Senior Project
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healthcare_ethics.pptxHEALTHCARE ETHICS BRANDY VAUGHN HCA 459: SENIOR PROJECT INSTRUCTOR: ERIC OESTMANN 14 November 2016
Introduction
Healthcare ethics is an important issue especially considering the fact that decisions made could affect mortality.
Ethics in healthcare involves making well- researched and considerate decisions about treatment, while taking into account the beliefs and wishes of the patient regarding all aspects of their personal health (Doukas, McCullough, & Wear, 2012).
The clientele of the healthcare industry is the patient: healthcare facilities have a high regard for issues surrounding their patients’ welfare. Healthcare professionals such as doctors and nurses who have the ability to affect the health of a patient have to make ethical decisions on a daily basis. It is common for healthcare professionals to clash with a patient’s family over decisions regarding treatment. Sometimes patients eventually suffer the consequences of an error made by a healthcare professional during the course of hospitalization. The decisions made during are under heavier scrutiny in the modern age with most healthcare facilities in the industry coming up with ethics committees. Such committees establish a written code of ethics that elaborate policies and procedures that determine proper conduct for the concerned healthcaere employees.
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Confidentiality
The protection of private patient information is one of the core duties of medical practice.
Healthcare providers should keep the health information of patients private unless there is consent by the patient to release the information.
The adoption of electronic health records has improved the quality of healthcare but it has brought a real challenge in terms of the safety of information in the system (Ozair, Jamshed, Sharma, & Aggarwal, 2015).
Security breaches are a real threat to the confidentiality of patient medical records. This is particularly so when the confidential health information is made available to others without the consent or authorization of the individual in question. Over the recent past, there have been incidents of security breaches which showed that inadequate data security can affect very many people. A breach at Howard University Hospital, Washington left the medical data of 34,000 patients compromised. It is crucial that healthcare organizations implement security measures such as antivirus software, firewalls, and intrusion detection software that will protect data integrity. This is a minor cost if the state of healthcare is to improve. The problem with security breaches is that patients will be less likely to share sensitive information with doctors which in turn negatively impacts their care.
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Referral Decisions
Medical referral is the action of guiding a patient via a solitary expert care giver to additional, who could be a professional and consequently be further informed in the analysing and additional supervision of the patient (Anyawu, Abedi, & Onohwakpor, 2015).
Unethical behaviour, in this context, applies in the case of self- referral, and fee- splitting where a fee is paid by one physician to another for a referral.
In the United States, 60 percent of physicians still practice independent physician- owned practices. The other percentage of doctors wither work directly for a hospital or in a practice that is at least partially owned by a hospital. The ethical dilemma comes in where a doctor has to choose where their loyalties lie: to the patient or to the hospital system. Doctors within a network facilitate referrals. At times, when making in- house referrals, some doctors do not disclose that they are referring patients within the same system that actually employs them.
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Dealing With Elderly Patients
Dealing with patients of advanced age brings with it a myriad of ethical challenges.
Since they are not capable of making rational decisions on their own, their families are left with this responsibility.
The situation becomes challenging when the patient in question is terminally ill and wants to end their life in order to avoid endless suffering.
Examining one’s own beliefs and values, and one’s subsequent biases, is essential in examination of ethical issues. Our values and beliefs will impact on care provision, that is, on what care is provided, as well as when, where, why and how it is provided (Ludwick & Silva, 2003). Ethical challenges, in this context, may arise around issues such as truth- telling and informed consent which are both important when dealing with elderly patients. Examining personal biases and stereotypes is addressed since it influences decision making greatly.
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Patient Protection and Affordable Care Act
The ACA creates new conflicts of interest for physicians.
One of the primary goals of the initiative is to control health costs.
As such doctors will face increasing incentives for under treatment rather than overtreatment.
The service model in the previous system has been replaced with a bundled payments model.
With the new system, hospitals and physicians would receive a fixed sum for treating a patient’s condition regardless of what it costs the healthcare providers.
In case they treat the patient for less than the bundle, they keep the excess. This essentially opens the door for unethical practices in healthcare.
One significant gap in the ACA is that, while it places some pressure on doctors to hold down costs, it doesn’t take any steps to address tort reform. The federal government has also proposed linking physician payments to “appropriate use criteria.” Such government practice guidelines may be appropriate for many patients. However, there will always be patients who don’t fit the guidelines. In those cases, doctors will have to choose between what’s medically appropriate for their patient vs. adhering to the government-approved treatment guidelines. To cut costs, many ObamaCare exchange plans also require “narrow networks” of providers, where patients may only receive treatment from a short list of approved hospitals and doctors.
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Allocating Limited Medications And Donor Organs
A current ethical dilemma in healthcare is whether there will be enough critical medications available to meet the needs of patients in the future.
The same applies to the allocation of organs when they will be in short supply.
This issue challenges the very core of decision making in healthcare.
Medication shortages often happen because there’s not enough economic incentive for manufacturers. Although some advances have been made to encourage the reporting of drug shortages in an effort to reduce them, the Food and Drug Administration still expects shortages to occur in the future. The Affordable Care Act may help transplant candidates with coverage for certain necessary medications, such as immunosuppressants. The ongoing shortage of donor organs begs the question of how the issue will be tackled in the future.
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Conclusion
Healthcare managers should always be informed of trends in healthcare ethics since the effects are usually far- reaching. A security breach or shortage of drugs could happen at any facility. As such, it is always better to be prepared.
Developments in healthcare ethics are mainly inclined towards quality patient care. As such patients are beneficiaries of the developments. As for administrators and shareholders, any ethical breach could have great consequences especially in terms of revenues.
Nearly every decision that’s made in a healthcare facility has ethical implications which may be for patients, for providers and for healthcare leaders. The concerns will continue to develop, such as healthcare technology’s impact on communication policies, medical records and patient privacy. Access to care is also a very important ethical issue. As such, it is important to deal with these issues before they implode.
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References
Anyawu, E.B., Abedi, H.O., & Onohwakpor, E.A. (2015). The Practice of Medical Referrals: Ethical Concerns. American Journal of Public Health Research 3(1): 31- 35
Doukas, D. J., McCullough, L. B., & Wear, S. (2012). Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism. Academic Medicine, 87(3), 334–341.
Ludwick, R. & Silva, M.C. (2003). Ethics: Ethical Challenges in the Care of Elderly Persons. Online Journal of Issues in Nursing 9(1)
Ozair, F. F., Jamshed, N., Sharma, A., & Aggarwal, P. (2015). Ethical issues in electronic health records: A general overview. Perspectives in Clinical Research, 6(2), 73–76. https://doi.org/10.4103/2229-3485.153997
