You are a member of your organization’s ethics committee. At this month’s meeting of the committee, two issues were discussed. The CEO has asked you to brief the new board chair on the importance of ethics in healthcare, how they differ from other industries, and how they apply to these specific circumstances. Select one of the two following scenarios as the focus of your analysis.
1. Hospital policy on influenza immunization.
The Centers for Disease Control and Prevention (CDC) have issued an advisory that the coming “flu season” is expected to be unusually severe. CDC projects a potentially historic level of illness and flu-related deaths.
Response to this, the president of thae medical staff has recommended that hospital staff, employees, and volunteers receive mandatory influenza immunizations. With exceptions for those who are allergic and anyone with a valid religious prohibition against vaccination, those who refuse the immunization would not be allowed to work. There is a small, but vocal, contingent of employees (including some nurses who are advocating for unionization of the nursing staff) who object to this policy, stating it is an infringement on individual rights and patient self-determination.
What issues should be considered in establishing this policy? To what groups is responsibility owed? What will you recommend to the hospital Board and C-Suite?
2. Balancing Needs
Your facility is a critical access hospital (CAH) serving a largely rural catchment area. The next nearest hospital, a comprehensive medical center is several hours distant.
During the monthly utilization review, the emergency department medical director noted a marked increase in cases of renal distress and failure, and that many of these patients do not have health insurance. They have been treated in accordance with the Emergency Medical Treatment and Active Labor Act (EMTALA), the federal statute that requires hospitals assess and stabilize anyone presenting for emergency services, regardless of ability to pay.
The chief of medical services responds that end stage renal disease requires ongoing evaluation and treatment, but that this is neither covered by EMTALA nor does the current medical staff have a specialist in this field.
What issues should be considered in addressing this situation? To what groups is responsibility owed? What will you recommend to the hospital Board and C-Suite?