...Running Head: LEGAL AND ETHICAL ISSUES 1 Legal and Ethical Issues Herzing College Online U7A1: MBA 663-8: Health Insurance and Managed Care LEGAL AND ETHICAL ISSUES Legal and Ethical Issues The current landscape of the healthcare industry changes rapidly with new rules and regulations, placing many healthcare insurance and managed care organizations in jeopardy of litigation because of legal and ethical issues. Controversy surrounds the healthcare industry because of the decisions made by managed care organizations regarding patient treatment and payment to providers. The following examines the legal and ethical issues surrounding the everchanging healthcare insurance and managed care organizations. Managed Care Conflict The problem facing managed care organizations and health insurance is the inherent conflict with their goal of cost containment by reducing service utilization, with the healthcare delivery system that places the patient’s health first (Kongstvedt, 2013). According to Saunier (2011), the definition of managed care is: 2 Processes or techniques used by any entity that delivers, administers and / or assumes risk for health services in order to control or influence the quality, accessibility, utilization, costs and prices, or outcomes of such services provided to a defined population. (Saunier, 2011, p. 22) Saunier (2011) describes the purpose of these organizations that manage care is the control of costs by “implementing aggressive cost containment...
Words: 1504 - Pages: 7
...Law and Ethics in Health Care Laws and ethical principles are essential for protecting the mankind, and they play a crucial role in the practice of health care. Laws and ethics play a vital role in cases such as organ donation, human genetics, and HIV/AIDS and confidentiality. The health care issue I selected for discussion is HIV/AIDS. In the case of HIV/AIDS patients, there is always ethical conflict of protecting the confidentiality of patient and disclosing the information to others about the risks of the disease. Salient Ethical and Legal Concerns Associated with HIV/AIDS As described by Pozgar (2013) one of the legal issues is the association between blood transfusion and HIV. Law suits often arise when a person with AIDA claims that he or she contracted the disease due to the administration of contaminated blood (Pozgar, 2013). Lawsuits commonly arise when there is transfusion of mismatched blood, improper screening, and improper storage procedures (Pozgar, 2013). Since May 1985, all blood donated in the United States are screened for HIV antibodies and even then patient’s may claim that they contracted the disease due to transfusion. Another legal and ethical issue is whether to allow the AIDS infected surgeons to perform surgeries. Pozgar (2013) described that the transmission of the virus from an infected surgeon to a patient is unlikely, but there is still a possibility. There is an ethical dilemma whether to allow these surgeons to perform surgeries...
Words: 942 - Pages: 4
...administrative issues that can arise in the health care field; one that not only can affect the patient but also their privacy is HIPPA. The Health Insurance Portability and Accountability Act (HIPPA) was made into a law on August 21, 1996 (HIPPA overview, p1). The law is steered toward improving the efficiency and effectiveness of the health care system by standardizing how to exchange data for administrative and financial transactions, while protecting the security and confidentiality of that information. While HIPPA was placed into effect to help patients and their confidentially, there are many issues that can arise. One important issue understands who is affected and its impact on the population. Also what arguments or facts are used to support the proposed solution, and what ethical and legal issues reported for the administrative issue. Understanding the managerial responsibilities related to administrative issues is also very important. Identifying solutions and how they can assess the issues at hand can be very beneficial as well. ` One factor to understand is who the issues of HIPPA effects, and what issues can arise because of these issues. There are many ethical issues that can arise from HIPPA, which can have a great effect on patients and their privacy. HIPPA allows and in many cases requires that confidentiality be kept, while patients can give written permission for their information to be shared with a medical organization or single physician. Health practitioners...
Words: 990 - Pages: 4
...The Summary Paper Legal/Ethics Issues In The Health Care Business BUS670 Rhunda Mitchell Instructor Little 10/24/11 More than any other industry, it is in the healthcare business that ethics are of utmost importance. This is because, people in this industry deal with such situations and circumstances, everyday, which have a direct bearing on another person's life. In this paper one will discuss the ethical/legal issues which are faced by the healthcare industry as a nurse, and ethical issues in healthcare, pertaining to both management and medical research and give suggestion on how to handle each situation in hand. Ethical/ Legal Issues as A Nurse: Nurses are subject to a wide range of legal, ethical and professional duties which can be very challenging. These duties are generally considered to be to respect a patient’s confidentiality and autonomy and to recognize the duty of care that is owed to all patients. As a nurse their duties have to be always professional, because there are legal implications if these duties are breached. They also must consider when it is okay as a nurse to breach these duties and therefore ethical issues arise. Ethics is a set of moral and practical guideline that influences nursing decisions big and small. One of the main priorities of a nurse is to advocate for their patients a nurse expresses and defends the cause of their patient, nurses are expected to protect their patients’ rights. Patients’ rights can vary from...
