Ethical Dilemmas and Competing Needs in Healthcare Leadership

1. Introduction

“Ethical Dilemmas and Competing Needs in Healthcare Leadership” by Michael A. DeVita, M.D. is an article discussing the ethical dilemmas and competing needs that healthcare leaders face. The author is the medical director of critical care services at Lenox Hill Hospital in New York, and an Associate Professor of Medicine at Hofstra University School of Medicine. Dr. DeVita has applied his knowledge and experience in critical care and healthcare leadership to develop an ethically based management strategy designed to lead a critical care team effectively. His life’s work focusing on critical care and the treatment of the critically ill has not only resulted in new treatment protocols, but has reinforced his beliefs in the need for ethical decision making and the right to implement them in the best interest of the patients. This article is published by the American Association of Critical Care Nurses. The introduction starts with a story of an 82-year-old woman who was brought to the hospital with overwhelming sepsis. The woman, who was living in a nursing home in New York, had severe Alzheimer’s dementia and she was unable to voice her treatment preference. However, her family did not like her to be supported indefinitely on life-sustaining treatment. Dr. DeVita highlighted the relevant ethical dilemmas in the case and the need to balance competing interests and needs among different parties in the healthcare team including patient, family, nursing staff and his professional obligations etc. He further elaborates that the advances in the medical field and the increasing malignant litigation, healthcare leaders no longer can escape from addressing and resolving complex and challenging ethical dilemmas. Such dilemmas exist when there is disagreement among different parties over the ethically correct course of action. National code of healthcare leaders in the United States also provided that it is the ethical responsibility of healthcare leaders to strive to design and manage healthcare organizations in a way that optimizes the public’s health and well-being. So these dilemmas not only cause moral distress among healthcare leaders, but also could lead to substantive negative clinical and organizational consequences. It is important for healthcare leaders to understand the nature of the ethical dilemmas and have conceptual framework to the process of addressing them.” Advertisements

1.1. Background and Context

“Ethical Dilemmas and Competing Needs in Healthcare Leadership” is a new edition and in-depth analysis of a well-known college textbook, authored by Michael S. Law and published by Health Administration Press. This edition is published in 2017 and the book provides new cases and new chapters on ‘The Individual and Population Health’. It is about 600 pages long comprehensive textbook that has three main sections and a total of 19 chapters. The book talks about the following discussion: healthcare legislation; background and environment of healthcare legislation; the historical, social, and political influences in the expansion of healthcare legislation. The major content includes Medicare, Medicaid, and the Children’s Health Insurance Program, the Patient Protection and Affordable Care Act and its impact on healthcare services. The book explains very technical terms very well. For example, it even details about the difference between law and legislative act. I found the authors maintain a fairly objective view throughout the book, even though they do provide a few sentence comments, like “It is difficult to predict the future development of healthcare system”. At the end of the book, it talks about ‘challenges that healthcare administrators face’, in which ‘compliance with healthcare legislation’. I think this book is very useful because it covers almost essential part of the healthcare legislation. By reading this book, readers should get a comprehensive understanding of healthcare legislation in the United States. I would highly recommend this book as a valuable reference to anyone who is interested in healthcare services, whether the reader is a student, an academic, a healthcare professional or a healthcare administrator. It’s a good reference book for conducting comprehensive literature review for students and working professionals as well. I believe practicing healthcare administration scholars can learn many useful and practical details from the textbook, such as James and Kristina Ingram, to improve the goal of achieving high quality, efficient care for the provided community. It helps my study and work in the future because healthcare legislation impacts both the organization and the client care, and various competing needs always exist in practice. I found the authors maintain a fairly objective perspective throughout the book, even though they do provide a few sentence comments, like “It is difficult to predict the future development of healthcare system”. In the book, it explains very technical terms very well. For example, it even details about the difference between law and legislative act. At the end of the book, it talks about ‘challenges that healthcare administrators face’, in which ‘compliance with healthcare legislation’ is at the first place. Also, the book provides many useful teaching tools, like summaries, key terms and extensive references.

1.2. Purpose of the Discussion

The essay attempts to explore and discuss the ethical dilemmas and the competing needs that a healthcare leader must overcome in his workplace. The primary purpose of the discussion is to provide the readers with a clear understanding of the very important fact that in the healthcare sector, there are numerous issues such as ethical, social, political or economic and these issues present multiple challenges to the healthcare administrators. By discussing the ethical dilemmas and competing needs that a healthcare leader must encounter, it is my hope that the essay will provide the readers with a better understanding of the effectiveness of the leadership and the relevant theory in healthcare, although I do not plan to discuss the leadership aspect in great detail. This is important to the study of healthcare management since, by understanding what type of ethical dilemmas are present within healthcare management, one can critically evaluate the effectiveness of the different types of leadership approaches and styles and make an informed decision in choosing the most suitable means to adapt. I will discuss the different sources of knowledge from healthcare leadership, the issues that can be brought before the court, some of the potential consequences of breaching the employment legislations, and how a healthcare leader should act, so it is quite a comprehensive overview of the essay. I will discuss the leadership aspects in greater detail in future publications.

2. Impact of Competing Needs on Policy Development

2.1. Definition of Competing Needs

2.2. Influence of Competing Needs on Policy Development

3. National Healthcare Issue and Competing Needs

3.1. Selection of a National Healthcare Issue/Stressor

3.2. Identification of Competing Needs in the Chosen Issue

4. Impacts of Competing Needs on the Chosen Issue

4.1. Effects of Competing Needs on Workforce

4.2. Effects of Competing Needs on Resources

4.3. Effects of Competing Needs on Patients

5. Policy Approaches to Address Competing Needs

5.1. Strategies to Balance the Needs of the Organization and Patient Care

5.2. Allocation of Limited Resources

5.3. Enhancing Workforce Efficiency and Safety

6. Conclusion

 

ORGANIZATIONAL POLICIES AND PRACTICES TO SUPPORT HEALTHCARE ISSUES

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