Health Care Managaement Questions
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Chapter_7_Government_Ethics_and_the_Law1.pptxChapter 7 Government Ethics and the Law
Please become familiar with the laws, acts, terms and concepts of this chapter, and be sure to use them in your assignments.
Learning Objectives (1 of 2)
Describe some of the reasons why there has been a loss of trust in government.
Explain the purpose of various government committees on ethics.
Discuss how public policy protects the rights of citizens.
Learning Objectives (2 of 2)
Describe federal laws designed to protect each individual’s rights.
Explain the concept of political malpractice.
Understand the importance of ethics in public service.
Let every American, every lover of liberty, every well wisher to his posterity, swear by the blood of the revolution, never to violate in the least particular, the laws of the country; and never to tolerate their violation by others.
—Abraham Lincoln
Executive Branch: U.S. Office of Government Ethics
Exercises leadership in the executive branch to prevent conflicts of interest.
Resolves those conflicts of interest.
Fosters high ethical standards for employees.
Strengthens public confidence in government business.
House of Representatives: Committee on Ethics
Designated The “Supervising Ethics Office” For The House Of Representatives.
Only Standing Committee Of The House Of Representatives With Membership Divided Evenly By Party.
Committee on Ethics: Common Ethical Issues (1 of 2)
Gifts From Outside Sources
Gifts Between Employees
Conflicting Financial Interests
Remedies For Financial Conflicts Of Interest
Impartiality In Performing Official Duties
Seeking Other Employment
Committee on Ethics: Common Ethical Issues (2 of 2)
Misuse Of Position
Outside Activities
Post-employment
Representation To Government Agencies And Courts
Supplementation Of Salary
Financial Disclosure
Senate: Select Committee on Ethics
Authorized to receive and investigate
Allegations Of Improper Conduct That May Reflect Upon The Senate
Violations Of Law
Violations Of The Senate Code Of Official Conduct
Violations Of Rules And Regulations Of The Senate
Recommend Disciplinary Action
Recommend Additional Senate Rules Or Regulations To Ensure Proper Standards Of Conduct
Report Violations Of Law To Federal And State Authorities.
Office of Congressional Ethics
Independent, nonpartisan office
Governed by a board composed of private citizens
Provides more public review and insight into the ethical conduct of members of the house of representatives
Mission is to assist the house in upholding high standards of ethical conduct for its members, officers, and staff.
U.S. Judicial Code of Conduct
Provides guidance for judges on issues of
Judicial integrity and independence
Judicial diligence and impartiality
Permissible extrajudicial activities
Avoidance of impropriety or even its appearance
Public Policy: A Principle of Law
Principle of law that holds no one can lawfully do that which tends to be injurious to public.
Sources of Public Policy
Legislation
Administrative rules, regulations, or decisions
Judicial decisions
Professional code of ethics may contain an expression of public policy
Sources Of Public Policy: Veterans Administration
House committee on veterans’ affairs
Reviews veteran programs
Examines current laws
Reports bills and amendments to strengthen existing laws concerning veterans and the department of veterans affairs (VA):
Health care and disability compensation
Headlines suggest failure in providing health care
Laws Influence Ethical Principles: Protecting Individual Rights (1 of 2)
1868: fourteenth amendment to U.S. Constitution
1964: title VI, civil rights act of 1964
1890: sherman antitrust act
1974: privacy act
1996: health insurance portability and accountability act
1986: emergency medical treatment and active labor act
Laws Influence Ethical Principles: Protecting Individual Rights (2 of 2)
1986: health care quality improvement act
1989: agency for healthcare research and quality
1989: ethics in patient referral act
1990: patient self-determination act
2002: sarbanes-oxley act
2010: patient protection and affordable care act
Fourteenth Amendment To U.S. Constitution
States
Cannot deny any person equal protection of law.
Shall not make or enforce any law which shall abridge privileges or immunities of citizens.
Shall not deprive any person of life, liberty, or property, without due process of law.
Shall not deny any person equal protection of laws.
