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In Week 4, we will focus our attention on the rights and responsibilities of patients and employees to ensure ethical conduct in healthcare settings. We will also explore patient consent and the importance of understanding the ethical and legal context for such consent. Your Learning Objectives for the Week: Evaluate the importance of confidentiality and examine different ways confidentiality can be violated. Analyze the rights and responsibilities that physicians have toward patients and analyze the role of legal and ethical principles in adhering to these rights. Analyze existing issues of malpractice and liability in healthcare organizations and assess the measures taken to limit malpractice claims. MHA6060 WEEK 4 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS Page | 1 Employee Rights and Responsibilities As we strive to uphold an ethically responsible healthcare environment, we rely heavily on our staff. Staff members have a variety of rights that healthcare administrators must ensure, and in turn, staff members have responsibilities to patients, employers, and the organization. In this lecture, we will discuss some of the major employee rights and responsibilities with which the healthcare administrator should become familiar. Staff rights include fair treatment and employment along with a working environment that is free from discrimination and provides equal opportunity to pay. Additionally, staff rights include freedom from harassment and intimidation, as well as respectful treatment and privacy. For healthcare administrators, it is also important to follow legal guidelines for family medical leave and unemployment compensation. Employee rights are guaranteed by over one hundred eighty federal laws that work to regulate workplace activities. One key point you need to be aware of is that the US Equal Employment Opportunity Commission (EEOC) is responsible for enforcing federal laws that outlaw workplace discrimination. Employees have the right (and responsibility) to report unethical conduct within the organization. Running parallel to employee rights are the responsibilities that employees must fulfill. Employees must adhere to codes of professional ethics and conduct. Compassionate care that honors patient autonomy and wishes is imperative in healthcare settings. Additionally, it is the responsibility of employees to ensure that they are in compliance with state and federal regulations, organizational policies, and job expectations. A professional demeanor detailed in codes of ethics, including collaborative spirit and adherence to professional standards, is also essential. Individual staff members with the ability to work with others and maintain professional relationships are a critical component of any successful workplace. While administrators may not be direct caregivers, we must still abide by the tenets of the caregivers’ pledge. The Caregiver’s Pledge The Caregiver’s Pledge by Pozgar (2018): I will be compassionate. I will not neglect my duties and responsibilities. I will read instructions and follow protocols. I will seek verification of questionable orders. I will report concerns for patient safety (e.g., staffing concerns). I will not assume responsibilities beyond my capabilities. I will call for help when any patient’s medical needs suddenly change. I will continuously improve my skills and participate in continuing education opportunities. (p.560) Reference: Pozgar, G. D. (2018). Legal and ethical Issues for health professionals. Burlington, MA: Jones & Bartlett Learning Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Employee Rights and Responsibilities From the South University Online Library, review the following articles: · Decent Work: The Moral Status of Labor in Human Resource Management  · Labour Rights Training 2.0: The Digitalisation of Knowledge for Workers in Global Supply Chains  Patient Rights and Responsibilities The healthcare administrator may be instrumental in upholding patient rights. These rights are numerous and include the patients’ right to be informed of their rights. This, essentially, means that the healthcare administrator and others involved in patient care have the duty to ensure that a patient is fully aware of what he or she is entitled to in terms of care, special needs accommodations, choice, and respect. With patients who may have communication issues, such as patients who speak English as a second language or elderly patients with learning differences, every effort must be made to inform and uphold rights. For example, hospital administration may sanction on-site translators or patient advocates assigned to help patients navigate the healthcare network. Additionally, the administration must work with information technology specialists to ensure that patient data is secure and confidential, while remaining accessible to the patient. Upholding patients’ rights to compassionate, quality care not only maintains compliance with a variety of federal laws and directives but also embraces organizational ethics. Patients also have a number of responsibilities. While many believe in individual choice and freedom, individuals have a responsibility to lead healthy lifestyles and seek medical care in a timely fashion. Some of the most challenging elements of effective patient care include noncompliance: patients who fail to keep follow-up appointments, patients who fail to take medications regularly and accurately, and patients who fail to fully disclose their medical history. An open and honest relationship between patient and provider is necessary to help ensure positive health outcomes. This partnership hinges on information exchange in a manner that is understandable and respectful. That is, as providers share information with patients, that information should be culturally sensitive and complete. Similarly, patients hold the responsibility to stay informed, ask questions as needed, and work with healthcare providers to get and stay healthy. The role of the healthcare administrator in promoting patient responsibilities may be through implementing outreach services for an appointment or medication reminders or providing necessary connections to ancillary services with health educators, weight loss specialists, or emotional support groups. Overall, patient rights and responsibilities