The Code of Mercy Hospital - Essay Example

Organizational of Ethics The Board of Directors Mercy Hospital and Medical Center Sirs/Mesdames: Your organization has been rated as one of the top 100 hospitals for cardiovascular care (www.mercy-chicago.org) and your Code of ethics statement has set out clear standards of ethical behaviour for the employees of your organization. The American Psychological Association, in its Code of Ethics revised in 2002, has clearly set out certain parameters for ethical conduct of business and I respectfully submit below, the following suggestions, identifying certain areas where your organization’s Code of Ethics, as it exists currently, may need modification in order to more accurately reflect the principles that are enshrined in the APA code of ethics. The code of ethics of Mercy Hospital clearly states that where employee responsibilities to patient are concerned, they are to refrain from exploiting relationships for personal advantage. (www.ethics.iit.edu). It must be noted that the APA code of ethics at section 3.02 has clearly stated that such a conflict of interest could arise when personal, scientific, legal, financial or other interests can be expected to impair objectivity. In the light of this requirement spelt out under the APA code of ethics, it may be necessary to revise Mercy’s hospital’s code of ethics to clearly spell out the fact that employee responsibility to patients will also include refraining from providing service to patients when there is any conflict of interest that can be established. The code as it stands now does not clearly establish that a conflict of interest would be unethical, and implies that it would be so only when such a conflict of interest is used for the employee’s advantage. For instance, the Code of Mercy Hospital has spelt out some instances where such a conflict of interest would occur, i.e, when an employee benefits from his or her position, uses this position for activities adverse to the organization. This limits the instances where an employee can be held responsible for making use of his or her position to engage in unethical conduct arising out of a conflict of interest. It is therefore, important to specify within the code of behaviour for employees that taking on a responsibility when there is a known conflict of interest would not be ethical. This would clarify for employees, the fact that should they suspect a conflict of interest, they seek guidance and have their duties assigned to someone else who does not have such a conflict of interest. While the code of Mercy Hospital clearly states that it will “safeguard the confidentiality and privacy of patients in the hospital”, (www. ethics.iit.edu), it may be necessary to clarify the limits that exist in so far as this confidentiality is concerned, rather than giving an impression that this confidentiality of patient information is absolute. This is necessary if the organizational code of ethics is to be brought more in line with the APA code of ethics. Under Sections 4.04 and 4.05, the APA code of ethics states that such confidential information may be discussed “only for appropriate scientific or professional purposes”. The Code does however, clarify that such disclosure of information will be only with the “appropriate consent of the organizational client, the individual client/patient or another legally authorized person on behalf of the client/patient”, but such disclosure would be mandated, irrespective of the individual’s consent, in certain cases. These would include instances where such disclosure of private medical information pertaining to patients is permitted under the law for (a) providing necessary professional services (b) obtaining appropriate professional consultations (c) protecting the patient or psychologist from harm or (d) to obtain payment for services from a client/patient (www.apa.org). The organizational code of Mercy Hospital as stated however, does not clearly spell out this limitation on confidentiality, which could arise in the above mentioned circumstances. The impression that would be conveyed to a potential patient from the present wording of the ethics code, i.e, that privacy and confidentiality would be preserved, is somewhat misleading. In order to bring this code in conformity with the APA code of ethics, it may be necessary to re-word the code to state that there may be a limitation on preservation of confidentiality in certain instances, and then those instances would need to be spelt out. The code of Mercy Hospital, as presently worded states that employees shall “avoid practicing or facilitating discrimination and institute safeguards to prevent discriminatory practices, as these relate to race, creed, color, sex, ethnic origin, age or disability” (www. ethics.iit.edu). Moreover, the code of ethics has also set out the responsibility of the organization to ensure that all employees are allowed to function in a workplace devoid of discrimination of any kind where their beliefs are respected and where their skills and abilities are properly utilized. This is in accord with the APA principles set out under Section 3, which have spelt out the need to prevent unfair discrimination of any kind or sexual harassment. However, it must be noted that in a hospital setting such as Mercy Hospital, there is a greater potential for such abuses like sexual harassment or discrimination based on age, etc, arising both on the part of employees towards patients and on the part of management to employees and as a result, there may be a need to clearly spell out the instances where such violations would occur. For example, the APA code of ethics, at section 3.04, states that the objective would be to take reasonable steps to avoid causing harm, and also to “minimize harm where it is foreseeable and avoidable” (www.apa.org). The code of Mercy Hospital could be enhanced considerably improved if its code of ethics included such a vision statement for its employees, to refrain from causing harm and to minimize the harm where they note the foreseeability of it happening. This would allow a much wider scope of actions that cause pain or distress to individuals to be brought under the umbrella of unethical conduct. In this day and age where bullying for example could also cause pain and distress to employees, but is very rarely included within the parameters of punitive action within an organization, setting out such objectives of minimizing harm could be very useful in ensuring that such scope for action is provided. This would also help to supplement the present statement in the code of ethics of the hospital that adequate grievance procedures and redressal mechanisms will be established. By setting out the parameters of causing no harm, this would ensure that even aspects such as workplace bullying can be addressed. The code of Mercy Hospital states that employees are to “participate in the hospital process that assures the autonomy and self-determination of patients or others served”. In this context, it is worthwhile to note that the APA code specifies that in addition to the competence of the professionals administering treatment and informed consent, it is also necessary to ensure that any patient who is participating in a test or treatment should also be fully informed about the results in a manner that will be comprehensible to him or her (www.psychsational.com). This is one area the hospital Code fails to address, because it does not clearly spell out the right of the patients to have full knowledge about the potential risks and results of the treatments that are being administered to them. While patient autonomy being respected is integral to the maintenance of an effective code of ethics, a part of such autonomy must also include the accurate disclosure about potential risks of treatment and results that can be obtained from various courses of treatment. It would also be necessary for the institution to specify this clearly in the written code, because while it may be argued that such conclusions are implicit, it is also necessary to bear in mind that most patients who approach the Centre may not be fully conversant with the full scope of patient rights and information they are entitled to in regard to their treatments. This could lead to the possibility of legal action being instituted against the Company for failure to disclose such risks, if complications occur later, especially since the hospital is a profit based enterprise. On this basis, I would recommend a revision of the Code of Ethics to reflect statements along the following lines: “Our vision is to provide medical and healthcare services of the highest standard and quality, in a non discriminatory atmosphere where harm shall be minimized. This is the goal and objective of all the services that we provide, in that we strive for quality and the highest standards of care while also ensuring that the atmosphere in which such services are provided are geared towards providing an equitable level of service devoid of discrimination or harm in any shape or form. We shall strive to maintain patient confidentiality and disclose all potential risks related to treatments proposed, while respecting patient autonomy.” I await your kind response and action on this proposal. Sincerely, References: “Mercy Hospital and Medical Center”, http://www.mercy-chicago.org/mercyCMS/; “Mercy Hospital and Medical Center: Preamble”, http://www.mercy- chicago.org/mercyCMS/; “The American Psychological Association: Ethics Code”, (2008), http://www.psychsational.com/2008/05/american-psychological-association.html; “Ethical principles of Psychologists and code of conduct”, APA Ethics Code 2002, http://www.apa.org/ethics/code2002.html#4_02; Read More