Harvard Medical School Center for Bioethics is proud to share the news of the publication of a new special issue of Perspectives in Biology and Medicine, entitled Organizational Ethics and the Promise of Justice in Health Care (Spring 2025). Co-edited by Dr. Kelsey N. Berry and Dr. Charlotte H. Harrison—co-chairs of the Center’s Organizational Ethics Consortium—the issue represents a milestone in the evolution of the field of health care organizational ethics and a concrete example of the scholarly and practical impact achievable through sustained learning communities and collaborative programming.

This special issue emerges from over a decade of sustained work by the Center for Bioethics to advance scholarship and practice in health care organizational ethics, a subfield of bioethics. From 2014 to 2024, the Center's Organizational Ethics Consortium convened scholars, ethics practitioners, and health care leaders in a unique cross-sector learning community focused on ethical issues at the organizational level—those that arise not just at the bedside, but in the policies, business strategies, and institutional decisions that shape health systems. Launched by Dr. James Sabin and Dr. Charlotte Harrison, and later joined in leadership by Dr. Berry, the consortium helped establish organizational ethics as a meaningful area of scholarly inquiry and practical application. In its final year, the consortium evolved into a public seminar series—The Ethics of Health Systems and Institutions, led by Dr. Berry—which continues this work by offering a national platform for developing and sharing insight on ethical challenges and moral leadership in health care systems.

Organizational Ethics and the Promise of Justice in Health Care builds on this legacy. Comprising 16 essays by 42 contributors, the issue reflects a maturing field increasingly concerned with justice and ethical accountability at the level of health organizations and systems. Topics span a wide range of timely challenges, from the pressures of corporatization and resource scarcity, to digital health innovation and the social determinants of health. The essays examine how health care organizations are navigating the ethical dimensions of these issues and offer frameworks, case studies, and models for practice that advance both theory and applied ethics. The introduction by the co-editors articulates a core theme of the issue: the moral work of health care organizations is both inescapable and under-examined, and continued ethical engagement is essential if these institutions are to meet the demands of justice in an evolving health landscape.

The issue's publication also marks a significant achievement in the Center's broader mission to serve as a pipeline for transforming bioethics education, programming, and collaboration into lasting contributions to the field. Of the essays included, nine emerged from presentations at Center-supported programming such as the Organizational Ethics Consortium and the Ethics of Health Systems and Institutions seminar series. Twenty-seven of the issue contributors are former discussants or presenters in these programs, and eight are members of the Center’s core faculty, affiliates, or alumni of its educational offerings.

"This special issue is a testament to the vision and editorial leadership of Drs. Berry and Harrison, and to the thoughtful contributions of scholars and practitioners committed to strengthening justice and ethics in health care," said Dr. Rebecca Brendel, Director of the Harvard Medical School Center for Bioethics. "We’re proud that the Center's programming has supported this work, and we see this publication as an example of the kind of scholarly and practical impact that long-term learning communities can achieve."

By focusing on the "meso-level" of ethics in health care—that is, the level of organizational, system, and institutional decision making—this collection marks a significant advance in articulating the roles and responsibilities of organizations in advancing health and social justice. In era in which questions of equity, trust, and accountability are increasingly urgent in health care delivery, the publication stands as a signal contribution to the ongoing development of health care organizational ethics, and to the broader project of bioethics as a field dedicated to ethics and justice in health care.

Essays include:

1. The Ethical Obligations of Health-Care Delivery Organizations: a dynamic view by Kelsey N. Berry and Lauren Taylor
2. Approaching Ethical Challenges at the Intersection of Medical and Social Care by Lauren Taylor, Monica E. Peek and Laura M. Gottlieb
3. Participatory Practice in Pursuit of Social Justice by Erika Blacksher, Jonathan M. Marron, Basel Tarab, and Julius Yang
4. Getting from “Just Us” to Justice: individual initiatives need organizational support by David N. Sontag
5. Organizational Accountability for Justice and Health Equity by Jenna Wright, Ellie Tumbuan, Marjorie Stamper-Kurn, and Marshall H. Chin
6. Patients Before Profits: restoring agency and mitigating moral injury in medicine by Jonathan M. Cahill, Ian Marcus Corbin, and Lydia S. Dugdale
7. Health Equity as Mission and Source of Moral Distress: examining health systems actions through a conflict of interest lens by Katherine R. Peeler and Emily B. Rubin
8. Ethics at the Hinge: health-care organizations and family caregivers during discharge planning by Nancy Berlinger and Alison Reiheld
9. What to Do About Complicity in Organizational Wrongs by Sean Pomory and Lauren Taylor
10. Reenvisioning Mission and Moral Leadership in Health Care: an interview with Sachin Jain by Sachin Jain, Lauren Taylor, and Kelsey N. Berry
11. From Awareness to Action: teaching ethical decision-making to health-care leaders by Ira Bedzow, Matthew K. Wynia, and Rebecca Weintraub Brendel
12. Margin, Mission, and the Sociology of Profession: a conversation by Frederic W. Hafferty and Lauren Taylor
13. Organizational Ethics and a Regional Health-Care Network: navigating surges and shortages in pediatrics by Emily Berkman, Douglas Diekema, and Mithya Lewis-Newby
14. Boots on the Ground in Childhood Cancer Drug Shortages: a multilevel approach by Brittany L. Greene, Delia C. Allen, Yoram Unguru, and Jonathan M. Marron
15. Centering Health Equity in an Increasingly Digital Environment by Elaine C. Khoong, Alejandra Casillas, Griselda Gutierrez, Courtney R. Lyles, Deepti Pandita, Safiya Richardson, and Jorge A. Rodriguez
16. Enacting Justice in Community Health Centers by Johanna T. Crane and Carolyn P. Neuhaus

Please contact the special issue co-editors, Kelsey Berry (kelseyberry@fas.harvard.edu) and Charlotte Harrison (chharris141@gmail.com), if you have questions.