Ethical Case Studies
Consider the ethical dilemma the health care professional is faced with in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).
Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.
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Incident 2: Emergency Department Repeat Admissions — A Question of Resource Use
Matt Losinski finished reading an article that provided grim details of a study of the overuse of emergency services in hospitals in central Texas. He smiled that sardonic half smile that meant there was a strong possibility that County General Hospital (CGH) might have the same problem. As chief executive office (CEO), Losinski always saw the problems of other hospitals as potential problems at CGH, a 300–bed, acute care hospital in a mixed urban and suburban service area in the south central United States. CGH was established as a county–owned hospital; however, 10 years ago the county wanted to get out of the hospital business and the assets were donated to a not–for–profit hospital system. The new owner has continued a strong public service orientation, even though CGH no longer receives the tax subsidy it did when it was county owned; it must look to itself for fiscal health.
The study data showed that nine residents of a central Texas community had been seen in emergency departments (EDs) a total of 2,678 times over 6 years. One resident had been seen in an ED 100 times each year for the past 4 years. Given that an ED visit can cost $1,000 or more, the nine residents had consumed $2.7 million in resources. These high users of ED services were middle age, spoke English, and were split between male and female. To Losinski, the problem seemed like a manifestation of Wilfredo Pareto’s classic 80/20 rule.
Losinski forwarded the article on a priority basis to Mary Scott, his chief financial officer (CFO), and asked her to see him after she read it. Scott stopped by Losinski’s office late the next day and began the conversation by asking him why he thought the article was a priority. Scott reminded Losinski that Medicaid paid 75% of costs for eligible ED users and that the cross subsidy from privately insured and self–pay ED admissions covered most of the unpaid additional costs. Losinski had a good working relationship with Scott, but he was a bit annoyed by her rather indifferent response.
Losinksi wanted details on use of the ED at CGH. He asked the administrative resident, Aniysha Patel, to gather data to identify use rates for persons repeatedly admitted to the ED. The findings that Patel gave to Losinski two weeks later were not as extreme as those reported from central Texas; however, they did show that a few persons were repeatedly admitted to the ED and accounted for hundreds of visits in the past year. The clinical details were not immediately available, but a superficial review of the admitting diagnoses suggested that most admissions involved persons with minor, nonspecific medical problems—persons commonly known as the “worried well.” Although Scott was correct that Medicaid covered the majority of costs, the fact remained that over $200,000 each year was not reimbursed to CGH. Were that money available, it could go directly to the bottom line and could be used for enhancements to health initiatives for the community. In addition, repeated admissions to the ED contributed to crowding, treatment delays, and general dissatisfaction for other patients.
Losinski presented the data to his executive committee, which includes all vice presidents, the director of development, and the elected president of the medical staff. The responses ran the gamut from “So what?” to “Wow, this is worse than I imagined.” Losinski was bemused by the disparity of views. He had thought there would have been an almost immediate consensus that this was a problem needing a solution. The financial margins for CGH were already very thin, and the future for higher reimbursement was not bright. A concern echoed by several at the meeting was the requirement of the federal Emergency Medical Treatment and Active Labor Act (EMTALA) that all persons who present at an ED that receives federal reimbursement for services must be treated and stabilized.
Losinski asked his senior management team for recommendations to address the problem of ED overuse.
[u06a1] Week 6 Assignment: Applying Ethical Principles
Due: Sun May 19, 2024 11:59pmDue: Sun May 19, 2024 11:59pm
Ungraded, 250 Possible Points250 Points Possible
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Prepare
For this assignment, you will apply the four ethical principles to your selected ethical health care dilemma. Consider the ethical dilemma the health care professional is faced with in your selected case study. In addition to the week’s readings, use the Capella library to locate at least one academic peer-reviewed journal article you can use to support your analysis of the situation.
If you have not yet done so, use the Ethical Case Studies interactive to select a case study. Specifically, identify which case study you selected and briefly summarize the facts surrounding the case study. Then, use the four core principles that health care professionals need to know and honor when helping patients:
Autonomy: To honor the patient’s right to make their own decisions.
Beneficence: To help the patient advance their own good.
Nonmaleficence: To do no harm.
Justice: To be fair and treat like cases alike, which will be used to inform your work.
Note: The case study may not supply all the information you may need. In such cases, you should consider a variety of possibilities and infer potential conclusions. Please be sure to identify any speculations that you make.
Create Your PowerPoint
To complete this assignment, do the following:
Provide a title slide (slide one).
Identify which case study you selected and briefly summarize the facts surrounding the
case study (slide two).
Apply each of the four ethical principles to your chosen health care issue (slides three through six).
Describe on one slide how autonomy plays a role in your health care issue.
Describe on one slide how beneficence plays a role in your health care issue.
Describe on one slide how nonmaleficence plays a role in your health care issue.
Describe on one slide how justice plays a role in your health care issue.
Provide a URL linking to your field’s professional code of ethics (e.g., health care administration or public health) (slide seven).
Reference slide (slide eight).
Do NOT use the author notes for this assignment. Provide content within each slide only.
Academic Requirements
Your PowerPoint should meet the following requirements:
Writing: Produce text with minimal grammar, usage, spelling, and mechanical errors.
