Evidence map›Paper›PMID 40837107›Full record

ArticleHealth systems (Basingstoke, England)2025

From structures to systems: towards a model of ethical healthcare.

Constantine Manolchev, Marco Campenni, Navonil Mustafee

Abstract read
In one paragraph

Article in Health systems (Basingstoke, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Constantine ManolchevSustainable Futures, University of Exeter Business School, Exeter, UK.
Marco CampenniSustainable Futures, University of Exeter Business School, Exeter, UK.
Navonil MustafeeThe Centre for Simulation, Analytics and Modelling (CSAM), University of Exeter Business School, Exeter, UK.ORCID https://orcid.org/0000-0002-2204-8924

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

"Hurt people hurt people" is a phrase which summarises the cyclical nature of painful experiences and harmful actions. Arguably, this cycle of hurt and harm applies to the UK's National Health Service (NHS), where employees are reporting record low levels of physical and mental wellbeing, while experiencing a climate of hostility, bullying and harassment, and pressures to meet targets. Such working environments carry several risks, not only for the employees themselves but also in terms of clinical outcomes for patients. As a result, a range of systemic and targeted infrastructure interventions have been trialled in several NHS hospitals (managed in the UK by independent Trusts), seeking to promote a culture of compassion, and improve the psychological safety of workers. However, the effectiveness of such measures in achieving ethical working environments and preventing unethical behaviours, has been questioned. We join the ongoing debate by proposing the need to go beyond ethical infrastructures and instead consider ethical environments in their systemic complexity. We conclude, by putting forward a model of a complex and ethical health system, which incorporates workplace networks, policy frameworks, and accounts for regional demographics.

Indexed as

bullying and harassmentcomplex adaptive systemsEthical infrastructureethical system

Identifiers

PMID40837107
PMCPMC12364096

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.