1. Describe the immediate responsibility as a healthcare administrator in an organization when you receive a subpoena duces tecum. (1–2 paragraphs)
2. Define the concepts of morals and ethics, and differentiate between the two. Give an example of how the two can come into conflict in a healthcare setting. (2–3 paragraphs)
3. Define “standards,” “principles,” and “rules,” and give an example of each as they might be applied when making treatment decisions about noncompliant patients. (2–3 paragraphs)
4. An 83-year-old diabetic male, Mr. Jones, is brought in to the emergency department because of respiratory distress by his care-giving daughter, with whom he lives. In examining him, the emergency department physician discovers that Mr. Jones has gangrene on his right foot up to his ankle. Mr. Jones’ daughter reports that her father has been diagnosed with Alzheimer’s disease. A preliminary capacity assessment is consistent with mild dementia but one of the nurses suggests that Mr. Jones’ confusion might be the result of his respiratory distress, coupled with the disorienting atmosphere of the emergency department. The clinical recommendation is to perform a below-the-knee amputation. The patient refuses this surgery, saying he has lived long enough and wants to die with his body intact.
Does the father have autonomy to make this decision? Why or why not? Discuss the principle of nonmaleficence as it relates to actions of the providers. (1–2 pages)
5. Clinical ethics requires grasping ethical issues, such as informed consent, truth-telling, confidentiality, end-of-life care, treatment futility, pain relief, and patients’ rights to self-determination. For each hypothetical situation described below, identify the conflicting ethical principles involved, and select at least oneappropriate action to resolve conflicting ethical principles in each case. (1–2 paragraphs each)
· An elderly patient suffers cardiac arrest and enters the intensive care unit. Her son insists that “everything possible” be done for her, and yet, she slips into a coma and is nonresponsive for months. As a healthcare administrator who oversees the organization, what steps would you recommend to address the son’s concerns?
· You are a healthcare administrator in a community with many devout Jehovah’s Witnesses. Many people in this faith refuse to receive blood transfusions. A mother calls your office to say that her 11-year-old son has been struck by a car, and asks for your reassurance that he won’t receive a transfusion if she brings him in. How will you respond?
· You are a healthcare administrator reviewing statistics on lab tests ordered, and realize that a few physicians account for the majority of orders of a certain very expensive lab test. You do a bit of research, and realize that these physicians have relationships with the manufacturers of this testing equipment. What are your next steps?
6. Justify whether healthcare in the U.S. is a right or a privilege. Apply ethical standards and state and federal laws to support your position. (1–2 pages)
7. A hospital finds that hypodermic needle-stick injuries have increased over the last year and, when they conduct an audit, they find evidence that there is wide variation in practice from unit to unit. Some rooms have sharps boxes and others do not, the sharps boxes are of different sizes, and there is variation in how often they are emptied. Using the seven-step risk assessment framework described by the Joint Commission (available at http://www.beckersasc.com/asc-quality-infection-control/7-steps-to-comply-with-joint-commission-risk-assessment-requirement.html) outline each of the steps to illustrate how a hospital might use a risk assessment framework to manage the risk of needle-stick injuries. (2 pages)
8. You are the CEO of a new hospital. Write a 1-page persuasive executive summary to the board of trustees outlining your proposal for a code of conduct and ethics to govern clinician and doctor behavior. Include a statement with a code of conduct for your staff for each of the following:
· Quality of care and patient rights
· Confidentiality of protected health information (PHI)
· Protection of information
· Legal and regulatory compliance