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?
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.
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?
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
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.
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…
This week, you will write your opinion paper for the case you’ve been researching in the previous weeks. Use outside resources (preferably refereed, scholarly journal articles) to defend your opinion of the case.
At this point, you have summarized the case and argued both sides. Your paper should clearly cite why you feel the way that you do about the case, including what should have been changed about its outcome, in your opinion.
Assume the vantage point of a professional in ethics and law, and make recommendations based on your opinion of how the outcome of the case should have been handled.
Purdue Online Writing Lab [OWL]. (2013). Introductions, body paragraphs, and conclusions for an argument paper. Retrieved from https://owl.english.purdue.edu/owl/resource/724/01/.
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.