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The achievement of the most important tasks, such as improving the quality and relevance of health care for the population of the country, causes various ethical dilemmas. The development of specialized types of services and the implementation of broad preventive measures are largely determined by the observance of the principles of ethics and deontology.
In the given case, a physician working for a managed care organization, faces that a patient was rejected care due to his statistical profile. Dr. Berkeley understands that the organization can exclude him from the list of physicians, which would reduce his income. It is a conflict of interests, a situation in which an employee has a personal interest in obtaining material benefits or other advantages that affect or may affect the proper performance of their professional duties.
On the one hand, Dr. Berkeley understands that as a physician, his duty is to help patients in improving their health outcomes. On the other hand, he needs appropriate remuneration to provide for himself and probably his family. According to Tong (2007), every healthcare professional must proceed from personal and community responsibility to patients and, ultimately, to society. Personal responsibility is to be based on his or her experience, human qualities, deep knowledge of the patient and his or her disease, and an individual approach to everyone.
Community responsibility can be interpreted as putting into practice the ideas, concepts, and traditions of a hospital. In addition, experience accumulated and generalized by supervisors and colleagues should be taken into account in the light of the basic principles of health care. Personal responsibility should proceed from a constant striving to deepen theoretical knowledge and improve practical skills, which can be accompanied by the improvement of professional view and a critical analysis of ones observations, mistakes, and fostering ethical and deontological norms.
In the given case, the concept of patient-centeredness, which becomes common in hospitals and managed care organizations, can be applied to make a decision. Today, medical organizations work to ensure that patients are satisfied with all the aspects of medical care, from the professionalism of doctors to creating a comfortable environment in a hospital.
Tong (2007) emphasizes that the best patient care can be ensured if it is assumed to be a team effort, which a new perspective n healthcare ethics. In this case, it may be recommended for Dr. Berkeley to consult with his colleagues, who are also involved in caring for the identified patient. If the organization refuses to cooperate on this matter, the physician would not be able to fulfill his foremost responsibility in terms of patient care.
The advantages of applying non-normative standards to this case include potential treatment to the patient, which would allow for improving his health. At the same time, its disadvantage would lead to breaking with the organization and decreased remuneration of the doctor. The use of the normative standards that are designed by the mentioned managed care organization would potentially lead to comorbidity and chronic diseases due to a lack of timely treatment (Tong, 2007). However, the benefit of such a decision is the continued contract of Dr. Berkeley with this care facility. Even though his income would not reduce, the professional ethics of this care provider would be compromised, which means that his authority would also be affected.
It is unethical for this doctor to stay enrolled in this organization by compromising patient care. Beneficence and non-maleficence are two ethical principles that are violated in this case. Namely, they imply that a physician is to find a balance between the intended treatment and preventing harm (Persson, 2017).
It is evident that if the given patient is not provided with the necessary care, his state will deteriorate. The prevention of the development of further complications is to be prioritized by Dr. Berkeley. Despite his personal needs, the doctor needs to act in the interest of the patient to make sure that his actions are ethical. The respect for non-maleficence and beneficence protects patient rights and contributes to balancing harms and benefits.
In the view of the above discussion, one can suggest that such cases should be endowed with the status of a legislative definition in the future as a means of expressing doctors interests and patient management in the healthcare sector. Due to this, patient-centeredness, in addition to the deontological ethics, will acquire legal significance, will enter the legal norms governing healthcare, for non-observance of which the corresponding legal responsibility will naturally follow (Persson, 2017). Thus, patient-centeredness will no longer be a recommendation, but a mandatory category of medical and legal relationships. This is likely to significantly increase its role in health care management, rationalizing some pertinent measures to enhance it.
To conclude, this paper discusses the ethical dilemma that is faced by the primary care physician, Dr. Berkeley, who has to reject a patients request for care because of his statistical profile. It was discovered that the decision to follow the normative standards violates the ethical principles of beneficence and non-maleficence, even though it would preserve the physicians level of income. It is recommended to communicate with the managed care organization to resolve the issue and act following non-normative standards, if they refuse to cooperate.
References
Persson, I. (2017). Inclusive ethics: Extending beneficence and egalitarian justice. Oxford University Press.
Tong, R. (2007). New perspectives in healthcare ethics: An interdisciplinary and crosscultural approach. Pearson Prentice Hall.
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