Administrative Ethics Paper
HCS 335/Ethics: Health Care and Social Responsibility
June 10, 2012
Biomedical ethical issues are seen frequently in the news and are in constant scrutiny. The demand for social responsibility is high and available resources are limited. Healthcare leaders are faced with numerous administrative issues regarding patient privacy, research, confidentiality, and terminal illness. Much debate has surrounded medical spending on the terminally ill, such as the cost and allocation of resources toward end-of-life care. Choosing between prolonged life and quality of life are two seemingly difficult decisions to make. Nonetheless, it is ...view middle of the document...
According to Doty (2012), a medical provider states, “As a community, we must address the reality of spending precious resources on end-stage patients who will die within a short amount of time with or without medical treatment” (para. 18). The method of triage rationing raises ethical concerns because patients are treated as if they were soldiers out on a battlefield where only the ones with a higher chance of survival are saved. Although unspoken, the practice of rationing services is common in the NMI. The population is negatively impacted by the healthcare crisis and by the lack of hospice care. Family members of ailing patients are seen holding signs requesting for donations so their loved one may receive off-island treatment (Doty, 2012). Cost and allocation of resources are clearly administrative issues that need ethical evaluation. A senior administrator of the NMI seems lost at finding a solution and reminisces of the time when people accepted their fate and lived on the principle, “we live and die on our islands” (Doty, 2012, para. 33).
Ethical and Legal Issues
The ethical and legal implications of rationing health services have many facets. Beneficence and autonomy are among the ethical principles associated with allocating health resources; however, that is not the case when resources are scarce and funding is limited. As demonstrated in the NMI, mainly the poor and middle class are subjected to health care rationing. Aside from the poor, people most affected by health care rationing are the elderly and disabled persons (Peters, 1995). It is unethical of those with tremendous discretionary power to favor the prestigious over the poor or disabled. However, rationing based on the ability to pay already exists and is completely legal, such as rationing care of Medicaid patients or rationing by insurance companies (Fremgen, 2009). Although some people may believe rationing health care is unethical, it is economically inevitable as the demand for scarce health care resources increase. Therefore, it requires ethical consideration when allocating health resources.
According to the article, the proposed solution is a policy on medical care rationing (Doty, 2012). However, some politicians claim the unnamed policy is already put into practice. Furthermore, the administration proposes a tighter budget for the 2012 fiscal year but does not elaborate on how it will be accomplished (Doty, 2012). The manager of the medical referral services suggested to administration that the program be suspended and only used for emergency cases (Doty, 2012). However, no action has been taken to suspend the program. Another suggested solution is to place high emphasis on prevention and primary care to avoid excessive referrals during critical stages. Furthermore, hospice care is not available to everyone on the NMI, which if made an option, may minimize the health crisis by decreasing the demand of healthcare...