Ethics

Must be a minimum of 150 - 200 original words and supported by academic, peer-reviewed references (at least 1) Whenever possible, please try to relate the course content to real-world applications from your work experience. I expect your message to reflect critical thought and an integration of the key themes and concepts from the readings. 1. How might you apply ethical philosophies and principles that summarize what you perceive to be the top five ethical issues challenging health care delivery today? Give two examples

2. Managers must find a way to balance all four ethical principles discussed by Garrett, Baillie and Garrett (2009).  Beneficence would seem to be an all encompassing principle but the application of this principle can be clouded by the potential for coercion, conflict of interest , medical errors or even malpractice. Stark and Fins (2014) point out the industry focus on the prevention of medical errors and the development of a culture of safety.  But, they go on to suggest that "less often addressed are the moral and professional obligations to take all available steps to prevent errors and harm in the first instance" (pg. 386).  This statement suggests that ethical principles can be used for managers can apply professionalism and prevention. Garrett, T. M., Baillie, H. W., & Garrett, R. M. (2009). Health care ethics: Principles and problems (5th ed.). Upper Saddle River, NJ: Prentice-Hall. Stark M, Fins JJ. (2014).  The ethical imperative to think about thinking.  Cambridge Quarterly of  Healthcare Ethics. 2014 Oct;23(4):386-96. doi: 10.1017/S0963180114000061. Epub 2014 Jul 17.

Think about your organization...how are ethical principles expressed where you work? Give two examples

3. Read the following case study and discuss the actions taken by the physician.  Provide a rationale based on the moral theories discussed in the text, not just your personal opinion.  Identify at least 3 ethical principles that could be applied to the scenario.  Respond to other students regarding their perspective.

Provide at least one professional reference.

Scenario

For the last three years, a five year old girl has suffered from progressive kidney failure that is not treatable.  She was not doing well on kidney dialysis and the staff proposed a kidney transplant after determining that the transplanted kidney would not be effected by the same disease process.  The parents accepted this proposal.  It was clear after "tissue typing" that the patient would be difficult to match for a transplant.  Her sisters were too young to be organ donors.  After testing, it was determined that the father was a perfect match.  When the physician met with the father and informed him of these results, as well as the uncertain prognosis for the daughter, the father decided not to donate one of his kidneys to his child.  He gave several reasons, including the possibility of a cadaver kidney; his daughter had already experienced a great deal of suffering; and he lacked the courage to make the donation.  However, he was afraid that if the family knew the real reasons he did not want to donate, they would blame him for allowing the child to die, and his relationships would be ruined.  He asked the physician to tell the family members he was not a compatible donor, when in fact he was.  The physician did not feel comfortable about carrying out this request, but he did agree to tell the man's family that he could not donate because of "medical reasons".

*** Adapted from Veatch, Robert Medical Ethics; Jones and Bartlett Publishers, Boston MA, 1989

4. The scenario certainly brings up emotions about what the right thing for the MD to do is...but....what is the ethical obligation of the MD?  To whom is the MD obligated and what ethical principles might apply? ****** The scenario brings up the point that the father is not the patient.  Does this observation change how you might think about the scenario?  To whom does the MD have the primary obligation to care for? Think about the ethical principles from the readings...how can they help clarify the obligation?  What about  autonomy?  Does this inform the decision making process?***** Morrison, E.E. (2011).  Ethics in health care administration:  a practical approach for decision makers (2nd ed.). Jones and Bartlett Publishers.  Sudbury, Massachusetts.

5. This week provides a great summary of the Health Insurance Portability and Accountability Act (HIPAA....not HIPPA).  It is hard to believe that this legislation is now almost 14 years old and much has changed in the privacy world since then.  These changes impact the ability of organizations and patients to keep protected health information (PHI) private. Terry (2014) states that as this legislation has evolved, electronic health information and social media has evolved as well.  Many of the privacy concerns regarding what we might call "big data" is not addressed in the HIPAA legislation (Fremgen, 2009). What obligations do managers have to ensure privacy with "big data"?  What are some specific strategies that can be used to address concerns not included in the HIPAA legislation? Provide two real-life examples as well.. Fremgen, B. F. (2009). Medical law and ethics (3rd ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Terry, N. (2014).  Health Privacy Is Difficult but Not Impossible in a Post-HIPAA Data-Driven World.  Chest. 2014 Sep 1;146(3):835-40. doi: 10.1378/chest.13-2909.PMID:25180726