Organizational Ethics in Health Care

This comprehensive and much-needed resource helps health care ethicists to meet the demand of challenges such as managed care, medical technology, and patient activism. Through a review of core principles and a rich selection of cases, practitioners and students will learn to apply ethics in the day-to-day administration of health care organizations. The authors are from the Park Ridge Center, the nationally acclaimed consulting and research firm.

Foreword xiii Laurence J. O'Connell Preface xv Acknowledgments xix The Authors xxi Part One 1 The Moral Ecology of Health Care Organizations 3 2 Organizational Theory, Culture, and Psychology: Tools for Organizational Ethics 29 3 Organizational Support for Ethical Behavior 52 4 Corporate Compliance and Integrity Programs: The Uneasy Alliance Between Law and Ethics 97 5 Managing Human Resources 112 6 Conflicts of Interest 146 7 Discretion and Control 178 8 Evaluating the Moral Life of an Organization: The Case of Resource Allocation Policies 204 9 Resource Allocation and Utilization: Structural Issues 221 10 Mission and the Bottom Line 247 Part Two: Cases 1 The Waiting Room 277 2 Nursing Strikes 279 3 A Gift, or an Obligation? 283 4 Obligations for Adequate Health Care Coverage 288 5 A Manager’s Dilemma in Hiring 292 6 Conflict of Interest, or Just a Great Lunch? 296 7 Organizations and Spousal Equivalent Benefits 299 8 Organizational Teflon: Making Sure the Case Doesn’t Stick 303 9 Investment Policy 306 10 Compassionate Sedation, or Euthanasia? Compassionate Communication, or Deceit? 309 11 Ethical Considerations in Charting 315 12 Executive Use of Discretionary Funds: The Bonus Pool 317 13 Integrating Spirituality in the Health Care Setting 320 14 Alternative and Complementary Medicine 323 15 Overstepping the Bounds of Expertise 326 16 Marketing Products and Practicing Medicine 329 17 Following the Rules, or Using Them as a Smokescreen? 333 18 Organizational Advancement and Corporate Compliance 337 19 The Compliance Officer and the Ethics Committee 341 20 Aggressive Accounting 344 Part Three: Appendixes Appendix One: Joint Commission on Accreditation of Healthcare Organizations 349 Appendix Two: Sample Ethics Statements 361 Appendix Three: American College of Healthcare Executives: Code of Ethics 377 Appendix Four: Partnership Health Care: Conflict of Interest Policy 387 Recommended Reading 393 Index 401