Administrative Issues - written Case Ananlysis

1) Name
2) Case number, case title, and class date
3) Case summary: Ethical dilemmas in the work place are often questioned for their influence in professional decision-making. Administrative and clinical ethical incidents in health welfare institutions somewhat appear to be highly relevant thus prompting to have more recognition from its workers. Administrative ethics in have questioned the personality assessment of its employees with regards to positions, authority, equality of rights, and/or ethical management strategies. Clinical ethics, on the other hand, poses inquiries on professionalism and experience in the field of medicine, health issues, and the quality of service rendered upon those in need especially financial proportions are considered. These two classifications of ethical incidents are further explained through ten situations (five each sector) which will present specific and limited mode of action applicable for every circumstance.
4) Key facts/ factors of the case:
* In response to the first incident regarding abuse of power by manifesting a breach of appropriate relationship between the managers and staff, the director for ancillary departments at Healing Hands Rehabilitation, Annabeth Jackson is disturbed by the kind of workplace attitude of her two-year employee Frank Anderson.
* There have been noticeable increases in repeated admissions in the emergency department. This was contributory to overcrowding, delayed treatments, and general dissatisfaction of other patients. Furthermore, the financial reimbursements of the hospital are made bleary by patients supported by medical aids, as there had been an observed overuse of the services rendered in the emergency department.
* City-owned hospital juggles its administrative rights in servicing the needy in accordance to its not-for-profit status, and as manifestation of the institution`s benevolent responsibilities. There is a present clash between the ethical propositions on practicality focusing on patients enrolled in insurance privileges and on humanitarian propositions claiming that people in economically depressed areas also deserve to be given proper health services. The organizational philosophy in this institution is not well defined and therefore faces an indefinite clash of perspectives.
* The fourth incident on administrative ethics revolves on external influences that affect managerial decision-making. The matter includes "gifts" being given to the staff appearing to be an act of earning their favours. Such acts baffle staff members whether they might be breaking a policy and thus give a false notion of relationship towards customers.
* During a volunteered work by a working aspiring for promotion, she gets to be involved in a situation challenging her moral philosophy. A construction worker in a developing site under her jurisdiction performed a seemingly "necessary crime" with the motive of having the project done successfully. The competent volunteer struggles on scaling moral judgment or professional success.
* The first case of clinical ethics revolved on screening the patients being admitted whether or not they harbour contagious diseases, and possess a high risk of infecting anyone present within proximity. Furthermore, having experienced several fata epidemic outbreaks, if ever there will be another concurring epidemic, the hospital staff was resolved not to disclose information to the community of such outbreak so as not to demote the hospital`s credibility and lose public confidence.
* The question of authority posted on the seventh incident where an old patient`s tending physician made decisions whether she will be resuscitated or not if ever unfortunate enough to experience a cardiac arrest. The physician`s decision on not resuscitating was out of the patient`s consent—a decision which greatly upset one of the servicing nurses. The nurse focuses on her professional values especially on having their patients express their opinions on matters regarding their life.
* Most hospitals have few physicians who deliver moderately good quality of service but barely anything near the highly-acceptable scale. The incident present here is the silent bout between position and experience. There had been a conspiracy in the information given out to a discharged patient regarding a slip during her surgery. Position fights for the disclosure of the information, having wanted to let the patient know; while Experience decides it is not of grave importance since the slip will cause nothing serious nor direly harmful, except tarnish the prestige of the surgeon`s image.
* A community hospital greatly experiences financial depression brought about by a large inner-city population where many of whom are uninsured or supported by a chronically underfunded Medicaid program. There have been several efforts made to alleviate such financial dilemma, however none worked. Hence, a staff tried a strategy promoting a "demarketing" of the emergency department, claiming that if the emergency department`s fine quality of service was to be the opposite, there would be more possibilities of decreasing the hospital`s deficit.
* The last incident in clinical ethics concerned confidentiality on health issues of hospital staff members themselves. Such issues provokes specifically to tending surgeons making contact with their patients and how their controversial health issues may affect their relationship and trust with their patients and workmates.
5) Heath administration issue analysis
Primary health administration problem:
Undefined nature and limitations of ethical perspectives
Secondary health administration problems:
* Poor staff management
* Poor quality control on emergency departments
* Lack of community`s support
* Lack of proper staff orientation
* Poor financial management
* Lack of communication between staff members
* Excessive superiority among staff members
* Lack of ethical justice
6a) Solutions
Solution 1: Since ethical judgment is abstract and very subjective in form, concretizing it to draw out a rule does not guarantee to yield an absolute positive outcome. Therefore, one suggested way to establish a ground for decision-making regarding administrative ethical dilemma, the organization must build a constitution levelling their priorities in the healthcare administration. There are several other factors to consider when making such. One would be the idealized vision and mission of the institution. The institution`s foundation must be geared towards providing the best healthcare benefits to those in need and then catering to the specific courses or needs that their community`s nature requires. Being able to establish a legal basis for decision making allows easier ethical judgments to be drawn. These will also influence a unity in decision and could create a stronger unity as well within the institution`s members. Positive decision making could also affect the institution`s public image by being able to earn public trust, and therefore being able to serve the community better. Another factor in establishing a constitution is its ability to inculcate moral reasoning among its members which will eventually enhance administrative leadership and professionalism. In the incident of the "necessary crimes", moral reasoning would intervene in the situation where the ethical standards of the supervisor would revolve not only on what she thinks is right, but on the grounds that it can be stated within the organization`s mother rules. Any of the aforementioned situations can be solved better by eliminating the idea of sheer practicality over morality. In the to-be established constitution, it should provide a clear statement of what the organization wants to put first to be...