Abstract
The profession of medicine has for a long time been known to work under the principle of self regulation based on physicians’ commitment to protect public trust and welfare. There has however been frequent criticism that the profession has not been adequately capable of identifying and disciplining employees who are incompetent and unethical. This can result in detrimental consequences on patients as well as the healthcare organization CEJA Report, 1992). There is need for all members of a healthcare organization to cooperate in promoting ethics (Nelson, 2010). This paper analyzes the provisions of the ACHE code of ethics that can be applied in handling healthcare management ethical issues related to incompetence. Several ethical aspects provided in the ACHE code of ethics are outlined and related to this case. As part of the conclusion, the ACHE code of ethics provides important standards that can be applied to handle cases of incompetence and unethical conduct.
Introduction
Healthcare decision making processes are frequently faced with great ethical challenges. Different healthcare principles have been formulated within a number of ethical codes of practice in order to provide standards for handling healthcare ethical dilemmas. One source of guidelines on ethical issues is the American College of Healthcare Executives (ACHE) code of ethics which provides guidelines on how healthcare executives should behave with regard to their professional relationship with other players in the healthcare environment (ACHE, 2011). ACHE code of ethics places great emphasis on key values like; the importance of people, the importance of learning, the importance of timing and the importance of integrity (Ozar, et al., 2000).
Ethics issue on employee incompetence
This case describes a scenario involving an incompetent registered nurse who does not show any commitment to his work. He does not follow directions from physicians with regard to what needs to be done as far as patient treatment administration is concerned. The worst part is that his colleagues repeatedly cover for his mistakes and therefore his mistakes go unpunished for a period of time (McLean, 2014). This case indicates ethical issues which ought to be addressed in order to prevent dire consequences in the long run.
Ethical issue 1
Lack of honest effort
The registered nurse lets others carry out the duties for which he is paid for. He should be paid for what he does and not what others do on his behalf. Being a registered nurse, he is qualified for his job and therefore he should show commitment to his work and be able to carry out his duties as required.
Ethical issue 2
Bribery
The retired nurse seems to be influencing his colleagues to cover for him by being friendly and offering them gifts such as hot doughnuts so that they do not tell on him. Bribery is unethical as it is corruptive and it is a way of soliciting for favors.
Ethical issue 3
Offering advantage
The colleagues who cover for the retired nurse’s mistakes are violating ethical standards because they are permitting him to gain undue advantage. It is dishonesty on their part which ends up benefitting the registered nurse while potentially harming the patients and the reputation of the institution (Connor, 2013).
Ethical issue 4
Lack of professional ethics
It is clear that the retired nurse lacks professional ethics. This is because he does not show commitment to the provision of services he is expected to offer. His priority should be the patients and their well-being just like the priorities of all health professionals are. His negligence for duty indicates that he does not care about the well-being of the patients, for instance, his failure to administer medications as ordered by the physician.
Ethical issue 5
Disrespect for authority.
It is not ethically right to defy authority. The registered nurse in this case does not respect the authority of the physicians in as far as the orders to administer treatments are concerned. He simply ignores the directions and leaves the patients to their own devices.
Why these issues raise ethical concerns
These issues raise ethical concerns because they are a violation of the ethical code of conduct of the profession. In medicine, unethical conduct includes; corruption, greed, lack of honesty and exploitation of others. Failure to report the incompetence and unethical behavior of colleagues poses a potential threat to the well-being of patients. It is the responsibility of medical practitioners to report dishonest, corrupt and incompetent behavior of their colleagues so that the relevant authority can take the necessary action (CEJA Report, 1992)
ACHE code of ethics
The ACHE code of ethics can be effectively used by a healthcare manager to handle these ethical issues. It addresses various aspects of ethics that can be used as standards for healthcare management to make the right decisions regarding ethical matters. Some of the provisions of ACHE which touch on issues to do with this case include:
Safeguarding the healthcare profession
The ACHE provides that professional activities be carried out with integrity, honesty and in good faith in order to give a good reflection on the profession. It also indicates that competent be maintained through continuous assessment and education and the manager can use this to prevent a repeat of the case. The actions in this case are demeaning to the credibility of the profession and therefore as the guidelines provide, this should be stopped.
Responsibilities to patients
According to the ACHE guidelines, the manager should ensure that the patients receive quality care and services. This can be achieved if the manager ensures that all the employees are competent enough in carrying out their duties.
Organizational responsibilities
According to the ACHE code of ethics, the manager should report negative information as soon as possible and ensure that the necessary action is taken. It also provides that the manager ensures that mistakes are reduced and addressed. This can be done by creation of an environment that permits effective communication. The manager should also, as per the guidelines of ACHE, provide resources on ethics to employees in order to ensure that they are well informed. Monitoring for compliance with the code of ethics is also an important aspect of ACHE which in this case the manager should ensure that it is effectively done.
Management responsibilities with respect to employees
It is an obligation of the manager to ensure that an ethical environment is provided. Free expression is an important consideration to make sure this kind of environment prevails as the ACHE provides. In addition the environment should work to discourage employees from coercion to act unethically.
Management responsibility to reporting when the code is violated
The ACHE provides that violations to the code of ethics be reported for disciplinary action. It is therefore paramount that the manager in this case reports the employee conduct to the appropriate authority so that the necessary disciplinary measures are taken before the problem escalates to bring more harmful consequences to those involved (ACHE, 2011)..
Conclusion
Healthcare ethics is a challenging aspect in healthcare provision which must be effectively handled. The ACHE code of ethics provides useful guidelines to assist in the management ethics of the healthcare industry. The healthcare management has crucial responsibilities towards the stakeholders in the healthcare system including responsibilities towards the healthcare organization, the employees, the patients and the healthcare profession in general. A manager in healthcare provision can effectively apply the provisions of the ACHE code of ethics to make appropriate ethical decisions that may arise within the organization.
References
ACHE. (2011). ACHE Code of Ethics: Retrieved from. https://www.ache.org/abt_ache/code.cfm
CEJA Report. (1992). Reporting Impaired, Incompetent or Unethical Colleagues: American Medical Association.
Connor, W. E. (2013). Employee Code of Ethics: Retrieved from. https://secure.ethicspoint.com/domain/media/en/gui/15228/Code_of_Ethics_1_22_07.pdf
McLean, M. (2014). We’ve Got You Covered: Santa Clara University. Retrieved from. http://www.scu.edu/ethics/dialogue/candc/cases/covered.html
Nelson, W. A. (2010). Preventing Ethics Conflicts and Improving Healthcare Quality Through System Redesign: Retrieved from. http://qualitysafety.bmj.com/content/19/6/526.abstract
Ozar, D. (2000). Organizational Ethics in Health Care: Toward a Model for Ethical Decision Making by Provider Organizations: American Medical Association.
