Transcript Chapter 6

Business Ethics in
HealthCare
Role of Ethics in Healthcare:
Six Underlying Values
• Beneficence: belief
that the best interests
of the patient should
be first
• Nonmalfeasance:
belief that every
action taken by the
health care worker
should not cause any
harm to the patient
• Autonomy: freedom
of every patient to
either accept or reject
the treatment offered
• Justice: belief that the
decisions made by the
health care workers are
fair
• Dignity: belief that all
patients have the right to
be treated with dignity
when they are in the
health care system
• Truthfulness and honesty:
belief that the patient is
aware of all benefits and
risks of all treatments
being offered
Doctor-Patient Relationship
•
Four models to describe the doctorpatient relationship
1. Engineering model: doctor carries out the
patient’s wishes
2. Priestly model: assumes that the doctor will
always do what is in the patient’s best
interest
3. Collegial model: assumes the doctor and
patient participate equally in decisions based
on trust
4. Contractual model: enters into an
agreement in which both parties assume they
are pursuing mutual goals
Health Care Codes of Ethics
• Many different codes of ethics from
many different sources
– Health care providers may have to
reconcile, sometimes in their own
minds, the differences in the codes of
ethics
– Must make the best decision under
unique, individual circumstances with
patients
Consumer Rights and Responsibilities
Concerning Healthcare (United States)
1.
2.
3.
4.
5.
6.
7.
8.
Information disclosure
Choice of providers and plans
Access to emergency services
Participation in treatment decisions
Respect and nondiscrimination
Confidentiality of health information
Complaints and appeals
Consumer responsibilities
Good Medical Practice
(United Kingdom)
1. Make the care of your patient your first
concern.
2. Protect and promote the health of
patients and the public.
3. Provide a good standard of practice and
care
4. Treat patients as individuals and respect
their dignity
5. Work in partnership with patients
6. Be honest and open and act with
integrity
Pharmaceutical Issues
• Pharmaceutical companies provide
financial incentives to doctors who
prescribe their drugs
• Pharmaceutical companies spend
millions of dollars advertising directly
to consumers
The Rise of E-Drugs
• Issue of safeguarding consumers
from fraudulent pharmacies selling
online prescription drugs
Using E-Drugs
• Advantages:
– Open 24 hours – seven
days a week
– Reduced intimidation
when patients obtain
embarrassing or sensitive
medications
– Patients may be allowed to
check medication profiles
online
– Price comparisons easier
– Delivered directly to home
– May be considered more
convenient
– Persons with disabilities
may find the process
easier
• Disadvantages:
May not be a pharmacist to
answer questions
– Concerns about privacy of
patient information
– Concerns about financial
information that is
transmitted in transactions
– Questions about integrity
of the drugs shipped to
patients
– Quality of drug
information that is
provided
Stakeholders and the
Healthcare System
• Patient’s family and friends
• Health insurance companies
• Hospitals and other healthcare
providers
• Pharmaceutical companies
• Government Medicare and Medicaid
• Doctors’ union
Questions for Thought
• Comment on the stakeholders in
Figure 6-1. Are any of them more
important than another group?
• Do codes of ethics work in the
health-care industry? Explain.
• Is there a difference in ‘health-care’
ethics versus ‘business’ ethics?
Explain.