Ethical Dilemmas - Research Paper Example

?Ethics Table of Contents Table of Contents 2 Introduction 3 Overview of the Facility 4 Organizational Structures and Responsibilities 5 Ethical Dilemmas 7 Ethical Standards 9 Implementing and Ensuring the Ethical Code of Conduct 11 Consequences in Case of Violation of the Code of Ethics 12 Conclusion 13 Bibliography 16 Introduction Ethics is provided with immense importance in the health care industry. The system of health care in America is known to deliver superior and finest care worldwide. But in spite of the superior level of technical accomplishments, the system is being increasingly bothered with various issues. The US is still known to keep hold of a health care system where there is an existence of a free market. Here, physicians perform their functions principally like free agents who sell by way of offering their services in exchange of certain cost to the patients. Most of the people prefer to protect themselves from the growing cost of availing health care services by keeping themselves insured. Therefore, the ethics related to the insurance industry also comes under consideration in this context. The health care industry deals with sensitive issues like the medical record of the patients, their relevant personal details and in case of insured patients, their financial details as well. Ethical instruction ensures the safeguard of such information and prevents them from getting misused. The concern for privacy has become an integral part of the medical profession from the formation of the ‘Hippocratic Oath’. This is known to be among the oldest obligatory conformity in the history. Ethical considerations or rather the guiding principles help in setting a specification for the kind of service that is to be expected from the physicians and the hospitals (Netiq, 2006). Overview of the Facility Ambulatory surgery centers (ASCs) are known to provide unique services in health care. They offer their patients with the chance to opt for preferred procedural as well as surgical services carried out beyond the environment of a hospital. ASCs were set up and have been serving people with their services for over three decades. ASCs have been successfully representing an outstanding and incomparable capability of enhancing quality along with their service towards their customers while concurrently bringing down the expenses over the years. ASCs are being considered to be an exception because of the mounting expenses of services in the health care industry. Developments in services and technologies in the health care industry are increasing the costs and in such a time ASCs are considered to be of great relief for the people (Ambulatory Surgery Centers, 2002). Great efforts are being made throughout the nation in order to enhance the system of health care and ASCs have appeared to be triumphant in altering the services related to health care in a positive way. All kinds of surgical procedures were carried out in hospitals in the past. Previously, people needed to wait for months in order to get an appointment and patients had to spend quite a few days in the hospitals in order to recover (Ambulatory Surgery Centers, 2002). The concept of ASCs was developed by physicians. The initial facility was started in the year 1970 by just two physicians. They felt the need and recognized a prospect to set up a superior quality, lucrative choice and a substitute for the surgical services being provided in the hospitals. Physicians were disturbed and annoyed of the postponements, inadequate rooms for carrying out operations and difficulty in acquiring new equipment for surgical procedures. This made them to look out for an alternative and build up centers with better facilities and services (Ambulatory Surgery Centers, 2002). Organizational Structures and Responsibilities The developers that are the physicians carry on offering force for growth of the already existing ASCs along with the new ones. Physicians enjoy more freedom while carrying out their operations compared to the hospitals. They are capable of commanding increased direct management on their respective surgical operations. ASCs involve teams which are particularly trained and engage personnel who are highly capable and experienced. The developers or the people in the management make certain that the apparatus and provisions which are used in the surgical procedure are best appropriate for their method. The structure of the amenities is customized by the management according to their area of expertise. The physicians are responsible for planning their procedures and making their own teams by choosing staffs, that are specially-trained along with highly experienced. The physicians arrange the complete procedure of the surgery. The staffs and personnel are responsible for assisting the physicians in their surgical procedures as well as to look after the patients. The people present in the management are responsible for the smooth and proper functioning of the centers. The management looks after and keeps supervision on the way of working of the staffs and ensures that the practices are according to the specifications and regulations of the industry that is being laid down by the federal government. The management makes certain of the fact that the center functions in a way that guarantees superior quality services and patients wellbeing (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002). The people in the management need to keep complete and precise medical records. The record should contain all the information which is relevant to the cause of the surgical procedure. The physicians are in charge for examining the patient just prior to the surgical procedure in order to assess the hazards related to anesthesia as well as the procedure which has been planned to be performed. The management also needs to structure a program so as to recognize and avoid infectivity, to continue keeping a hygienic surrounding and also convey the consequences or the results on a periodical basis to the suitable authorities. The program should be structured so as to vigorously keep observation and involve particular actions for avoidance, discovery near the beginning, manage and also analysis of infectious as well as contagious infections in agreement with the provided suggestions by the Centers for Disease Control (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002). It is required in the case of ASCs that there should be trained nurse while using any kind of an emergency apparatus. ASCs even need to provide the facility of an efficient way of moving patients to