Ethical Issues In Health Care

Ethical Issues In Health Care

Now that you've heard the facts, what do you think now?

1. How should organ allocation be conducted?

2. Should health care institutions become more profit-oriented or patient-centered?

Quality of Care vs. Profitability

Organ Allocation

What factors determine who will get an organ?

Dilemma: As a health care administrator, do you focus more on maximizing profit or maximizing quality of patient care?

• Age

• Blood type

• Medical urgency

• Waiting time

• Geographic distance between donor and recipient

• Size of the donor organ in relation to the recipient

• Type of organ needed

• Dilemma: There is a shortage of organs. How should organs be allocated? First come first serve? Need-based? Age? Ability to pay? Who should make these decisions? How?
• Current System: United Network for Organ Sharing (UNOS)

What is "quality of care"?

the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.

Quality of Care between the different types of institutions

Steps to get in the organ waiting list?

1. Non-profit

2. For-profit

3. Government operated

Which of those different types of institutions would likely provide better quality care?

1. Obtain a physician referral

2. Contact a transplant hospital

3. Schedule an appointment for evaluation

4. Ask questions to learn as much as possible about your candidacy during the evaluation

5. If deemed a good transplant candidate, placed on national waiting list.

UNOS: maintains a centralized computer network, UNetSM, which links all organ procurement organizations(OPOs) and transplant centers

How can "quality of care be objectively measured?

1.Patient experience

2.Process quality

3.Mortality rates

4.Readmission rates

5.Hospital Safety Score

Key Dimensions of Quality of Care

1. Appropriateness 4. Continuity 7. Efficiency

2. Availability 5. Effectiveness 8. Prevention

3. Competency 6. Efficacy 9. Respect & Caring

How Organ Allocation Policies Are Made

1. An individual, such as a member of the public, brings an issue to the attention of the OPTN/UNOS.

2. OPTN/UNOS committees discuss the issue and consider recommending a new policy or policy change.

3. Patients, OPTN/UNOS members and the public comment on any proposed policy change or new policy.

4. The OPTN/UNOS committee considers all public comment before recommending a policy change of new policy to the OPTN/UNOS Board of Directors.

Game Plan

5. The OPTN/UNOS Board of Directors votes on whether to adopt the policy change or new policy.

6. OPTN/UNOS submits the policy to the Department of Health and Human Services (HHS) for review and approval. Organ allocation policy is voluntary until approved by HHS.

Through its various committees, anyone, at anytime, can bring an issue to the attention of the OPTN/UNOS

1. What is an ethical dilemma?

2. How should the allocation of organs be decided?

3. Make as much money as you can? Or make sure your patients get the best care?

NOTE: Transplantation is the ONLY field in medicine in the U.S. in which patients have a formal role in making policies.

Gabriel Andrada

Joey Cifra

Rachel Helfman

Miles Ramirez

Tania Velasco

Ethical Dilemma

n. - a complex situation that often involves an apparent mental conflict between moral imperatives, in which to obey one would result in transgressing another