Words: 2214 - Pages: 9
...The Managerial Environment of Health Care HCS/265 April 18, 2016 The University of Phoenix Send to: Oleathia King@bellsouth.net Subject: Types of Laws and Ethical Issues. Dear. Oleathia It has come to my attention that you are wanting to pursue a manager career in HealthCare. Which I have founded myself working in the healthcare industry for more than 20 years, to be an amazing career. Not only will you earn a good salary. You will enjoy job security. You will be doing the kind of work that interests you. You can live and work anywhere you want because, hospitals and other types of healthcare facilities are in almost every region of the United States. You can find a health career that fits your educational plans, you can learn hand on experience, you will have a clear path to advancement, not only do you get to work with people that are sick or dying you get to make a difference in their lives. The healthcare industry has many scholarships, financial aid programs, grants and student loans that can help you pay for going back school also. However, Otheathia, these are some of the benefit in pursuing a manager career in HealthCare. But there are other things to be knowledgeable about when pursuing a manager career in HealthCare. For example; knowing the differences between laws and ethics in health care. According to, (Week Three,...
Words: 1166 - Pages: 5
...relationship among professional values, ethics, and legal issues. A person’s personal values and ethics can influence their professional values and ethics in the workplace. Finding the right balance between personal and professional views in the workplace will help foster a successful career. This paper will cover relationships between legal and ethical issues as well as personal values and professional ethics. Relationships between Legal and Ethical Issues According to Wacker-Guido & Watson (2010), there are eight ethical principles that nurses encounter when making decisions in clinical settings, autonomy, beneficence, no maleficence, veracity, justice, paternalism, fidelity, and respect or others. In other terms nurses have personal freedom, the right of self-determination, a duty to perform good actions, duty to prevent any harm for occurring to their patients, the obligation to tell the truth, treat all patients equally and fairly, allow others to make decisions for individual patients, keep promises and commitments they make, and to treat everyone with respect. Ethical values are influenced by personal feelings, and are interpreted differently depending on the beliefs of the individual. The Britannica Concise Encyclopedia defines the code of ethics for nurses as follows: The code of ethics for nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality on nursing care and the ethical obligations of the profession. With the...
Words: 2628 - Pages: 11
...Paper Administrative ethical issues occur in health care today such as patient privacy, confidentiality or HIPAA. It is best to resolve this type of issue because patient privacy in health care is very important. These policies are designed to protect the rights of patients by making sure personal information of the patient is not disclosed in any way. Protecting a patient’s privacy by way of disclosing personal information and is not to be released without personal formal consent. Also, of employees discussing patient information on the job to people with no knowledge of the patient or even off the job. Many health care organizations enforce privacy policies such as HIPAA and confidentiality although all employees do not abide by such policies. It is being found that more frequently that people from these health care organizations are breaking these policies and their must be changes to provide patients with protection. Administrative ethical issues of the HIPAA Policy within health care organizations must make necessary changes to appropriately protect the rights of patients. The issue at hand is that of health care organizations properly protecting the rights of their patients. The article that will be discussed in this paper is that of OCR issues proposed Modifications to HIPAA Privacy and Security settings (Frank Irving, 2004). The population that is affected by it most has been impacted by such ethical issues brought upon by employees of health care organizations. The...
