The institutionalization of healthcare is a major source of ethical conflicts. When looking at ethics, we consider the question; what do we owe to the other person? Today, healthcare management is an arrangement among the following groups: consumers or the patients, the providers who are the physicians and other health care professionals, the insurer who reimburses for any care given, and finally, the primary buyer of health services (Darragh & McCarrick, n.d.).
Ethics is always seeking to know what ought to be the morality of health care institutions. In healthcare management, it includes the concepts of virtues, interest, autonomy, and beneficence issues. Virtues make the physician consider the patient’s interests, and interest is the stake claimed on the outcome. Beneficence makes the physician protect patient interest as understood from a clinical discipline perspective. Autonomy directs the physician to protect the patient’s interest as observed in their beliefs and values (McCullough, 1993).
The main ethical issues currently facing healthcare management are:
- Discrimination: whether or not insurance firms go out of their way to only have healthy clients and discriminate against unhealthy clients.
- Age: should the old and feeble receive the same cover as the young?
- Doctors: are they manipulating data so that they are within parameters set by the insurance companies?
- Patient’s rights and responsibilities: Are patients being given only what they can afford by their insurance cover or what they deserve? Is it correct to deny coverage to individuals who have neglected their health or those who have taken care of their health?
- Utility versus rights: is it good to offer health in a way that everyone benefits at a minimum, or should providers honor people’s rights to obtaining the best health they can get?
- Patient autonomy: are clinicians respecting the patient’s decisions to receive suboptimal care?
Present Climate around Ethical Issue
America’s health care, financing, organizing, and delivery is now increasingly being provided by large scale institutions. Employers and government are less concerned about the individual needs of their workers and continue to buy health insurance in bulk for all employees; this becomes an excess for some and inadequate for others. As a result, medical disasters due to limited resources are increasingly being observed (McCullough, 2010). Physicians are forced to practice on the guidelines of institutions that provide for the patients’ wellbeing. Secondly, there is the issue of escalating healthcare costs brought about by the bureaucratic procedures that focus on procedures for insurance cover.
Factors that Impact Issues
Profit pursuit by the insurance companies makes their management to formulate policies that ensure they remain with healthy consumers who are not a cost to the company. As a result, unhealthy or those with the risk of illness like the old are forced to purchase expensive covers or be left out. Social rights of universal healthcare demand that patients get all that they require to be healthy again, and this is a costly approach, and providers are forced to limit the amount of cover they provide. The need for physicians to operate within the parameters of insurance firms in patient care pressurizes them to neglect important procedures in fear of lawsuits. Personal values and beliefs lead patients to reject what clinically is viewed to be the most optimal care (Lantos, Matlock & Wendler, 2011).
Conclusion and recommendations
The formulation of policies should consider the respect for autonomy for the patient and ensure that interests are considered. Cases, where individual liberties are overridden, should be supported on the grounds of the policy’s effectiveness in realizing its goal. Secondly, the policy should be proportionate, publicly justifiable, and necessary and should be the alternative promising the least infringement (Childress et al., 2002). Physicians and patients should interact in an informed, meaningful way, especially when it comes to the decisions process. It should not be a formal bureaucratic ritual. Public policy should consider whether fiduciary institutions are necessary and how they will be supported financially (McCullough, 1993).
Childress, J.F. et. al. (2002). Public health ethics: Mapping the terrain. The journal of Law, Medicine & Ethics, 30:2.
Darragh M. and McCarrick P. M. (n.d.) Managed health care: new ethical issues for all. Web.
Lantos, J., Matlock A. M. and Wendler D. (2011). Clinician integrity and limits to patient autonomy. JAMA 305(5):495-9.
McCullough, L. B. (1993). Ethics in the management of health care organizations The Free Library. Web.
McCullough, L. B. (2010). Taking seriously the “what then?” question: an ethical framework for the responsible management of medical disasters. Journal of Clinical Ethics, 21(4):321-7.