Nobody will argue the fact that at the present moment the system of the US healthcare delivery has become not a social institute that is aimed at provision of the nation’s welfare but a business organization that has to respond quickly to the changing market needs. There are many institutions catering for the needs of the US nation in cases they have problems with health, but their cooperation is based solely on the contracts they conclude, and it was a strange inference to understand that actually the government does not carry any responsibility and does not have any obligations concerning the provision of healthcare services to its citizens. The healthcare organization selected for analysis is home health agency that employs nurses, physical therapists, and nursing assistants. For this organization, ethical programs means strict ethical rules and stipulated medical principles applied to the profession.
The main parts of the ethics program are:
- Code of ethics
- Ethics training part
- Reporting and auditing
Code of Ethics
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The aim of the program is to stipulate moral and social responsibility issues, fair treatment of customers and colleagues. The ethics program is based on the Judeo-Christian ethic.
The min principles of ethical behavior:
Medical staff of the organization should recognize that
- Clients served by professionals have no choice but to rely upon their lawyers for expert advice.
- All professionals are assumed to have a command of a complicated and changing subject matter; that is why they have been hired. But this also means that clients are rarely able to evaluate the professional's competence.
- Inside the organization, this is a more complex notion because of the issue of third parties.
- This ethics generally considered to be the foundation of Western ethical and moral standards.
- The Ten Commandments and the Golden Rule are firmly ingrained in this ethic as is the Protestant work ethic and faith, love, charity, fairness, and justice.
NB: The problem today is that much of this basic truth has either been distorted, corrupted or applied only under certain circumstances or to the other person. It is not difficult to get most people to agree with the Ten Commandments, or at least on Commandments 5 through 10; that is, to agree with them in general or as they might apply to someone else (Boyle et al 2001).
Main moral principles of the ethics program
- The main principles include
- dignity on the mercy of patients
- sensitivity to individual needs and patience,
- personal aspiration and commitment to work,
- humanism and,
Note: Openness involves impartiality and objectivity in assessing the validity of the beliefs of oneself and others, and a willingness to revise beliefs as new evidence comes to light. Also, it is important for a nurse to possess critical thinking and an awareness of the consequences of one's actions in rational decision-making, and to the need for patients to develop a critical response to the attitudes and values. The healthcare philosophy is based on the ideas that a nurse should be well informed about ethical issues in nursing, have moral knowledge and have a complex range of learned skills and guided experience that will enhance their ability to act wisely and creatively as reflective moral agents when confronted with moral problems, to anticipate moral problems and take the necessary action to prevent them from occurring in the first place; to think critically and reflectively about emergent and emerging moral issues. A nurse should be able to discern a range of possible solutions to moral problems identified, and to communicate effectively with others. Special abilities of a nurse are to respect, listen to, understand and be compassionate toward others, to be tolerant, flexible, creative and imaginative when dealing with and attempting to resolve moral problems (Pence, 2007).
In order to familiarize employees with the program and ethical principles, on-job-training will be introduced. The purpose of training is to demonstrate communication deficiencies and propose concrete steps which would help the hospital to eliminate these problems and improve performance. It is known that effective management is the ability to influence others to work together in the search of organizational success. Effective management and leadership are envisioning what the company must do in order to prosper. Training will be provided for nurses and doctors separately. It will take place twice a week for 2 hours each lecture and a practical part.
Reporting and auditing
Reporting and auditing will be the final part of the implementation. It will involve interviews and questionnaire analysis.
The Benefits of the Ethics Program
The benefits of the program are:
-motivation of employees
-clear understanding of the ethical, morals and professional code of ethics
- involvement of all employees in ethical program.
If the organization recognizes these beings and is able to improve their condition, then a duty of beneficence arises (Pence, 2007). The fact that duties of beneficence are recognized by managers of organizations is demonstrated by the fact that they cause the organizations to make charitable contributions. One is hard pressed to swallow utilitarian reasoning that such contributions may in the long run improve profitability by the creation of goodwill. In fact, the best arguments against such action are utilitarian in nature. Milton Friedman represents perhaps the best-known proponent of this utilitarian point of view) (Garrett et al 2001).
An example is the practice of companies paying the cost of sending managers to universities to improve their education. Medical professionals would undoubtedly argue that such action is taken to improve profits through lower costs generated from the better management the organization expects to receive from better-educated managers.
The proposed program will improve quality of work and increase productivity. Organizations would undeniably justify this practice on such utilitarian grounds. However, the imagination must truly be stretched to translate an individual manager's education to the bottom line. A more plausible explanation for such things as classes in human relations might be found in the desire to fulfill a duty for self-improvement. For example, one could argue that by failure to improve managers' knowledge of business ethics, a organization has caused the public to incur greater risk of unethical conduct by the organization. A commonly held and frequently cited belief is that business organizations have the duty to make profits. Total impact healthcare provides the broad classification into which the deontological basis suggested here will fit.
