To many consumers, ethical healthcare management has become something of an oxymoron. At the very least, the well-documented rise of cost-cutting has undercut patients' confidence that caregivers always have their best interests in mind.
A seminar titled "When Values Collide: Ethical Issues in Healthcare Management" seeks to find a path for the peaceful coexistence of ethics and active healthcare management. The meeting is scheduled for 2 p.m. on Tuesday, March 4.
William Nelson, education coordinator for the National Center for Clinical Ethics, Veterans Affairs Medical Center, New York, will lay a framework for bringing everyday notions of right and wrong to bear on healthcare decisionmaking-particularly in the clinical setting.
First and foremost, clinical healthcare ethics rest on valid patient consent or the ability to refuse a given medical course of action, Nelson says. Ethics become especially critical when a patient or his designated agent is unwilling or unable to grant consent.
Unfortunately, there are no stock solutions to the variety of thorny problems facing healthcare workers. Guidelines for common cases can help. But applying ethical reasoning, Nelson says, is the best way to assure honorable outcomes for even unexpected problems.
To foster ethical reasoning, Nelson suggests establishing internal networks in which people can exchange ideas and setting up a standing ethics advisory committee to serve as a resource for decisionmakers.
Get patient advocates involved, too, Nelson counsels. And think about ways to make ethics part of the institution's fabric, rather than something applied only on a case-by-case basis.
Organizational ethics will be tackled in more detail by Paul Hofmann, senior consultant at Alexander & Alexander, San Francisco.
"We'll be encouraging participants to take their ethical temperature or moral pulse, and our hope is that they'll leave the session with a better understanding of basic ethical principles," Hofmann says.
As with most organizational initiatives, good ethical behavior starts with clear missions, goals and values that are reflected faithfully in institutional policies.
Compliance with ethics goals for individuals as well as organizations can't be left to chance, Hofmann says. Like quality, ethics need to be audited.
As part of his talk, Hofmann will review a self-assessment test being developed by the ACHE that individuals can use to audit themselves. When audits-either organizational or personal-find ethical discrepancies, a corrective action plan, usually including a large dose of education, should be implemented.
"A lot of the issues are in fact common sense," Hofmann says, "but we all need to be reminded of the fundamental altruistic values that should be governing our behavior and attitudes."