Essay on Ethical and Legal Issues Faced by Healthcare Executives

Today, an array of guidelines, laws, legislation, and more complicated ethical principles regulate the healthcare industry. Much of these guidelines and laws revolve around matters such as patient confidentiality, informed consent, and patient physical relationship. Importantly, with so many guidelines, ethical and legal issues can appear out of nowhere even when physicians and other medical professionals have the best intentions at heart (Aitamaa et al., 2010). What is termed legal might not be considered ethical, and there is the ever-present threat of healthcare institutions being sued for negligence and malpractices. Moreover, there are unresolved issues around physician-assisted dying that need to be settled. All in all, many legal and ethical issues face healthcare executives, some of which are highlighted in this article.

The first legal issue has to do with patient confidentiality. Health executives are legally responsible for protecting patients and hospital data. It is important to note that when a breach of electronic data happens, hospital executives are usually held accountable. Moreover, the Health Insurance Portability and Accountability Act (HIPAA) highlight guidelines on when and how hospitals can release patient information (Cohen et al., 2014). The HIPAA and other related laws state the type of information hospital ought to release to third parties, and the information that needs to be kept private. A slight misrepresentation, in this case, can lead to unwarranted instances. In most cases, medical executives find themselves entangled in court cases and legal suits regarding the loss or theft of social security numbers, and exposure of personal health information.

The other legal issue is related to physician referrals. It is important to note that United States law prohibits doctors from referring patients for selected health services paid by Medicare to institutions in which they have a financial connection. The common law prohibiting this act is known as the Federal Stark Law (Goldsmith, Kaufman, & Burns, 2016). Recently, different healthcare companies in the U.S. have found themselves or their employees in court battles for violating the Federal Stark law. For example, two healthcare managers pleaded guilty to Medicare fraud in 2010 (Tom Watkins, 2020); the two (Robert Bourseau and Rudra Sabaratnam) pleaded guilty for recruiting homeless individuals for unwarranted medical services, which were billed to government healthcare programs.

In addition to the issues caused by the Stark Law, healthcare executives may face further problems that arise due to instances such as completion, pricing, and customer allocation. Healthcare completion, pricing, and customer allocation are governed by antitrust laws that outlaw practices such as price-fixing, market division, bid-rigging, and other such practices. Antitrust laws apply in other industries as well. In the healthcare industry, it regulates how hospitals relate to other hospitals, hospital-physician relations, and how hospitals relate with their patients (Nahed et al., 2012). In this case, healthcare executives have to ensure that their organization healthcare costs are aligned with government preset healthcare costs.

The first ethical issue that medical executives are likely to face in the contemporary world is related to physician-assisted suicide (Snyder, 2012). Many healthcare practitioners in the United States today are aware that in most states, including Oregon and California, physician-assisted dying is legal. In such states, physicians are allowed to offer relief to patients who are dying or suffering due to fatal illness. Nevertheless, healthcare leaders need to be prepared to deal with patient assisted dying issues when they arise. Studies also show that about 50 percent of doctors in the United States some form of physician-assisted dying.

Malpractice and negligence is another ethical issue predominant within the healthcare industry (Snyder, 2012). Executives in healthcare typically run the risk of being prosecuted for medical malpractice and negligence. A patient injured by faulty medical equipment or a patient injured during a medical procedure can sue to recover their damages (Snyder, 2012). In addition to this, patients can also sue a healthcare organization when the physicians in that particular organization fail to offer needed medical service or treatment. In delivering medical services, health care professionals must carefully cover all of the bases to avoid the ever-present danger of litigation.

Initiating personal patient-physician relationships can be dangerous at times as doctors, and other medical professionals are banned from forming personal relationships with their patients, particularly while providing treatment (Snyder, 2012). Breaking this rule, particularly when it involves sexual relationships can lead to detrimental instances such as license termination, and lawsuits. Establishing sexual relationships with a patient is one of the most severe violations of patients’ rights; it is also considered an act of abuse of power. Patients are deemed vulnerable while under medical treatment; hence, a slight display of sexual relationship with a patient in such an instance can have significant consequences for the healthcare organization.

The medical practice is surrounded by numerous governing laws and policies which ensure that patients are offered the best available care. These guidelines protect the patients; however, they create significant legal and ethical issues from the medical executives’ perspective. Patient confidentiality, patient referrals, developing unjustified patient-doctor relations are some of the issues that may face healthcare executives today and in the future.

References

Aitamaa, E., Leino-Kilpi, H., Puukka, P., & Suhonen, R. (2010). Ethical problems in nursing management: The role of codes of ethics. Nursing Ethics, 17(4), 469-482. https://doi.org/10.1177/0969733010364896

Cohen, I., Amarasingham, R., Shah, A., Xie, B., & Lo, B. (2014). The legal and ethical concerns that arise from using complex predictive analytics in health care. Health Affairs, 33(7), 1139-1147. https://doi.org/10.1377/hlthaff.2014.0048

Goldsmith, J., Kaufman, N., & Burns, L. (2016). The tangled hospital-physician relationship. Health Affairs Blog, 9. https://www.healthaffairs.org/do/10.1377/hblog20160509.054793/full/

Nahed, B., Babu, M., Smith, T., & Heary, R. (2012). Malpractice liability and defensive medicine: a national survey of neurosurgeons. Plos ONE, 7(6), e39237. https://doi.org/10.1371/journal.pone.0039237

Snyder, L. (2012). American college of physicians’ ethics manual. Annals of Internal Medicine, 156(12), 73. https://doi.org/10.7326/0003-4819-156-1-201201031-00001

Tom Watkins, C. (2020). Hospital chain to pay $16.5 million in kickback case involving the homeless – CNN. CNN. Retrieved 24 June 2020, from https://edition.cnn.com/2012/08/24/health/homeless-kickbacks/index.html