Health care Capstone - Research Paper Example

Running Head: HEALTHCARE MANAGERS AND ETHICAL AND SOCIAL ISSUES Health Care Capstone Final and Number of of Instructor] [Date of Submission] Introduction The subject of how to deal with ethical issues in the healthcare industry has received a considerable level of interest among various health stakeholders in recent times. Important to the discussions and debates surrounding healthcare ethics is the definition of healthcare ethics, which encompass numerous individuals and professions in the industry. Healthcare ethics refer to the difficult decisions about medical treatments and procedures to be undertaken or undergone that patients, families, and health care professionals/organizations face (Kimbrough & Lautar, 2011). These decisions often involve individual and organizational moral principles, religious beliefs, or professional codes/guidelines. For healthcare managers, ethics refers to the ability and capacity to explore all the available ethical and socially acceptable options and opportunities on how to best react to a given medical situation (Kimbrough & Lautar, 2011). In the chosen course of action, healthcare managers should no only act well but should also make moral choices on the basis of values and beliefs regarding death, life, pain, health, and suffering. Generally, for healthcare managers, ethical issues pertain to the right course of action to take in circumstances that are unclear or in situations where there seems to be a disagreement on the most appropriate thing to do. Examples of ethical situations that healthcare managers encounter in the daily execution of their duties and responsibilities include the use and stoppage of life-sustaining equipment such as breathing machines and feeding tubes. Other ethical situations relate to the role of family and professionals if patients refuse a medically promising procedure. Additionally, the question of who needs to come in and give consent or make decision for patients who are not in position to do so or communicate to that effect also poses ethical dilemmas to healthcare managers (Kimbrough & Lautar, 2011). Closely working with healthcare managers are ethics committees whose mandates include the identification, understanding, and resolution of difficult healthcare ethical questions and situations. This paper thus explores the implications of ethical issues to healthcare managers in regard to the Identification of the primary stakeholders in ethics management processes, regulatory and ethical issues which may occur, and strategies by which managers may resolve professional, organizational, and personal ethical issues identified. Healthcare and Ethics Among the major world professions, health care or the health industry is perhaps among those most affected by ethical issues. The reason for this scenario could be the fact that healthcare deals with personal and private aspects of peoples’ lives, thus requiring patients’ consent and acknowledgement before any procedures or treatments are implemented. Ethics and ethical issues are thus central to the delivery of health care in whatever capacity or facility (Swayne et al., 2009). The situation has become more complex with the emergence of new technologies and medical practices and procedures every other day. Consequently, new legislations have been drafted and passed in many a country to regulate and ensure medical practitioners and other health industry workers uphold professional ethics while attending to patients, their parents, guardians, caregivers, and the local community/public (Swayne et al., 2009). Importantly, the newly developed laws govern, shape, influence, and regulate the use of these new technologies to treat various conditions. Duties and Responsibilities of Managers Even though there are numerous laws and regulations governing the use of medical technologies and the conduct of healthcare professionals, ethics remains a rather central issue in the application of medical processes, professional behaviors, and the handling of patients and their caretakers/families. In other terms, it is imperative that healthcare professionals, particularly managers, conduct themselves, in accordance to the guidelines of their professions, in ways more ethical than even the provisions of the relevant laws and regulations. In the United States for instance, health care ethics and ethical issues are quite crucial concerns to health care managers whose mandates include the application, regulation, resolution, and assessment of health ethical issues (Pozgar, 2011). These duties and responsibilities are particularly addressed through managers’ legal mandates, laws, consultations, and with the help of professional societies. Importantly, healthcare managers use organizational mission and vision statements to guide their subordinates about the idea of healthcare ethical practices and their scope in the practice of their services (Pozgar, 2011). In fact, some managements offer ethical consultation services, with more still in the process of indoctrinating these services into their organizational culture. Notably, there are a number of organizational processes and management functions that require ethical consideration although most managers seem to ignore them as non-ethical (Swayne et al., 2009). For instance, management activities such as staffing, consultations, and budgeting are among the management processes that require ethical considerations. Although generally considered non-ethical, the mentioned activities, among others, have considerable influences on the ethical applications and assessments of healthcare services. That is, such management processes should have ethical consideration, necessitating their regulation and assessment to meet clients’ ethical needs and expectations. Nonetheless, the appropriate level of business function must be obtained even as ethical considerations are accorded high priority. In fact, a management that fails to equate its core activities and operations with ethically important matters run the risk of failure in achieving organizational objectives. In this regard therefore, managers in healthcare facilities must always make ethical decision before venturing to implement their strategies, policies, and action plans. Healthcare Managers and Ethical Decision Making In healthcare facilities, just like in many other types of organizations, there are poised to be competing values or issues on which the resultant conflicts and uncertainties must be