Ethical Principles of Turkish Health Managers

Abstract

The purpose of this research is to emphasize the importance of professional ethical principles for healthcare managers, improve the quality of healthcare services by making decisions based on ethical principles, and develop a proposal for professional ethics principles and a professional oath specific to the healthcare management profession to prevent unethical practices. To identify these principles, a literature review was conducted, and legislation regarding ethical principles on the websites of health institutions and organizations was examined. Ethical principles were evaluated by considering the multifaceted responsibilities of healthcare managers and their obligations toward healthcare workers, service users, society, suppliers, and others. The evaluations revealed that there are no specific professional ethics principles or binding professional oaths for healthcare managers in Turkey. In this context, ethical principles comprising a total of 56 articles across three main categories—“Basic Ethical Principles,” “Ethical Principles Related to Auditing,” and “Ethical Principles in Administrative and Financial Services”—were identified, and concrete recommendations were developed. It is proposed that these ethical principles be mission-based. Additionally, it was suggested that a professional symbol and an oath be required to institutionalize health management. The proposed ethical principles will help health managers adopt an accountable, transparent, fair, and responsible management approach that prioritizes the public interest.

Keywords

• Ethics
• Ethical principles
• Health manager
• Hospital administrator
• Health management
• Hospital management

Türk Sağlık Yöneticileri Etik İlkeleri

Abstract

Bu araştırmanın amacı, sağlık yöneticileri için mesleki etik ilkelerin önemini vurgulamak, yöneticilerin etik ilkelere dayalı kararlar alarak sağlık hizmetlerinde kalitenin artırılması ve etik dışı uygulamaların önlenmesi için sağlık yöneticiliği mesleğine özgün meslek etiği ilkeleri ile meslek yemini önerisini geliştirmektir. Etik ilkeleri belirlemek için literatür taranmış ve sağlık kurum/kuruluşlarının web sayfalarındaki etik ilkelerle ilgili mevzuatları incelenmiştir. Etik ilkeler sağlık yöneticilerinin sahip olduğu çok yönlü sorumluluklar, çalışanlar, hizmet alanlar, toplum, tedarikçiler vb. karşı yükümlülükleri göz önünde bulundurularak değerlendirilmiştir. Yapılan değerlendirmeler, Türkiye’de sağlık yöneticilerine özgün meslek etiği ilkelerinin ve bağlayıcı meslek yeminlerinin bulunmadığını ortaya koymuştur. Bu kapsamda “Temel Etik İlkeler”, “Denetimle İlgili Etik İlkeler” ve “İdari ve Mali Hizmetlerde Etik İlkeler” olmak üzere üç ana kategoride, toplam 56 maddeden oluşan etik ilkeler belirlenerek somut öneri geliştirilmiştir. Etik ilkeler, görev temelli olarak önerilmiştir. Ayrıca, sağlık yöneticiliğinin kurumsallaşması için meslek sembolü oluşturulması ve meslek yemini gerekliliği önerilmiştir. Geliştirilen etik ilke önerileri, sağlık yöneticilerinin kamu yararını gözeten, hesap verebilir, şeffaf, adil ve sorumlu bir yönetim anlayışını benimsemelerine katkı sağlayacaktır.

Keywords

• Etik
• Etik ilkeler
• Sağlık yöneticisi
• Hastane yöneticisi
• Sağlık yönetimi
• Hastane yönetimi

References

1. ACHE. (2017). American College of Healthcare Executives code of ethics. https://www.ache.org/-/media/ache/chapters/chapter-education/template-131-materials-to-distribute.pdf
2. Akca, H. (2019). The Role and Importance of Ethics Education in Public Administration Education and Teaching [Master’s Thesis]. Pamukkale University, Institute of Social Sciences.
3. Alper Ay, F., & Oktay, S. (2020). The impact of nepotism and its practices on organizational trust leading to ethical collapse: A study on physicians and nurses at a university hospital. Journal of Business Ethics, 13(1), 135-168. https://doi.org/10.12711/tjbe.2020.13.1.0161
4. Avcı, E. (2022). The relationship between quality and ethics in healthcare services. Journal of Health Performance and Quality, 20(1), 57-70.
5. Aydin, N. (2025). Ethical Principles for Healthcare Managers (Chapter 6). In M. Öztürk (Ed.), Management Transformation and Strategic Resilience in Healthcare Systems (1st ed., pp. 89–106). Bidge. https://doi.org/10.70269/10.70269/3977364864
6. Aygın, D., & Gül, A. (2020). Management of patient information and protection of confidentiality. Journal of Business Ethics, 13(1), 79-100. https://doi.org/10.12711/tjbe.2020.13.1.0144
7. Bakoğlu Deliorman, R., & Üstünoldu Kandemir, A. (2009). An ethical project for the prevention of corruption: An academic research study on professional organizations with public institution status and ethics. Istanbul.
8. Barkhordari-Sharifabad, M., & Mirjalili, N. S. (2020). Ethical leadership, nursing errors, and error reporting from the nurses’ perspective. Nursing Ethics, 27(2), 609-620. https://doi.org/10.1177/0969733019858706

