Essay: Managing and conducting business in the medical field (ethics and morals)

A1. Ethical Traits
When it comes to managing and conducting business in the medical field it without question demands strong ethics. The extreme need for constant checks and balances within the departments is vital to the survival of the organization and the privacy of the patients. My thought is that this is especially important when it comes to the emergency department because of all the things that are happening and can happen when you are a level two trauma center. All the events and situations that can as well as will occur will cause extreme evaluations in the ethics of how business is conducted. With all this being said the person I believe to embody ethical conduct skills is Michael Zimmerman, Director of Emergency Services at Piedmont Columbus Regional. Michael is in charge of the area’s only level 2 trauma center as well as a pediatric ER and another recently opened ER on the northside of town. When it comes to an ethical leader for an emergency department you need to be honest, hold employees accountable, and be fair. You have to be able not only focus on what is right for the company and your staff but also you have to take what is right for the patients.
One of the first traits that I feel that Michael exhibit is the discussion of value awareness. The need to emphasize the importance of reinforcing the values of the department and organization creates a framework for the employees to know what is expected of them on all fronts and what they can expect of Michael. The most important value that is preached is the importance of always making the best decision for the patient as well as the company. This is difficult because of the nature of the moments the employees are sometimes making life and death decisions. I have attended many of the staff meetings and one example of this was the emphasis on patient-centered care. See our organization has taken the decision to make sure that we are putting our patients first, which includes the family as well as anyone else in the room. The way he discussed it with his team was not only in a way to uphold the value but as well to motivate and invigorate the team to treat everyone as if they were their own family. The other values he would discuss with them was maintaining and upholding company value of being an owner. What this means is being an owner in the business in a way that you are always focusing on treating each moment as if it were your own business. He would attempt to involve them trying to participate in making decisions on frontline issues and would help them navigate them towards not just focusing on their personal needs but what would be best for the whole.
The next thing that I could think of as an ethical trait that I see is encouraging initiative as much as possible. The importance of this ethical trait has extreme implications for developing and improving protocols as well as overall departmental functionality. This is another process that I have had the opportunity to be a part of these interactions between him and his team. He would in open forum welcome any type of suggestions from staff members in order to improve the flow or workload of their team. Sometimes these suggestions would be even more beneficial to the company as opposed to the staff. One of those suggestions came about when we were having a lot of trouble with having people’s belongings being left behind and the solution came from one of the medical assistants. The suggestion was to ensure that we would make sure that patients belongings would not be left behind we would take our belongings sheets which includes three copies a white, pink, and yellow, after filling out the belongings sheet the white copy would go in the bag, the pink would go in the chart, and the yellow would go back to the patient. This was an amazing suggestion, we were prior to costing the company around $1,000 dollars a month causing a loss in profit, but with the implementation of the process, we drastically reduced this to around $100 dollars a month after a few weeks of constant reinforcement. Michael made sure to show appreciation and recognition for the bringing up of the idea by placing her picture and story in the monthly newsletter thanking her for improving the business.
A2. Ethical Conduct
Now that we have reached the area of ethical conduct I able to discuss some of the things that I believe have made the most impact on me from observing Michael during interactions. The first ethical conduct that I notice about him is being respectful at all times. His ability to be respectful of those who are disrespectful to him (mostly because of what they are going through) is something that I feel to be extremely important with his job duties. He is sometimes requested to address customer services issues within the department which can range from inability to smoke inside the hospital, all the way up to improper care received. Personally, I have seen him maintain extreme composure in the face of patients and family members just yelling and cussing at him. He always calmly addresses the concerns and no matter the outcome of his ability to remain composed about trying to make a difference in their care. Michael also uses this conduct when dealing with colleagues as well, when they are being critical of his department he is able to be understanding without hesitation and refuses to engage in arguments, but instead attempts to understand and reason with them.