Words: 1153 - Pages: 5
...Professional EThics Professional Ethics Legal and ethical issues are frequently encountered in the health care setting and present unique challenges to health care professionals. Practicing nurses need to be knowledgeable with these concepts to ensure patient’s rights. In this paper, the author will describe the relationships between legal and ethical issues. In addition, the author will identify personal values and professional ethics and examine ethical theories and principles. Examples of applications of legal and ethical issues to current practice will also be provided. Relationships Between Legal and Ethical Issues “Ethics is the branch of philosophy concerned with evaluating human action” (Guido, 2010, p. 3). It is based on the principles of right and wrong and provides structure to behaviors and actions. Ethics are closely intertwined with morals and values. Morals are “personal principles that are acquired from life experiences, family and peer relationships, religion, culture, and the law” (Guido, 2010, p. 3). Values are “personal beliefs about the truths and worth of thoughts, objects, or behavior” (Guido, 2010, p. 3). Therefore, ethics are subject to an individual’s personal interpretation. In contrast, laws are rules and regulations established by some authority and enforced by judicial decision (Dictionary.com, 2011). The legal system governs actions and behaviors without regard to personal values, beliefs, and views. Laws are constantly evolving to...
Words: 2080 - Pages: 9
...Administrative Ethics Paper HCS 335/Ethics: Health Care and Social Responsibility June 10, 2012 Administrative Ethics Biomedical ethical issues are seen frequently in the news and are in constant scrutiny. The demand for social responsibility is high and available resources are limited. Healthcare leaders are faced with numerous administrative issues regarding patient privacy, research, confidentiality, and terminal illness. Much debate has surrounded medical spending on the terminally ill, such as the cost and allocation of resources toward end-of-life care. Choosing between prolonged life and quality of life are two seemingly difficult decisions to make. Nonetheless, it is difficult to base one’s opinion until cancer has taken over one’s life. A close look at administrative issues surrounding end-of-life care will demonstrate the impact on a population, ethical and legal implications, potential solutions to the problem, and managerial responsibilities. Impact of Ethical Issue on the Population The Northern Mariana Islands (NMI) is a part of the United States territory since its establishment of commonwealth in political union and is home to approximately 44,000 people (Central Intelligence Agency, 2012). Because of the increase in chronic diseases and lack of available resources, several residents are referred to go off the island to seek health care in Guam and Hawaii (Doty, 2012). However, the medical referral program has a crucial problem with financing...
Words: 1226 - Pages: 5
... There are a plethora of issues concerning patient privacy, confidentiality, and HIPAA. Unfortunately, these are issues that have arisen more recently; patient privacy and confidentiality wasn’t a largely disputed issue before the introduction and increase of health information technology implementation and usage. According to the Center for Democracy and Technology, “Health information technology has tremendous potential to improve health care quality and reduce costs while empowering patients to play a greater role in the management of their own care. At the same time, however, electronic storage and exchange of personal health information poses risks to privacy. Unaddressed, privacy concerns can stand in the way of realizing the benefits of health IT, for neither patients nor providers will make full use of a system they do not trust.” One has no choice but to take the two into consideration: do the speed, accuracy, and reduced cost of health information technology outweigh the potential privacy concerns? As stated in a brief article published by the National Center for Biotechnology Information, “The combination of these technologies will improve the quality of health care by making it more personalized and reducing costs and medical errors. While there are benefits to technologies, associated privacy and security issues need to be analyzed to make these systems socially acceptable.” While these may not be considered issues that pose a serious, heavy threat or...
Words: 1190 - Pages: 5
...meet. With only six employees, the company’s owner cannot afford to offer health insurance. Leo’s annual salary of $30,000 allows him to purchase only the most basic of health plans, one that does not include coverage for prescription medications. Leo frequently must decide between medications and food, often opting for cheap junk food that is neither nutritious for his young family nor appropriate for a diabetic diet. Leo has recently applied for and been offered several other jobs, but at a lower salary and with no health insurance coverage. Recently, Leo’s diabetes has worsened. He has developed a serious infection that has led to lost wages and, far worse, the loss of his right leg below the knee. Leo is weighing his options. He has heard about a new clinical research trial open to insulin-dependent diabetics that pays $100 a week to research subjects. He has also been quite depressed and begun to wonder if his children might not be better off without him. He has several life insurance policies that would pay off generously if something were to happen to him, and he has broached the subject of assisted suicide with his long-time physician. Is there a way, he asks his physician, to have his death look like it was from natural causes so his children could collect on the policy? CHAPTER QUESTIONS 1. What ethical responsibilities do health care professionals have to their patients? 2. What ethical rights do patients have?...
