hospital Trustees
J. David Seay

3. Hospital Trusteeship in an Era of Institutional Transition: What Can We Learn from Governance Research?
Jeffrey A. Alexander

4. The Role of Hospitals in the Community
Romana Hasnain-Wynia, Frances S. Margolin, and Mary A. Pittman

5. The Role of Trustees and the Ethics of Trusteeship: Findings from an Empirical Study
Bradford H. Gray and Linda Weiss

Part II: Ethical Perspectives

6. The Trustees of Nonprofit Hospitals: Dealing with Money, Mission, and Medicine
William F. May

7. Trustees and the Moral Identity of the Hospital
David H. Smith

8. Trusteeship as Representation
Bruce Jennings

9. Ethical Dimensions of Trusteeship on the Boards of Catholic Hospitals and Systems
Charles J. Dougherty

Part III: Trusteeship in Practice: Decisions and Systems

10. Hospital Partnering, Sale and For-Profit Conversions: Trustees' Responsibility and Perceptions in a Time of Change
Linda Weiss and Bradford H. Gray

11. Fitting Board Information to Board Function
Anthony R. Kovner

12. What Hospital Trustees Can Learn From Ethics Committees: An Essay on Pragmatism, Ethics, and the Governance of Health Care Organizations
Joseph J. Fins

13. Patient Safety and the Role of Hospital Boards
Virginia A. Sharpe



Supplemental Materials


About the Author

292 pp., 6 x 9
9 figures, 5 tables
ISBN: 978-1-58901-015-4
Jun 2004

292 pp., 6 x 9
9 figures, 5 tables
Jun 2004

292 pp.
9 figures, 5 tables
ISBN: 978-1-58901-439-8
Jun 2004

Hastings Center Studies in Ethics series
Gregory E. Kaebnick and Daniel Callahan, Series Editors

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