Health Care Risk Management
Helpm31990
Chapter6.pptxChapter 6: Ethical Issues for Risk Managers
Why is Ethics Important to Risk Management?
For many issues, there are laws to guide how facilities need to deal with ethical situations
Abortion -- EMTALA
HIPAA -- Civil Rights Act
For other issues, no legal guidelines are available.
The Risk Manager needs to assist the facility to develop appropriate procedures for dealing with ethical issues
Ethical Issues
Ethical Issues have become increasingly important to risk management.
Some issues are bound by law while others are not, leaving the risk manager to confront and solve them to the best of their ability.
Many healthcare organizations establish ethics committees to assist with managing ethical situations
History of the Ethics Committee
The forerunners of Ethics Committees:
Dialysis committees of the 1960s
Abortion and Sterilization committees
Impetus for establishing today’s Ethics Committees sprang from high profile cases
Karen Ann Quinlan
Baby Doe
Growth in the field of Bioethics has also provided support for Ethics Committees
Growth of Ethics Committee
The healthcare industry has witnessed a growth in use of ethics committees due, in part, to the focus of accrediting bodies on patients’ rights and ethical issues during the survey process.
Organizations with ethics processes and oversight in place may see better outcomes for patients
Role of the Ethics Committee
Education
Policy Development
Consultation
Composition of the Ethics Committee
Generally interdisciplinary (the committee’s most important aspect)
May also include a member of the clergy, the healthcare organization’s attorney, a risk manager, and/or administrative personnel.
Ethical Guidelines for Risk Managers
Autonomy (Self-determination)
Patients have the right to make their own healthcare decisions.
Beneficence
Obligation to do good for the patients
Justice
Obligation to treat all in an equitable fashion
Ethical Standards for Decision Making
Decisional Capacity
An individual’s ability to weight the relative benefits, risks or burdens of treatments plans and make an informed decision
Substituted Judgment
Applies when an individual who previously had decisional capacity has either temporarily or permanently lost that capacity.
Seeks to find what that person would have decided in the circumstance
Ethical Standards for Decision Making
Best Interest
Applies when an individual never had decisional capacity or when there is no way of knowing the individual’s wishes
Makes use of the ‘reasonable person’ standard
Informed Consent
In keeping with the concept of autonomy, clinicians are obligated to provide patients with information regarding their condition and possible treatments in order for them to make an informed decision as to their choice of healthcare services.
Code of Ethics
Almost every profession of healthcare providers provides its members with a set of standards detailing the values, duties and ethical responsibilities of the profession.
A practitioner’s Code of Ethics is a set of guiding principles
Everyday Ethical Issues
Many ethical dilemmas arise in providing healthcare services for the following vulnerable populations:
Perinatal
Pediatric
Geriatric
Terminal
Summary
Risk managers work to protect their organization from litigation and should therefore participate in cases of ethical issues.
Institutional ethics policies and consultation with an Ethics Committee can assist the organization through ethical situations and may reduce legal liability.
