write a three-page essay detailing how healthcare providers and/or members of a healthcare ethics committee can impact change in these areas for a more equitable healthcare system.

BHA 3801, Critical Issues in Health Care 1

Course Learning Outcomes for Unit II Upon completion of this unit, students should be able to:

1. Critique arguments related to the impact of social factors that influence the U.S. healthcare system.

3. Analyze the factors necessary to create a more equitable healthcare system.

Reading Assignment Chapter 13: Healthcare Institutional Ethics: Broader Than Clinical Ethics, pp. 211-223 Chapter 14: Hospital Ethics Committees: Roles, Memberships, Structure, and Difficulties, pp. 227-240

Unit Lesson Healthcare ethical issues occur at all levels of healthcare organizations. Healthcare administrators have a responsibility to always conduct business with ethical integrity (Morrison & Furlong, 2014). A vast majority of ethical issues within the healthcare delivery system occur at the clinical level. The clinical level is where healthcare products and services are provided to individuals who are in need. Areas of ethical concern that result at the clinical level include treatment termination, patient autonomy, informed consent, confidentiality, and advance consent (Morrison & Furlong, 2014). There are guidelines for treatment termination that exist and are based on case law. Such guidelines are derived from clinical and legal practices and other ethical decision-making principles. Patient autonomy is the rejection of recommended medical treatment. Patients have the right to choose other alternatives that are medically appropriate but may be against medical advice. However, issues arise when inappropriate treatment is demanded by patients and/or their representatives. Healthcare providers are responsible for obtaining informed consent prior to providing patients with healthcare services. In essence, informed consent is the treatment permission that providers must obtain from their patients before they can treat them. There have been several cases where providers have neglected to obtain the necessary treatment consent, which raises ethical concerns. Adherence to patient confidentially is a major ethical concern in clinical practice. Although patient health information should remain private at all times, inappropriate disclosure of private health information has been released without patients’ consent. As a result, in 1996, the federal government implemented the Health Insurance Portability and Accountability Act (HIPPA), a law designed to restrict access to patients’ health records. Advance directives, also known as living wills, can create ethical concerns when they are not adhered to by providers or patient representatives. They are considered legal documents that contain information regarding patients’ medical treatment when they are unable to communicate their desires due to a medical condition. The rapid changes in the U.S. healthcare delivery system between the late 1980s through the 1990s broaden the bioethics scope (Morrison & Furlong, 2014). Bioethics inquiries were raised to address concerns related to the instructional structure of healthcare organizations. Bioethics inquiry is also known as organizational ethics, an approach designed to enhance ethics within a given organization (Morrison & Furlong, 2014). An example of such an enhancement is when organizations attempt to change their climate and culture in an effort to

UNIT II STUDY GUIDE

The Impact of Ethical Constructs and Healthcare Systems

BHA 3801, Critical Issues in Health Care 2

UNIT x STUDY GUIDE

Title

minimize negative ethical issues. Although organizational ethics exist, there will continue to be a need to address current and future ethical issues. Hospitals provide a number of healthcare products and services and are one of the largest segments of our healthcare delivery system. Hospital administrators and clinicians are challenged with making difficult healthcare decisions daily, which increases the demand for ethical oversight. Considering the role that they play in healthcare, hospitals must hire and maintain staff who are well-versed in ethical practices and principles. Hospitals respond to changes in patient care guidelines and healthcare policies through their ethics committees (Morrison & Furlong, 2014). Ethics committees for patient care came into play around the 1970s. However, it was not until 1992 that the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) was established out of a need for hospitals to have a standard means of addressing ethical conflict (Morrison & Furlong, 2014). The three main functions of hospital ethics committees (HECs) are listed below:

1. developing policies and procedures; 2. training and educating staff; and 3. conducting clinical consultations.

Ethics committees are comprised of individuals with a broad range of backgrounds and expertise. Ethics committee members typically include clinicians, administrators, social workers, bioethicists, and hospital board members. Some ethics committees may include patient representatives as well. Also, in order to address patient-centered ethical issues, it is important for the ethics committee to be diverse, especially in cases of cultural or religious issues (Morrison & Furlong, 2014). Diversity is known to be an extremely effective component of decision-making. The continued growth of the U.S. population and advances in technology perpetuates the need for a standard approach to addressing complex healthcare matters beyond hospital settings. In addition, as individuals from an array of ethnic backgrounds continue to migrate to the United States, the need for more diverse ethics committees will increase. Members of such committees must also be well-versed in ethical principles and complex decision-making (Morrison & Furlong, 2014). Patients and their families play a vital role in addressing healthcare matters and should have ethics committee representation.

Reference Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Burlington, MA: Jones & Bartlett Learning.

Learning Activities (Nongraded) Nongraded Learning Activities are provided to aid students in their course of study. You do not have to submit them. If you have questions, contact your instructor for further guidance and information. Research and review an article on a hospital’s patient care policies and their staffing model. If you need help locating an article to review, click the following link to access a video that is available in the CSU Online Library: http://libguides.columbiasouthern.edu/findjournalarticlesvideo Feel free to discuss your findings with your classmates in the Student Breakroom forum.