The best ethical conduct that I have witnessed from Michael pertains to his ability to be considerate. This is something that becomes difficult for most people within their early professional life due to the fact that they are trying to make a name for themselves and instead of trying to listen to other’s opinions and then doing what is right by the organization, they try to force their agenda. Michael is considerate of all opinions and suggestion when it comes to making the ER better. He listens to everyone who provides input on whether it is positive or negative in nature and considers all of the different views while trying to do what is best for the company as well. The importance of being considerate when it comes to being a leader is important to me because there are always things going on or happening that we may not be aware of.
B. Dilemma Analysis
You are a sales representative for a medical device company that manufactures artificial joints. Your company has developed an artificial knee joint that is less expensive than the competition and will dramatically reduce the healing time for patients. However, it is also known to produce a serious, and potentially lethal, infection in a small percentage of patients. Your company refuses to disclose this potential side effect to patients. You feel you have a duty to disclose, but signed a non-disclosure agreement (a contract stating that you would keep all information about the company confidential) when you were hired by the company.
When evaluating the dilemma from a Consequentialist approach we are trying to see how to create the least harm for the best outcome. The issue at hand is if I were to disclose the information about the infection there are a couple things that negatively could happen. If I were to disclose the issue with the prosthetic it would cause a re-evaluation of the device and cause a delay in patients receiving the new better model. Even though it is a small percentage that is affected “do no harm” is the motto of the medical profession. Then by reporting the issue, the company could lose massive amounts of profit as well as the legal ramifications for not disclosing the issue with the prosthetic in the first place. Then ultimately the legal recourse that would lead to the loss of my job as well as legal issues due to filling out the non-disclosure agreement. The consequentialist approach, unfortunately, would force me to want to report the flaw which inherently would cause me to lose my job, but in the long run, it could potentially save thousands of lives.
Now looking at it from the Deontological viewpoint you have to take in to account the rules instead of the pros and cons of the situation. From this view, I am aware of the potential risk and harm it could cause to a small group of individuals if the information is not disclosed and due to the fact it would be unethical for me not to disclose the information. The harm it could cause to those individuals regardless of what could potentially happen to me, I would have to do the ethical thing of reporting the issue to the proper authorities so that it can be addressed.
B1. Levels of Cognitive Moral Development
• What actions would be best for society in the long term?
After evaluating this incident the Postconventional and social contract are being followed in this sense because the rules are noticed and agreed upon about what is appropriate. The rules are also important in a sense to protect social order as well as individual rights. Therefore it would be best for society to report the incident and suffer whatever the consequences because of the harm that could potentially come to those who receive the prosthetic. This, in turn, will breach the non-disclosure agreement causing legal ramification.
• If I reveal this information, will my company find out and fire me?
When asking this the cognitive moral falls under Preconventional and obedience and punishment orientation. Instead of making decisions that benefit society as a whole these individuals focus on what is in their best interest or what would keep them out of trouble.
The individual has too many things to personally worry about such as job loss, income loss, and the thought of the legal ramification from not adhering to the non-disclosure agreement. With all this being said there are things set in place to protect those who decide to go against their companies to prevent repercussions for doing so. Most companies have whistleblower protection which means you can report anything you deem immoral anonymously and you are essentially protected.
• Which course of action would best serve justice?
The answer to this question is Postconventional and Universal Ethical Principles because it is the just thing to bring forth the issue. This type of approach is when they deem what is right and supports justice over all else. The best way to look at it is an attempt to find a way for the company to fix the issue, to begin with, but if all else fails they will do the just thing report the issue to the property authority.
• Are there any laws that indicate whether I should disclose this information?
In response to the above question, the answer would be Conventional and the stage is Social Accord and System Maintenance. The thing to do is to follow the law unless there is extreme conflict internally. Essentially when looking at the scenario there are regulations and other things in play that protect individuals as well as rules and regulations to protect the organizations involved.
• If I keep quiet, will my company reward me for that?
