Eksistentielle dilemmaer i ledelsesbegivenheder i det borgernære sundhedsvæsen

Malene Grindsted & Peter Lynge Kjær

Student thesis: Master executive thesis


thesis investigates the existential dilemmas experienced by leaders in the citizen-oriented healthcare sector in cases directly pertaining to their administrative leadership choices. These investigations depart from a perceived discrepancy between the conditions for leadership in times of reform and the values promoted by the “competition state”, which must be balanced with the values of the leader in question. The authors are prompted by their own feelings of guilt associated with their work as leaders in the sector in question, where the conditions for making leadership choices necessitate working against one’s own beliefs and values. For this reason, the question of guilt, related to the life world of the leader, is included in the analysis. The thesis is methodically grounded in a phenomenological approach focused on subjective experiences, consciousness and the concept of the “life world”, which shifts the focus of the analysis to the administrator as a human being. Empirical evidence in the form of semi-structured interviews focused on life worlds, evidentiary interviews, outsider-witness-interviews, protreptic interviews, observations, and an ethnographically inspired study all contribute to answering the questions framing the thesis:  Which fundamental values are essential for the leader professionally and as a human being?  In which leadership situations in a politically controlled organisation do the dilemmas occur?  How does the feeling of guilt manifest itself in the life world of the leader? The analysis is further supported by discourse analysis of various documents, focused on clashes in values and the use of “human language” versus “technocratic-economical” language. Supported by the theoretical background, which serves to contextualise and reformat the field of empirical evidence hermeneutically, the cases is continuously revised in the discovery of additional phenomena and connections. Our theoretical approach consist of theory of strategic management / public governance and existentialism, etics and personal leadership. The thesis concludes that the observed participants do not distinguish between their roles as leaders and their “personal” identity and that their norms and values are linked to humanistic and existential values such as “the good”, “the true”, “the just” and “the beautiful”. They face dilemmas when the opportunities within which they work are limited and they are prohibited from “doing good”, understood as doing something good for the Other, especially in a communal sense. The participants see their work in the context of “the greater good” and display willingness to do smaller harms in service of a higher purpose. In the group conversations, the participants did not relate to the feeling of guilt in their administrative work, whereas in the protreptic interview the concept of guilt was discussed with a great deal of pathos and metaphor, which suggests that the feeling of guilt is present in the administrators in connection with their work, but suppressed in conversation.

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2015
Number of pages82