Strong ethical principles of employees will have a positive impact on company’s reputation and customers’ loyalty. The classifications system could take the form of accounts set up for each of the duties that a company has chosen as applicable to it.. Since doing one's duty has an associated impact upon profit, an account would also be created to summarize those effects over periods of time. The healthcare is a key professional involved in assisting management with the task of setting responsibilities and with monitoring progress toward meeting such responsibilities (Garrett et al 2001).
The involvement and participation of staff
The involvement and participation of staff in ethics programs will be achieved by active involvement of all employees in training and discussions. The main difference between personal and professional codes of ethics is that independence is not allows in the healthcare organization. In the personal code of ethics, independence may be defined in a professional context as a state in which one is self-reliant and not easily influenced by others. Professionals rely upon their own expertise and judgment rather than opinions, biases, or emotions of other persons. Independence, as an ethical concept, is prominent in the profession. Indeed, all professionals should be independent in that they should not subordinate their judgment to make a client happy (Garrett et al 2001).
The main similarity between the personal and professional codes is that they demand fair treatment of all people and high professional skills. Conflicts of moral duty come in various shapes, sizes, and intensities. We cannot anticipate all such problems. But what such conflicts have in common is both situational and philosophical. By situational we mean that a personal moral dilemma is experienced by the professionals. She is faced with a concern and, often, a hard-choice situation. By philosophical we mean that thinking about essentials--goals, purposes, reasons--is ignited by the moral conflict. Confronting ethical dilemmas in professional is a real task (Harris, 2007).
Professional morality demands adherence to the law. But legislation, court opinions, administrative decisions, and (especially) bureaucratic interpretations of the law are rarely crystal clear. Because of this necessary imprecision, there are many opportunities to "bend the rules" or to "find the loophole." Such behavior, by healthcare professional, is not inherently wrong. Nor is it subject to prosecution or condemnation if discovered. In healthcare, especially, a premium is put upon creative interpretation of regulations (and of prior interpretations) (Boyle et al 2001). The system exists to be used, we are told; a clever professional takes advantage of ambiguity and resolves it in the perceived best interest of his client. This is normal professional practice. The political and social views of professionals do not, usually, impinge upon work-related tasks (Harris, 2007).
The ethics code will help employees resolve moral issues and problems of moral choice. Independence is a critical concept that sets ethics apart from other professions. This is the only exclusive function that the ethics performs for society. In rendering an opinion the healthcare professional assumes a public duty. Moreover, this public duty must transcend any employment relationship or other duty toward the client. In many cases, healthcare system follows ethical relativism, the view that says there are no absolutes, there are no "blacks" or "whites," things are always changing, and everything is relative. There is no common standard in time or position; what is fair to one person may be unfair to another, what is fair in one situation may be considered unfair in another situation, and what might be accepted in one country might be unacceptable in another country. The final determinant of right and wrong and the worth of any belief is one's own belief and justification that supports it. It puts major emphasis on what is popular (and this is continuously changing) instead of what is necessarily right or wrong. Rather than offer a moral judgment that is binding on all people, at all times, everywhere, it is flexible and changeable in every situation (Pence, 2007).
Cultural sensitivities in your monitoring program
The ethics program will pay a special attention cultural differences and sensitive religious issues of both nursing staff and customers (Pence, 2007). This will be achieved with the help of cross-culture management and activate participation of the HR professionals. The point of this dilemma is that attempting to regulate the morals of others in the community is at best a difficult morass. We will attempt no simplistic solution in this perplexing area except to state that though individual cases must be handled separately, the ethical models, and ethical realism are useful to professionals. From a utilitarian perspective, the consequences of kitchen tabling are mostly bad for all parties. From the perspective of the partners, the firm does not receive proper compensation for professional services rendered. Moreover, clients who receive services, particularly auditing services, so cheaply, come to expect future prices at comparable bargain levels (Harris, 2007). Since most countries and religions of the world have some form of belief that comes close to the part of the Golden Rule that relates to treating others as you want them to treat you, then in theory if properly adhered to it can personalize business relations as well as bring fairness into business. The only problems with this is that unless all parties involved also believe in and adhere to the Ten Commandments there may be marked difference in what constitutes fairness, love, charity, and justice between the parties whenever any exchange situation exists. Without a common foundation upon which to build, there are bound to be many differences and many problems (Boyle et al 2001).
The ethical question in healthcare organization needs to address is not whether or not members of minority groups should be hired as healthcare professional s. The healthcare profession along with the rest of society long ago settled the ethical question of excluding persons from the professional community because of race, religion, or culture. The question concerns upward mobility of these healthcare professional s once they are in the profession. healthcare professionals assert that it is not only good ethics, it is also good business to include persons from diverse backgrounds in our profession. This is especially true in the case of large international healthcare that find themselves doing business in places where cultural diversity is an asset from a human resource and client development point of view.
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