some other hospitals in instances when there is a further requirement of care in case of emergencies. It is compulsory for ASCs to have a proper structure of the guidelines summarizing the provisions for ambulance facility as well as conveying of proper and accurate medical information in a written format. It is mandatory for ASCs to have a written contract with any of the local hospitals with regard to transfer or admitting opportunities. All these mentioned issues are being managed and looked after by the people present in the management. The management is also responsible for putting into application and supervising the policies which guarantees the superior quality of service in health care provided by the center and in a secured environment (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002). Ethical Dilemmas The two ethical dilemmas that might be encountered in ASCs would be maintaining the privacy of the details of the patients and convincing patients to undergo a certain treatment or surgery that is considered to be necessary by the physician. It is already a known fact that in order to opt for a treatment or surgery or any kind of service related to health care, a person needs to disclose all his personal details as well as previous medical records to the physician. It becomes important for the physician and the staffs dealing with the person to maintain secrecy of the personal details. It comes under the code of conduct or ethical conduct of the ASCs and all such centers or hospitals providing services in the field of health care. The particular physician responsible for a person should keep the details limited to oneself. The physician should disclose the details to other staffs or physicians only when it is considered necessary. The physician is not supposed to and is not allowed to share the details of the patients to any person outside the ASCs circle. At times in case of an urgent situation it becomes necessary to transfer the patient to another hospital. In such instances, it becomes important for the physician to disclose the details of the patient with the physicians and management of the other hospital (Rohraff, 2010; Ambulatory Surgery Centers, 2002). The physician responsible for the patient should be cautious while disclosing personal details which mean that only those details of the patient should be shared with the other authorities which are considered to be compulsory by the physician. The physician and the authorities of the ASCs should take necessary measures and ensure that information or details of any patient is not shared with any other patient or person not included in their organizational team. Certain measures need to be taken by the management in order to guard the information so that it is not leaked to any person who can misuse the information (Rohraff, 2010; Ambulatory Surgery Centers, 2002). The other ethical dilemma which is often faced or encountered in hospitals or ASCs is to convince a patient to opt for a particular treatment or surgery which is considered to be important by the physician. People opting for treatment or going in for a treatment completely depend on the physicians or the management authorities for the decisions taken regarding their treatment. However, at times the patients fail to understand the importance of certain treatments or requirements due to lack of medical knowledge and disagree to such suggested decisions. The ethical code of the centers or the hospitals does not permit the authorities or physicians to force a patient to undergo a treatment or a surgery. Whereas, if the particular treatment or surgery is not opted for then it might prove fatal for the patient in the long run and this again comes under the ethical code of the physicians (Rohraff, 2010; Ambulatory Surgery Centers, 2002). The ethical code which is followed by the physicians does not permit them to let go of a patient who is suffering from a life threatening disease or such a disease or problem which might prove to be dangerous in the long run. A physician comes under immense pressure and dilemma in such a kind of situation. In such a circumstance, it becomes important and obligatory for the physician to convince the patient to undertake the treatment. The physician should communicate all the details regarding the disease and the consequences related to it to the patient. The physician and the authorities should inform the patient of all the benefits and dangers involved with the treatment. The physician should try and convince the particular patient by providing relevant details of the treatment and examples. The physician and the concerned authorities should behave in an amicable manner with the patient and should provide answers to all the queries of the patient in such instances (Rohraff, 2010; Ambulatory Surgery Centers, 2002). Ethical Standards The people present in the governing body and management need to keep a check on the operating functions of the respective ASCs and ensure that the business operations are being carried out according to the standards along with the guidelines that are being laid down by the federal government. The professional staff of the respective centers should also make sure that the activities among them are carried out according to the standards and guidelines of the center. The people and every individual present in the organization or rather working in the organization are responsible for performing activities in accordance with the code of conduct. The physicians are referred to as the developers of the centers and so it becomes obligatory for each physician in the centers to monitor and supervise the activities that are being carried out in the centers. Each and every physician would be in charge of the control as well as management of the surgeries. They would be responsible for the guarantee of the care as well as service quality. They would also be accountable for the compliance of the respective ASCs with the local, federal and state laws as well as regulations with regard to safety standards, managing infection, preventive measures in case of fire and level of sanitation and its standards. It would be also obligatory for them to look into the health as well as safety requirements as well. The management of the ASCs would also need to offer physical capital, suitable personnel and apparatus which would be required in the course of the provided services. The management would also need to appoint an administrator who would look after the overall management as well as operating functions of the particular center. A medical director also needs to be appointed