Ethics Decisions, Essay Example

Introduction

This paper describes ethical issues encountered in health care profession and provides the necessary decisions the healthcare professionals and administrators employ to solve such ethical conflicts. Ethics questions and conflicts will always occur in healthcare profession because of the environment and the nature of persons who are involved in it (Willam, 2005). Despite the ethical knowledge and skills that administrators and clinicians may possess, ethics conflicts causes stress and waste a lot of time because of the inherent uncertainty that surround them.

To manage the possible harmful effects of the conflicts, professionals in healthcare and healthcare institutions should use various strategies including stepwise decision making to decrease or curb the occurrence of such ethics conflicts in healthcare environment(Willam, 2005). Some of the effective strategies that healthcare professionals and institutions employ include identifying ethics resources; network creation with professional colleagues, ethicists, and sanatorium ethics committees; initiating development and propagation of ethical standards of practice, facilitating trainings throughout the community and discussions, and enjoining with professional bodies just to mention a few. The article written by Nelson titled “An Organizational Ethics Decision-Making Process” provides a stepwise procedure of solving/ resolving conflicts in health care profession. The following is a review of this article.

Review of the article “An Organizational Ethics Decision-Making Process”

This article by nelson is all about healthcare profession and the ethical conflict that is encountered regularly between the parties’ involved in healthcare such as patients, clinicians, administrators and physicians. Nelson argues that healthcare management is often encompassed with making decisions that involve ethical implications for many issues such as access to organizations service, a particular employee’s behavior, clinical practices, and allocation of limited resources. The decision made to address the above issues/ ethical concerns are critical since they affect the quality of care directly (Willam, 2005). Nelson goes a step ahead to provide a guideline of resolving ethical questions in healthcare profession procedurally and calls it the concept of procedural justice. He argues that the organizations should rely on the deliberative process to foster fair treatment through a clear understanding of the competing values in reaction to a particular ethical issue.

The simple rule he provides is that when the process of decision-making is fair the outcome of the resolution will definitely be fair also. For this to happen, decision makers should put into consideration all the perceptions and values of those involved in the conflict and are affected by the decision made and explore various options and how the options are led by the underplaying values. When the options and values are understood well decision makers choose the value-driven option (Willam, 2005). The procedural justice approach to decision making works not only to provide one lasting solution to an ethical conflict but rather works to provide arrange of perspectives to the problems, organize and prioritize once thinking, and appreciate the implications of various options.

Nelson then describes a multi step ethical decision-making process and denotes that the process reflects procedural justice and that it will help healthcare executives react to challenging ethical conflicts in a well-planned and systematic manner. The process weather used by an individual or a group it enhances the quality of decisions by helping one to clarify ethical conflicts, structure ones reasoning and promote ethical standard of practice (Willam, 2005). I will use the case of one dispensary in the community where ethical conflict was witnessed and how nelsons procedural decision-making guidelines were used to resolve the problem. The dispensary in question had been alleged of corruption where the healthcare professional employed were unqualified and resulting in wrong medication to patients who ended up losing life and other suffering severely due to drug abuse. The steps as provided by William A. Nelson (2005) include;

Step one: Clarify the ethical conflict; this step requires the healthcare professional to ask the question “what is the specific ethical question or conflict?” the professional must clearly and succinctly articulate the ethical conflict that needs resolution. The parties involved in decision-making must agree that it is an ethical question or the question has ethical ramifications before embarking on solving it. If the issue at hand has no ethical ramification then, it is sent to the other persons to solve it. For the case of the dispensary, it was agreed by the stakeholders that the presence of unqualified staff at the dispensary had been affecting the patient’s medical care and healthcare management. So ethically, it was conflicting the community.

Step two: identify all the affected stake holders and their values; all the stake holders including patients, clinicians the clinical administrators, representatives from management team, legal counsel, members of the governing body and the community representative should be identified and engaged in decision making process. This helps in gathering all the stakeholders perspectives and valued concerning the issue and they impact on the decision arrived at. For the case of the dispensary, the patient’s values and rights had been violated and have been getting wrong medication.

Step three: understand the circumstances surrounding the ethical conflict; this step involves an extensive investigation of the reason why the ethical question has arisen and in what situation and how the organization is trying to address the issue. For the case I was involved in the dispensary carefully studied many past issues related to the conflict and discovered that the management had been practicing corruption by employing non-qualified staff.

Step four: identify the ethical perspectives relevant to the conflict; this step involves identification of ethical concepts relating to the ethical conflict and explore the relationship between the ethical question and ethical thinking. This step involves consulting professional codes such as ACHEs code of ethics; organizational and business ethics and ACHEs ethical policy statements. For the case of the dispensary, the groups reflected on the concepts of fiduciary and individualistic reasoning ethical perspective. This put the conflict on a clear viewpoint for easy handling. For the case of the dispensary it was discovered that the professionals were not certified and thus not qualified to offer medical services to patients.

Step five: identify different options for action; it entails identifying other relevant options of responding to the ethical conflict. For the case of the dispensary, there was an option of closing the dispensary because the practitioners were not qualified. But it was important to review all the possible options and values driving one to make such a decision. The dispensary was the only one in that community and closing it would mean compromising healthcare needs of the community so it was decided that the practitioner be prosecuted and new qualified ones employed.

Step six: select among the options; this step involves selection of the systematically and quantitatively evaluated option. For the case of the dispensary, the option of employing qualified new clinicians was selected over closing the dispensary. The option selected must be practical with a clear ethical foundation.

Step seven: share and implement the decision; this step entails publication of the decisions by the organization along with the ethical reasons behind them. For the case of the dispensary, the organization published a notice informing the community of the situation and change of professionals detailing the reasons for the above decision. This enabled the community to be aware of the new changes.

Step eight: review the decisions to ensure that it achieved the desired goal; this is the final step of decision-making. After implementation of the decision of step seven above the organization sits back to review it and measure its worthiness in addressing the ethical conflict involved. For the case of the dispensary, the management is keen on the changes they implemented and are constantly asking the stakeholders especially the patient of the kind of care they are receiving since the change of the health care professionals.

Reference

Willam A. Nelson (2005) Healthcare Executive: “An Organizational Ethics Decision-Making Process” Volume: 20, Issue: 4, Pages: 8-14, PubMed