The Veteran Affairs hospital’s

The management of the Veteran Affairs hospital failed to provide an enabling environment for the doctors and nurses to carry out their everyday responsibilities. It took the intervention of doctors who took matters into their own hands to save patients who had been admitted to the hospital.
A successful firm must adhere to strict ethical standards. Behavior and ethics boost performance through improving morale and teamwork. Different businesses have specific requirements that personnel must follow in order for various activities to perform smoothly. All nurses, doctors, and other practitioners in the medical area and health service industry must adhere to ethical norms. The health administrators are responsible for availing required resources to the practitioners for effective healthcare operations. The failure to act ethically and morally when delivering care to patients may result to litigations. The paper will address ethics in the healthcare system with reference to the movie Article 99 (1992) directed by Deutch, Cutler, Elfman, Liotta, Sutherland and Whitaker.

Title

The state of healthcare delivery to the veterans and other regions of the country are atrocious. The setting of the movie is a Veteran Affairs Hospital that is crueler compared to the harsh North Vietnamese war zone. The movies highlighted the bureaucracies that make healthcare delivery almost impossible. The hospital lack humanity in the medical practice as the war veterans cannot access health services. The doctors cannot work efficiently due to crippled budget. The down-sized funds literary take abilities of the practitioners out of their hands. The doctors had to hoard supplies and created more space for other patients to get equal health care services. The doctors acted accordingly though out of their professional ethics to help the war veterans.



MEMO

To: The Reader

From: Name

Date: December 2, 2017

Subject: Ethics at the Workplace

Context

During crises, it is important to be creative, sneaky and utilize available methods to do the correct thing. In the movie Article 99, a group of doctors conscientiously went their way to assist patients deprived hospital access due to bureaucracies (Elfman et al. 2004). Doctors in Veterans Hospital try to care for patients despite the existence of a stingy administrator. The movie is a medical melodrama where the physicians do not perform acts of valor. Instead, they fail to perform life-saving as required of them. To function as doctors, the heroic doctors have to become outlaws in the organization.

The hospital itself is a war zone. The working environment is booby-trapped with Byzantine regulations, a mountain of paperwork and constant cases of lost medical records. As a new member of the staff at the hospital, Doctor Morgan (Kiefer Sutherland) discovered the anomalies in this organization; nothing was working as it should. Morgan was shocked on arrival at the operation room as patient scheduled for prostate surgery had a by-pass chest opening. Working as an intern, he was a new kid on the block and found a sentimental attachment to the elderly patients such as Eli Wallach (Elfman et al. 2004). The reason given by other doctors was that a soldier is eligible for treatment only if injured during the service. The move aimed at cost cutting administrative loopholes. The medical practitioners faced with insurmountable barriers, they had to act on their own and took the matter individually. Dr. Sturgess (Ray Liotta) played an essential role in maintaining humanity and dignity of patients (Elfman et al. 2004).Together with other doctors, Dr. Sturgess, they formed guerilla surgeons. Every move intended to fray Dr. Henry Drefoos’ nerves who constantly urged the clinicians to acquire ‘the right perspective’. Sturgess functioned as the hospital’s best-loved prankster and troublemaker. They became Hippocratic anarchists and took patients to the operation room without permission. Additionally, they hid patients in the laundry rooms as well as raiding stores to acquire medical supplies.

Task Statement

The administrator at the hospital Dr. Henry Dreyfoos (John Mahoney) played the evil nemesis in the film was only interested in cutting down the budget rather than assisting the suffering people in the hospital. Mahoney had no commitment to the patient’s care and welfare of the doctors too. It resulted in chaos and mishandling of patients as the doctors lacked resources and motivation to work. Mahoney did not observe biomedical ethics of Nonmaleficence that obligates health care providers not to cause harm to other (Weise, 2016). They carried out wrong surgical procedures leading to further pain, suffering and deprived goods of life. The doctors failed to improve the welfare of the patients. The beneficence principles call for positive steps to assist and not merely refraining from harm. The welfare of the patients must be justifiable, rational and set towards achieving a certain goal. The doctors were not just in their dealing until the revolutionary doctors arrived. The justice tenet requires fairness and equal treatment to all. In recent years, treating patients as one would wish to be treated is no longer enough (Dickenson & Vineis, 2002). The observation or following the tenet blindly may land one in trouble.

