Hcs 335 - Ethical Health Care Scenarios

Ethical Health Care Scenarios

Lanetra Williams

HCS/335

October 3, 2016

Professor Anne Nevers

Ethical Scenarios

        Scenario #1: Medical coding in a physician’s practice

Imagine you work in a high-pressure cardiology physician’s office and you are one of two medical coders. Your supervisor is focused on the greatest reimbursement to satisfy revenue projections for the practice. As a result, you are asked to “up-code” billing. How can the pressure of acquiring the maximum repayment for services lead to manipulating or falsifying documentation?

Answer: The pressure of acquiring the maximum repayment for services is an unethical action that could cause a lot of trouble for the cardiology physician’s office. At times, employees want to do the best job they can by pleasing the supervisor when they know the action is wrong. Not only will the medical coder be in trouble legally, but it can cause them to lose their job, and not be able to work in the field again. Because the action was approved by the supervisor, this can cause them as well to be fired, and lose their license to practice medicine in health care.  Falsifying or manipulating repayment services is never a good ethical choice because you are providing false amounts of money for patients to pay for services that were most likely a lesser amount. This action is never fair to the patients. Legally, the physician and possibly the medical coder who submitted the false action will be responsible to pay back the extra money stolen, and most likely additional fines for making such an unethical choice. The practice very well may be forced to shut down, and cause other employees of this office to suffer from the loss of their jobs as well. It would be a chain reaction for the worst which is an action that could have been avoided if the right ethical choice was made in the first place.

        Scenario #2: Administration of patient medications in the hospital setting

Imagine you are a new graduate nurse working nights on a busy medical unit. You just received a new patient who needs to be admitted to your unit and you just finished medicating a patient with a narcotic injection with a dose greater than ordered. Clearly understanding medication errors may lead to patient injury and even death, explain why a clinician may choose NOT to report the incident.

Answer: There could be several reasons that the unethical choice would have been made NOT to report the incident of overmedicating a patient by the clinician. Because the nurse on duty was a new student, the fear and embarrassment of getting the dosage wrong right after graduating could have caused this poor decision which put the patient at risk for health injury and possibly death. Overnight shifts can be overwhelming in a busy unit, and if the clinician hadn’t had an adequate amount of rest before starting the shift, this could have caused a misreading on the dosage amount from fear of admitting being tired. If the patient end up having a bad reaction or fatal reaction, the clinician’s job could have been at stake. Not wanting to be fired as soon as the job was received is a possible reason the unethical choice was made to keep it undisclosed. It could have also very well been the fact that admitting to overdosing the patient would have led to the hospital being sued (malpractice claims), and making a name for the hospital and the employees in a bad way.