Friday, October 11, 2019
Ethical Healthcare Issues
Running Head: ETHICAL HEALTHCARE Ethical Healthcare Issues Paper Wanda Douglas Health Law and Ethics/HCS 545 October 17, 2011 Nancy Moody Ethical Healthcare Issues Paper In todayââ¬â¢s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR). Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) ââ¬Å"ethical concerns shroud the proposal in skepticism, most notably privacy. At the most fundamental level, issues arise about the sheer number of people who will have ready access to the health information of a vast patient population, as well as about unauthorized access via hacking. â⬠à This paper will apply the four principles of ethics to EMR system. EMR History Pickerton (2005), ââ¬Å"In the 1960s, a physician named Lawrence L. Weed first described the concept of computerized or medical records. Weed described a system to automate and recognize patient medical records to enhance their utilization and thereby lead to improved patient careâ⬠(para 1). The advantages of EMR system includes shared information integrated information, improvement of quality care, and adaptation of regulatory changes. Even though EMR systems have many advantages, EMR systems also have some disadvantages too. Some disadvantages of EMR systems are security, and confidential, which can raise ethical issues. In order to help identify and vercome ethical issues with EMR systems, health care professionals can use the four principles of ethics to help identify where ethical issues are compromised. The four principles of ethics are autonomy, beneficence, nonmaleficence, and justice. Autonomy According to Mercuri (2010) ââ¬Å"autonomy means allowing individuals make their own choices and develop their own lives in the context of a pa rticular society and in dialogue with that society; negatively, autonomy means that one human person, precisely as a human person, does not have authority and should not have power over another human personâ⬠(para 2). Autonomy has an effect with ethics concerning EMR systems because health care organizations should have an EMR system that should maintain respect for patient autonomy. Respect for patient autonomy should have health care organizations to make decisions concerning user access of the records. Access of Records Before a health care organization implements an EMR system, they should have a security system in place, which includes ââ¬Å"access controlâ⬠component. Access control within an EMR system is controlled by distinct user roles and access levels, the enforcement of strong login passwords, severe user verification/authorization and user inactivity locks. Health care of professionals regardless of their level, each have specific permissions for accessing data. Even though the organization have the right security system in place to prevent unauthorized users from access patient records, autonomous patients will expect to have access to his or her records with ease. Access their record will ensure that their information is correct and safe. Beneficence According to Kennedy (2004) ââ¬Å"beneficence is acting to prevent evil or harm, to protect and defend the rights of others to do or promote goodâ⬠(p. 501). Beneficence has an effect with ethics when it comes to EMR systems because health care professionals can help to improve the health of individual patients by using patient records to help with medical research. EMR systems contain an enormous amount of raw data, which can innovate public health and biomedical research. This research will not only do good to help the health of individual patients, but also to the health of society (Mercuri, 2010). As a result, as new EMR systems are designed, patients should be given the ability to release information from their EMRs to researchers and scientists. Nonmaleficence Not only does beneficence have an effect with ethics concerning EMR systems, but also nonmaleficence. According to Taberââ¬â¢s Cyclopedic Medical Dictionary ââ¬Å"The principle of not doing something that causes harm. Hippocrates felt this was the underpinning of all medical practice. He advised his students,à primum non nocereà (ââ¬Å"first, do no harmâ⬠)â⬠(ââ¬Å"Nonmaleficence,â⬠2010). Nonmaleficence has an effect with ethics concerning EMR systems because it is the employeeââ¬â¢s responsibilities to report any negligence or fraud of patient medical records. However, if an employee doesnââ¬â¢t report negligence or fraud it will cause harm to the organization and to the patient. Reporting negligence will make the organization aware of the problem and help them find a solution. Employees can help prevent negligence or fraud notifying management when a problem is discovered. Employees can also help prevent negligence or fraud by making sure that their system access information is secure. In addition, employees can also help prevent negligence or fraud by making sure that they are creating accurate records. If the employees follow these policies of EMR security systems, they will ensure that the patient medical records are secure and safe from harm. Justice Not only does nonmaleficence have an effect with ethics when it comes to EMR systems, but also justice. According to Mercuri (2010) ââ¬Å"justice is commonly defined as fairness. With respect to health care, justice refers to societyââ¬â¢s duty to provide its members with access to an adequate level of health care that fulfills basic needsâ⬠(para 5). Justice has an effect with ethics concerning EMR systems because EMRs are most helpful when the system is easy to use, fully integrated, and easily searchable. EMR systems have the potential to assist health care organizations by providing higher quality care to the users and to the patients. In addition, EMR systems also assist health care organizations by having a system that is more unbiased through advanced effectiveness. Conclusion Even though there are still some ethical issues with EMR systems, health care professionals are moving in the right direction by being more aware. Health care professional want to do the right thing by following the organizations code of ethics, but sometimes they are not always clear on how they should handle certain EMR systems situations properly. In order for health care professionals to handle certain EMR systems situations properly, they can use the ACHE as a reference. Using ACHE as a reference ensures that they are meeting ACHE standards. Health care professionals can also apply the four principles of ethics to determine a resolution. Applying the four principles of ethics ensures that they are following the proper protocols and guidelines and leaves considerable room for judgment in certain cases. Reference Carel, D. (2010, October). The Ethics of Electronic Health Records. Yale Journal of Medicine Law, VII (1), 8-9. Kennedy, W. (2004). Beneficence and autonomy in nursing: a moral dilemma. British Journal of Perioperative Nursing, 14(11), 500-506. Retrieved from EBSCOhost. Mercuri, J. (2010). The Ethics of Electronic Health Record. Retrieved from http://www. clinical correlations. org/? p=2211 Nonmaleficence. 2010. Taberââ¬â¢s Cyclopedic Medical Dictionary, 21st ed, Retrieved from EBSCO host. Pickerton, K. (2005). His tory of Electronic Medical Records. Retrieved from http://ezinearticles . com/? History-Of-Electronic-Medical-Records&id=254240
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