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Analysis of ethical challenges in health care
Managing conflict in healthcare organizations
Managing conflict in healthcare organizations
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Abstract
This study is related to a case conducted at Faith Community Hospital to assess the problems due to issues with their mission statement and how it is being interpreted. According to the CEO of Faith Community Hospital, very few of the members and partners seem to be following the mission statement. There are issues with organizational processes, ethics issues, and communication systems. Many staff members are operating as individuals and not as a collective unit based on their values. A moment's distraction can result in a tragic outcome.
Introduction
Faith Community Hospital, an organization who's mission statement is to promote health and well-being of the people in the communities. They serve through the extent of services provided in collaboration with the partners who share the same vision and values. Though the mission statement is the model that everyone should be following, everyone does not think the same about every issue. We all may face similar situation at one point in time but the end result may be different for each individual because we all have different values and beliefs. There are many differences between ethics, laws, beliefs, and oaths that all affect the decisions from patients to staff members. Some patients refuse to take medical services and there are staff members who refuse to provide certain services due to those value lines. Some of the staff members are caring so much for the patients that they sometimes take radical positions to respond to their well-beings. In these situations medical intervention can conflict with religious beliefs or personal moral convictions. Hospital pharmacists are even taking positions which they believe to be important such as filling uninsured prescriptions by accepting payments in installments. Staff members in ICU initiated Do Not Resuscitate procedures with out written orders. Doctors are putting patients first from various interpretations. In "right to die" situations the doctors seem to be getting too involved in compassion and passions with their patients. We need to stay focused on what our jobs are and what we are promoting which is to provide healthcare and its services to members of the communities. Counselors are also treating some of their clients with no authorization of the values and beliefs they have. On the other hand, there are some staff members within the hospital who refuse to serve patients unless they have confirmed insurance coverage. If a patient is to pass away because of unauthorized decisions, this can cause a stir with the media as well as with current or future patients in the community.
Hardwiring Excellence gives a general map for creating a culture focused on service, leadership, accountability, and employee and patient satisfaction. While Studer provides firm foundations and ideas, at points the reader is left wanting more in-depth explanation. Overall, Studer’s text emphasizes strategies to capitalize on a hospital’s most positive aspects, and how to motivate employees to use these strategies.
For anyone who has ever worked in healthcare, or simply for someone who has watched a popular hit television show such as Grey’s Anatomy, General Hospital, House or ER know that there can be times when a doctor or health care provider is placed in extremely difficult situations. Often times, those situations are something that we watch from the sidelines and hope for the best in the patient’s interest. However, what happens when you place yourself inside the doctors, nurses, or any other of the medical provider’s shoes? What if you were placed in charge of a patient who had an ethically challenging situation? What you would you do then? That is precisely what Lisa Belkin accomplishes in her book “First Do No Harm”. Belkin takes the reader on
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
An article discussing the importance of a mission statement states that a mission statements’ job is to outline the organization’s unique purpose and establish the basis of its values and traits, as well as describe the attitude that is to be expected of those a part of the organization. Furthermore, this philosophical foundation sets the “tone” for physical actions, meaning that the content of the mission statement can determine the behavior of personnel (Hitt & Ireland, 1992).
Healthcare ethics is defined as a system of moral principles that guide healthcare workers in making choices regarding medical care. At its core lies our attitudes regarding our personal rights and obligations we have to others. When an unprecedented situation comes into play, we rely on medical ethics to help determine an outcome that would be the best case scenario for all involved. In order to appropriately review this case study, we must first identify the key stakeholders, the ethical principles, policy implications at the federal, state, and local levels, financial implications, and a viable resolution for the situation.
For those of us who work in an acute care setting nursing is more about vital signs, electrolyte imbalances, arrhythmias, respiratory status and mental status changes just to mention a few of the things that demand our attention on a day to day basis. However, at times we are faced with issues that call into play ethical decision and hence it is important to understand ethical concepts that can influence such decisions. Concepts such as scientism, relativism, post modernism have been recognized as playing a key role in the conflict between science and religion. A conflict that has hindered an important healthcare goal of holistic patient care (Grand Canyon University, 2015).
