Whistleblowing As a Failure of Organizational Ethics

Mary Cipriano Silva, PhD, RN, FAAN, Jeanne M. Sorrell, PhD, RN, FAAN, and James J. Fletcher, PhD



Given the move toward managed care, the increased competition among health care organizations, and the need to cut costs in order to remain competitive, one can anticipate that the conditions which give rise to typical instances of whistleblowing will continue to get worse. This online article provides recommendations for reducing the need to resort to whistleblowing behavior in the defense of patient welfare and professional conduct.

Purpose/Goal: To provide professional nurses with an understanding of how to assess and alter whistleblowing as a failure of organizational ethics.


1. Understand how factors that increase whistleblowing apply to the case example.
2. Analyze whistleblowing as failure of organizational ethics.
3. Assess how codes of ethics and nurse practice acts help/hinder whistleblowers.
4. Assess strengths and weaknesses of JCAHO accreditation standards.
5. Formulate steps healthcare organizations take to establish an ethical environment.


When this article was written, Mary Cipriano Silva, PhD, RN, FAAN, taught healthcare ethics and was Professor and Director of the Office of Healthcare Ethics, Center for Health Policy and Ethics, George Mason University. She served as a member of the ANA Code of Ethics Project Task Force that authored the 2001 ANA Code of Ethics for Nurses with Interpretive Statements and also contributed a chapter to the 2008 ANA Guide to the Code of Ethics for Nurses: Interpretation and Application. Dr. Silva has been engaged in scholarship and research related to healthcare ethics for over 35 years. Jeanne Sorrell, PhD, RN, FAAN, is Senior Nurse Researcher in the Department of Nursing Research and Innovation at the Cleveland Clinic, where she assists nurses in preparing research proposals for the Institutional Review Board. She is also Professor Emerita of the School of Nursing at George Mason University and adjunct faculty at the Frances Payne Bolton School of Nursing, Case Western Reserve University, and Ursuline College. She has organized her program of research around the impact of ethics on clinical practice. Most recently, she has focused on ethical concerns related to quality of life in persons with Alzheimer’s disease. At George Mason, she served as Special Projects Coordinator, Office of Health Care Ethics, and was a member of the Institutional Review Board. James J. Fletcher, PhD, is Professor Emeritus of Philosophy at George Mason University, Fairfax, Virginia. He joined the George Mason faculty in 1972 serving in a variety of teaching and administrative capacities, including fifteen years in the Office of the Provost as Associate Provost and Dean for Undergraduate Studies. He specialized in courses in ethics, bioethics and ethics and health care. His research interests in the area of bioethics include organizational ethics for health care providers, end of life issues and community health needs. In addition, he has written and presented extensively on higher education issues relating to faculty roles and rewards. At the time this article was written, he was the Ethics Collaborator in the Office of Health Care Ethics in the College of Nursing and Health Sciences. He serves as a community member of the Prince William Health Systems (PWHS) Bioethics Committee for which he provides consultancies and educational programming. He is the chair of the PWHS Human Subjects Review committee and a member of the IRB (Institutional Review Board) for ATCC (American Type Culture Collection). He is a member of Data Safety and Monitoring Boards and Protocol Review Committees for the NIH and was recently appointed to Fifth District, Section III Disciplinary Committee of the Virginia State Bar. He is the recipient of the 2003 Loftus Award for Outstanding Achievement in Education from his alma mater, Iona College. Please note that the author order and bios are for the study module and not for the original article.

The planners and author of this continuing nursing education activity have disclosed no relevant financial relationships with any commercial companies pertaining to this CNE.

Contact Hours: 1.5

Expiration Date: 12/31/2014


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Non-Member Price: $20.00

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