EthicalIssues in health care
EthicalIssues in health care:
Theimportance of ethics to healthcare organizations cannot beunderstated. As much as the primary goal of a healthcare organizationis to provide quality healthcare to the patients, they are also facedwith economic crises that face other businesses. Although the corepurpose of such health organization is not necessarily to makeprofits, they have to operate effectively and efficiently so as tosurvive the current economic constraints. This calls for propermanagement and efficient service delivery which mandates thehealthcare organizations and health administrators to continuallyadhere to the laid out ethical standards (Filerman, 2013).
However,unlike other business, adherence to the ethical standards poses majorchallenges especially to the physicians. A physician may be tornbetween acting ethically and saving life of the patient at hand. Anethical dilemma exist when one has to do all that is possible to savethe life of a patient, given the limited time to do furtherconsultations. Ethical dilemma is a common occurrence in mosthospitals and the physicians are provided with guidelines to assistthem in such scenarios so as to ensure that their actions werejustified and for the common good of the patient. These guidelinesalso eliminate negligence. Similarly, a physician may beincapacitated to act ethically if he is impaired. Impairment is theinability of the licensed personnel to perform his assigned duties asa result of certain factors such as illness, mental disorder orsubstance abuse related disorders (Filerman, 2013). This paper willanalyze the impairment case that was experienced in the universityhospital, level 1 trauma centre that serves the tri-county area ofnorthwestern state.
Thehospital is charged with the responsibility of ensuring that thepatients entrusted to its care are handled appropriately in safeenvironments (Filerman, 2013). The hospital also must ensure thatthe patients are treated by qualified and licensed professionals inthe respective fields. This is in line with the hospitals mission ofefficiently and effectively delivering quality services to thepatients and the population surrounding them.
Therehabilitation of the impaired health professionals equates to publicsafety. It is the responsibility of the physician to identify,monitor and report any kind of impairment to the respectiveauthorities so that measures can be taken to manage it before itbecomes functional impairment (Filerman, 2013). If an impaired or apotentially impaired physician reports to the authorities seekingguidance or assistance on rehabilitation, should not be interpretedas disciplinary matter and should be treated with the requiredconfidentiality. Early detection and treatment of potentiallyimpaired physicians is in line with the public protection mandate.
Adherenceto professional codes of ethical standards:
Theactions by the nurses were in accordance to the professional codes asthey prepared the patient in time with the expectation thatDr.Spalding will arrive in the hospital within a short time as he wason his way to the hospital. However, the alcohol addiction of Dr.Spalding posed an ethical dilemma to the resident physician. Theresident physician, even though he was capable of conducting thesurgery, was required to only do such an operation under supervision.However, if he waited for three hours for the Dr. Spalding to arrive,they would have lost the patient as the patient was bleedingprofusely. His actions therefore were for the common good of thepatient and were aimed at saving the patient’s life.
Adherenceto the organization’s mission statement…..
Both,Dr Spalding and Ian, did not adhere to the organizations standards asthey did not perform their required duties appropriately. Ian wasentrusted by the hospital in ensuring that the surgeons followprotocol as she has great knowledge of the skills of every surgicalstaff (Filerman, 2013). She failed to call the surgeon on secondcall so as not to get Dr. Spalding in trouble. Her failure to actwas unethical and could have placed the patient’s life in danger.Similarly, Dr Spalding was required to report his impairment beforeit becomes functional impairment. He therefore, demonstratedunethical behavior by failing to turn up for the surgery on time asthe surgery was to happen under his supervision.
Managementrole and responsibility:
Ian,being the OR supervisor, was charged with the responsibility ofensuring that the surgeons report to duty while required and if notavailable, to inform the surgeon on second call. Similarly, sheshould report to the necessary authorities’ issues that are beyondher scope (Filerman, 2013). Covering up for a drunken surgeon whileallowing unsupervised surgeries is negligent.
Failureto apply hospital policies in a fair manner:
Accordingto the case scenario, Ian acted in attempt to cover up for DrSpalding. She therefore traded the life of the patient and herloyalty to the organization to personal loyalty towards Dr, Spalding(Filerman, 2013). Even if Dr Spalding was competent and alsoreliable, her behavior was inappropriate. Such favors may lower thestaff morale jeopardizing overall performance as they will feel thatsome of their colleagues are treated differently. It may also leaddiscredit the entire hospital management especially if such behaviorsare known to the public or lead to loss of life.
Itis clear that the hospital policies were not followed. This couldexpose the hospital to further litigations in future as two of itspolicies were overlooked (Filerman, 2013). This includes the use ofthe surgeons on call and the capacity to handle impaired physicians.The actions of the hospital staff expose the hospital at large nomatter who was responsible for the misconduct. Even if the hospitalcould transfer the legal penalties to the errant staff, the grossliability lies on the hospital at large.
Ofcourse, this case scenario will have a negative impact to theorganization as the hospital will be perceived as incapable ofattending to the patients professionally. It may lead to disciplinaryaction from the regulatory bodies and accrediting agencies. Thepatient should be made aware that the hospital resulted to save hislife in every way possible since the surgeon on call was not presentand the resident physician did his best to ensure the patientssafety. However, the burden of responsibility does not only fall onDr Spalding since it is the responsibility of the hospital as anorganization to address stress factors that may lead to alcoholabuse. Such organizations should also not excuse alcohol intake nomatter how minimal as it poses danger to the patient life.
Implicationfor graduate medical education:
Failureto comply with ethical standards can have long-term impact on thegraduate medical education program as it relies on governmentsubsidies, tax exemption, training support and research grants(Filerman, 2013). Such benefits will be eroded if the governmentfeels that there are continuous actions of negligence in suchtraining organizations. Also, the public will not feel confident tobe treated in such a hospital especially when they are handled byunknown physicians. They will always perceive them as students.Performance of unsupervised surgery may lead to invalidation ofcertificates by the Accreditation councils.
Filerman,G.L., Mills, A.E., and Schyve, P.M, 2013, Managerial Ethics inHealthcare: A New Perspective. New York: Routledge