Ethics in Healthcare
Individual Case Study: Approaches to Ethical Dilemmas Using the text, Ethics Case Studies for Health Information Management select one of the 29 case studies listed in the text. Write a 1,000-to-1,250 word paper including the following: Answer the discussion questions located at the end of the case you selected. Describe what ethical issues you may encounter and how you intend on approaching them (and why). Include what therapeutic approach you would use if appropriate (and why). Format your paper consistent with APA guidelines. Identify the case study on your Title Page. The case study should be cited and then listed on the Reference Page. ETHICS CASE STUDIES FOR HEALTH INFORMATION MANAGEMENT C A S E 2 9 A Case That Hits Close to Home Kendra Brown, Registered Health Information Technician, CCS, is the Assistant Director of Health Information Services at Memorial Hospital. Dr. Philip Russell, the chairman of the medical staff committee, enters Kendra’s office accompanied by Sue Davidson, the facility risk manager. Sue requests records of all patients in the past two years who have had gastric bypass surgery by Dr. Lester Brown and states that they will be back for them in 20 minutes. Kendra reminds Sue that the department policy for study requests is 24 hours, but Sue tells her that this is an urgent matter. Sue and Kendra are close friends and have both worked at Memorial Hospital for 15 years. Sue confides in Kendra that Dr. Russell needs the records in response to a patient death after surgery, with the family threatening a lawsuit against the facility. She also states that there have been similar incidents with Dr. Brown’s patients over the past two years, and Dr. Russell wants to look into the situation and potentially take appropriate action. Kendra lets Sue know that she will pull the records immediately and thanks her for sharing the information with her. She runs the report of Dr. Brown’s patients who have had gastric bypass procedures over the past year and pulls the records from the list. Kendra’s mother is scheduled to have gastric bypass surgery by Dr. Brown next week, so naturally, she is curious about the reason for Dr. Russell’s inquiry. As Kendra pulls the records for Dr. Russell, she briefly examines the documentation on the charts that indicate a complication may have occurred. She is astonished to discover that all except for one of Dr. Brown’s patients were either re-admitted with serious complications or had extended stays due to complications from the procedure. She notes that 24 of the 78 patients expired due to complications from the procedure. Because of these findings, Kendra feels the need to warn her mother to reconsider her decision for surgery or to seek another surgeon. Kendra returns to her office and calls her mother. Although not revealing any details of her findings, she tells her mother that she has seen something disturbing at work regarding Dr. Brown’s gastric bypass patients. She does include her concern regarding the fact that there have been a significant number of gastric bypass patients who have died after the procedure. Kendra asks her mother if she might reconsider her surgery scheduled for next week or at least seek a different surgeon. Sue overhears Kendra’s phone conversation and enters Kendra’s office. When Kendra gets off the phone, Sue confronts her about the content of her discussion with her mother. Kendra responds, “I couldn’t help but notice a trend in the outcomes of the records I was pulling, especially the number of patients who died after the procedure. Obviously, you are well-aware of what is going on. Wouldn’t you do the same thing if your mother were scheduled to have gastric bypass with Dr. Brown?” 9781133822981, Ethics Case Studies for Health Information Management, Leah A. Grebner - © Cengage Learning. Discussion Questions 1. What internal and external forces impact Sue’s concerns in this case? 2. What internal and external forces impact Kendra’s concerns in this case? 3. What ethical concerns are presented in this case? 4. Discuss the issues presented in this case as they relate to the American Health Information Management Association Code of Ethics. CASE 29 A CASE THAT HITS CLOSE TO HOME 93 9781133822981, Ethics Case Studies for Health Information Management, Leah A. Grebner - © Cengage Learning. 94 ETHICS CASE STUDIES FOR HEALTH INFORMATION MANAGEMENT 5. What legal issues need to be considered regarding this case? 6. How should Sue respond to Kendra’s statement at the end of this case? 7. List the legal and ethical violations made by Kendra in this case. 8. Discuss the case from both Sue and Kendra’s point of view. What would you do if you were in either of their positions? 9781133822981, Ethics Case Studies for Health Information Management, Leah A. Grebner - © Cengage Learning. 9. Using the case method, identify what you consider to be the greatest legal or ethical dilemma in this case and determine the best option for resolution. CASE 29 A CASE THAT HITS CLOSE TO HOME 95 9781133822981, Ethics Case Studies for Health Information Management, Leah A. Grebner - © Cengage Learning.
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Introduction
The field of ethics is one of the most ambiguous, yet one of the most crucial. Ambiguity in ethics sets in when people cannot exactly draw the line what ought to be done and what must not be done. Despite the numerous grey areas that exist in the field, various guidelines have been set which offer the way forward any time there is a gridlock (Carr, 2013). This discussion concerns itself specifically on ethics in the healthcare industry. The discussion will explore some of ethical issues arising in the healthcare industry and the appropriate actions that should be taken.
Safeguarding private information
As a general rule, it is unethical for patient information to be divulged without the consent of the patient. All the information that is provided by a patient to the hospital in the cause of treatment is confidential. This means that such information should be safeguarded and should not be let out to any unauthorized persons (Carr, 2013). It should also be safeguarded so that there is no unauthorized access to such information. If a third party requests for such information, it is only with the consent of the patient that such information can be given. Even then, there ought to be a justified reason as to why the third party wishes to obtain such information.
The safeguarding of information is not just limited to patients. Instead, it also extends to all health records of the hospital including those that are kept by doctors (Carr, 2013). Just as is the case with patient information, health records kept by doctors should not be accessed without consent. If this is done, then such information must remain confidential and should not be diverged. Employees in the healthcare sector are guided by the principle of confidentiality which is normally part of their contract. Under common law, all health workers are under duty to ensure that information obtained in confidence in the course of duty is preserved. The American Health Information Management Association Code of Ethics requires that employees must do all that is within their ability to ensure that such information is secure and is not accessible to any unauthorized party
Exception to the General Rule
Every general rule has a number of exceptions. Therefore, even with the general principles to preserve confidentiality, there are some instances where confidential information may be diverged without necessarily obtaining the consent of the patient (Carr, 2013). The first instance is during court proceedings. If during ongoing court proceedings the court orders for medical records to be produced, then such an order must be complied with. The second instance is when divergence of private information is done in public interest.
Sue’s Concerns
Looking keenly at the matter at hand, there are various issues that emerge. The first one is that there is genuine concern regarding the surgeries that Dr. Brown had carried out. According to the health records from the hospital, most of the surgeries that were carried out by Dr. Brown had ended up ...