Applied Ethics in Nigerian Healthcare Management: Navigating Conflicts of Interest in Public Hospitals

This study examines how applied ethics frameworks can guide healthcare managers in navigating conflicts of interest in Nigerian public hospitals, focusing on institutions in the South West and North Central geopolitical zones. Healthcare management in Nigeria operates within an environment of scarce resources, political pressure, procurement corruption, and dual public-private employment, all of which generate persistent conflicts of interest that undermine patient welfare. Using a professional practice design, the study draws on applied ethics literature from Tom Beauchamp, Norman Daniels, and African healthcare ethics scholars, supplemented by secondary literature published between 2020 and 2024. Structured interviews with 30 hospital administrators, clinical directors, and ethics committee members in Lagos and Abuja provide the primary data. The study analyses specific conflict scenarios including procurement decisions, referral practices, and the allocation of scarce medicines using Beauchamp and Childress's four principles framework and utilitarian priority-setting ethics. Findings reveal that most public hospital managers lack formal ethics training and rely on informal collegial norms that systematically favour institutional and personal interests over patient welfare. The study recommends the establishment of formal healthcare ethics committees with philosophical competence in all tertiary hospitals, the integration of professional ethics into hospital management training, and the adoption of transparent conflict of interest disclosure policies. Keywords: healthcare ethics, conflict of interest, hospital management, applied ethics, Nigeria.