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Weekly Overview

Week Five

Overview

This week, we will integrate the knowledge gained over the past few weeks and focus on emerging ethical issues, such as abortion, harvesting embryos, euthanasia, and direct vs. indirect killing. A solid understanding of ethical principles and practices may provide a strong foundation for ethical decision-making. As you confront new ethical dilemmas, keep the basics of ethical decision-making in mind, adhere to strong principles, implement a corporate system of ethics through sound policies and a clear statement of values, and use ethics review committees (IRBs) to make solid ethical decisions. Make ethical compliance a priority in what you do.

As we focus on emerging ethical trends, you will have a chance to apply what you know about ethical theory and principles to new situations. Continue to keep solid principles of ethics, such as autonomy, justice, beneficence, and nonmaleficence, in mind as you guide ethical decision-making in your workplace. Even though ethical dilemmas of the future may be new, the existing principles and theories may guide you to make effective ethical decisions.

Ethical issues will continue to emerge and invoke changes in health care delivery, obligations, relationships, and the way you manage people. These issues cannot necessarily be anticipated, but with a comprehensive approach, they may be addressed in an effective, moral manner.

What you will cover

1. Emerging Ethical Issues

a. Explain future ethical issues in the rapidly changing health care environment.

1) Integrate ethical theories and principles into a health care setting.

a) Into organizational principles and cultures

b) Into administrative ethical issues and managerial decisions

c) Into biomedical ethical issues and managerial decisions

d) Relate to individual health care settings

2) Discuss emerging future ethical issues brought about by the rapidly changing health care environment.

a) Reproduction methods

1) Natural

2) Artificial insemination (AI)—injection of seminal fluid into vagina

3) In vitro fertilization—ovum and sperm cells combined outside woman’s body. Cells grown in laboratory and later implanted into woman’s uterus

4) Surrogate motherhood—contract established that allows a woman to bear a child for infertile couple

b) Birth control

1) Contraception

2) Sterilization: voluntary, therapeutic, eugenic

c) Transplants

d) Testing and screening

e) Biomedical research

f) Ethical issues surrounding abortion

1) Historical progression of cases affecting abortion

2) The courts

3) Partial-birth abortion

4) Incompetent persons and abortions

5) Opposition

6) Medical employee’s right to refuse to participate in abortions

7) Funding

g) Genetic counseling and testing

h) Prenatal testing

i) Harvesting embryos

j) Death and dying

1) Definition of death

2) Uniform determination of death act

3) Withdrawing versus withholding treatment

a) Withdrawing means to discontinue treatment after it has been started.

b) Withholding means never starting treatment.

c) Many people believe both are unethical.

d) Patients have the legal right to refuse treatment and food.

4) Active euthanasia vs. passive euthanasia

a) Active euthanasia: intentional killing of the terminally ill is illegal in all jurisdictions in the United States except Oregon

b) Physician-assisted suicide (PAS): physician provides patient with medical know-how or means to enable patient to end their own life

c) Passive euthanasia: allowing patient to die naturally is legal

5) Direct vs. indirect killing

a) Direct killing: death is result of another person’s intended action or inaction

b) Indirect killing: death is result of unintentional result of another’s action

c) Double-effect doctrine: an action may have two consequences, one desired (and intended) and one undesired (and unintended)

6) Ordinary vs. extraordinary means

a) Direct killing: death is result of another person’s intended action or inaction

b) Indirect killing: death is result of unintentional result of another’s action

c) Double-effect doctrine: an action may have two consequences, one desired (and intended) and one undesired (and unintended)

7) Right to die legislation or right to refuse treatment

a) Patients have the right to refuse treatment.

b) If refusal places the patient’s life in danger, legal action sometimes results.

3) Discuss how emerging trends will affect health care managers.

a) Privacy of records: maintain confidentiality, HIPAA rules and regulations, and patient confidentiality

b) Consent: patient rights

c) Social responsibility

DISCUSSION PROMPTS

1. What do you perceive as being the biggest ethical challenges facing health care managers in the future?

2. What is the relationship and impact that scarce resources have on administrative ethics?

3. Who or what will direct the emergence of future health care ethical issues in America and worldwide?

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