amicably addressed. In these conflicts and uncertainties, the values competing could be organizational, personal, or societal values. In addition, an employee’s personal values may have clashed with those of an organization or the society/community within which a health organization operates. It then becomes of the essence that the management team concerned with the handling of a particular ethical issue tables all the ethical principles for open discussion by all the parties involved in the ethical conflicts. Among these ethical principles that should bear a lot of weight in ethical decision-making processes by healthcare management includes beneficence, autonomy, justice, professional/organizational ethical standards/codes. Addressing Factors Promoting Ethical Issues The most common types of ethical issues in the healthcare industry however always pit healthcare professionals and organizations against their clients (patients, parents, relatives, friends, caretakers, and governments). The management of the concerned healthcare facilities must therefore recognize and address the various factors that have contributed to the emergence of ethical issues as great concerns to health professionals. These factors include healthcare accessibility, utilization, affordability, availability, high costs, and healthcare mergers and acquisitions. Additionally, medical technological advances, financial and other resource constraints have also resulted in quite a number of ethical issues in the healthcare industry (Jonsen et al., 2010). For instance, with the use of more sophisticated machinery and equipment to manage certain types of patients and conditions, it has become imperative that healthcare professionals seek the consent of patients, their spouses, or children before venturing to apply these technologies (Jonsen et al., 2010). These ethical situations predominantly present themselves in emergency or critical situations in which the lives of patients may only be prolonged or supported by certain machines in Intensive Care Units or life support machines. Ethical Interventions It is now imperative that healthcare managers address the ever-increasing number of ethical issues and dilemmas that they encounter at their workplaces. Nonetheless, it would be counterproductive for them to make such decisions alone without far-reaching consultations. Worse still, making such ethical decisions without basing them on a sound decision-making framework and processes could be detrimental to the operations and successes of a healthcare facility/organization. Healthcare facility managers should therefore establish appropriate and effective mechanisms and organizational structures to help in managing and making decisions regarding ethical issues. Examples of these structures and mechanisms are well-written organizational procedures, policies, and guidelines not only for management use in decision-making but also for the use of other junior professionals who may need such guidelines. Moreover, healthcare managements should establish ethics committees and initiate ethics consultation services for all its managers and subordinate staffs. In fact, these mechanisms have been proved to be quite effective and appropriate in the tackling of healthcare ethical issues between professionals/organizations and their patients, families, caregivers, local communities, and the government (through its regulatory and other concerned agencies/authorities). Establishing Policy Position The establishment of an ethical policy position is one sure way the management of a healthcare organization may lead and set an example to others employees regarding the ethical tone of an organization (Perry, 2001). Among the components of a good ethics policy is education in ethics, a practice that has been shown to be quite effective in committing an organization, it managers, and subordinate staffs to high ethical standards, codes, and conducts at professional and personal levels. Besides ethics education, healthcare managers must establish a policy position that supports the various ethical mechanisms that prop up the appropriate and expeditious addressing of ethical issues and conflicts in an organization. Unlike nurses and physicians who may only need a case-to-case resolution of ethical issues, healthcare managers are faced with a broad range of ethical issues covering the organization, the immediate community, and the society (Perry, 2001). It is thus important that healthcare managers take the initiative and an active role in the development of sound policy position, mission and value statements, ethical mechanisms, and decision-making processes. Although health care managers have done a lot in addressing ethical issues relating to their professions, there is till enough room for improvement, provided professional regulation, evaluation, and reform are implemented. Recommended Course of Action for Managers To realize the above objectives and ensure the amicable solution of most, if not all the ethical issues that may be encountered in healthcare organizations, certain recommendations are in order. First, it is important that healthcare managers create and inculcate a culture that supports and fosters both administrative and clinical practice, policies, and procedures that are ethically sound and support ethical decision-making (Harris, 2007). Second, healthcare executives need to communicate to junior employees on the organization’s commitment to the policy statement on ethics and ethical-decision making. These commitments must be portrayed to all stakeholders by their inclusion in organizational or departmental mission and value statements, not to mention organizational codes and standards of ethics (Harris, 2007). Furthermore, an management’s commitment to organizational ethics codes and standards should be displayed in the professional and personal behaviors of its managers. That is, the conducts of managers and executives should send the message of the importance of ethics in an organization to other employees. The third strategy is for the management to provide or arrange for educational programs not only to the top management and board but also to other employees such as nurses, physicians, and even non-medical/support staffs such as the catering and cleaning staff. This education or training should not only cover organizational ethics but also the current global trends in healthcare procedural ethics and decision-making (Harris, 2007). Besides in-house education or training, ethics