Words: 9363 - Pages: 38
...Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property Name: Hanadi Rabadi Course: LEG 500 Professor: Gus Weekley Date: 09/01/2014 Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Propertyt Inreduction Ethical dilemma may be defined as a situation where one has to make a decision but the decision to be made has some impact on either of the choices taken. In different organizations, there are times where a manager may be faced by ethical dilemmas that he or she is supposed to look into. The process may be difficult since the manager has to deal with such situations without discriminating on any individual. Any activity that relate to business management in relation to the society, consumers, and the business itself should consider all ethical issues relating to the environment. It is important for business owners to alight ethical issues to their business plans. Ethical issues may relate to advertising and marketing, regulation of product safety, and intellectual property. Marketing and advertising, relating to any industry in the market, may have different forms of ethical issues. For example, advertising may be unethical when the content in the advertisement has unethical issues such as the use of harsh language or pictures that may not be pleasant to all age groups (Ashcroft, 2007). It is important for advertising agencies to consider all ethical factors while posting any advertisement to the public...
Words: 2872 - Pages: 12
...of Phoenix Health Law and Ethics NUR 478 Susan Lawson, RN, MS, CLNC July 18, 2010 Professional Ethics Paper The purpose of this paper is to describe the relationships between legal and ethical issues, identify personal values and professional ethics, examine ethical theories and principles, and apply these to current practice examples. Nurses face an ever-growing complexity within their practice as professionals. Understanding the relationship between legal and ethical issues and how to apply that understanding to every day practice is paramount for today’s professional nurse. This paper will further explore these ethical theories and principles while discussing how personal values affect an individual’s nursing practice. The Relationship Between Legal and Ethical Issues Nurses, as with any job, face challenges in order to accomplish the tasks of their role. This is one of the reasons that it is important to have a description that serves as guidance as to how the role is to be accomplished. Without such guidelines, it is likely that there will be a breach of established rules along the way to performing duties and accomplishing the job duties. In situations where one person exercises authority over another, there are important guidelines that define relationship between the two parties. Legal and ethical principles define how a job is to be carried out and how individuals are to relate to one another. Legal and professional ethics...
Words: 2093 - Pages: 9
...Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property LEG 500 August 26, 2014 Legal and Ethical Considerations in Marketing, Product Safety, and Intellectual Property Ethical dilemma may be defined as a situation where one has to make a decision but the decision to be made has some impact on either of the choices taken. In different organizations, there are times where a manager may be faced by ethical dilemmas that he or she is supposed to look into. The process may be difficult since the manager has to deal with such situations without discriminating on any individual. Any activity that relate to business management in relation to the society, consumers, and the business itself should consider all ethical issues relating to the environment. It is important for business owners to alight ethical issues to their business plans. Ethical issues may relate to advertising and marketing, regulation of product safety, and intellectual property. Marketing and advertising, relating to any industry in the market, may have different forms of ethical issues. For example, advertising may be unethical when the content in the advertisement has unethical issues such as the use of harsh language or pictures that may not be pleasant to all age groups (Ashcroft, 2007). It is important for advertising agencies to consider all ethical factors while posting any advertisement to the public. In addition, marketing may lead to unethical issues...
Words: 2863 - Pages: 12
...Ethics Paper The Online Journal of Issues in Nursing has a current article named “Caring for Patients While Respecting Their Privacy: Renewing Our Commitment”. The basis of the article concerns the ethical and legal issues concerning the “Health Insurance Portability and Accountability Act” otherwise known as (HIPPA). This law has impacted the healthcare industry and the way in which healthcare workers conduct themselves with patients, their families, and with one another. In nursing the importance of confidentiality has always been the forefront of patient care. The current Code of Ethics for Nurses (ANA,2001) is clear in its intent and meaning as it relates to the nurses primary role in promoting and advocating patient’s rights relating to privacy and confidentiality. Every nurse has always understood the need for patient confidentiality even before (HIPPA) was law. Truth being with advanced technology, new demands in healthcare, and recent developments in the world at large has made it more difficult to keep this promise. But keep it they must. As healthcare workers on any given day we hear and see private and confidential information, it is our duty to protect it. On occasion we do become comfortable with patient’s medical information that it can be easy to forget that as healthcare workers how important it is to keep information secure and private. Thus, a recommended solution to this issue is to recap the -privacy section of the “Health Insurance Portability Act” and refer...
Words: 1166 - Pages: 5