Title VI: Civil Rights Act of 1964
Racial discrimination prohibited.
HHS program discrimination prohibited.
Sherman Antitrust Act
Contracts in restraint of trade illegal
Areas of concern for health care
Reduced market competition
Price-fixing
Preferred-provider arrangements
Exclusive contracts
Privacy Act of 1974
Safeguards individual privacy
Provides individuals access to records
Established privacy protection safety commission
Health Insurance Portability and Accountability Act
Designed to protect the privacy, confidentiality, and security of patient information.
Standards are applicable to all health information in all of its formats:
Electronic
Paper
Verbal
Emergency Medical Treatment and Active Labor Act
Hospital emergency departments are
Required to provide an appropriate medical-screening exam.
Forbidden to “dump” patients from one emergency department to another.
Case: EMTALA Violated (1 of 2)
In Burditt v. U.S. Department of Health & Human Services, EMTALA was violated by a physician when he ordered a woman with dangerously high blood pressure (210/130 mm hg) and in active labor with ruptured membranes transferred from the emergency department of one hospital to another hospital 170 miles away.
Case: EMTALA Violated (2 of 2)
What are the main issues in Burditt?
What ethical theories, principles, and values are of concern? Describe them.
Health Care Quality Improvement Act
Restricts ability of incompetent physicians to move from state to state without disclosure of incompetence.
Provides professional review bodies limited immunity from damages.
Facilitates exchange of information among professionals conducting peer review.
Protects physicians improperly subjected to disciplinary action.
Agency for Healthcare Research and Quality
Improve quality of health care
Reduce healthcare costs
Broaden access to essential healthcare services
Ethics in Patient Referral Act
Prohibits physicians who have ownership interest or compensation arrangements with clinical lab from referring medicare patients to that lab.
Requires medicare providers to report names and provider numbers of all physicians or their immediate relatives with ownership interests in a provider entity.
Patient Self-Determination Act
Right to be informed of rights.
Right to execute advance directives.
Right to accept or refuse medical care.
States required to provide description of state laws regarding advance directives to providers.
Providers ensure written policies and procedures regarding advance directives are established.
Sarbanes-Oxley Act
The Sarbanes-Oxley Act Was signed into law by president bush on july 30, 2002, in response to the enron debacle and high-profile cases of corporate mismanagement.
Sarbanes-Oxley Act: Promoting Due Diligence
Act is not about regulation; it is about self-regulation.
Selecting a leader with morals and core values.
Examining incentives.
Monitoring the organization’s culture.
Building a strong, knowledgeable governing body.
Searching for conflicts of interest.
Focusing attention on the right things.
Having the courage to speak out.
Sarbanes-Oxley Act: Know Your Moral Values
Be willing to stand up for them.
Be prepared to pay the cost.
Sarbanes-Oxley Act: The “System”
Do not think lightly of evil, saying, “it will not come to me.” By the constant fall of water drops in a pitcher, a pitcher is filled, accumulating evil little by little, becomes full of evil.
— Buddha, Dhammapada, verse 121
Patient Protection Affordable Care Act
A federal statute that contains a set of healthcare reforms passed by congress and signed into law by president Barack Obama on March 23, 2010.
Hope remains that ethics will become something of value that is practiced both in the workplace and in one’s personal life. It is more meaningful than a word to discuss, a book to read or a course of study.
Ethics in Practice
Political Malpractice
Political malpractice is the negligent or unethical conduct on part of an elected official.
Duty to care
Breach of duty
Injury
Causation
Foreseeability
Nonaction seems to be harming the nation (e.g., Veterans care)
Review Questions
Discuss how the various branches of government address ethical issues.
Discuss how public policy protects individual rights (e.G., Privacy and self-determination).
Discuss the legal and ethical implications of the public policy acts presented here.
Describe how the concept of “political malpractice” is similar to “medical malpractice” as discussed in this chapter.
Should the role of an ethics committee be expanded from one of consultation to that of a decision-maker? Support your position. Here there is no right or wrong answer, but a better answer.
Review Questions