Your text should be concise.
Use bulleted or numbered lists.
Sources: Integrate scholarly sources and evidence into your text using APA in-text citations.
Length: Include eight slides, which include the title page and reference slides.
You will NOT use the author notes in this assignment-only provide information on the
slides themselves.
References: Use at least two references (the case study and an academic peer-reviewed
journal article) within the PowerPoint presentation.
APA format: Follow current APA guidelines for in-text citation of outside sources in the PowerPoint presentation and also on the reference slide.
Competencies Measured
By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and rubric criteria:
Competency 1: Apply information literacy and library research skills to obtain scholarly information demonstrating a spirit of inquiry that fosters flexibility and professional maturity.
Apply autonomy to the identified health care issue.
Competency 3: Apply ethical principles and academic standards to the study of health care embracing principles of diversity, equity, inclusion, and antidiscrimination.
Apply nonmaleficence to the identified health care issue.
Apply justice to the identified health care issue.
Competency 4: Write in appropriate tone and style, in accordance with Capella’s writing standards, while demonstrating professional and personal honesty and integrity.
Apply beneficence to the identified health care issue.
Provide a URL linking to one’s field’s professional code of ethics.
Integrate into text appropriate use of scholarly sources, evidence, and citation style.
Produce text with minimal grammatical, usage, spelling, and mechanical errors.
View Rubric
Applying Ethical Principles
Applying Ethical Principles
Criteria Ratings Pts
Apply autonomy to the identified health care issue.
40 to >34 pts
DISTINGUISHED
Applies how autonomy relates to a health care issue and supports with evidence or real-life examples.
34 to >28 pts
PROFICIENT
Accurately applies how autonomy relates to the identified health care issue.
28 to >0 pts
BASIC
Defines autonomy, but does not apply it to the health care issue or applies it incorrectly.
0 pts
NON_PERFORMANCE
Does not address autonomy in relation to the identified health care issue.
/ 40 pts
Apply beneficence to the identified health care issue.
40 to >34 pts
DISTINGUISHED
Applies how beneficence relates to a health care issue and supports with evidence or real-life examples.
34 to >28 pts
PROFICIENT
Accurately applies how beneficence relates to the identified health care issue.
28 to >0 pts
BASIC
Defines beneficence, but does not apply it to the health care issue or applies it incorrectly.
0 pts
NON_PERFORMANCE
Does not address beneficence in relation to the identified health care issue.
/ 40 pts
Apply nonmaleficence to the identified health care issue.
40 to >34 pts
DISTINGUISHED
Applies how nonmaleficence relates to a health care issue and supports with evidence or real-life examples.
34 to >28 pts
PROFICIENT
Accurately applies how nonmaleficence relates to the identified health care issue.
28 to >0 pts
BASIC
Defines nonmaleficence, but does not apply it to the health care issue or applies it incorrectly.
0 pts
NON_PERFORMANCE
Does not address nonmaleficence in relation to the identified health care issue.
/ 40 pts
Apply justice to the identified health care issue.
40 to >34 pts
DISTINGUISHED
Applies how justice relates to a health care issue and supports with evidence or real-life examples.
34 to >28 pts
PROFICIENT
Accurately applies how justice relates to the identified health care issue.
28 to >0 pts
BASIC
Defines justice, but does not apply it to the health care issue or applies it incorrectly.
0 pts
NON_PERFORMANCE
Does not address justice in relation to the identified health care issue.
/ 40 pts
Provide a URL linking to one’s field’s professional code of ethics.
40 to >34 pts
DISTINGUISHED
Provides a URL linking to one’s field’s professional code of ethics and provides a short description.
34 to >28 pts
PROFICIENT
Provides a URL linking to one’s field’s professional code of ethics.
28 to >0 pts
BASIC
Provides a URL linking to a professional code of ethics that does not apply, or link does not work.
0 pts
NON_PERFORMANCE
Does not provide a URL linking to one’s field’s professional code of ethics.
/ 40 pts
Integrate into text appropriate use of scholarly sources, evidence, and citation style.
25 to >21.25 pts
DISTINGUISHED
Integrates into text appropriate use of scholarly sources, evidence, and citation style without errors and uses current reference sources.
21.25 to >17.5 pts
PROFICIENT
Integrates into text appropriate use of scholarly sources, evidence, and citation style.
17.5 to >0 pts
BASIC
Integrates into text mostly appropriate use of scholarly sources, evidence, and citation style, but there are lapses in style use.
0 pts
NON_PERFORMANCE
Does not integrate into text appropriate use of scholarly sources, evidence, and citation style.
/ 25 pts
Produce text with minimal grammatical, usage, spelling, and mechanical errors.
25 to >21.25 pts
DISTINGUISHED
Produces text that is free of grammatical, usage, spelling, and mechanical errors.
21.25 to >17.5 pts
PROFICIENT
Produces text with minimal grammatical, usage, spelling, and mechanical errors.
17.5 to >0 pts
BASIC
Produces text with some grammatical, usage, spelling and mechanical errors, making text difficult to follow at times.
0 pts
NON_PERFORMANCE
Produces text with significant grammatical, usage, spelling and mechanical errors, making text difficult to follow.
/ 25 pts
