Ethical Issues in Healthcare

The DNR instructs healthcare providers who are trained to save patients’ lives not to perform CPR if the patient’s heart stops or they stop breathing. With 17% of survey respondents naming end-of-life issues as a top ethical issue, there’s little doubt why the DNR and its instructions represent one of the major ethical dilemmas in healthcare.

Identified as one of the biggest legal and ethical issues in healthcare, this concern underscores the importance of a health provider or plan’s obligation to maintain patient privacy as a covered entity under HIPAA’s rules. HIPAA imposes stiff penalties on covered entities who fail to uphold this obligation. Gray areas, however, do persist in situations where withholding aspects of a patient’s medical condition might do more harm than good.

In spite of the gains made since the passing of the Affordable Care Act, 9.6% of Americans remain uninsured, limiting their access to emergency and preventative care. The uninsured rate is particularly higher among Black and Hispanic populations, and residents of states that have not expanded Medicaid coverage.

HIPAA’s Privacy Rule outlines standards to protect all individually identifiable health information handled by covered entities or their business associates. This rule is crucial for the protection of consumer data, or PHI, which includes medical history such as procedures, diagnoses and prescriptions, but extends to credit card information and social security numbers as well. The rule requires standard safeguards for information, sets boundaries around the use and release of health records and gives patients more control over their information.

HIPAA’s Security Rule establishes standards for protecting electronic PHI that a covered entity may create, use, receive or maintain. While the privacy rule governs the privacy and confidentiality of PHI, the security rule provides standards to secure electronic data. In compliance with the Security Rule, covered entities must ensure the confidentiality, integrity and availability of ePHI they receive, maintain, create or transmit. This is done through various physical, technical and administrative safeguards. They must also identify and protect against threats to the security or integrity of the information, reasonably protect it against impermissible uses or disclosures and ensure compliance by their workforces.

A breach is identified as any impermissible use or disclosure of PHI under the Privacy and Security Rules. In the event of a breach, an organization is required to conduct a risk assessment to determine the breach’s scope and impact, and make certain notifications to the affected populations, depending on how many individuals the breach has affected. Notifications under this rule comprise individual notifications to all those impacted, a notification to the media if the breach affects more than 500 residents of a state or jurisdiction and, in all cases, a notification to the Secretary of Health & Human Services.

Ensure that only individuals with the appropriate permissions have access to the electronic PHI stored in a system.

A system must be implemented to monitor, record and review all activity.

Ensure that electronic PHI has not been altered or destroyed improperly.

A user’s identity must be confirmed before access is granted to the data system in which electronic PHI is stored.

Access to electronic PHI must be protected through encryption. 

To prepare their organizations for what’s to come, healthcare leaders need to stay current on industry trends, examine data and seek feedback from patients and staff. Adapting quickly to change, the effective healthcare leader is proactive in preparing for advancements as well as challenges and manages resources effectively while navigating unexpected obstacles.

As an effective healthcare leader, you will be expected to navigate a lacework of relationships with stakeholders such as patients, doctors and other clinicians, families, insurance companies and even government agencies. The ability to listen actively and maintain an openness to new perspectives while practicing empathy and emotional intelligence in your decision-making are all must-have skills here.

Strong leaders create a positive workplace culture in which every person feels they are part of a team and their work is valued. Good leaders in this area put programs in place that inspire and motivate their teams and create an open and collaborative atmosphere.

Especially when responding to natural disasters or medical crises, it is crucial for healthcare systems to have effective leaders in place. As a healthcare leader, you may be called upon to establish a chain of command and protocols for emergency situations and make quick decisions that affect the health and well-being of those in your facility and the community it serves.