Preferred Provider Organization (PPO) Scenario
A patient who has been dealing with a back injury for the past 2 months runs out of pain medication and asks his PCP for a refill. The PCP denies the refill and suggestions over-the-counter medication. The patient decides to go see another doctor and get a prescription.
- Ethical issues: Yes.
- Legal issues: Yes.
What is the issue? (ethical and/or legal)
A possible legal issue is that a doctor is obliged to provide a patient with comprehensive treatment. Moreover, the PCP did not explain the reason for the denial. That also may cause an ethical issue, as it undermines the patient’s trust in a doctor and medicine in general.
Recommendation
A probable solution to this problem is a detailed conversation between the doctor and the patient. If the denial of prescription of a particular medicine is reasonable, that should be explained to the patient.
Physician-ownedhospitals Scenario
A patient is meeting with her PCP and the doctor notices that her blood pressure is elevated. The PCP tells the patient that she should go to the ED immediately and refer her to a specialty hospital, which he has ownership across town.
- Ethical issues: Yes.
- Legal issues: Yes.
What is the issue? (ethical and/or legal)
An ethical issue could be that the PCP deprived the patient of the right to choose a medical organization and a doctor. A legal issue may regard the advertisement of a particular hospital, which is forbidden.
Recommendation
The PCP should have called an ambulance or used the clinic’s facilities. Moreover, he may have offered the patient medical services provided by the insurance.
Liver transplant for a patient that is an alcoholic Scenario
A patient with cirrhosis of the liver and is a known recovering alcoholic has been on the transplant list for two years and has moved to the top of skipping a young child. A donor’s liver has just become available, a match for both patients.
- Ethical issues: Yes.
- Legal issues: No.
What is the issue? (ethical and/or legal)
A possible ethical issue with a liver transplant is that the alcoholic damaged his health himself. The reason for the operation is his weak will and lack of discipline. Moreover, there is a possibility that the person would keep abusing alcohol. The young child was likely to have a specific disease at birth.
Recommendation
The situation presents an intractable problem, as the recovering alcoholic was right in terms of the law. This way, the solution should be found in special legislation, for instance, providing sick children with some privileges.
Health insurance status Scenario
Two patients enter the hospital both complaining of severe abdominal pain with the same symptoms. One patient has insurance and the other does not. The acting physician decides to treat the patient with insurance.
- Ethical issues: Yes.
- Legal issues: No.
What is the issue? (ethical and/or legal)
The doctor’s actions are correct from the standpoint of law. However, both patients deserve competent treatment if they need it, and this fact presents an ethical issue.
Recommendation
One recommendation will be to ask another doctor for help if he/she is available. Another option is to offer the patient pain medication when the doctor is treating the one with insurance.
Mandatory health insurance Scenario
The Patient Protection and Affordable Care Act of 2010 mandates that all U.S. citizens have health insurance coverage or pay a tax for not doing so.
- Ethical issues: Yes.
- Legal issues: No.
What is the issue? (ethical and/or legal)
A possible ethical issue may be the cost of healthcare services in the United States. Frequently, the tariffs are extortionate for citizens, and this fact appears to be a burden, especially for large families.
Recommendation
A possible solution may be providing citizens with discounts and privileges for severely ill patients. In addition, it is essential to elaborate on the ways of decreasing the price of insurance.