Identifying themes of ethical challenges in healthcare leadership during and after the COVID-19 pandemic: a scoping review

Purpose This study aims to describe the themes of ethical challenges identified in healthcare leadership during and after the COVID-19 pandemic. Design/methodology/approach This review followed the Joanna Briggs Institute scoping review methodology. A systematic search was done in CINAHL, Scopus, Web of Science, ProQuest, Mednar, PubMed and the Finnish database Medic. The search was conducted from 2020 to 2025, as the scoping review focused on the period during and after the COVID-19 pandemic. Data was analysed using narrative synthesis. The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews. Findings A total of 21 articles were included in the review: 11 research articles and 10 anecdotal articles. Five main themes of ethical challenges identified in healthcare leadership during and after the COVID-19 pandemic were: operating in a turbulent and unpredictable environment; digitalisation and the ethical use of technology; ethical considerations in leadership practice; staff competence and ethical awareness; and patient vulnerability and justice in care. Practical implications The findings suggest that organisations need to invest in leadership support, fair policies, workforce sustainability and ethical frameworks that evolve in tandem with technological advancements. Healthcare systems need to strive for greater clarity, purpose and alignment in their data-driven practices. There is a need for ethical training, mentoring and a culture of ethical reflection. Originality/value This review produced new, comprehensive information and valuable insights into the existing literature describing ethical challenges in healthcare leadership during and after the COVID-19 pandemic.