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Every situation is somewhat different, and ethical dilemmas can arise even when a hospital has policies in place to address them. Healthcare Briefings spoke with a number of experts in medical ethics and got their opinions about the top ethical issues facing healthcare today--plus insights on how managers are dealing with them.
Avoiding conflicts of interest.
Doctors and nurses are often prime targets of promotions from pharmaceutical, medical device and equipment manufacturers. The same perception applies to meals and travel expenses. Of the doctors and medical students who replied to the survey, While encouraging their clinicians to turn down giveaways and any compensation that might influence their decision-making, hospital management teams are also scrutinizing whether their trustees and boards of directors should be allowed to maintain financial ties to the institution or health system, such as selling their own goods or services.
Balancing profit with serving patients and providing charity care. Healthcare organizations need to take a long, hard look at how they make ethical decisions involving their business operations, she explained.
Wrestling with equal treatment vs. VIP treatment for donors and other influential people. Individual cases should be monitored and policies put in place to clarify expectations. Managing pediatric and geriatric patients who may not have decision-making capacity.
The patient also should be able to rationalize in selecting one choice over another.
And it bothers them that others go without care due to lack of funding. Examples like the Terry Schiavo case in Florida — in which the patient was kept alive and cared for in a vegetative state for 15 years, including a long, publicized legal battle involving family members with opposing points of view — showed how difficult these cases can be for everyone involved.
Berlinger emphasized the importance of helping nurses and other staff members deal with these kinds of issues. Institutional investment in advance care planning, which helps patients to identify and document their treatment preferences in ways that can guide care if they are unable to make decisions in the future, is one step institutions can take to prevent crises.
This mechanism is generally an ethics committee. Ethics committee members or consultants should be available around the clock to assist employees, patients and families, and can be called on to help resolve a perceived conflict between the parties. Administrators and clinicians can also enhance ethical practices at their institutions through ongoing education and open discussion, said Joseph Carrese, M.
Blending a formal ethics policy and support mechanisms with a culture that allows people to discuss some of the gray areas of their practice can prepare clinicians to tackle many of these problems in stride.Legal and Ethical Issues for Pharmacy Technician (LAW) This course presents the material dealing with pharmacy laws, regulations and ethics aimed specifically at the pharmacy technician.
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