Frontiers of Health Services Management - Fall 2013 - (Page 17)

(national commission for the Protection of Human Subjects of Biomedical and Behavioral research 1979). the report spells out the three fundamental ethical principles that must guide all research involving human subjects (Darr 2011, 108): • respect for persons • Beneficence • Justice Compliance, Ethics, and the Need for a Broader View compliance is demonstrated by carrying out one’s responsibilities to the organization in conformance with law and established practices. an effective compliance program is an essential component of risk John J. D onne l l a n Jr ., FAC H E • 17 f e a t u r e Most individuals who oversee or manage healthcare—especially those who manage academic healthcare systems—are well aware of the myriad laws, regulations, and policies governing the proper conduct of research activities and the consequences associated with nonadherence. Compliance relates to those statutes, rules, regulations, and policies that govern administrative conduct. the concept of managerial ethics is often considered in terms of compliance. training in managerial ethics is typically given by legal counsel, compliance officers, or human resources staff. this training focuses for the most part on making sure staff members are familiar with codes of conduct, regulations, statutes, and case law governing business practices (e.g., billing, coding, contracting, conflict of interest, acceptance of gifts or donations) and that they understand the consequences associated with violating these rules—with the focus largely on preventing fraud, misconduct, abuse of office, discrimination, and so on. management. it reduces costly litigation, negative media attention, and the loss of community support. it also reflects the organization’s commitment to an important shared societal value—that one should obey the law. But compliance has its shortcomings. compliance programs rarely provide guidance in uncertain situations. Does simply being compliant with laws or directives mean one acts ethically? How should one act if she believes a law or an organizational mandate directs her to behave in a manner that she considers unethical? for example, how should a physician proceed in a situation in which she believes that complying with organizational policy (e.g., discharge of a frail geriatric patient from acute to subacute care) is contrary to the patient’s best interest? How should a hospital ceo proceed with the closure of a community health center that provides vital care to lowincome and non- or underinsured individuals but consistently incurs significant financial losses in spite of repeated efforts to improve efficiency? an established venue in which clinical and administrative staff can articulate and clarify the ethical conflicts they face, identify competing values and viewpoints, and discuss alternatives for action can set the stage for improved decision making and reduced staff distress. an american Medical association (1994) opinion clarifies the distinction between law and ethics, noting that ethical obligations exceed legal obligations. the opinion states that “when physicians believe a law is unjust, they should work to change the law” and further notes that a physician being “acquitted or exonerated in civil or criminal proceedings does not necessarily mean that the physician acted ethically.” the three types of ethics in healthcare—clinical ethics, research ethics, and

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Fall 2013

Frontiers of Health Services Management - Fall 2013
Contents
Editorial
The Case for Values as a Basis for Organizational Culture
A Moral Compass for Management Decision Making: A Healthcare CEO’s Reflections
Ethics, Values, and Decision Making
Wanted: Morally Courageous Leaders
The Imperative of a Moral Compass–Driven Healthcare Organization

Frontiers of Health Services Management - Fall 2013