Question

What are the ethical challenges you could see arise when healthcare organizations are run according to business principles? Include ways that you think healthcare organizations should differ from other businesses because of these ethical issues.

Answer 1

There are various ethical challenges you could see arise when healthcare organizations are run according to the business principles.

The foremost that comes into the light is the conflicts of interest that should be avoided. Here, doctors and nurses are often prime targets of promotions and promotional activities from pharmaceutical, medical device and equipment manufacturers. Some studies enlightened that physicians’ behavior is even influenced by trivial freebies, that’s why more hospitals are banning free meal presentations, pens, notepads and other logo items.

In spite of these measures taken by the authorities, some research shows many physicians don’t mind accepting free samples from drug companies or collaborating with medical device manufacturers. Hence, this also applies to meals and travel expenses. While encouraging these practices to turn down the giveaways and any compensation that might influence their decision making, hospital management teams are also scrutinizing whether their trustees and boards of directors should be allowed to maintain financial ties to the institution or health system, such as selling their own goods or services.

The second issue is about balancing profit with serving patients and providing charity care.

Healthcare organizations need to take a long, hard look at how they make ethical decisions involving their business operations. Should organizations invest scarce resources in profit making areas that are likely to serve a relatively small number of patients, or in areas that will provide basic care to a larger number of patients? Here Nurses are a scarce resource. So is cash, hence, Healthcare organizations must balance the books.

However, with all said and done, it is crucial for healthcare institutions to support good care through ethically sound policy, clear and fair processes, and ongoing ethics education for patient care providers at all levels.

Thirdly, it is difficult for the organizations to provide equal treatment for VIP treatment for donors and other influential people. The care treatment for VIP patients such as financial donors, trustees’ family members, and other influential people in the community take many forms. They generally result in shorter waiting times or longer physician consultations, or it also mean that the hospital administrator drops by to make sure they don’t have any problems and that their care is first class, which some times hamper the treatment to the normal patients in the queue.

Now that managing pediatric and geriatric patients who may not have decision making capacity are very much questionable situations, providers need to determine whether the patient understands his medical condition, the benefits and burdens of the treatment options, and what would happen if the patient elected no treatment at all. If a patient can’t give informed consent to a medical provider, then the responsibility falls to his legally authorized representative. That person is supposed to decide based on the patient’s known preferences in the best of his interest.

Finally, moral distress about providing care with minimal benefits falls in the preview of the nurses. This distress, is the anguish that bedside nurses feel upon providing care for some patients when there’s minimal medical benefit or quality of life. Caught in the crossfire, nurses feel they’re hurting people rather than helping people. This situation bothers them that others go without care due to lack of funding. They feel, in other words that they robbing Peter to pay Paul, and the nurses at the bedside know that this is the only truth.

It should be noted and well taken care of the patient when care near the end of life should be a particular focus of an ethically sound organization, as most cases referred for ethics consultations involve patients with life threatening conditions, impaired capacity to make treatment decisions. Institutional investment in advance care planning, which helps patients to identify and document their treatment preferences in ways that can guide care if they are unable to make decisions in the future, is one step institutions can take to prevent crises.

It is advised that hospitals to have an ethics mechanism that helps staff deal with ethical dilemmas. This mechanism is dealt by the ethics committee. Ethics committee members or consultants should be made available around the clock to assist employees, patients and families, and can be called on to help resolve a perceived conflict between the parties. These consultants need to be well grounded in the hospital’s policies and should have additional ethics training.

It is very important for every one to understand ethical practice as to how to do good and avoid doing harm that involves recognizing the complexity of the patient care environment, which requires workers to respond and adapt to changing conditions as a normal part of work, where in the duty to plan, and to make plans that can work in practice, is an ethical obligation.