education could also be obtained from academic organizations and professional societies, both of which promote open discussion on ethical issues. The other management strategy in instilling ethical practice in healthcare is the development and use of organizational structures and mechanisms that uphold and reflect organizational ethical mission, values, and codes. However, these mechanisms and strategies must cover the wide spectrum of ethical issues such as clinical, business, organizational, personal, professional, and management ethics that bedevil the healthcare industry (Harris, 2007). Importantly, managers in healthcare facilities must ensure the established mechanisms are readily available and could be implemented as soon as ethical issues arise. The implementation of these ethical mechanisms must however be executed by competent professionals who can amicable handle the divergent perspectives of ethical issues. For an illustration, it is vital that an ethics committee comprises of representatives from all the departments and professions in a healthcare facility. Those represented could be nurses, physicians, board members, managers, social workers, attorneys, all non-medical departments, patients, and/or the community. The advantage of including all the stakeholders is the inherent wealth of knowledge and divergent perspectives with which ethical issues would be discussed and decisions made by their contribution to ethical deliberations. Importantly, healthcare managers should continually and continuously evaluate the progress and effectiveness of the established and applied ethical mechanisms and policies (Harris, 2007). Finally, it is important that healthcare managers promote ethics via the balancing of individual, organizational and societal issues and interests in ethical conflicts. The Need for Consultation Despite the fact that managers should be conversant with the broad range of ethical issues affecting healthcare, it should not be held that managers are all-knowing about ethics. Therefore, consultation and advice-seeking should form part of a management’s policy towards the resolution of healthcare ethical issues. In fact, there are many ethics professionals from whom healthcare managers may seek advice. However, such consultations should be done professionally through official and accredited meetings. Examples of these professionals are ethics committees or teams or departments, for large healthcare facilities. The role or importance of these professional ethics organizations or individuals would be in the identification, analysis, and resolution of ethical issues via strategies such as data/information gathering and wide-ranging discussions. In addition, ethics professionals are quite effective at understanding, interpreting, and clarifying ethics policies, regulations, and laws to healthcare workers and patients or their families. It is however important for healthcare managers that ethics consultations only play an advisory role since they do not compel professional health workers to make decisions. In fact, medical professionals, patients, family members remain solely responsible for their decisions even if professional advice has been obtained from ethics committees and other professionals. Managers should therefore allow and advise patients and their families and caregivers to also seek advice from ethics professionals by not only suggesting a few known ethicists but also providing their contacts. Communicating Ethics One last effective strategy for healthcare managers to promote ethics and ethical practices in their organizations is proper communication with employees, patients, their families, and caregivers. This communication should be done in a way that not only informs employees and patients but also affects their behaviors towards each other in situations of ethical dilemmas (Walters, 2011). This communication tip should form the bases on which a healthcare manager may incorporate organizational ethical policies into its daily operations. Before communicating an ethical strategy or policy, it is of benefit if a manager examines the underlying intentions of such an ethics policy. For instance, a manager should ascertain that an ethical issue addressed by a policy statement or strategy is a sign of greater ills affecting the organization (Walters, 2011). That is, there could be certain publicity ethics statements that do not serve the interest of an organization. In communicating ethics, healthcare managers should emphasize an organization’s past/legend that epitomizes ethical practices and share them with other employees (Walters, 2011). In communicating ethics to other employees, managers should provide examples that would show the applicability and relevance of the various ethical standards and practice that they are expected to uphold. Conclusion Ethics and ethical issues have undisputedly bedeviled the healthcare sector for quite sometime. However, healthcare managers have been up to the task of addressing these ethical issues with their patients, caregivers, families and healthcare employees alike. Consultation, policy, value, and mission statement, effective communication and ethical regulation and assessment are among the strategies that healthcare managers have effectively applied in the implementation of ethical policies and procedures. However, there is still a lot of room for improvement in line with recommendations and advice from ethics experts, both individuals and organizations. References Harris, D. M. (2007). “Contemporary Issues in Healthcare Law and Ethics, Third Edition.” Health Administration Press. Jonsen, A., Siegler, M., and Winslade, W. (2010). Clinical ethics: a practical approach to ethical decisions in clinical medicine, seventh edition (Lange clinical science), seventh edition. McGraw-Hill Medical. Kimbrough, V., and Lautar, C. (2011). Ethics, jurisprudence and practice management in dental hygiene, third edition. Prentice Hall. Perry, F. (2001). The tracks we leave: ethics in healthcare management, first edition. Health Administration Press. Pozgar, G. D. (2011). Legal aspects of health care administration, eleventh edition. Jones & Bartlett Learning. Swayne, L. E., Duncan, W. J., and Ginter, P. M. (2009). Strategic management of health care organizations sixth edition. Wiley-Blackwell. Walters, J. (2011). “Defining and Communicating Ethics in Your Business.” Retrieved on February 15, 2012 from http://www.support4change.com/work/ethics/defining.html Read More