UMUC HMGT372 All Weeks Discussions Latest 2019 JUNE (NO Week 4 Discussion) Question # 00602061 Course Code : HMGT372 Subject: Health Care Due on: 06/07/2019 Posted On: 06/07/2019 08:33 AM Tutorials: 1 Rating: 4.5/5

HMGT372 Legal and Ethical Issues in Health Care

Week 1 Discussion

Theme 1:

It is a
challenging job to be a student. All students juggle multiple priorities and
responsibilities trying to gain the highest grades at the same time. Please
offer your strategies on time management and study skills to your peers.
Provide minimum three of the most helpful tools and/or strategies that you use
to a high degree of success. Tell us how you apply those tools or skills by
sharing an example. Discuss the tips offered
by your peers and reflect how or if they will work for you. Some of the
additional information could be found in Helpful Tips overview.

Theme 2:

Discuss
with your colleagues the following questions: What is “Legality”?
What are “Ethics”? Compare and contrast legality and ethics in health care. Provide one (1)
specific real life legal case example of a violation of legality in a
healthcare organization and one (1) specific real life legal case example of a
violation of ethics in a healthcare organization that you find on the internet
or in the print media. See Discussion Expectations and Grading for rules on
discussions. Read background articles. This discussion requires additional
research beyond reading the articles.

Assigned
reading materials:

Understanding
Federal Courts – (Control>>Click>>From Drop down Menu select Open
in New Window or Copy/Paste into your URL)
http://www.uscourts.gov/about-federal-courts/court-role-and-structure

Introduction
to the U.S. Legal System- http://litigation.findlaw.com/legal-system/introduction-to-the-u-s-legal-system.html

Legal
issues facing health care
professionals-http://www.beckershospitalreview.com/hospital-management-administration/13-legal-issues-for-hospitals-and-health-systems.html

Ethical and
legal analysis of health care
case-http://ijahsp.nova.edu/articles/Vol2num1/pdf/lazaro.pdf

This
educational resource is designed to help health care organization directors ask
knowledgeable and appropriate questions related to health care corporate
compliance.http://www.hcca-info.org/Portals/0/PDFs/Resources/Conference_Handouts/Clinical_Practice_Compliance_Conference/2007/Fri/601Handout.pdf

Example of
an Employee Handbook from Johns Hopkins:
https://www.hopkinsmedicine.org/human_resources/_docs/employee_handbook_non-union_non-represented.pdf

Health Care
Ethics – samples.jbpub.com/9781449665357/Chapter2.pdf (copy/paste into your
URL)

A Framework
for Thinking Ethically

This
document is designed as an introduction to thinking ethically. We all have an
image of our better selves-of how we are when we act ethically or are “at
our best.” We probably also have an image of what an ethical community, an
ethical business, an ethical government, or an ethical society should be.
Ethics really has to do with all these levels-acting ethically as individuals,
creating ethical organizations and governments, and making our society as a
whole ethical in the way it treats everyone.

What is
Ethics?

Simply
stated, ethics refers to standards of behavior that tell us how human beings
ought to act in the many situations in which they find themselves-as friends,
parents, children, citizens, business people, teachers, professionals, and so
on.

It is
helpful to identify what ethics is NOT:

Ethics is
not the same as feelings. Feelings provide important information for our
ethical choices. Some people have highly developed habits that make them feel
bad when they do something wrong, but many people feel good even though they
are doing something wrong. And often our feelings will tell us it is uncomfortable
to do the right thing if it is hard.

Ethics is
not religion. Many people are not religious, but ethics applies to everyone.
Most religions do advocate high ethical standards but sometimes do not address
all the types of problems we face.

Ethics is
not following the law. A good system of law does incorporate many ethical
standards, but law can deviate from what is ethical. Law can become ethically
corrupt, as some totalitarian regimes have made it. Law can be a function of
power alone and designed to serve the interests of narrow groups. Law may have
a difficult time designing or enforcing standards in some important areas, and
may be slow to address new problems.

