6 36 As Per Writer

Week 1:

Healthcare ethics should be followed by all medical workers but sometimes they do not cover small issues that arise such as:

The cost of healthcare should be fair and make sense.

As
stated in the healthcare code of ethics doctors should inform their
patients of their medical fees. However, transparency is not enough,
medical bills should be fair and within reasonable limits for patients.
Fees charged by health care personnel especially specialists have been
recently been criticized for being too high (Cooper, Frank & Hansen
2002). According to recent research, these specialists ask for
unreasonable fees. Studies show that it is common for such practitioners
to charge prices higher than the medical boards set. This leaves
patients with acute diseases in suffering as they cannot afford to pay.

The
code of conduct does not forbid setting high prices which give medical
specialists the power to set fees. However, they should improve on
transparency to ensure practitioners do not take advantage of their
customers’ vulnerability. Patients are informed of the basic fees, but
most fees are incurred during the actual procedure and they must cater
for that through personal costs. I have developed keen interest on the
same as there are no guidelines that safeguard patients against high
costs imposed by hospitals. Should healthcare experts take advantage of
their expertise to overprice their practice? Also, what role should the
government play in ensuring specialists do not take advantage of their
clients?

The security of health records

Family Planning
records were recently hacked, and this caused a lot of controversy and
uproar. The legal and medical personnel should ensure the security of
their technological processes while always maintaining the privacy of
their customers. Privacy should be emphasized in a medical institution
as it is done in other businesses. Laws on the practice of privacy and
security of medical online procedure should be more streamlined and
specific.

Health records are very important and ensure easy
access to medical data of a patient and provide the necessary research
by doctors, therefore the medical personnel should work hard to secure
them hence earning the trust of the clients. Medical information is
personal, and exposure may cause significant challenges in the health
record system (Hattab 2004). I would like to explore this issue to find
out more about any strategies being set to improve this system. What
amount of information should patients disclose in their records? What
strategies is the government set to address cybercrime especially in the
health sector?

Crowdfunding for treatment

Through recent
technology, people have come up with ways to borrow money through
certain websites for emergencies or treatment of chronic diseases. The
customers use online platforms to seek support from well-wishers who
help reduce the cost of the bills. However, this has become common
though there are ethical concerns that are raised in connection with the
same (Austin 2017). I concur that medical crowdfunding is a cause and
does not meet the intended solution where there are injustices with
regards to meeting the essential medical services. Does this forms the
basis of my research on the viability of these crowdfunding initiatives
and the ethical implications?

Policies should be set to address
this issue to make sure that practitioners do not take advantage of
unknowing clients to seek useless cures. Studying this issue helps me
investigate the principle that states no harm should be done in
treatment only benefits, some treatments are not necessary therefore
cause harm. Are there any laws that can protect a patient from false
advice from their doctors? What does all the money raised in
crowdfunding do?

REFERENCES

Hattab, A. S. (2004). Current trends in teaching ethics of healthcare practices. Developing World Bioethics, 4(2), 160-172.

Cooper,
R. W., Frank, G. L., Gouty, C. A., & Hansen, M. C. (2002). Key
ethical issues encountered in healthcare organizations: perceptions of
nurse executives. Journal of Nursing Administration, 32(6), 331-337.

Austin, W. (2017). The ethics of everyday practice: Healthcare environments as moral communities. Advances in Nursing Science, 30(1), 81-88.

Week 2:

Medicaid Expansion Case (Unfair Health Care Costs)

One
of the legal considerations in the provision of health services is
ensuring that individuals gain access to healthcare services at a fair
cost. However, there exist some healthcare disparities, whereby some of
the individuals incur fewer costs in accessing the health care service.
On the other hand, some people incur higher costs. One of the cases that
present an ethical and legal case in the provision of the health care
services is the Medicaid expansion in the United States which favors the
younger and stronger individuals over the elderly individuals, the
infants, and children (Kino and Kawachi, 2018). In most cases,
vulnerable individuals are given preference or priority when it comes to
the provision of welfare.