in order to give surety regarding the attainment and continuation of the required quality standards with regard to the professional medical applications. The management and the governing body would design or structure policies as well as distinct procedures in order to describe the liability and accountability for the performance as well as the applications of the center. The structured policies would also facilitate to recognize the intentions and the ways of satisfying them. The management would also be responsible to re-assess the set or designed policies along with the procedures annually. The governing authority as well as the management needs to ensure that the activities are performed taking into consideration the industry standards and also make sure that quality is maintained in the provided services. The professional staff would need to work and carry out their operation keeping into consideration the policies as well as the regulations of the organization or the center (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002; Rhode Island.gov, 2000). Implementing and Ensuring the Ethical Code of Conduct The management of the organization or rather the center would be responsible for implementation of the ethical code of conduct within the center. The management with assistance of the governing body needs to design policies along with regulations according to which the business operations of the center should be carried out. The policies as well as the regulations should be developed so as to ensure conformation with the business operations of the center with the specified standards set by the federal government. This would help the center to perform their activities according to the standards. This would further facilitate the center to avoid any strict measures by the government in case of failure to abide by the stated specifications by them. The professional staffs should be given proper training regarding the quality and way of services offered which would help them to abide by the policies as well as regulations easily. Strict checking and supervision should be employed by the management so as to make certain that the professional staff of the centers is abiding by the organizational policies as well as the regulations. Strict actions should be taken by the management in case of any non-compliance of the activities with the developed organizational regulations or policies. The strict actions would facilitate in ensuring that the implemented ethical code of conduct is being followed (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002; Rhode Island.gov, 2000). Consequences in Case of Violation of the Code of Ethics The management along with the people in the governing body needs to employ strict actions and measures if any violation of the organizational policies as well as regulations is found. The ASCs cannot make the mistake of violating the policies as this would call for huge damage for the centers as well as lead to even cancellation of their licenses. In order to avoid such grave aftermath, the management needs to design strict preventive measures which would ensure that the activities are being carried out in compliance with the structured policies. Failure to abide by the policies would also bring down the quality of the provided service by the centers which is considered to be their main focus. Deterioration in the quality of the service would have an adverse effect on the reputation of the center which might provoke government intervention (ASC Quality Collaboration, 2011; Ambulatory Surgery Centers, 2002; Rhode Island.gov, 2000). Conclusion From the above discussion, the importance of ethics in the Ambulatory Surgical Centers operating in the health care industry is evidently reflected. Ethical considerations were not considered to be important in the course of making decisions concerning the various facets of healthcare. The consequences of such deficiency can be observed from the augmenting amount of filed criminal charges against the organizations operating in the health care industry. Taking ethical issues into consideration would assist in avoiding such grave consequences as well as enhance the quality of the service. Following the ethical code of conduct in the health care organizations such as in ASCs would help to abide by the regulations laid down by the federal government. It would also help to gain customer satisfaction which is also considered to be an important aspect in this industry (Pauly & Et. Al., 2005; Hunt, 2008; Rohraff, 2010). References Ambulatory Surgery Centers, (2002). Ambulatory Surgery Centers: A Positive Trend in Health Care. Association. Retrieved Online on November 05, 2011 from http://www.ascassociation.org/advocacy/AmbulatorySurgeryCentersPositiveTrendHealthCare.pdf ASC Quality Collaboration, (2011). ASC Quality Measures: Implementation Guide. ASC Quality Measure Development by the ASC Quality Collaboration. Retrieved Online on November 05, 2011 from http://www.ascquality.org/documents/ASCQualityCollaborationImplementationGuide.pdf Hunt, M., (2008). Ethics of Health Care Practice in Humanitarian Crises. McGill University. Retrieved Online on November 05, 2011 from http://proquest.umi.com/pqdlink?did=1974112621&Fmt=14&VType=PQD&VInst=PROD&RQT=309&VName=PQD&TS=1320828452&clientId=79356&cfc=1 Netiq, (2006). Addressing Regulatory Compliance in the Healthcare Industry. Healthcare Industry Overview. Retrieved Online on November 08, 2011 from http://download.netiq.com/CMS/WHITEPAPER/NetIQIndustryWP_HC.pdf Pauly, B. M., (2005). Close to the Street: The Ethics of Access to Health Care. University of Victoria. Retrieved Online on November 09, 2011 from http://dspace.library.uvic.ca:8080/bitstream/handle/1828/770/pauly_2005.pdf?sequence=1 Rhode Island.gov, (2000). Rules And Regulations For The Licensure of Physician Ambulatory Surgery Centers And Podiatry Ambulatory Surgery Centers. State of Rhode Island and Providence Plantations Deaprtment of Health. Retrieved Online on November 09, 2011 from http://sos.ri.gov/documents/archives/regdocs/released/pdf/DOH/DOH_2331.pdf Rohraff, T., (2010). A Phenomenological Study of Healthcare Leader’s Ethical Perceptions in Decision Making. University of Phoenix. Retrieved Online on November 09, 2011 from http://proquest.umi.com/pqdlink?did=2285300601&Fmt=14&VType=PQD&VInst=PROD&RQT=309&VName=PQD&TS=1320828519&clientId=79356 Bibliography Morrison, E. E., (2011). Ethics In Health Administration: A Practical Approach For Decision Makers. Jones & Bartlett Publishers. Pera, S. A. & Tonder, S. V., (2005). Ethics in Health Care. Juta and Company Ltd. Read More