Ethical Vitality: Identity, Responsibility, and Change in an Australian Hospital

This article reports and reflects on a narrative ethnographic account of organizational change in a large public hospital in Australia. We describe how the conduct and identity positions of people in the hospital were related to three prevalent discourses; one of authoritarian professionalism, one of collaboration and open disclosure, and one of inspection and retribution. We suggest that the presence of multiple and competing organizational discourses on which to base decisions, highlighted the need for managers to take a personal stake in deciding their own conduct. We propose the notion of ethical vitality as a means of registering the ways that ethical responsibility can only come alive in organizations when people take, and are in a position to take, a reflexive responsibility for their conduct. On this basis, we suggest that the presence of multiple ethical norms and rules in organizations, on a plural model, might actually make people in organizations more rather than less ethically responsible.