Societies and nations consider
individuals with low incomes and those who do not have the potential to
care for themselves as vulnerable people. However, in the Medicaid
program, vulnerable individuals are categorized into deserving and
undeserving individuals (Kino and Kawachi, 2018). As such, this presents
an ethical issue since the undeserving group does not get the benefits
that are offered through the Medicaid expansion. One of the legal
questions pertaining to the case is that; is there a better way of
ensuring that the Medicaid program depicts equality? The ethical
question for this case is; why is it unethical to categorize the
vulnerable individuals as the deserving and undeserving groups?

Former Hospital Worker Charged with HIPAA Violation (The Security of Health Records)

One
of the cases that depict the HIPAA violation or the breach of
confidentiality is whereby the former worker in Texas was jailed for
disclosing the confidential information of the patient. The hospital
employee by the name Hippler was arrested in Georgia after it was
evidenced that the individual was in possession of the medical
information of the patients (Kolbasuk, 2014).

According to the
given information, the employee disclosed the information of the
patients and medical records for personal benefits and gains (Kolbasuk,
2014). According to the Health Insurance Portability and Accountability
Act, the information of the patients should be kept private and
confidential. The case under evaluation presents both a legal and
ethical issue. The case is a legal case since it violates the provision
of the Health Insurance Portability and Accountability Act. The case
presents an ethical Case since it is a breach of confidentiality for the
patient. One of the ethical questions regarding the case is; did the
employee act ethically by disclosing the information of the patient?
What if the employee had the consent of the patient, would it present an
ethical dilemma?

Crowdfunding for Treatment (The Case of a Woman from Ontario)

The
evolution and development of technology have triggered most people to
source funds for treatment through social websites. Crowdfunding
provides an opportunity for individuals to post for an appeal of seeking
funds. However; there are ethical concerns that are associated with
such a practice. Crowdfunding is at times associated with misinformation
and fraudulent activities.

The potential donors are triggered
to accept the description of the patients who require funds even if they
are not aware of the medical conditions of the patients. One of such a
case is the case of a female patient from Ontario who lied that she had
the condition of cancer. The female individual used Facebook and other
social media sites to obtain funds (Snyder, 2016). The individual raised
a total of $200,000 (Snyder, 2016). The case presents an ethical issue
since it as an act of blackmailing the public to provide funds for an
individual who does not have the stated healthy condition. One of the
ethical questions that would emerge from the case is; What are the
adverse impacts does crowdfund pose to the public? The legal question
that emerges from the case is; would it be fair to sue the female
individual?

References

Kino, S., &
Kawachi, I. (2018). The impact of ACA Medicaid expansion on
socioeconomic inequality in health care services utilization. PLoS ONE,
13(12), 1–13. https://doi.org/10.1371/journal.pone.0209935

Kolbasuk, M. (2014). Former Hospital Worker Faces HIPAA Charges. Retrieved from https://www.careersinfosecurity.com/former-hospita…

Snyder, J. (2016). Crowdfunding FOR MEDICAL CARE: Ethical Issues in an
Emerging Health Care Funding Practice. Hastings Center Report, 46(6),
36–42

Week 3:

Healthcare Management

To
probe further into the issue of healthcare ethics and legal
considerations on the same, I’ll discuss healthcare cost, and express
diverse opinions with regards to the same, in an attempt to unveil the
illicit behavior that has stained the healthcare system in the US,
representative of some more countries all over the world. As previously
alluded, the code of ethics for healthcare insists that a doctor be open
about his/her charges, yet this is barely the case with millions of
patients being left with an unfathomable bill to take care of after
consultation and treatment, and the rest living with their diseases in
fear of going to hospital and going into debt for the same. What’s worse
is that the specialists; those dealing in life-threatening diseases are
the unreasonably expensive ones and have consequently been accused of
overcharging their patients. To think that doctors would hold more
meaning to life since their very role is saving it.

