Question

Healthcare organizations face challenges including the need to balance patient needs with fiscal responsibility. 1. How do organizations practice ethics to serve both patients and the community? 2. What challenges will ethics committees face as health care evolves in a PPACA era?

Answer 1

The Healthcare Organisations andf their member institutions serve the patients and the community in a complex interdependent systems.

The bioethical principles of autonomy, and the traditionally formulated may not be sufficient to address the ethical issues. Since patient care is still the focus of much of an institution’s activity, the need to the clinical bioethical issues remains a priority.

Examples raised include the nature of advocacy in the patient-physician relationship, when physicians are subject to outside influences that might affect care decisions, due to the financial conflicts of interest challenges the nature of the physician-patient relationship, and the provision of preventative healthcare services to the community.

Healthcare organizations, and institutions are the key forces in public and political life. The health care concerns are broader than the clinical context, and they are still being defined. Managers and trustees of healthcare organizations, must systematically address their role in promoting public welfare, protecting employees, creating a better environment for healthy living, influencing the politics and economics of the community. Trustees and managers should focus on distinct, but complementary, objectives to achieve these general goals. To accomplish this, there must be a deliberate and systematic approach to address, implement, and monitor the ethical commitments of healthcare organizations.

Issues in healthcare ethics are not clinical situations but they are also increasingly difficult for the institutions that address healthcare needs. This chapter presents some of the areas of concern for these institutions and systems, issues surrounding personnel, and the nature of the work itself. Because of healthcare organizations, a discussion concerning organizational identity and obligation to the community is included. Finally, the reader is reminded of the need to be aware of ethical issues and to continue to address them, now and in the future.

PPACA is related to misinterpretations of the legislation which distort public opinion. Understanding the legislation can help us examine the facts from the perspective of what is good for society. The PPACA is characterized as a step toward socialism of health care. The act requires that most citizens and legal residents have health insurance, but this insurance could be from private companies, employers, Medicare, or from state-based insurance companies.

The act does not specify the government control on the system, but it improves both access and efficiency to be carried out by states, insurers, and private health care providers. It was presumed that PPACA will provide free care to undocumented immigrants The act neither provides free care for non-U.S. citizens, nor are they eligible for insurance through the state exchanges.

There has been a publicity that the act will include physician panels that will decide which older adults will receive ongoing care. This myths generated, this has been most damaging. Long term financial benefits of the act, according to a report by Health and Human Services, include a reduction of government expenditures. There has been a great deal of discussion about the negative effects that PPACA will have on small business. The facts do not bear this out. Only those businesses with more than 50 employees will be required to make coverage available to employees and contribute to its cost or pay a fee.

Advantages that the plan includes for small business include a limit on the amount that insurance premiums can go up each year and elimination of surcharges that insurance companies now impose on businesses with insured clients who have serious medical conditions.

The nurses and other health professionals need to consider how the implementation of the PPACA relates to their role in understanding and trying to rectify conditions of injustice in health care. Changes in social attitudes and resources require the combined efforts of different disciplines to identify the problem and find a way to remediate it.