Conflict of interest: organizational vs. executive ethics in health care.

This survey of 207 senior- and mid-level administrators from across the U.S. details the surprising level and type of ethical conflicts and unethical practices they face on the job and how their organizations create and respond to these challenges. The findings suggest widespread ethical conflict caused by situational and environmental factors, financial incentives, boards of directors, and stakeholder pressure. Particularly poignant is the apparent inability of executives to alter the ethical environment. Substantial differences were found between nonprofit and proprietary sector administrators as well as gender and age groups.