How does servant leadership affect unethical pro-organizational behaviors: examining a moderated mediation model

Background: Servant leadership in the healthcare sector can lead to negative outcomes in certain contexts, such as encouraging unethical pro-organizational behavior (UPB) for the benefit of the organization. The purpose of this study is to examine the mediating role of identification with leader and the moderating role of positive reciprocity belief in the relationship between servant leadership and UPB, drawing on social exchange and social identity theory. In this context, the aim is to highlight not only the generally accepted positive outcomes of servant leadership in literature but also its potentially unknown other outcomes. Methods: Healthcare workers employed at healthcare institutions in a province located in Türkiye’s Eastern Anatolia Region were selected as the working sample. Data was collected from 456 nurses using the convenience sampling method. Scales whose validity and reliability were confirmed by other investigations were employed in this cross-sectional study. Results: When the findings of the study were evaluated, a positive and significant relationship was found between servant leadership and UPB. However, it was determined that identification with leader mediating role in the relationship between servant leadership and UPB. Furthermore, the results supported the moderated mediation model and showed that the indirect effect of servant leadership on UPB through identification with leader was stronger in situations where positive reciprocity belief was high compared to situations where it was low. Conclusions: This study has revealed a positive relationship between servant leadership and UPB in the healthcare sector, and that this relationship involves the mediating role of identification with leader and the moderating role of positive reciprocity belief. Consequently, this research provides some theoretical and practical implications for practitioners by revealing that servant leadership may lead to unethical behaviors that could be detrimental to the organization in the long term, that identification with leader in the healthcare sector may have dark or potentially negative aspects, and that it is extremely important to know the levels of positive reciprocity belief among employees in healthcare organizations. © The Author(s) 2026.