Jauhar,
(2014), a medical practitioner and author of the famous medical book,
Intern, states that indeed the healthcare services are in a disheveled
state, with enormous overuse that is uncalled for, waste and unfavorable
medical costs as well as lack of an elaborate legal system confining
the field. This overuse of the money can be linked to diagnostic
uncertainty, where patients, as well as doctors, will perform numerous
tests on a patient, to make sure s/he did not miss anything. Doctors
also do this to avoid lawsuits, ending up spending numerous resources on
an illness that would never surmount to the figure it surmounts to as
of now. New technology, as well as improved drugs, has also seen
overspending and an increase in the cost of medical care in the states.

Despite
all this, however, Jauhar brings out a key element that has resulted in
an increase in the cost of medical care; overspecialization. The
medical field changed drastically in the last half-century, with most of
the physicians being general practitioners in 1940, to only twenty-five
percent being general practitioners today; seventy-five percent are
specialized. This saw an increase in medical expenditure from three
billion dollars to seventy-five billion dollars in just thirty years,
since 1940. What’s more, is that primary-care physicians no longer rely
on their knowledge but often will always refer a patient to a
specialist. Specialist undoubtedly feels like they’re worth more since
they’re a notch higher than a general physician and the small economies
of scale because of specializing push them to increase the cost of
services rendered.

The overall result of this is a
specialist-driven healthcare service that is unforthcomingly expensive
to citizens. With this, he gives his own personal experience where a
friend of his was experiencing shortness of breath that was
unexplainable and was admitted as a result. Following this, he was taken
through a cardiologist, podiatrist, hematologist, and another seventeen
specialists, only to be discharged without a diagnosis. This cost him a
bewildering one hundred thousand US dollars. Undoubtedly, the outcome
of overspecialization has cost citizens a lot of money, time and
anxiety. Jauhar suggests that the way to solve this is to have an
accountable-care forum for payment where a doctor is only paid after the
outcome of his medication yield positive results. Besides this, he
suggests a regulation in the amount of money paid for services rendered,
something that is currently non-existent in the healthcare legal
system.

He also suggests a new form of medical pedagogy where
citizens are made aware of medical systems, to know when they’re being
over-diagnosed and sent for un-necessary tests by practitioners. Indeed,
the proposed measures would be numerously beneficial to patients who
would say no to exploitation, be able to detect exploitation, as well as
enable the law to protect them against over-costing by the medical
practitioners, especially specialists.

Kathryn Watson, (2017)
supports Jauhar’s position, saying that indeed healthcare is too
expensive, and more so for the neediest in society. Based on statistics,
in 2016 medical care cost increased by four percent and since then has
been going up. The reasons for increased cost in her assessment,
however, is the high cost of running hospitals; ‘Administrative costs
contribute to 25.3 percent of all health care spending in the U.S.’, as
well as the controlled nature of setting up medical practices. The
latter implies that there is reduced competitions since only a minimum
number of practitioners meet the legal requirements of setting up a
practice. The lack of a limiting competition eliminates standardization
and encourages medical practitioners to take advantage of their
patients.

Nonetheless, Watson identifies that the high cost is
also linked to the demand for high-quality healthcare and technological
advancement in the medical field by citizens, who even pursue legal
enforcement when misdiagnosed or failure in treatment. In saying this,
high expenses paid by the citizens increase the standards for
deliverables as well as provide a pool of capital to invest in research
and technology. This said, medical care in the US is well advanced, and
as a result higher life expectancy has been reported.

According
to Watson, the way to solve this problem is through insurance cover for
all. She argues that when it is a group effort, the economies of scale
are deemed to lower the cost of healthcare altogether. I, however,
differ in this opinion. For everyone, including the poor to afford
insurance, it would mean that it goes down to levels that generate
minimal revenue, and see the healthcare system collapse in terms of
quality; the case of the tragedy of the commons. Subsidization of fees
is needed but not to an extent where everyone could afford it, but the
majority. Despite this seeming unfair, I see it as saving the entire
healthcare system from ruin.

