An Introduction to Healthcare Organizational Ethics PDF
Preview An Introduction to Healthcare Organizational Ethics
An Introduction to Healthcare Organizational Ethics This page intentionally left blank AN INTRODUCTION TO HEALTHCARE ORGANIZATIONAL ETHICS Robert T. Hall West Virginia State College OXFORD UNIVERSITY PRESS 2000 OXPORD UNIVERSITY PRESS Oxford New York Athens Auckland Bangkok Bogota Buenos Aires Calcutta Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul Karachi Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Paris Sao Paulo Singapore Taipei Tokyo Toronto Warsaw and associated companies in Berlin Ibadan Copyright © 2000 by Oxford University Press, Inc. Published by Oxford University Press, Inc., 198 Madison Avenue, New York, New York, 10016 http://www.oup-usa.org 1-800-334-4249 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Hall, Robert T. (Robert Tom), 1938- An introduction to healthcare organizational ethics / Robert T. Hall. p. cm. Includes bibliographical references and index. ISBN 0-19-513560-1 1. Health maintenance organizations—Moral and ethical aspects. I. Title. RA413.H35 2000 362.1'04258—dc21 99-049875 987654321 Printed in the United States of America on acid-free paper Dedico este libro a Mary Kay, quien alienta e ilumina mi vida. This page intentionally left blank Preface This book is an attempt to address ethical questions in health care as they arise on the business or organizational level: to spell out an ethical perspective for healthcare organizations. I do this, first, by considering the nature and function of an organizational ethics perspective in healthcare and, second, by taking up many of the topics with which this field must be concerned. Far from being the last word on many of these topics, given the virtual absence of relevant litera- ture in most cases, this is hardly the first word. It is my hope, however, that this discussion will be useful to students in health services management, healthcare professionals, and healthcare administrators who are facing these issues. Chapter 1 begins with an analysis of ethical decision making in healthcare organizational management, including an outline of two analytical strategies that might be adopted for the development of an organizational ethics perspec- tive. Chapter 2 addresses some of the macro questions of organizational ethics through an analysis of corporate social responsibility in for-profit and not-for- profit organizations, as well as the issue of uncompensated care. Chapters 3 to 11 take up many of the topics that healthcare organizational ethics analysis will have to address. These include aspects of patient services, marketing, managed care, program development, community relations, diversity, employee relations, regulatory compliance, and medical records. Healthcare institutions are, in fact, business organizations, with most of the problems faced by corporate manage- vii viii PREFACE ment in other fields. They differ, however, in that health care holds a special place among human needs and has traditionally been addressed from an altruis- tic perspective. Chapter 12 offers some comments on the development of orga- nizational ethics programs that may be of interest to administrators and to pro- fessionals who serve on clinical ethics committees—especially those who are grappling with the new standards on organizational ethics promulgated by the Joint Commission on Accreditation of Healthcare Organizations. Many cases are included not only to illustrate points but also to direct the reader's attention to aspects of issues not previously mentioned. The cases are all either real incidents or composites drawn from similar situations that have arisen in different places. Identifying details have been changed in most cases and, of course, specific sources are not cited. References to relevant documents are included: Appendices 1 to 6 contain a few of the most important sources. Alderson, West Virginia R. H. September 1999 Acknowledgments This project would not have been possible without the help of a large number of people. I owe special thanks to Mary Kay Buchmelter, Gerry Beller, L. O'Brien Thompson, Tom Michard, John Richards, Mary Lucas, Sharon Hall, Gary Chernenko, Karen Frashier, Woody Moss, Jackie Glover, Cynthia Bar- nette, Bruce Foster, Robin Reynolds, Drema Pierson, James Patterson, Michael Lewis, Sean Chillag, Greg Rosencrance, Ed Welsh, Les Melton, Robert Lyman Potter, Bob Bendiksen, Mark Sheldon, Paul Schyve, Jill McDaniel, Warren Point, J.K. Lilley, Elizabeth Spangler, Lillian Morris, Fran Brooks, Denise Maillot, Chuck Lucente, Martin Kommor, Joyce Broglio, Mary Lou Lewis, Mary Hogue, Charles Covert, Warren Radtke, Jeannie Bess, Abainesh Mitiku, Ann Rinehart, Gladys Kuhn, Don Patthoff, Patricia Schafer, Jeff House, and Charlie Cohen. Research for this book was supported by The West Virginia Humanities Council. ix
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