Preconventional and stage 2 Instrumental Purpose and Exchange apply to this question. The idea here is I will follow the rules if it will somehow benefit me in the long run. This stance is lining it up so that the person could potentially use their knowledge to bribe the company to either fix the issue that they have or use that information to bargain for wages or “hush money” so to speak. If you are thinking in this manner it is basically assuming that your knowledge of the issues is enough leverage to get you whatever you want.
C. ELI Results
See attached.
D1. Preferred Ethical Lens
According to the ELI (Ethical Lens Inventory), my preferred lens is the Reputation lens. I tend to let my heart and feelings lead me in the way of making ethical decisions. Which makes absolute sense for me because a majority of the time I tend to put my feelings into my work. When I decide to invest in an idea, process, or even just a goal at work I do not just put my mind to it I put my heart in it. I put my heart in my work to build what others may think or view of me, if I have their respect then I become more trustworthy and valuable in their eyes.
D1A. Different Settings
When it comes to evaluating whether I have the same view outside of work it is actually easy for me to answer no. In my personal, professional, and any other life I let my heart lead and try to be all that I can for those who are involved in my life. The previous statement involves family, friends, co-workers, and loved ones because I believe that a good reputation can get you places and motivate others.
D2. Blind Spot, Risk, Double Standard, or Vice
My blind spot lies in unrealistic role expectations. This I accept and wholeheartedly believe due to the fact that I am always trying to help other people figure out their situations. I tend to set extreme expectations of myself and then upon failure to reach them I become very critical of myself.
D2A. Steps to Mitigate
In order to mitigate my blind spot I must allow others to perform their roles as needed for their own success this will show that they are valued. I should adhere to being compassionate without allowing myself to become cold and emotionless distancing myself from my core values. The final step that is needed for mitigation is to never stop improving myself and to always demand excellence in everything so I set out to do.
D3. Primary Values and Classical Virtue(s)
My primary values are Sensibility and Equality. In regards to sensibility as said in previous sections I a tendency to follow what my heart feels as opposed to what might be rational thought. My emotions and passion for the things I want to do or pursue in life give me purpose or energy as I seek them out by always giving my all. When it comes to equality I do believe that no person is greater than another. We each play our integral roles and have our own set of skills that we bring to the table to help build the organization as a whole. We are all part of the same machine and each individual is as important as the next. My classical virtue is fortitude, which after reading the quick summary is spot on for me. I tend to bear a great weight on my shoulders that I should not carry, and I do this sometimes so that others won’t have to. I have always tried to show compassion in my work when dealing with any type of situation as well as standing up for those in need of help.
D3A. Comparison to Top Five Values
When comparing the results from my Ethical Lens Inventory and the Clarifying Your Values exercise I am impressed at how closely they are to each other. When it comes to sensibility in the ELI I see that upon review of the exercise I chose items such as compassion and customer satisfaction. The values are important in my line of work due to the vulnerable state that people are in when they are sick and in the hospital. I find it important to show compassion to them for what they are going through as well as trying to meet any other needs they may have. Then upon further analysis, I chose equality, respect, and teamwork which according to the ELI I value equality. This does not surprise me for the simple fact that I believe that no matter your status you are no better than anyone else and should treat everyone as an equal. Also when it comes to teamwork I feel that equality applies because you should always be willing to roll up your sleeves and help others for the betterment of the organization.
D4. Use of Ethical Lenses
After reviewing and learning about my own Ethical Lens I have quite a bit of information to take away from it as a leader. The first thing that I notice is that I use my heart to make decisions which could lead me down a path of destruction. What I mean by that is sometimes the heart does not know what is best when it comes to decision making. My heart can also lead me to feel as if I have sacrificed something for the greater good and cause me to become self-righteous. Equality is the strongest discovery that I feel attached to because I feel as if we are all equal and all deserve the same courtesy and respect. The ELI has opened me up to some flaws that can be easily addressed but the biggest thing that I keep coming back to is the unrealistic expectations that I place on myself on a day to day basis. This is something that I wish to work on because it can cause me to collapse from who I really am.
E. Sources