Brinded, (2018) takes a positive
affirmation in all this; he supports the high expenses in medical care.
To prove his point, he compares the quality of health services in the
UK, whose policy avails free access to all, and the US, which is
unreasonably expensive. He concludes that the reason why the United
States system is effective and by far the best in the world is because
of the unforgiving prices the system demands from its citizens. To
support his claim are examples of incidences in the UK; based on think
tank UK2020,” If they had the survival rates of those countries with the
best health outcomes, over 46,400 lives a year would be saved.” This
implies that the low prices have resulted in incompetent systems that
lead to the loss of 46,400 lives each year.

To support this,
services are of poor quality, untimely emergency ambulance services,
shortage of resources; in 1000 people, only 2.7 beds in hospitals are
available. It also has a lower number of doctors, by a large margin,
compared to the US, basically because the environment is not attractive
to people in the medical field. Most have gone private, but still, are
lower in number than those in the US. Indeed, many are the focus at
criticizing the expenditure of the US government and thus citizens
complaining it is too expensive, yet people fail to acknowledge that as a
result, they have quick access and responses to emergency ambulances,
better treatment for illnesses and in general, better medical
facilities.

She proposes that the way to improve the NHS in the
UK is to increase the pool of capital but then argues that this would be
seen as oppressive, owing to the increase in tax on the citizens. She
concludes by quoting Steven D. Levitt, an economist, who claims that
‘when a service is deemed “free,” there is more likely to be wasted by
those using it and those who administer it.’ This said, she supports the
higher priced services that ultimately result in better healthcare
services. In my opinion, her argument is indeed valid; cheap is cheap.
Cheap healthcare gives you cheap treatment, cheap services, and cheap
practitioners. The intrinsic value of healthcare should not be compared
to any monetary value, though to favor the families that are suppressed
by chronic diseases, the poor and marginalized in general,
standardization or some form of legal control on the specialized
professionals should be implemented.

From the views above,
healthcare is a sensitive subject, one that could literally mean the
deaths of numerous people in a country. For this reason, then, I feel
that the ethical considerations and recording of the same, as well as
legal documents; those prepared by statisticians, actuaries, lawyers as
well as people in the medical field have been disregarded. The
government should thoroughly assess proper standardization that would
see a generation of high revenue while at the same time being accessible
to most if not all. With times headed in the direction they are, and
chronic diseases like cancer, diabetes, tumors, strokes and so on, it is
high time that the healthcare board takes into considerations all these
aspects to make the health sector admissible for all.

References

Bonnie F. Fremgen. (2015) Medical Law and Ethics.Ed/Year: 5th Ed., 2015. Published by Pearson Education ISBN:978-0133998986

Dr.
Sandeep Jauhar. (August 19, 2014) Time: One Patient, Too Many Doctors:
The Terrible Expense of Overspecialization. Retrieved from http://time.com/3138561/specialist-doctors-high-co…

Kathryn Watson. (2017). CBS News: Why is health care so expensive in the first place? Retrieved from https://www.cbsnews.com/news/why-is-health-care-so…

Lianna
Brinded. (February 22, 2018). The first step towards fixing the UK’s
health care system is admitting it’s broken. Retrieved from https://qz.com/1201096/by-deifying-the-nhs-the-uk-…

Sabatino, C. (2016). Overview of legal and ethical issues in healthcare. Retrieved from https://www.merckmanuals.com/home/fundamentals/leg…

Week 4:

Summary of Healthcare Ethics

The health care ethical issues revolve around the terms and criteria for payment of healthcare services, the professional guidelines on the provision of healthcare services and the terms guiding the handling of patient’s data. Funding of healthcare services suffers from non-ethical issues that include the unfair cost of services and the issue of equity in accessing healthcare services. Similarly, in a healthcare setting, patient’s records need to be stored in a secure setting with the highest level of confidentiality among the health care providers. This paper summarizes the ethical issues in the healthcare setting.