9. Bilgin, R., & Küçükhazar, M. (2018). An overview of unethical behaviors and practices in public health institutions in Turkey. Munzur University Journal of Social Sciences, 7(13), 119-140.
10. Civaner, M. (2018). The deontological duties of professional organizations. In N. Bulut (Ed.), The responsibility of the Turkish Medical Association and Medical Chambers to protect medical ethics and deontology (pp. 9-19). Turkish Medical Association Publications. http://www.ttb.org.tr
11. Çıraklı, Ü., Uğurluoğlu, Ö., Şantaş, F., & Çelik, Y. (2014). The effect of ethical leadership behaviors on organizational justice: An application in a hospital. Journal of Business Science, 2(2), 53-69.
12. Çitak, G., & Bayrak Kahraman, B. (2021). Managers’ ethical leadership behaviors and nurses’ perceptions of organizational justice. Journal of Health and Nursing Management, 1(8), 31-41. https://doi.org/10.5222/shyd.2021.64326
13. Dağdelen, İ. (2005). Managerial ethics. Journal of Legislation, 8(90), 1-5.
14. Dinç, L. (2009). Ethical obligations in nursing services. Hacettepe Medical Journal, 40(2), 113-119.
15. Doğan, S. (2022). An examination of the relationship between organizational identification and unethical proorganizational behaviors in healthcare institutions. Journal of Business Academy, 2(3), 217-228. https://doi.org/10.26677/TR1010.2022.1028
16. Doğan, S., & Karataş, A. (2011). A study on the effect of organizational ethics on employee satisfaction. Journal of the Faculty of Economics and Administrative Sciences, Erciyes University, (37), 1-40.
17. Elbeyoğlu, K. (2019). Patient rights and ethics in healthcare services. In A. Demirci & G. Manavgat (Eds.), Healthcare Institution Management (pp. 263-288). Gazi Publishing House.
18. Erdem, İ., & Erdem, R. (2019). Hospital ethics from an organizational ethics perspective. Süleyman Demirel University Visioner Journal, 10(23), 151-163. https://doi.org/10.21076/vizyoner.441786
19. Eren, M. (2012). “Health is also a somewhat tainted field”: Representatives within the Turkish healthcare sector. Work and Society, (1), 187-217. http://www.etik.gov.tr/duyurular/digerleri/proje2006_etik/akademik_arast%C4%B1rma_
20. Görügen, Ü., Şenyuva, E., & Yalnız, N. (2024). Levels of ethical value orientation and influencing factors among health associate degree program students taking a professional ethics course: A case study at a foundation university: A cross-sectional descriptive study. Turkey Clinics Journal of Medical Ethics, Law, and History, 2(32), 108-115. https://doi.org/10.5336/mdethic.2024-102155
21. Gürol, A. (2019). Ethics in medical documentation services. In M. Kaşıkçı (Ed.), Medical Documentation (14). Atatürk University, Open Education Faculty Publication.
22. Hiçyorulmaz, E., & Kullu, Ş. (2024). Ethics in the healthcare sector. Journal of Management Theory and Practices Research, Vol. 5(2), 201-211.
23. Occupational Health and Safety Law. (2012). Law No. 6331, Legislation Date: June 30, 2012, Issue No. 28339.
24. Regulation on the Principles of Ethical Conduct for Public Officials and Procedures for Applications. (2005). Official Gazette Date: April 13, 2005, Official Gazette No.: 25785.
25. Karaca, H. (2012). An evaluation of public officials’ perceptions of adherence to ethical conduct principles and ethical education: The case of Bitlis Province. Turkish Journal of Public Administration, (475), 101-118.
26. Kasap Uysal, E., & Bahçecik, N. (2020). Determining nurses’ attitudes toward ethical principles in healthcare practices. Gevher Nesibe Journal of Medical & Health Sciences, 5(6), 51-58. https://orcid.org/0000-0002-5290-1017
27. Kırılmaz, H., & Kılıç Kırılmaz, S. (2014). The benefits of empirical ethical studies in ethical dilemmas in healthcare services. İnsan&İnsan, (1), 35-44. www.insanveinsan.org
28. Öztürk, G. (2006). The effect of the logo on institutional identity. Istanbul Commerce University Journal of Social Sciences, 5(9), 1-14.