come together when the individual takes an active role in his or her health and well-being. Patients' Bill of Rights Review each button to learn more. · The patient’s Bill of Rights is a list of guarantees—patient information, fair treatment, and autonomy over medical decisions—for all those receiving medical care in the United States. While there was an effort to pass a bill in 2001 as a “Bipartisan Patient Protection Act,” the effort failed. However, many providers still look to the 1995 document set forth by the Association of American Physicians and Surgeons for patient freedoms. According to this document (Association of American Physicians and Surgeons), the following freedoms are guaranteed to patients: · To seek consultation with the physician(s) of their choice; · To contract with their physician(s) on mutually agreeable terms; · To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient; · To use their own resources to purchase the care of their choice; · To refuse medical treatment even if it is recommended by their physician(s); · To be informed about their medical condition, the risks and benefits of treatment and appropriate alternatives; · To refuse third-party interference in their medical care, and to be confident that their actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physicians; · To receive full disclosure of their insurance plan in plain language, including: · Contracts: A copy of the contract between the physician and health care plan, and between the patient or employer and the plan; · Incentives: Whether participating physicians are offered financial incentives to reduce treatment or ration care; · Cost: The full cost of the plan, including copayments, coinsurance, and deductibles; · Coverage: Benefits covered and excluded, including availability and location of 24-hour emergency care; · Qualifications: A roster and qualifications of participating physicians; · Approval Procedures: Authorization procedures for services, weather doctors need approval of a committee or any other individual, and who decides what is medically necessary; · Referrals: Procedures for consulting a specialist, and who must authorize the referral; · Appeals: Grievance procedures for claim or treatment denials; · Gag Rule: Whether physicians are subject to a gag rule, preventing criticism of the plan. Reference: Association of American Physicians and Surgeons. (n.d.). Patient bill of rights. Retrieved from https://aapsonline.org/patient-bill-rights/ Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Patient Rights and Responsibilities From the South University Online Library, review the following articles: · Does Volk v DeMeerleer Conflict with the AMA Code of Medical Ethics on Breaching Patient Confidentiality to Protect Third Parties?  · The Role of the Health Service Safety Investigations Body  · EMTALA's Impact on Patients' Rights in Colorado Emergency Rooms  Patient Consent Patient consent is an important part of running healthcare organizations that are compliant with legal and ethical expectations. Consent may be defined as “. . . voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow something properly by another to be performed . . .” (Pozgar, 2016, p. 413). Generally, patient consent may come in two forms: · Expressed consent is communicated verbally or through written words—explicit permission. · Example: Yes, I consent to this procedure. · Implied consent involves the presumption that consent has been authorized—action relayed. · Example: Rolling up a sleeve to give blood for testing. Consent must be informed that is, a patient has the legal right to understand the risks, benefits, and alternatives to any proposed procedure. This ensures that the patient is making a sound decision based on complete knowledge and evaluation of available options. As a healthcare administrator, you may be asked to develop or maintain informed consent forms for your organization. An informed consent form should include the following elements: · The nature of the patient’s illness or injury · The name of the proposed procedure or treatment · The purpose of the proposed treatment · The risks and probable consequences of the proposed treatment · The probability that the proposed treatment will be successful · Any alternative methods of treatment along with their associated risks and benefits · The risks and prognosis if no treatment is rendered · An indication that the patient understands the nature of any proposed treatment, the alternatives, the risks involved, and the probable consequences of the proposed treatment · Signatures of the patient, physician, and witnesses · The date the informed consent form is signed In some cases, however, consent must be statutory. In emergency scenarios, for example, where immediate intervention is necessary to prevent long-term impairment or death, consent is statutory. Additionally, parents or legal guardians may give consent on behalf of a minor child or for an individual who is deemed incompetent to give consent. Case Study Consent can be implied in nonemergency situations. For example, a patient may voluntarily submit to a procedure, implying consent, without any explicitly spoken or written expression of consent. In the Massachusetts case of O’Brien v. Cunard Steam Ship Co. (1891), a ship’s passenger who joined a line of people receiving injections was held to have implied his consent to a vaccination. The rationale for this decision is that individuals who observe a line of people and who notice that injections are being administered to those at the head of the line should expect that if they join and remain in the line they will receive an injection. The plaintiff entered the line voluntarily. The plaintiff had the opportunity to see what was taking place at the head of the line and could have exited the line but chose not to do so. The jury appropriately determined this to be consent to the injection. The O’Brien case contains all of the elements necessary to imply consent to a voluntary act: The procedure was a simple vaccination. The proceedings were visible at all times, and the plaintiff was free to withdraw up to the instant of the injection. Reference: O’Brien v. Cunard Steam Ship Co., 28 N.E. 266 (1891) Additional Materials From your course textbook, Legal and Ethical Issues for Health Professionals, review the following chapter: · Patient Consent From the South University Online Library, review the following articles: · Transparency and Choice in Learning Healthcare Systems  · Recording Advance Decisions to Refuse Treatment  · Patient Preferences toward an Interactive E-Consent Application for Research Using Electronic Health Records  · The Quality of Informed Consent after the Establishment of Patient Safety Standards: The Consent of the Physician, The Presence of a Third Party, The Description of the Type of Procedure, The Description of the Benefits of the Procedure  Week 4 Discussion Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right” and any specific instructions for this topic. Your initial posting should be addressed at 300–500 words. Make your post to this Discussion Area by the due date assigned. Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area. DIFFICULT DECISIONS Review the following case study and address the questions that follow: The plaintiff, Bonita Perkins, in Perkins v. Lavin, was a Jehovah’s Witness. She gave birth to a baby at the defendant’s hospital. After going home, she began hemorrhaging and returned to the hospital. She specifically informed the defendant’s employees that she was not to be provided any blood or blood derivatives, and she signed a form to that effect: I request that no blood or blood derivatives be administered to [plaintiff] during this hospitalization, notwithstanding that such treatment may be deemed necessary in the opinion of the attending physician or his assistants to preserve life or promote recovery. I release the attending physician, his assistants, the hospital, and its personnel from any responsibility for any untoward results due to my refusal to permit the use of blood or its derivatives. Because of the plaintiff’s condition, it became necessary to perform an emergency dilation and curettage. She continued to bleed, and her condition deteriorated dramatically. Her blood count dropped, necessitating administration of blood products as a lifesaving measure. Her husband, who was not a Jehovah’s Witness, consented to a blood transfusion, which was administered. The plaintiff recovered and filed an action against the defendant for assault and battery. The plaintiff’s claim as to assault and battery was sustained. The plaintiff specifically informed the defendant that she would consider a blood transfusion as offensive contact. Although both parties noted that the plaintiff’s husband provided his consent for the transfusion, the defendant had not argued that his consent was sufficient to overcome the plaintiff’s direction that she was not to receive a transfusion. The plaintiff submitted sufficient evidence to the trial court to establish that there was, at least, a genuine issue as to whether the defendant intentionally invaded her right to be free from offensive contact. Because of the plaintiff’s recognition that the defendant acted to save her life, a jury may find that she is entitled to only nominal damages. Tasks: · Should the court be the ultimate decision maker when there is a dispute over whether a lifesaving measure should be administered to a nonconsenting patient? Explain. · Should a parent have the right to refuse a lifesaving treatment (e.g., transfusion) for a minor? Explain. 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. Week 4 Project  Instructions Before beginning work on this assignment, please review the expanded grading rubric for specific instructions relating to content and formatting. NONCONSEQUENTIAL ETHICS Each week, you will have the opportunity to explore an ethical theory—consequential ethics, utilitarian ethics, deontological ethics, and nonconsequential ethics—in the context of a case scenario from your textbook. In this week, the focus will be on nonconsequential ethics. Nonconsequential ethics suggests that the assessment of right or wrong must be based on the action and not the consequences. Tasks: 1. Download and save the  assignment template  to your computer and update the file name to include your last name. 2. Review the assigned case in its entirety. 3. Address the questions posed in detail and with appropriate scholarly support. 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. MHA6060: Health Law and Ethics Week 4 Assignment NON CONSEQUENTIAL ETHICAL THEORY Please review the following case: Chelsea was preparing to drape Mr. Smith’s leg in OR 6 for surgery when she was approached by Nicole, the nurse manager. Nicole asked, “Chelsea, please come to OR 3. We have an emergency there and urgently need your skills to assist the surgeon.” Chelsea turned to Daniel, the surgical technician, and asked him to continue prepping Mr. Smith’s leg for surgery. Daniel prepped the leg prior to the surgeon entering the room. The surgeon entered the room a few minutes later and asked, “Where is Chelsea?” Daniel replied, “She was called away for an emergency in OR 3. Karen will be shortly in to assist us.” Following the surgery, Mr. Smith was transferred to the recovery room. While he was in the recovery room, a nurse was looking at the patient’s medical record as to the notes regarding the patient’s procedure during surgery. She noticed that the surgery was conducted on the wrong leg. Although there was a heated discussion between the surgeon and the nursing staff, each member of the staff had good intentions, but the outcome was not so good. Nonconsequentialists believe that right or wrong depends on the intention. They generally focus more on deeds and whether those deeds are good or bad. In this case, the intentions were good but the outcome was bad. It should be noted that nonconsequentialists do not always ignore the consequences. They accept the fact that sometimes good intentions can lead to bad outcomes. In summary, nonconsequentialists focus more on character as to whether someone is a good person or not. Nonconsequentialists believe that right or wrong depends on the intention. Generally, the consequentialist will focus more on outcomes as to whether they are good or bad. Please address the following questions drawing support from your course resources and credible scholarly resources cited in APA format : Describe how the nonconsequential theory of ethics applies in this case. What questions might a consequentialist raise after reviewing the facts of this case and why. 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