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2013 ; 4
(3
): 39-48
Nephropedia Template TP
gab.com Text
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Understanding the Severity of Wrongdoing in Health Care Delivery and Research:
Lessons Learned From a Historiometric Study of 100 Cases
#MMPMID26523237
DuBois JM
; Anderson EE
; Chibnall JT
AJOB Prim Res
2013[]; 4
(3
): 39-48
PMID26523237
show ga
BACKGROUND: Wrongdoing among physicians and researchers causes myriad problems
for patients and research participants. While many articles have been published
on professional wrongdoing, our literature review found no studies that examined
the rich contextual details of large sets of historical cases of wrongdoing.
METHODS: We examined 100 cases of wrongdoing in healthcare delivery and research
using historiometric methods, which involve the statistical description and
analysis of coded historical narratives. We used maximum variation,
criterion-based sampling to identify cases involving 29 kinds of wrongdoing
contained in a taxonomy of wrongdoing developed for the project. We coded the
presence of a variety of environmental and wrongdoer variables and rated the
severity of wrongdoing found in each case. This approach enabled us to (a)
produce rich descriptions of variables characterizing cases; (b) identify factors
influencing the severity of wrongdoing; and (c) test the hypothesis that
professional wrongdoing is a unified, relatively homogenous phenomenon such as
"organizational deviance." RESULTS: Some variables were consistently found across
cases (e.g., wrongdoers were male and cases lasted more than 2 years), and some
variables were consistently absent across cases (e.g., cases did not involve
wrongdoers who were mistreated by institutions or penalized for doing what is
right). However, we also found that some variables associated with wrongdoing in
research (such as ambiguous legal and ethical norms) differ from those associated
with wrongdoing in healthcare delivery (such as wrongdoers with a significant
history of professional misbehavior). CONCLUSIONS: Earlier intervention from
colleagues might help prevent the pattern we observed of repeated wrongdoing
across multiple years. While some variables characterize the vast majority of
highly publicized cases of wrongdoing in healthcare delivery and
research-regardless of the kind of wrongdoing-it is important to examine and
compare sets of relatively homogenous cases in order to identify factors
associated with wrongdoing.
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