Ethically, healthcare providers have the basic mandate of providing quality services to patients regardless of their financial contribution. As much as the uncertainty in the occurrence of diseases forces patients to demand urgent medical attention, their satisfaction relies on the doctor’s adherence to the code of conduct. Doctors need to disclose the amount for each service on a fairground. According to Singh et al. (2019), medical practitioners overcharge patients especially when the patients look vulnerable for health care services. The finical strength of most patients at such a scenario prevents them from accessing healthcare services since they cannot afford. Due to this most patients suffering from acute diseases develops chronic and severe injuries from the delay of services and inaccessibility of care.

Even though the code of conduct allows doctors to set the service fee to some extent, it forbids the doctors from overcharging the patients. Because doctors take advantage of the provision, hospitals need to centralize the payment system such that doctors do not charge patients directly, but patients are charged from a central base. Also, hospitals need standard pricing for healthcare needs with the aim of informing the patient prior to the service provision.

Secondly, Entzeridou et al. (2018) explain that the patient’s data and health-related records require a maximum level of confidentiality and privacy. Neither the patient’s doctor nor the patient’s caretaker has the right to exposes the health details of a patient. The patient’s consent must be obtained for disclosure of their medical reports. However, the physicians tend to violet the patient’s rights through consultations that do not priorities the confidentiality of the information, for example, using the patient’s name while consulting, and giving information on the patients to other health providers on the patient’s Absentia. To ensure the safety of the patient’s information, healthcare needs to avoid paperwork and adopt an electronic system of information storage such as computers since they provide maximum security through passwords and other controlled access features.

Finally, financing of healthcare services, especially for chronic conditions that require a high amount of resources, has taken a new approach. Patients reach the websites and applications that support financial donations intended to support the settlement of health bills. However, after acquiring the funds, patients redirect donations to other activities. The action provides an unfair situation for patients with future needs and donors. In some cases where the patient involves the health provider in the fund mobilization process, the healthcare provider risks its reputation. Health promotions need to focus on encouraging patients to acquire medical insurance to ease the payment process.

Management of the healthcare financing strategies solves most of patients concerns. Therefore, the best approach in reducing the disparities of patient’s relies on the elimination of the cash system of funding. Rather, health services need to be financed through insurance companies. Since doctors would not handle cash, the system discourages the doctors from initiating unnecessary medical services to exploit the patient financially. Also, the financing system always prepares to seek health service despite the economic situation.

References

Raphael, J. L. (2018). Healthcare Financing and Social Determinants. In Disparities in child health (pp. 47-52). Springer, Cham.

Singh, A., & Prasher, A. (2019). Measuring healthcare service quality from the patients’ perspective: using Fuzzy AHP application. Total Quality Management & Business Excellence, 30(3-4), 284-300.

Entzeridou, E., Markopoulos, E., & Mollaki, V. (2018). Public and physician’s expectations and Ethical concerns about electronic health record: Benefits outweigh risks except for information security. International journal of medical informatics, 110, 98-107

QUESTION:

For your final assignment, develop a PowerPoint presentation that
clearly highlights your case. Draw from all that you have built upon
throughout the five previous weeks. Include:

• A summary of your case with critiques
• Ethical and legal ramifications (be thorough)
• An assessment of both sides of the argument in your case
• Recommendations for change
• Evaluation of how you will use this information in the future

At the end of your presentation, relate your case to your overall
interpretation of the concepts learned in this course. Evaluate how the
subject matter of this course affects your interests for further study
in ethics and law. Cite any sources you used in the last slide of the
presentation in APA format.

To support your work, use your course and textbook readings and also
use the South University Online Library. As in all assignments, cite
your sources in your work and provide references for the citations in
APA format.

Complete your PowerPoint presentation in 10–12 slides with comprehensive explanations in the notes pages of the presentation.