Ethics is
not following culturally accepted norms. Some cultures are quite ethical, but
others become corrupt -or blind to certain ethical concerns (as the United
States was to slavery before the Civil War). “When in Rome, do as the
Romans do” is not a satisfactory ethical standard.

Ethics is
not science. Social and natural science can provide important data to help us
make better ethical choices. But science alone does not tell us what we ought
to do. Science may provide an explanation for what humans are like. But ethics
provides reasons for how humans ought to act. And just because something is
scientifically or technologically possible, it may not be ethical to do it.

Why Identifying
Ethical Standards is Hard

There are
two fundamental problems in identifying the ethical standards we are to follow:

1. On what
do we base our ethical standards?

2. How do
those standards get applied to specific situations we face?

If our
ethics are not based on feelings, religion, law, accepted social practice, or
science, what are they based on? Many philosophers and ethicists have helped us
answer this critical question. They have suggested at least five different
sources of ethical standards we should use.

Five
Sources of Ethical Standards

The
Utilitarian Approach

Some
ethicists emphasize that the ethical action is the one that provides the most
good or does the least harm, or, to put it another way, produces the greatest
balance of good over harm. The ethical corporate action, then, is the one that
produces the greatest good and does the least harm for all who are
affected-customers, employees, shareholders, the community, and the
environment. Ethical warfare balances the good achieved in ending terrorism
with the harm done to all parties through death, injuries, and destruction. The
utilitarian approach deals with consequences; it tries both to increase the good
done and to reduce the harm done.

The Rights
Approach

Other
philosophers and ethicists suggest that the ethical action is the one that best
protects and respects the moral rights of those affected. This approach starts
from the belief that humans have a dignity based on their human nature per se
or on their ability to choose freely what they do with their lives. On the
basis of such dignity, they have a right to be treated as ends and not merely
as means to other ends. The list of moral rights -including the rights to make
one’s own choices about what kind of life to lead, to be told the truth, not to
be injured, to a degree of privacy, and so on-is widely debated; some now argue
that non-humans have rights, too. Also, it is often said that rights imply
duties-in particular, the duty to respect others’ rights.

The
Fairness or Justice Approach

Aristotle
and other Greek philosophers have contributed the idea that all equals should
be treated equally. Today we use this idea to say that ethical actions treat
all human beings equally-or if unequally, then fairly based on some standard
that is defensible. We pay people more based on their harder work or the
greater amount that they contribute to an organization, and say that is fair.
But there is a debate over CEO salaries that are hundreds of times larger than
the pay of others; many ask whether the huge disparity is based on a defensible
standard or whether it is the result of an imbalance of power and hence is
unfair.

The Common
Good Approach

The Greek
philosophers have also contributed the notion that life in community is a good
in itself and our actions should contribute to that life. This approach
suggests that the interlocking relationships of society are the basis of
ethical reasoning and that respect and compassion for all others-especially the
vulnerable-are requirements of such reasoning. This approach also calls
attention to the common conditions that are important to the welfare of
everyone. This may be a system of laws, effective police and fire departments,
health care, a public educational system, or even public recreational areas.

The Virtue
Approach

A very
ancient approach to ethics is that ethical actions ought to be consistent with
certain ideal virtues that provide for the full development of our humanity.
These virtues are dispositions and habits that enable us to act according to
the highest potential of our character and on behalf of values like truth and
beauty. Honesty, courage, compassion, generosity, tolerance, love, fidelity,
integrity, fairness, self-control, and prudence are all examples of virtues.
Virtue ethics asks of any action, “What kind of person will I become if I
do this?” or “Is this action consistent with my acting at my
best?”

Putting the
Approaches Together

Each of the
approaches helps us determine what standards of behavior can be considered
ethical. There are still problems to be solved, however.

The first
problem is that we may not agree on the content of some of these specific
approaches. We may not all agree to the same set of human and civil rights.

We may not
agree on what constitutes the common good. We may not even agree on what is a
good and what is a harm.

