The Identification and Resolution of Ethical Issues in Health Care: Theoretical and Practical Viewpoints

This paper provides an overview of ethical issues facing the health care industry – along with strategies for resolution. The issues were prioritized using the practical perspectives of twenty-six health professionals, employed in various setting in the health care field. The insight of these professionals was deemed most valuable based on the combination of professional experience and ethical training. The responses of the health professionals were compared with theoretical viewpoints of twenty-four healthcare management students enrolled in ethical / legal issues in health care class. The findings from each group were ranked in individual charts. A final chart was used to compare similarities and differences (variations) in the rankings. Suggested solutions for the ethical challenges were also provided by the health care professionals and the healthcare management students. THE IDENTIFICATION AND RESOLUTION OF ETHICAL ISSUES 2 The Online Journal of Health Ethics Volume 6, No. 1 July, 2010 The Identification and Resolution of Ethical Issues in Health Care: Theoretical and Practical Viewpoints Introduction The United States health care system has been described as the best in the world. Reasons for the ranking include: highly trained physicians, eradication of many infectious diseases and advancements in technology (Conrad, 2005). Even so, the United States health care system has been plagued by issues related to cost, access and quality – sometimes referred to as the three-legged stool. Because of these issues, including the issue that an estimated 47 million people have no health insurance, health care in America is becoming an increasingly important ethical issue (Hales, 2010). The health issues have not been resolved despite the more than one trillion dollars spent annually on health care. Health care providers have to make decisions relative to what care to provide and who to provide care to daily. Thus, ethics are also making choices that may not always feel good or seem like they are beneficial, but are the “right” choices to make. They are choices that are examples of “model citizens” and examples of the golden rule (Curry, 2004). Ethics relates to how well professionals perform their responsibilities to others both inside and outside their organizations. It is the application of right and wrong standards according to a professional code of conduct. A survey done in 1995 examined ethics in midSouth organizations. Sixty-three percent (63%) of respondents said ethics had deteriorated in the past 10 years (Business Source Premier, 1999). Organizations are now challenged with regaining public trust in order to survive in today's demanding environment (Business Source Premier, 1999). More and more, corporations are beginning to realize that ethics cannot be left behind when entering into the workplace but must be used throughout the work day. THE IDENTIFICATION AND RESOLUTION OF ETHICAL ISSUES 3 The Online Journal of Health Ethics Volume 6, No. 1 July, 2010 Some companies, including health care providers, are attempting to bring codes of ethics into the work place through written policies. Written codes of ethics are adopted in the work place for many reasons. The American Management Association recognizes four reasons to adapt a code of ethics (Business Source Premier, 1999). The reasons are as follows: to define the purpose of the organization, to state moral/ethical principles to guide action, to communicate the purposes of ethics of the company, and to provide an overall guide for independent actions within the framework of the organization's principles. Ethics makes specific judgments about what is right or wrong, it makes claims about what should be done or what should not be done. In reference to the workplace, ethics makes judgments about care decision, right to life, service delivery, payment of services and general organizational protocol. Even though the definition and concept of ethics is clear, often times, ethical dilemmas are not. This is especially true in the health care system. Ethical dilemmas require health professionals to choose between two equally opposing unfavorable alternatives. Oftentimes, the ethical dilemmas include circumstances that may be beyond the health professional’s span of control, for example legislative decisions, politics and/or organizational policies. Today, issues related to the three-legged stool of cost, access and quality remain controversial relative to equity