2. Presentation Contents
• Program Plan
• Ethics Training Program
• Monitoring Ethics
• Enforcing with Rewards
• Enforcing by reprimanding
• Functions of program
• Examples of Medical Ethical Dilemmas
3. Ethics Program Plan
• Introducing an Alternative Strategy
• Virtual Ethics Committee
• Virtual Peer Review
• Multi-facility Ethics Committee
• Ethics Outreach Services
9. Examples of Medical Ethical Dilemmas
• Employee Infractions
• Case Consultations
• Policies
10. References
• Bolin, J. N., Mechler, K., Holcomb, J., & Williams, J. (2008). An Alternative Strategy for Resolving
Ethical Dilemmas in Rural Healthcare. American Journal Of Bioethics, 8(4), 63-65.
doi:10.1080/15265160802147231.
• Gillette, Ph.D., Michael. (2002). Bioethical Services of Virginia: Functions of an Ethics Program-An
introduction into doing medical ethics. Article retrieved from:
http://www.bsvinc.com/ethics_function.htm.
• Nelson, W. A. (2007). Ethics Programs in Small Rural Hospitals. Healthcare Executive, 22(6), 30-33.
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Editor's Notes
I am here to present to you today an ethics program for Patton-Fuller Community Hospital. This rural area hospital has been operating for 37 years and does not have an ethics program or committee on hand to support the decision making for ethical dilemmas. Which is not surprising because 50 percent of rural hospitals do not have ethical committees of any kind. (Nelson, 2007)
I will be examining five concepts. The first is an ethics program plan for the hospital. The second is the training program that I plan to include. The third is how we are going to monitor the ethical dilemmas. The fourth is the rewards we might use for enforcement and the fifth is how we plan to reprimand for any unethical behavior.
I will be introducing an alternative strategy to normal ethics committees. Usually there is someone assigned as chairman to oversee ethical dilemmas that is already part of the hospital staff, such as the resident doctor. In urban areas, this is not usually a problem, but in rural areas this can present many problems, for example, in a small town, it is likely that the chairman and the parties involved in the ethical dilemma will know each other and this presents a conflict of interest and bias opinions that might compromise judgments. (Bolin, Mechler, Holcomb, & Williams, 2008)Virtual Ethics Committees can solve these kinds of problems by creating a network of doctors and peers for hospital administrators to turn to in the likelihood of ethical dilemmas by phone or video conferencing, email, or instant messaging. There is someone available 24 hours a day and seven days a week to handle any ethical medical questions. (Bolin, Mechler, Holcomb, & Williams, 2008)Virtual Peer Review is how the hospital would handle monitoring ethics by enforcing them with rewards and reprimanding. (Bolin, Mechler, Holcomb, & Williams, 2008)Multi-facility Ethics Committees, in a rural community, take care of the situations, training, monitoring, and education while being at a centralized location through virtual networks. Since there is probably a hospital in every county, there is really no necessary reason to have a single onsite ethics committee in every hospital. (Nelson, 2007)For example, at Texas A&M University, they provide a virtual ethics committee, virtual peer review, and multi-facility ethics committee for all of their hospitals in the immediate area. The college’s studies have proven quite beneficial in all areas that need review. (Bolin, Mechler, Holcomb, & Williams, 2008)
The training included will start with education DVDs to be watched on hire date of the employee. Then proceed to medical ethics testing with a complex quiz after they are finished. Finally, monthly seminars are held at the ethics committee headquarters or at the nearest university.
There will still need to be a chairman assigned to oversee the DVD viewing and testing of new hire employees. This will be the person to report everything to the virtual ethics committee. Monthly video or phone conferences with the virtual ethics committee will be scheduled on the same day every month.
We will be enforcing ethical behavior with rewards which will include interdepartmental promotions, 25 cent pay raises, and one day vacation extensions for good ethical behavior that has been brought to our attention by a supervisor.
We will give notice to the employee of the infraction the first time with a verbal warning only. Next, after there are three written warnings for the same problem, termination will be immediate and the employee will their vacation time and sick pay if caused by misconduct.
The first priority will be primarily to educate the medical and other staff. Second is the need for case by base consultation. Third, the development and review of policies for the future dilemmas is very important. (Gillette, 2002)
Examples of employee infractions: tardiness, absenteeism, and theft.Examples of case consultations and policies: removal of life support, withholding or withdraw of treatment, and settling a disagreement between family members on patient care. (Gillette, 2002)