The healthcare administrators’ role is to ensure that patients receive ethical and high-quality treatment. They should heighten their leadership capabilities in the organization and oversee the function of their healthcare facilities (Weise, 2016). The leaders need to engage the nurses and doctors in continuous training programs on professional ethical practices.

Recommendations

• The hospital directors and medical practitioners should apply the moral code in their practice; adhere to the ideals and Hippocratic Oath.

• Healthcare administrators to increase their supervision skills

• Enabling environment for the nurses and doctors

• Resource allocation and proper compensation

• Training of nurses and doctors

• Striking a balance between fiscal responsibility and Ethics

• Improving physician-hospital relationship

Recommendation discussion

The hospital management needs to ensure that everyone put the efforts towards achieving the mission statement. The policies created should not be in contravention with the ethical codes of nurse and doctors. The leadership should focus on promoting and encouraging the initiatives coming from the medical staff in the implementation of ethical guidelines. The doctors should virtuous and act as the moral agent thus strive to avoid immoral and vice activities.

Adhering to Professional Ethics

The purpose of ethics in the medical professional is to provide all practitioners with relevant information on codes of ethics, ethical principles and highlight different situations healthcare professionals encounter during their practice. They act as the reference point in case of conflict or confusion. Ethics in the medical field allows patients irrespective of their social or ethnic background a principled and quality care (Jonsen, Siegler & Winslade, 2006). Healthcare professionals need to abide by values such as beneficence, non-maleficence, justice and autonomy (Beauchamp, 2013). The tenets allow the care providers, clinicians, doctors, and families to come up with a working treatment plan towards a common goal without hitches.

The social setting of the healthcare systems abounds in ethical conflicts and problems caused neither by the workers nor hospital management. The conflict between the patients and nurses, sloppy informed consent before engaging patients in clinical trials or conflict among the clinical officers do not even reach the management level. Nevertheless, the managers in the hospitals must perform exceptional responsibilities in hospitals. Their position in the healthcare system hierarchy allows them to make decisive and concrete directions within health delivery frameworks. The leaders’ decision making is an essential pre-condition that allow other staff to integrate ethics into their work. It is the responsibility of the management to ensure proper care to patients, staff work in appropriate conditions and the community benefit directly from the services delivered. According to AHA (American Hospital Association), the patients must be treated equally. The hospital staff must apply social and ethical standards as they serve the community (Jonsen, Siegler & Winslade, 2006).

The healthcare facilities are responsible and accountable for the patients seeking treatment. The asymmetrical relationship between practitioners and patients allows the service givers the opportunity to apply knowledge and authority. The patients’ rights are protected under the AHA code of conduct that include confidentiality, respect for cultural, spiritual beliefs and informed consent during therapy. The hospital administration ensure continuity of care to the patient and at the same time create enabling environment for the doctors to provide possible alternatives to their ailments thus improved therapy and quality of care.

Striking a balance between fiscal responsibility and Ethics

The health administrators make financial decisions that have an impact on both quality of care and the organizational operations. It is a daunting task to balance competing demands thus pits ethics, budget, and quality against each other. The rationing or scarce resources in the medical field result to ethical problems. The private and public organization aims at reducing the cost of operations. If taken too far, fewer resources result in serious challenges in health delivery. It is the responsibility of the nurses and doctors to use what is within their powers to save the life of patients. Doctors need enough resources to carry out their daily activities. The hospitals cutting down their budget on required resources effectively betrays the clients. Such behavior is unethical and is unacceptable.

In addition to inadequate resource allocation, lack of working hours as well as poor pay limits staff engagement in ethically important activities. The management needs to use its influence to minimize such challenges through fir benefits, fair compensation, and equal opportunity for career advancement to all medical workers. The continuous education will be an integral part of the steady improvement of quality in the healthcare system. Secondly, it is important to develop the right incentives for the physician when strengthening alignment in the organization. Increased salaries or reimbursement to incorporate risk sharing components works magic. The rewards and metrics must be clearly stated before the parties embark on specific incentive strategy.

Training

The nurses, doctors and other care providers oversee the health of each patient on a daily basis. However, the hospital administrators facilitate important decisions about the care of the patients especially on issues concerning ethical and moral dilemmas. According to Nicolaides (2014), administrators play an essential role in determining whether to carry out the genetic testing on a fetus or euthanasia. Additionally, the advanced technology, as well as state-of-the-art equipment, increase doctors’ abilities to advance the quality of care. In this regard, the healthcare ethics experience constant changes. It will require the health administrators to acquire proper training to meet current and future challenges encountered when ethically assisting patients towards the best care services (Selvakumar & Joseph, 2004).

