Ethical Leadership

Full Answer Section

A Potential Ethical Issue in Healthcare Leadership

Approaching and Addressing the Issue Ethically, Professionally, and Responsibly

1. Gather All Facts and Identify Stakeholders:
   • Facts: I would first ensure a comprehensive understanding of the financial implications of providing the gene therapy (exact cost, potential impact on budget, alternative funding sources like grants or philanthropy). I would also gather clinical data on the therapy's efficacy, long-term outcomes, and the specific needs of our eligible patients.
   • Stakeholders: I would identify all affected parties: the patients and their families, the medical staff (physicians, nurses, specialists involved in the therapy), other hospital departments whose budgets might be affected, the hospital board, insurance providers, the wider community (who rely on our services), and regulatory bodies.
2. Consult Ethical Frameworks and Committees:
   • I would convene the hospital's Ethics Committee to facilitate a thorough discussion. This committee, comprising diverse professionals (clinicians, administrators, ethicists, community representatives), can provide invaluable perspectives.
   • I would refer to the ACHE Code of Ethics, particularly principles related to patient welfare, organizational integrity, and social responsibility. The "Ethical Decision-Making for Healthcare Executives" resource would guide the structured approach, emphasizing identifying ethical principles at play (e.g., beneficence, justice, stewardship, non-maleficence) and exploring alternatives.
3. Explore All Possible Alternatives and Their Consequences:
   • Full Provision: Provide the therapy to all eligible patients, understanding the potential financial strain and its impact on other services.
   • Limited Provision: Develop criteria for prioritizing patients, which raises significant justice concerns.
   • Alternative Funding: Actively pursue grants, philanthropic donations, or partnerships with pharmaceutical companies to offset costs.
   • Negotiation: Attempt to negotiate lower prices with the therapy manufacturer.
   • Advocacy: Engage with policymakers and insurance companies to advocate for broader coverage or different reimbursement models for such high-cost, life-saving therapies.
   • Process Optimization (Cost Savings Elsewhere): Identify areas within the hospital where efficiencies can be gained without compromising patient care (e.g., supply chain management, administrative overhead reduction, energy efficiency).
4. Prioritize Patient Welfare and Justice:
   • While financial sustainability is crucial for the hospital's long-term ability to serve, the primary mission of a healthcare institution is patient care. I would advocate strongly that compromising the quality or access to critical care should be a last resort.
   • The principle of justice would be central. How can we ensure fair access to this therapy without disproportionately disadvantaging other patient populations or services? This might involve developing transparent, ethically sound criteria for treatment if full provision is truly impossible, though this is an incredibly difficult ethical tightrope.
5. Transparent and Empathetic Communication:
   • Regardless of the eventual decision, I would ensure open and honest communication with all stakeholders. For patients and families, this means explaining the complexities and the decision-making process with empathy and compassion. For staff, it means addressing concerns about potential cuts and reinforcing the hospital's commitment to its mission.
   • This transparency builds trust, even when difficult decisions are made.

Sample Answer

Ethical Leadership in Healthcare: Summary and Application

Summary of "Ethical Leadership: Doing What It Takes" by J. Lesandrini