The second
problem is that the different approaches may not all answer the question
“What is ethical?” in the same way. Nonetheless, each approach gives
us important information with which to determine what is ethical in a
particular circumstance. And much more often than not, the different approaches
do lead to similar answers.

Making
Decisions

Making good
ethical decisions requires a trained sensitivity to ethical issues and a
practiced method for exploring the ethical aspects of a decision and weighing
the considerations that should impact our choice of a course of action. Having
a method for ethical decision making is absolutely essential. When practiced
regularly, the method becomes so familiar that we work through it automatically
without consulting the specific steps.

The more
novel and difficult the ethical choice we face, the more we need to rely on
discussion and dialogue with others about the dilemma. Only by careful
exploration of the problem, aided by the insights and different perspectives of
others, can we make good ethical choices in such situations.

We have
found the following framework for ethical decision making a useful method for
exploring ethical dilemmas and identifying ethical courses of action.

A Framework
for Ethical Decision Making

Recognize
an Ethical Issue

Could this
decision or situation be damaging to someone or to some group? Does this
decision involve a choice between a good and bad alternative, or perhaps
between two “goods” or between two “bads”?

Is this
issue about more than what is legal or what is most efficient? If so, how?

Get the
Facts

What are
the relevant facts of the case? What facts are not known? Can I learn more
about the situation? Do I know enough to make a decision?

What
individuals and groups have an important stake in the outcome? Are some
concerns more important? Why?

What are
the options for acting? Have all the relevant persons and groups been
consulted? Have I identified creative options?

Evaluate
Alternative Actions

Evaluate
the options by asking the following questions:

Which
option will produce the most good and do the least harm? (The Utilitarian
Approach)

Which
option best respects the rights of all who have a stake? (The Rights Approach)

Which
option treats people equally or proportionately? (The Justice Approach)

Which
option best serves the community

as a whole,
not just some members?

(The Common
Good Approach)

Which
option leads me to act as the sort of person I want to be? (The Virtue
Approach)

Make a
Decision and Test It

Considering
all these approaches, which option best addresses the situation?

If I told
someone I respect-or told a television audience-which option I have chosen,
what would they say?

Act and Reflect
on the Outcome

How can my
decision be implemented with the greatest care and attention to the concerns of
all stakeholders?

How did my
decision turn out and what have I learned from this specific situation?

This
framework for thinking ethically is the product of dialogue and debate at the
Markkula Center for Applied Ethics at Santa Clara University. Primary
contributors include Manuel Velasquez, Dennis Moberg, Michael J. Meyer, Thomas
Shanks, Margaret R. McLean, David DeCosse, Claire André, and Kirk O. Hanson. It
was last revised in May 2009.

HMGT372 Legal and Ethical Issues in Health Care

Week 2 Discussion

Patients
have a bill of rights. Patients also consent to care and have a right to
self-determine their care. Those who care for patients are to keep information
protected.

Select one
of the patient rights (ethical or legal issues) from readings this week.
Discuss with your colleagues the right, the legal and/or ethical basis for this
right and how this translates into responsibility for a specific health service
organization setting. Provide two specific real life legal case examples that
you find on the internet or in the print media. Examples: assisted living
facilities for disabled, long term care facility, a home care nursing
association, a small physician practice, a hospital, a rehabilitation center,
or a first responder/ambulance. Remember:

1. The
patient right (with proper legal citation);

2. The
setting; and

3. The
health care organization’s responsibility.

Peer
comments should compare and contrast the impact of the patient rights on each
setting. Read the background articles. This discussion requires research beyond
the above articles. See Discussion Expectations and Grading for rules on
discussions.