29. Öztürk, H. (2010). Ethical behaviors of nurse managers and a study [Master’s Thesis]. Istanbul University, Institute of Social Sciences.
30. Öztürk, M. (2009). Organizational efficiency and professional ethics. Journal of Business Ethics, 2(3), 121-133.
31. Öztürk, R. (2023). The content of the physician’s oath: Is there a universal text? Is the oath a legal requirement? Journal of Health Thought and Medical Culture (SD), 64(2023/2), 90-91.
32. Ministry of Health. (2023). Public ethical conduct rules. Ministry of Health, General Directorate of Health Promotion. https://sggm.saglik.gov.tr/TR,34761/kamu-etik-davraniskurallari.html
33. Ministry of Health. (2024). Basic Ethical Principles for Healthcare Professionals. Ministry of Health, General Directorate of Health Services, Directorate of Health Professions. https://shgmsmdb.saglik.gov.tr/TR-104337/saglikmeslek-mensuplari-icin-temel-etik-ilkeler.html
34. Regulation on the Job and Duty Descriptions of Health Professionals and Other Professionals Working in Health Services. (2014). Official Gazette Date: May 22, 2014, and Number: 29007. https://resmigazete.gov.tr/eskiler/2014/05/20140522-14.htm
35. Sarıhan, M., & Yarar, O. (2021). Ethical concerns in healthcare management. European Journal of Science and Technology, (27), 267-282. https://doi.org/10.31590/ejosat.826022
36. Sayan, İ. (2023). Ethical education in health management. In Z. Ayvaz Reis (Ed.), Ethical Issues in Education. Istanbul University–Cerrahpaşa Publishing House. https://doi.org/10.5152/4200
37. Sayim, F. (2011). Common practices in the healthcare sector that may fall outside the realm of ethics and their classification. In Health Market and Ethics (pp. 77-85). MKM Publishing. https://www.researchgate.net/publication/296467532
38. Serin, S. (2012). An evaluation of the need for professional hospital managers before and after the decentralization of public hospitals [Master’s Thesis]. Institute of Social Sciences.
39. Şahin, B., & Dündar, T. (2011). An examination of the relationship between the ethical climate and bullying behaviors in the healthcare sector. Ankara University SBF Journal, 66(1), 129–159.
40. Tamer, G., Ünsal Jafarov, G., Boz, D., Tetik, G., & Oktay, S. (2024). Health workers’ ethical codes scale: A scale development study. Istanbul Gelişim University Journal of Health Sciences IGUSABDER, (23), 468-488. https://doi.org/10.38079/igusabder.1472850
41. Tengilimoğlu, D., Işık, O., & Akbolat, M. (2012). Health Management (5th ed.). Nobel Academic Publishing.
42. Turkish Dental Association. (2024, November 7). Turkish Dental Association’s Code of Professional Ethics for Dentistry. Turkish Dental Association. https://dishekimlik.akdeniz.edu.tr/tr/etik_ilke_ve_kurallarimiz-5565
43. Turkish Nurses Association. (2009). Ethics, Principles, and Responsibilities for Nurses.
44. Turkish Society of Cardiology. (2009). Introduction: Ethics and Medicine (Chapter 1). In Turkish Society of Cardiology Ethics Guide: 2009;37 Suppl 3. (1). Arch Turk Soc Cardiol.
45. Turkish Physical Therapists Association. (2018, October 21). Ethical principles: Ethical principles for Turkish physical therapists. Turkish Physical Therapists Association. https://www.fizyoterapistler.org.tr/etik-prensipler
46. Üstüner, Y., & Kalav İdrisoğlu, F. (2014). Public sector work ethics and neo-Taylorist practices: A case study of performancebased pay in Turkish public health services. METU Development Journal, 41, 177-200.
47. Yıldırım, G., & Kadıoğlu, S. (2007). Basic concepts of ethics and medical ethics. Cumhuriyet University Journal of Medicine, 29(2), 7-12. https://www.researchgate.net/publication/338165915
48. Yıldırım, T. (2019). Ethics in healthcare institutions. In Y. Akbulut (Ed.), Healthcare Institution Management II. Atatürk University, Open Education Faculty Publication.
49. YÖK. (2017). National Core Education Program for Health Management 2017 (SAYÇEP 2017). https://www.yok.gov.tr/Documents/Kurumsal/egitim_ogretim_dairesi/Ulusal-cekirdek-egitimiprogramlari/saglik_yonetimi.pdf