When Accountability Exceeds Agency: Executive Moral Injury and Organizational Fragility in Healthcare Leadership

Clicks: 3
ID: 333452
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #87 of 92 articles by views in Military Medicine

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Moral injury in healthcare is most often discussed in relation to clinicians, but healthcare executives may also experience morally significant distress when they remain accountable for organizational outcomes without sufficient agency, information, trust, or voice. This commentary introduces accountability without agency as a potential pathway to executive moral injury. Drawing on scholarship on moral injury, moral distress, psychological safety, and organizational conditions, it examines how suppressed candor, routine bypassing of accountable executives, and persistent centralization of decision-making can harm leaders and weaken organizational coordination and resilience. Although evidence specific to healthcare executives remains limited, research among healthcare workers demonstrates that moral conflict can have consequences beyond occupational dissatisfaction. The commentary concludes that healthcare organizations can reduce these risks by aligning responsibility with decision rights, protecting executive voice, distributing strategic context, and developing leaders capable of exercising judgment in service of the mission.
Reference Key
openalex_W7223232571 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Brian F Turner
Journal Military Medicine
Year 2026
DOI
10.1093/milmed/usag485
URL
https://doi.org/10.1093/milmed/usag485
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.