Assigned
reading materials:

Federal Law
on Advance
Directives-http://www.nrc-pad.org/images/stories/PDFs/fedaddirectives2a.pdf

Patients’
rights, protections and the law-
http://www.healthsourceglobal.com/docs/patient%20bill%20of%20rights_merged.pdf

Partnership
for patients- http://partnershipforpatients.cms.gov/

Shared
decision making- http://www.nejm.org/doi/full/10.1056/NEJMp1209500

HMGT372 Legal and Ethical Issues in Health Care

Week 3 Discussion

Health care
fraud is a form of white collar crime. It involves filing illegitimate health
care claims to turn an illicit profit. The 3 major laws that protect against
healthcare fraud are the Anti-kickback statute, Stark, and the False Claims
Act. From the readings and independent research, find one (1) specific real
life legal case example of how kickback arrangements would violate the Stark
Law. In addition, discuss with your colleagues how the kickback arrangements
could violate trust between provider organizations and patients. From the
readings and independent research, find one (1) specific real life legal case
example of a breach of the False Claims Act by a health-related organization.
In addition, discuss whether health care organizations are properly equipped to
ensure compliance and minimize exposure risks. If not why not?

Read the
background articles. This discussion requires research beyond the articles. See Discussion Expectations and Grading
for rules on discussions.

Assigned
reading materials:

Medicare
Fraud and Abuse: Prevention, Detention, & Reporting –
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/fraud_and_abuse.pdf

Stark and
AKS Chart-http://oig.hhs.gov/compliance/provider-compliance-training/files/StarkandAKSChartHandout508.pdf

Breakdown
of False Claims Act-(Control>>Click>>From Drop down Menu select
Open in New Window or Copy/Paste into your URL)
https://www.justice.gov/sites/default/files/civil/legacy/2011/04/22/C-FRAUDS_FCA_Primer.pdf

The Stark
Truth about the Stark law Part I http://www.aafp.org/fpm/2003/1100/p27.html

Deficit
Reduction Act-http://www.crowell.com/documents/docassocfktype_articles_919.pdf

Brown,
J. (2008). Develop a policy for amended records. Journal of Health Care compliance, January-February, 37- 38. [must
use UMUC library]

Mekel, M.
(2012). The Health Care Quality Improvement Act of 1986 Meets the Era of Health
Care Reform: Continuing Themes and Common Threads. Journal of Legal Medicine,
(33), 106. [must use UMUC library]

HMGT372 Legal and Ethical Issues in Health Care

Week 4 Discussion

Discuss
with your colleagues how a health care organizations can promote a culture of
compliance and responsibility? Through your research, identify a specific
organizational structure or program that could serve as a “best practice” for
other health organizations. What
specific health care organization currently uses the program or structure you
picked? Describe the program in a paragraph. Is it a training program? A
handbook? An immunization program? A patient care involvement program? A
financial management practice? Penalties for fraud detection and reporting in
the organization? Policy development? Procedure (SOP) creation? Benchmarks?
External QA/QC consultants? Is this “best practice” specific to just this
setting? Peer comments should compare and contrast their findings with others
presented. See Discussion Expectations and Grading for rules on discussions.

Assigned
reading materials:

It is
important that managers understand the responsibilities of operating within the
tax-exempt structure-http://www.irs.gov/pub/irs-tege/eotopice00.pdf

Corporate
Responsibility and Corporate Compliance: A Resource for Health Care Boards of
Directors
(n.d)]-http://oig.hhs.gov/fraud/docs/complianceguidance/040203CorpRespRsceGuide.pdf

Facts about
The Joint Commission’s Hospital Accreditation –
https://www.jointcommission.org/accreditation/accreditation_main.aspx

Benefits of
The Joint Commission Accreditations –
https://www.jointcommission.org/benefits_of_joint_commission_accreditation/

Joint
Commission: Conflict of Interest –
https://www.jointcommission.org/conflict_of_interest_policy/

HMGT372 Legal and Ethical Issues in Health Care

Week 5 Discussion

Health
executives have a code of ethics and policy statements which guide their
behavior. Examine one of the policy
statements provided by ACHE.org and comment on how this code may differ in
nature than the health care provider codes. Be specific. Do you see any ethical
issues emerging out of health care reform yet are not consider in the ACHE
documents? Peers are expected to demonstrate critical thinking in their
questions related to the classmates’ descriptions. See Discussion Expectations
and Grading for rules on discussions.

