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Ethical Dilemma Within a Clinical Organization

The behavior of ethical analysis is of high academic relevance to any professional practice because it addresses several issues related to operational effectiveness at once. Exploring ethical dilemmas within a clinical organization has high relevance to all stakeholders, including medical staff, clients, and district administration. Consequently, how successfully a particular professional code of ethics issue is addressed determines how smoothly and highly effective the company’s subsequent clinical operations will be. This essay discusses in detail one of the most pressing problems of the current agenda, namely patient confidentiality as an object of health care delivery. It is true that physicians often violate ethical principles by disclosing private patient data. The purpose of this essay is to provide critical analysis of this problem, realized through discussion and examination of authoritative sources.

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Of primary importance within the issue under discussion is the clarification of the ethical dilemma that is being investigated. To begin with, it should be noted that the patient is the key actor in any clinical process since any manifestation of health services has a patient-centered orientation. At the same time, this relationship is always strictly individual: qualified clinicians clearly understand that the exact instructions may affect different patients differently. This understanding is justified by the atypicality of human bodies, the presence of chronic and concomitant diseases, and genetic differences, after all. On the other hand, the multiplicity and heterogeneity of clinical cases often become the foundation for discussions of the case. In an effort to explain in more detail the nature of a particular patient’s pathophysiological condition, physicians or nurses may share this information with colleagues, their family members, or members of the patient’s family. Moreover, in many developing regions, the concept of medical confidentiality is not yet fully legally and morally established. To put it another way, it is not uncommon for incompetent physicians to disclose a complicated diagnosis — for instance, cancer — first to the family, that they more sensitively pass it on to the patient. In addition, many of the patients’ parents or partners may not always accept that some of the medical information cannot be divulged to them, despite their family or loving intimacy with the patient. All of this adds up to a serious moral problem. The ethical dilemma, in this case, determines the morality of such discussions realized without the patient’s consent. The critical issue is to determine whether it is permissible to disclose confidential patient data — including test results, prognoses, and diagnoses — without the individual’s consent.

Admittedly, this issue is an important one that falls under the responsibility of the health care administrator. As the leader of a clinical organization, the administrator is hardly eager to violate the code of ethics. The consequences of such a violation can significantly diminish the reputation of the institution, as well as a result in losses if the patient decides to take legal action (How much, 2021). However, poor management effectiveness, lack of corporate training programs for health care workers, and insufficient sanctions are catalysts for the ethical dilemma. More specifically, even in spite of organizational leadership strategies, unscrupulous institutional employees may surreptitiously disclose data and share work-related incidents with their family members. Technically, these acts are difficult to trace, but the very act of disclosure should be considered a violation of the professional code of ethics. The adverse effects of such a crime usually lie in economic and organizational issues.

From an economic point of view, disclosure of confidential patient data can lead to financial imbalance. As a general rule, if no external or internal factors cause dislocation, the economic systems of clinical organizations are in a state of stability. A financial management system built up over many years of operation allows clinics to intelligently allocate revenues to pay salaries, utilities, medications, and equipment upgrades. Saved money can always be sent to a reserve fund, which will be used if necessary. However, the ethical dilemma under discussion could significantly upset this balance since a breach of patient clinical confidentiality could result in a lawsuit. In fact, U.S. jurisdiction — namely, Federal Law — fully protects any written, oral, or digital patient health information from disclosure. In addition, the U.S. has a 1996 act, HIPAA, which governs the protection of such data in more detail (OCR, 2020). If this law is violated, the patient is entitled to recover damages from the clinic, including fines for moral, emotional, and reputational interference. For example, under HIPAA regulations, the maximum fine for disclosing a patient’s personal information is $1.5 million (How much, 2021). Another type of sanction — which is often combined with a fine — can be imprisonment. In either case, it is clear that both fines and criminal prosecutions are states that put significant pressure on a clinic’s financial balance sheet. The need to pay for an employee or to have him or her fired would increase costs and, as a consequence, impair the operational efficiency of the institution.

Aspects of the accessibility of medical services may also suffer as a result of this ethical dilemma. On the one hand, an attempt to disseminate sensitive information about a patient to family members may be well-intentioned. In this case, health care providers may be guided by the idea that relatives will find a better approach to the patient, which will ultimately increase trust in the clinic and increase the availability of healthcare services. However, on the other hand, the disclosure of personal data would be a significant blow to the organization, which would affect its reputation and could even lead to a temporary suspension of professional activities for the duration of the judicial investigation. Then, those who wish to obtain medical care will not be able to turn to this organization, which will complicate the availability of its services. In turn, the decrease in the reputation and trust of clients may be accompanied by a deterioration in the quality of clinical care provided. A reduction in the client base will entail a reduction in funding and, as a result, a decrease in the quality of services.

It is not difficult to determine that aspects of strategic planning will also be threatened. Typically, a health care administrator will have a formalized plan for the months ahead that will guide the organization toward commercial and professional development. However, a breach of the ethical dilemma could entail a halt in operations and a shrinking of the client base. It is understandable that prospective patients will refuse the services of a clinic that cannot enforce the fundamental legal principles of HIPAA and Federal law. Then the whole plan for development will be frozen because of the rapidly changing agenda.

This problem can also be considered from another angle. As it is known, strategic planning ensures the viability of the company in a competitive market. This is mainly realized through the correspondence between normative organizational indicators and accurate data that can be measured. Thus, if a clinic repeatedly violates the ethical framework, it leads to a disconnect between the professional code and the reality of the institution. This contributes to an increased distance between employees and, as a result, a reduction in the sustainability of the facility.

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One additional consequence of a breach of the code of ethics, lying in the plane of organizational change, is a decline in risk management. The initial risk assessment and, as a consequence, the orientation of strategic planning may not be designed for acts of violation of professional ethics. In other words, the risk assessment carried out will prove to be untenable because it will not take into account internal crimes. On the other hand, violation of the rule of non-disclosure of confidential data is, as has already been emphasized, a severe legal problem. If a clinical organization is repeatedly spotted in such episodes, it will terminate the clinic’s active license. At the same time, it will become a reason to suspend the professional activities of the company.

In conclusion, it should be emphasized that strict adherence to the code of ethics is an essential professional obligation for any medical professional. Nevertheless, scenarios in which employees disclose confidential patient information — even in good faith — cannot be completely ruled out. In such cases, the clinical institution is exposed to severe economic, reputational, organizational, and legal risks, as has been shown in this paper. Addressing such ethical concerns is possible by supporting training programs, instilling corporate values in employees, and encouraging adherence to the code.

References

How much do HIPAA violations cost? (2021). True Vault.

OCR. (2020). Your rights under HIPAA. HHS.

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