Introduction
Ethics in the healthcare refers to a set of moral beliefs, principles as well as values that act as a guide for making choices in medical care. Thus, it entails the sense of what is wrong or right as well as the beliefs about the rights that the industry personnel owe to others. Thus, it is crucial for those responsible for providing services to the industry to make choices that are fair, just and right. In that view, this article review uses a case study involving an ethical issue in health care and identifies the issue, explains how it was addressed, the outcome and how a future leader could address such issue.
Analysis
In the case, a neurosurgeon Dr. Henry, who is in the final year of his practice, has a patient in his examination room. The patient has had paresthesia on her right leg and back pain. After the patient’s examination, the Dr. identified that the patient had a ruptured L5-S1 disk as well as degenerative changes in addition to her right leg being slightly weaker than the left leg. The Dr. explained the results to the patient and informed her that she could have surgery at the time or could wait to find out if the symptoms would resolve on their own. The patient indicated to the Dr. that they also thought they would need surgery. However, the DR had been facing a shortage of surgery cases in his practice although it was required that the practice involve meeting the surgery threshold as a surgeon. (Brody & Zientek, 2007)
In addition, the Doctor also felt that they were more confident they could address the patient’s problem through surgery and that would have a favorable outcome for the patient who was 58 years old and was in good health. In addition, she also had the expectation for treatment through surgery as she also had insurance that could pay for the costs. However, the Dr knew that they could explain to the patient that some patients recover without the need for the surgery as the dusk fragment could be absorbed by the body hence relieving pressure on the nerves. However, the Dr also knew that it was difficult to predict when the problem might resolve hence he told the patients that they needed surgery as the longer they waited the more would be the damage to the nerves. Thus, the doctor was caught in a dilemma when a patient asked him if he thought that she needed surgery. (Brody & Zientek, 2007)
Issue
Ethical responsibilities in healthcare depend on the nature of decisions to be made as part of the roles played by various stakeholders. In that respect, patients and their physicians plays different roles and ethical duties are defined by four main principles. The four include autonomy that entails honoring patients rights to make own decisions. It also includes benefiance that entails helping the patient to advance their own good. Further, there is justice that entails fair treatment of like cases. Finally, there is the principle of nonmaleficence that states that there should be no harm. (Schafer, 2004)
In that view, the case entailed conflict of interest that is a key issue in medicine and which entails making decisions based on the four principles in seeking to serve the patients interest, doing no harm as well as allowing them to make own decisions. That is because the Dr. had the interest of achieving their practice target that was larking behind his peers as well as giving ion to the partner’s pressure to increase the number of surgeries for financial gain. On the other hand, there was the patent’s interest that could have be served by the Dr explaining to them the pros and cons of the surgery and a watchful waiting process option that did not require rushing to the surgery operation hence the patient could have appreciated that other option which they seemed not to be aware of. (Rodwin, 1993) Thus, the Dr sought to elevate his interest to the level of duty with the argument that he owed it to the practice to increase the number of surgeries. That was a mistake and an act contrary to the medical profession’s priorities as a Dr.
Issue handling
The Dr. gave into the partners’ pressure to increase the number of surgeries as a way of enhancing their income. The choice for the surgery was also based on the Dr need to increase his surgery cases as a way of increasing his rating among his peers. In that respect, the surgery was recommended to the patient without being informed of the other option that only required watchful waiting. (Brody & Zientek, 2007) Thus, the issue involved various parties including the Dr’s partner who sought to serve the institution’s interest, the patient who was in need for a effective treatment and the Dr who was directly responsible for offering the best suited solution to the patient.
Outcome
Given the choices, the patient had the surgery that was not only expensive, but also involved pain that could not have been strictly necessary to treat the problem. (Brody & Zientek, 2007) In that respect, the patients’ interest was not served in an ethical manner as it entailed an approach that sought to benefit the DR at their expense.
Dealing with the issue as a future health care leader
In managing the conflict of interest, there can be application of prohibit on activities as well as divesting the physician's involvement in entities if the nature of activities involved is extremely likely to compromise their obligations to patients. (Schafer, 2004) Thus, although it could have been difficult to expect the Dr. to have given up the surgery as a means of avoiding recommendation of surgery that could have net been strictly necessary. However, there could be a problem of shortage of such surgeries had all Dr withdrawn from the service as a way of managing their conflict of interest. Thus, the Dr. needs to consider the patient interest, and if the partners seek to take advantage of the patient’s vulnerability, the DR should avoid the situations where they could compromise their patients’ interest. (Klaidman, 2000)
Thus, as a future leader, I would deal with the issue by ensuring that patients’ issues are addressed with their interest. That would avoid conflict with the organization and employees’ interests. In that respect, expectations on employees would be set in view that they should not push them to compromise patients’ interests. In addition, I would establish employees’ training programs to help employees including the doctors to focus on the core principle of providing value to customers.
Conclusion
In view of the analysis, the ethical issue in this case involved a conflict of interest for the Doctor. That is because the doctor is faced by a situation in which they can efficiently serve the patient's interest but not maximize theirs of maximize benefit at the expense of the patient's interest. In that view, the Doctor’s decision to serve their interest at expense of the patient was unethical and the outcome was high costs for the patient who also had to undergo unnecessary surgery causing pain that could have been avoided. In that view, the most efficient way of addressing the conflict of interest problem is by doctors divesting their interest from obligations that could cause patients unnecessary costs and seek to serve the patient's interest first.
References
Brody, H. & Zientek, D. (2007). Is the Surgery Necessary Now? The Surgeon's Conflict of
Interest. Virtual Mentor. 9(7), 476-482. Retrieved from, http://virtualmentor.ama- assn.org/2007/07/ccas1-0707.html
Klaidman S. (2000). Saving the Heart: Battle to Conquer Coronary Disease. New York,
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Rodwin M. (1993). Medicine, Money, & Morals: Physicians' Conflicts of Interest. New
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Schafer A. (2004). Biomedical conflicts of interest: Defense of the sequestration thesis—
Learning from the cases of Nancy Olivieri and David Healy. Journal of Medical Ethics. 30(1), 8-24.
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