H.C. Ethics Week 3

It's week three and we are moving right along!!! A lot of the reading this week had to do with managed care, which is a great topic to touch one when talking about ethical decisions. I plan on writing my mini-paper on manged care. I have not yet decided the actually topic but I feel that managed care relies heavily on providers and insurance companies making ethical decisions to benefit patients. This week another big portion of the reading was related to the importance of ethical programs, performing effective audits and creation of compliance boards and ethics committees. Having an effective and well defined system for ethics in an organization is very important to ensure that not only employees are making everyday ethical decisions but also top level executives. This is also extremely important for a managed care system, which is naturally suspect to unethical decision making. In the "Tracks we Leave" text, 6 principles of medical ethics are presented, which are in direct relation to manged care environments. Autonomy, Beneficence, Nonmalefice, Fidelity, Veracity and Justice and the 6 principles talked about in this chapter. The real question presented here is whether health care should be treated as just another business or should its own set of ethical principles and guidelines. Whether you answer yes or no, would determines where the loyalty of the physicians, and managers lies. This decision bring about ethical dilemmas for the physicians and managers.

Personally I think of my self as an ethical person and I do sincerely care about individuals. If i were a physician my loyalty would lye with my patient and their well being. In that situation I would think of health care as not just another businesses, it would mentally be separate. This decision might be too easy for me to make since I am not trained in this area, one might feel completely different when they are actually working the profession. For example my undergrad degree is in Business management so when I think of being put into the situation as a manger I might feel more inclined to look at health care from a business perspective. Stakeholders are different and the patient is not the only important outcome. When profits come in to play the game changes. Business can be cold hearted to the customer. The text specifically talks about marketing and in a manged care system how the optimal customer is young and healthy. So is it ethically to market to the young and healthy and exclude others if that is what is profitable to the business??? I would not like to be the one who makes that decisions. It is seems difficult to decipher what is appropriate. The book says no this is not appropriate ethical behavior, and calls this "cherry picking." In this situation the loyalty lies with the community and a duty to provide optimal health care for all, not just provide the highest profits for the organization.