Assigned
reading materials:

Patient
Privacy and Genetic Testing-http://www.eeoc.gov/laws/types/genetic.cfm

Standards
for Ethical Behavior Among Health Care Executives-
http://www.ache.org/ABT_ACHE/code.cfm

Teaching
Clinical Ethics Using a Case Study Family Presence During Cardiopulmonary- http://ccn.aacnjournals.org/content/25/1/38.full.pdf&embedded=true

HMGT372 Legal and Ethical Issues in Health Care

Week 6 Discussion

Find a
newspaper or scholarly article where a health care organization or a provider
was found guilty of malpractice, criminal negligence, false credentials,
failure to treat or patient abandonment. Provide specific details of the case.
Discuss with your colleagues: 1. Which critical health care error does the
article address? 2. Explain the setting and details using your own words. 3. Drawing from your readings and experience
to date, what do you assess are factors leading up to the error? Touch on
duties and standard of care. Peers are expected to demonstrate critical
thinking in their questions related to the classmates’ descriptions. See
Discussion Expectations and Grading for rules on discussions.

Assigned
reading materials:

Credentialing
and Privileges-http://ctel.org/expertise/credentialing-and-privileging/

Summary of
Credentialing and Privileges-
http://www.hcca-info.org/Portals/0/PDFs/Resources/Conference_Handouts/Compliance_Institute/2013/Tuesday/600/607print1.pdf

A Short
Overview of Medical Malpractice
http://malpractice.laws.com/medical-malpractice-law/medical-malpractice-overview

Medical
negligence: Criminal prosecution of medical professionals, importance of
medical evidence: Some guidelines for medical practitioners-
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779964/

HMGT372 Legal and Ethical Issues in Health Care

Week 7 Discussion

Bow-Tie
Analysis is one of many effective tools for communicating risk assessment. Discuss the bow-tie method and then provide
another specific example of an effective tool that hospitals use for risk assessment.
Which one would you implement in your area and why? Must provide specific
examples of each being used and results.
Discuss in what areas you feel a risk management analysis could be effective
and why? Peers are expected to demonstrate critical thinking in their questions
related to the classmates’ descriptions. See Discussion Expectations and Grading
for rules on discussions.

Assigned
reading materials:

Bow tie
-http://www.r4risk.com.au/Bow-tie-Analysis.php

Bow tie –
(Control>>Click>>From Drop down Menu select Open in New Window or
Copy/Paste into your URL) http://www.ncbi.nlm.nih.gov/pubmed/19591531

Risk
Management, Quality Improvement, and Patient
Safety-(Control>>Click>>From Drop down Menu select Open in New
Window or Copy/Paste into your URL)
https://www.ecri.org/components/HRC/Pages/RiskQual4.aspx

The Purpose
of Risk Management in
Healthcare-http://elearning.scranton.edu/resource/health-human-services/purpose-of-risk-management-in-healthcare

HMGT372 Legal and Ethical Issues in Health Care

Week 8 Discussion

Research
and discuss with your colleagues two health care challenges in the future for
public or private health care organizations. You must select two challenges and
discuss: How will these challenges affect patients and the health care
organization? Be specific as to which type of health care organization you are
dealing with [i.e. HMOs. PPOs, POS, urgent care centers, physician outpatient
care surgical centers, etc.]. Peers are expected to demonstrate critical
thinking in their questions related to the classmates’ descriptions. See
Discussion Expectations and Grading for rules on discussions.

Assigned reading
materials:

Improving
Ethical Decision Making in Healthcare Leadership
https://www.omicsonline.org/open-access/improving-ethical-decision-making-in-health-care-leadership-2151-6219-4-e101.pdf

Ruger, J.P.
(2011). Shared Health Governance. The
American Journal of Bioethics, 11 (7), 32-45. See
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1752295 [you can download
entire paper for free]