The health administrators require a graduate degree to enter the field. However, the tasks require more skills and knowledge. Therefore, the people working as administrators need to have a master’s degree in Health Administration. The instructors from the various field of the healthcare have a considerable contribution towards creating an ethical practice program that will address the challenges facing the medial system today (Selvakumar & Joseph, 2004). Teaching medical ethics in the medical school will assist in improving decision making processes. The doctors and nurses will have the correct know-how, knowledge, and skills to allow them to make appropriate analyses and diagnosis. Subsequently, they will be able to offer ethical solutions to challenges and dilemmas encountered (Nicolaides 2014). The drive to implement the core curriculum to all medical school will enhance ethics education among the practitioners. It is imperative that learners acquire an adequate understanding of non-negotiable moral reasoning in their role as future practitioners.

The training of ethics should be a continuous process but this does not happen as required. The ethical issues are becoming complex and demand careful investigations in finding the correct answers. The time to study the ethical content in the curriculum has been the main question. Some studies suggest that undergraduate’s curriculum is best suited time to cover ethical topics. Conversely, other studies suggest that medical ethics should be taught at the postgraduate level. The program coincides with the required continuous professional development initiatives (Singer 2000). The findings show that postgraduate level student is aware of the ethical dimensions of the medical practice. However, the time does not matter. Learners should recognize the ethical and humanistic component of the healthcare system and be able to translate and integrate ethical principles into their medical filed.

Improving physician-hospital relationship

During the recruitment process, it is important to clearly define the expectations regarding performance, communication with junior staff and medical ethics. The physicians need to be involved in setting clinical benchmarks and key decision-making processes (Samadi-Niya, 2015). Dictatorship from the management leads to resistance and disruption of activities. Physicians with the feeling that the management is hiding something derail partnerships. Interdependent relationships, however, creates a win-win situation for everyone. Physicians will enjoy management support, the patients will benefit from improved care. Subsequently, the hospital achieves the set goals and objectives at a reduced cost to the taxpayers. Therefore, it is crucial to accommodate all stakeholders in setting goals and expectations. Frequent communication between the staff and the administration creates better connections between staff members and the executives (Samadi-Niya, 2015). The hospital needs to have a committed two-way channel of communication. It is also essential to hold quarterly meetings with different speakers to discuss networking opportunities and information exchange.

The healthcare administrator needs to create a strong group of physician leaders. Involving the staff in the daily management of the hospital creates a solid team with common goal, dedication, commitment and substantial support from the top leadership (Samadi-Niya, 2015). The leaders must be willing to foster communication and listening to colleagues. The leadership program should be a core element or curriculum during continuous improvement initiatives. Effective doctor and nurse leaders need to grasp the leadership concepts and operationalize them in the working environment.



References

American Hospital Association (AHA). AHA management advisory—ethical conduct for healthcare institutions. Chicago: AHA, 1992. Retrieved on December 2, 2017, from http://www.hospitalconnect.com/aha/resource_center/resource/resource_ethics.html

Deutch, H., Cutler, R., Elfman, D., Liotta, R., Sutherland, K., & Whitaker, F. (2004). Article 99. Paris: MGM home entertainment [éd., distrib.

Dickenson, D., & Vineis, P. (January 01, 2002). Evidence-based medicine and quality of care. Health Care Analysis : Hca : Journal of Health Philosophy and Policy, 10, 3, 243-59. Jonsen, A. R., Siegler, M., & Winslade, W. J. (2006). Clinical Ethics. Blacklick, USA: McGraw-Hill Professional Publishing.

Nicolaides L (2014). The critical role of ethics training in medical education. A frican Journal of Hospitality, Tourism and Leisure Vol. 3 (1)

Samadi-Niya, A. (January 01, 2015). Suggested methods to improve physician-hospital relationships in Canada. Healthcare Management Forum, 28, 3, 106-113

Selvakumar, D., & Joseph, L. B. (January 01, 2004). The importance of including bio-medical ethics in the curriculum of health education institutes. Education for Health (abingdon, England), 17, 1, 93-6.

Singer, P. A. (January 01, 2000). Recent advances. Medical ethics. Bmj (Clinical Research Ed.), 321, 7256, 282-5.

Weise, M. V. (January 01, 2016). Medical Ethics Made Easy. Professional Case Management, 21, 2.)