Luppo Kuillman

Facilitating and motivating factors for reporting reprehensible conduct 97 4 DISCUSSION The objective of our study was to assess whether the reporting of ethical mistakes committed by colleagues could be predicted by the extent to which healthcare professionals regard ethical care as important and the extent to which they perceive to have behavioral control. More precisely, we hypothesized that converting motivation to report reprehensible conduct requires that the individual must feel capable of doing so. We therefore expected behavioral control targeted at preventing harm (BCPH) to moderate the effect of ethics advocacy (EA) on reporting behavior. The results of our study provide evidence to confirm this hypothesis. According to our results, although EA was correlated with “reporting reprehensible conduct in care” (RRC), it had no statistically significant main effect on RRC in the overall regression-based moderation model. The hypothesis that BCPH acts as a “facilitator” to strengthen the relationship between EA and RRC was confirmed. The interaction between EA and BCPH showed that the positive effect of EA on RRC was only present for people with an above-average perception of control (BCPH score ≥ 80, representing the 33.6% highest BCPH scorers). For people with an average or below average perception of control, EA did not increase the intention to report. These results suggest that the motivation to act morally based on EA is not sufficient to ensure actual reporting behavior. The professional must also be convinced that reporting reprehensible conduct will be of benefit to those who have been negatively affected. In other words, a sufficient level of behavioral control is needed in order to ensure that a professional will feel able to convert the motivation to report into the actual reporting behavior. These results are in line with Bandura’s claim that perceived behavioral control helps individuals to determine what to do with the knowledge and skills they possess (Bandura, 1997). Our data suggest that, within the context of healthcare, the perception of having control over doing no harm to the patient can help health professionals to act upon the importance that they attach to moral values in care by reporting any reprehensible conduct of colleagues that they might observe. In this regard, BCPH facilitates the translation of the motivation to report morally questionable behavior of colleagues into action. Our findings that both ethics advocacy and behavioral control play an important role in the likelihood of reporting reprehensible conduct can also be understood within the context of the Theory of Planned Behavior (Ajzen, 1991). In their systematic