The purpose of this article is to discuss an external whistleblowing event that occurred after all internal whistleblowing through the hierarchy of the organization had failed. It is argued that an organization that does not support those that whistle blow because of violation of professional standards is indicative of a failure of organizational ethics. Several ways to build an ethics infrastructure that could reduce the need to resort to external whistleblowing are discussed. A relational ethics approach is presented as a way to eliminate the negative consequences of whistleblowing by fostering an interdependent moral community to address ethical concerns.
Canadian Nurses Association . I see and am silent/I see and speak out: the ethical dilemma of whistleblowing. Ethics in Practice. CNA , 1999.
2.
Bernstein M , Jasper JM.Interests and credibility . Soc Sci Inf1996; 35: 558-565 .
3.
Judd PB.Whistleblowing . J Bus Ethics1999; 21: 77-94 .
4.
Fletcher JJ , Sorrell JM , Silva MC.Whistleblowing as a failure of organizational ethics . Online J Issues Nurs1998. Retrieved 22 March 2004, from: http://www.nursingworld.org/ojin/topic8/topic8-1.html
5.
Austin W , Bergum V , Goldberg L.Unable to answer the call of our patients: mental health nurses’ experience of moral distress . Nurs Inquiry2003; 10: 177-183 .
6.
Austin W , Bergum V , Dossetor J.Relational ethics. In: Tschudin V ed. Approaches to ethics. Butterworth-Heinemann , 2003: 45-52.
7.
Marck TB.Nursing in a technological world: searching for healing communities . ANS Adv Nurs Sci2000; 23(2): 62-81 .
8.
Marck TB.Ethics in hard places: the ecology of safer systems in modern health care . Health Ethics Today2004; 14: 2-5 .
9.
Zoloth L , Rubin SB.Margin of error: the ethics of mistakes in the practice of medicine. University Publishing Group , 2000.
10.
Storch JL , Rodney P , Starzomski R eds. Toward a moral horizon: nursing ethics for leadership and practice. Pearson/Prentice Hall , 2004.
11.
Sinclair JM. The report of the Manitoba Pediatric Cardiac Surgery Inquest: an inquiry into twelve deaths at the Winnipeg Health Services Centre in 1994. Provincial Court of Manitoba, 2000. Retrieved 24 March, 2004, from: http://www.pediatriccardiacinquest.mb.ca
12.
Webster GC , Baylis F.Moral residue. In: Rubin SB , Zoloth L eds. Margin of error: the ethics of mistakes in the practice of medicine. University Publishing Group , 2000: 217-300.
13.
Hersh MA.Whistleblowers - heroes or traitors? Individual and collective responsibility for ethical behavior . Annu Rev Control2002; 26: 243-262 .
14.
Silva MC.Organizational and administrative ethics in health care: an ethics gap . Online J Issues Nurs1998. Retrieved 22 March, 2004, from: http://www.nursingworld.org/oijn/topic8/topic8_1.html
15.
Canadian Nurses Association . Code of ethics for registered nurses. CNA , 2002.
16.
College of Nurses of Ontario . The standards of practice for nurses. CNO , 2000.
17.
Chambliss DF.Beyond caring: hospitals, nurses, and the social organization of ethics. University of Chicago Press , 1996.
18.
Mohr WK , Horton-Deutsch S.Malfeasance and regaining nursing’s moral voice and integrity . Nurs Ethics2001; 8: 19-35 .
19.
Kelly B.Preserving moral integrity: a follow up study with new graduate nurses . J Adv Nurs1998; 28: 1134-1145 .
20.
International Council of Nurses . Code of ethics for nurses: ethical concepts applied to nursing. ICN , 2000.
De Maria W , Jan C.Eating its own . Aust J Soc Issues1997; 32(2): 37-59 .
23.
Gunderson LH , Holling CS , Light SS eds. Barriers and bridges to the renewal of ecosystems and institutions. Columbia University Press , 1995.
24.
Hunt G.Introduction: Whistleblowing and the breakdown of accountability. In: Hunt G ed. Whistleblowing in the health service: accountability, law and professional practice. Edward Arnold , 1995, xvii-xvii.
25.
Freedom to Care . The charter of public accountability of Freedom to Care . Nurs Ethics2004; 11: 629-636 .
26.
Reiser SJ.The ethical life of health care organizations . Hastings Cent Rep1994; 24(5): 28-35 .
27.
Groesnick LE.Governmental ethics and organizational culture. In: Cooper TL ed. Handbook of administrative ethics. Columbia University Press , 1994: 183-197.
28.
Higgs ES.What is good ecological restoration ? Conservation Biology1999; 11: 338-348 .
29.
Hardingham LL.Integrity and moral residue: nurses as participants in a moral community . Nurs Philos2004; 5: 93-186 .
30.
Bergum V.Dossetor J.Relational ethics: the full meaning of respect. University Publishing Group , 2004; 173-176.
31.
Bergum V.Relational ethics in nursing. In: Storch J , Rodney P , Starzomski R eds. Toward a moral horizon: nursing ethics for leadership and practice. Pearson/Prentice Hall , 2004; 485-503.
32.
Potter RL.From clinical ethics to organizational ethics: the second stage of the evolution of bioethics . Bioethics Forum1996; 12(2): 3-12 .
33.
Renz DO , Eddy WB.Organizational ethics and health care: building an ethics infrastructure for the new era . Bioethics Forum1996; 12(2): 29-39 .
34.
Victor B , Cullen J.The organizational bases of ethical work. In: Worthley JA ed. The ethics of the ordinary in healthcare: concepts and cases. Health Administration Press , 1997; 119-121.
35.
May L.The socially responsive self: social theory and professional ethics. University of Chicago Press , 1996.
36.
Winslow B , Winslow G.Integrity and compromise in nursing ethics . J Med Philos1991; 16: 307-323 .