Some medical facilities are not-for-profit organizations. They can be a charitable organization or an educational organization or both. There are other not-for-profit medical and public health programs that provide health care to many communities in this country. Some of the best hospitals in America are educational not-for-profit facilities. They work with some of the newest technology and some perform experimental procedures. Most public health programs are ran as not-for-profit organizations and operated for charitable and educational purposes. The not-for-profit organization is not liable to pay taxes under IRS code 501 (c)(3) (.org). This allows the organization to put its revenues back into the organization versus having to pay investors or owners. Unfortunately, over the past 20 years the amount of for-profit organizations has increased (Santa). The growing commercialization of health care has ethical implications and has become a matter of heated controversy (Santa). It’s becoming more difficult despite all the laws and regulations to protect patient’s privacy and confidentiality. An ethical implication that for-profits face is physicians receiving incentives for keeping cost down to increase profits. Some for-profits will encourage doctors to promote profit producing drugs, surgeries, tests and treatments. (Santa). Some of these same physicians may own the facility they operate which creates a huge conflict. On the other hand, financial incentives can cause physicians to delay important tests and treatments or to not perform them at all. In some cases patients are being discharged from hospitals before they are ready to go home (Orentlicher). On an ethical standpoint, the patient’s well being is put in jeopardy and the...
Ethical principals are extremely important to understand in the healthcare field. Ethical responsibilities in any situation depend on the role of the healthcare worker and the nature of the decision being made. Healthcare administrators and professionals must make ethical decisions that can be an everyday or controversial situation. When making such decisions, it is imperative to consider the four major principles of ethics: autonomy, nonmaleficence, beneficence, and distributive. By using these four principles, ethical decisions can effectively be made. For the purpose of this paper, examined will be the example of the treatment of an uninsured homeless patient. Poor health care be a cause and a result of homelessness.
Integrity is one of the most essential principles in business practice. Without integrity, the reputation of a business can suffer unrepairable damages in which consumerism becomes nonexistent. Integrity must be built into the organizational infrastructure in health care to build a foundation of ethical integrity and adopt a culture that prioritizes this value (Mantel, 2015). I chose this business principle because I strongly believe that integrity is the heart and soul of a business’s character. Character reveals the core of business standards and is vital to sustain trust. Integrity is incorporated at my facility under the value system, to enable communities to rely on our health care organization. Integrity is chief in health care because it encompasses the foundation of veracity and honesty. Consumers such as patients, heavily rely on integrity of health care organizations to provide the best care. Integrity is important to me because it represents a network of trust and honor. As a health care professional, ethically and morally sound decisions have to be made with
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
One of the first steps in developing an organization is to develop the vision, mission and philosophy of the organization. Vision statements are used to define the goals of an organization. The mission statement of an organization is a brief statement that explains the purpose that an organization exists. The organizational philosophy outlines the set of values and beliefs that controls the operations of an organization (Marquis, 2011). UMC’s vision is “to be nationally recognized for excellence in patient care, medical education, and biomedical research.” Their mission statement is “to serve through healing, education, and discovery.” The philosophy of UMC is “to value integrity, excellence, compassion, innovation, collaboration and dedication.” (www.mc.uky.edu)
One notable example of an ethical dilemma presented within this report is the battle of belief referring to a situation where some patients tend to reject specific medical procedures attributed to the religious, cultural, or personal beliefs. Every patient has the right to decision based on his or her beliefs thereby meaning that patients may reject specific medical procedures based on what they believe (Guido, 2014). However, this conflicts with the position of the nurses who are mandated with providing their patients with the best quality of medical services as part of promoting positive health outcomes. The best remedy for this specific ethical dilemma would involve having to hold a discussion between the nurse and the patient where the nurse would accord the patient his or her clinical
The debate over whose decision it is to uphold a human life is one with a vast range of opinions. Some believe it should be up to God, whereas others assert that it is the right of an individual; however, the ultimate verdict rests in the hands of the government. When tragedy leaves a victim in critical condition with no assurance of recovery, circumstances do not allow for a straightforward action plan. In any state of affairs, it is optimal to continue the life of a patient, even if it seems as though the ideal solution is death. Medical practitioners, relatives, and patients themselves do not deserve the pressure to decide this grave fate. The choice between life and death should not exist. Every human is entitled to the right to live, and
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the