virtual class room excercise

Chapter 13

Health Care Institutional Ethics: Broader than Clinical

Ethics

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Definitions

• Organizational ethics apply to health care organizations including hospitals.

• Organizational ethics: – Examines organizational climate and culture. – Examines the organization’s relationships with

people. – Addresses its decision making and activities.

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Moving to Organizational Concerns

• Organizations are expected to uphold clinical ethical concerns but must also go beyond them.

• They need processes to meet accreditation standards for patient care.

• They must address issues of appropriate and quality care.

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Moving to Organizational Concerns

• The Joint Commission includes an accreditation standard for patient rights and organizational ethics.

• Organizations are supposed to operate ethically in their business practices.

• Many organizations have added to the organizational ethics discussion.

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Scholarship on Organizational Ethics

• Many articles in the bioethics literature addressed organizational ethics issues.

• Professional societies began to address the meaning of organizational ethics.

• A myriad of questions were posed.

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New Challenges for Organizational Ethics

• Ethics committees can support clinical ethics decisions.

• However, clinical ethics issues may include areas of organizational ethics.

• New issues are also evolving for organizations in their practice of ethics.

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Stakeholder Theory

• This is a business ethics theory that has been applied to health care.

• If this ethics position is part of the work of ethics committees, new membership should be added.

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Other Approaches to Organizational Ethics

• Restructure the ethics committee to address organizational ethics.

• Design an ethics mission leader. • Create an ethics advisory group. • Work toward an integrated ethics system.

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Ethics and Human Resources

• Some ethics principles related to human resources should be prima facie.

• Principles do not guarantee ethical practice. • Organizations need to build an ethics climate.

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Ethics and Human Resources

• Rights of employees must be protected. • Boards of trustees must establish parameters. • Organizations must have commitment to their

employees and employees must be open to change.

• There must be a meaningful work environment.

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Organizational Identity and Strategic Direction

• What are the organization’s ethical duties to the community?

• How does the shift to a business orientation affect this duty?

• Communities have a schizophrenic attitude toward health care.

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Organizational Identity and Strategic Direction

• Health care facilities must respond to the needs of the communities that they serve.

• They must develop definitional strategies and • Procedural strategies must be geared toward

these definitions.

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Procedural Concerns Include:

• Procedures that address legal and regulatory concerns.

• A procedure for rationing. • Non-secret policies that are communicated. • Procedures that ensure integrity.

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The Public Nature of the Corporation

• Commitment to service is a public statement. • The board of trustees must address organizational

ethics questions. • Social justice is a special concern. • Health care organizations are political and economic

forces. • Organizations must be self-critical in dealing with

ethics issues.

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In Summary…

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