PBHE215 Midterm Exam Questions

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PBHE215 Midterm Exam Questions PBHE215 Midterm Exam Questions INSTRUCTIONS: Please answer the following 8 questions. Suggested answer length is notated behind the question. Answer questions underneath the questions on this document. ORDER COMPREHESIVE SOLUTION PAPERS ON PBHE215 Midterm Exam Questions 1. Define ethics and explain the difference between ethics and laws. (1 paragraph–including in-text citations and references in proper APA format) Ethics and law, while intertwined, are distinct concepts. Ethics refers to a system of moral principles and values that guide our actions and decisions. These principles are often informal and unwritten, rooted in societal norms and individual beliefs. They inform our sense of right and wrong, often prompting us to consider the consequences of our choices beyond legal ramifications (Bhattacharyya et al., 2022). Law, on the other hand, consists of formal rules and regulations established by authorities. Laws are codified and enforceable, with sanctions prescribed for non- compliance. While laws often draw upon ethical principles, they may not always perfectly align with them. Additionally, laws are designed to apply broadly, whereas ethical considerations often require nuanced sensitivity to specific situations and individual circumstances (Bhattacharyya et al., 2022). 2. What is the difference between administrative and biomedical ethical issues. (2 paragraphs–including in-text citations and references in proper APA format) Administrative ethics focuses on ethical dilemmas faced by individuals within organizations, specifically concerning the use of power, resource allocation, and

decision-making within bureaucratic structures. This often involves issues of transparency, accountability, fairness, and conflict of interest (Darr, 2011; Levy Guyer et al., 2000). Biomedical ethics, in contrast, addresses ethical concerns arising from advances in medical technology and healthcare practices. This domain grapples with complex questions surrounding patient autonomy, informed consent, end-of-life care, resource allocation in healthcare, and the use of new technologies such as genetic engineering (Darr, 2011). 3. List the steps to managers’ problem solving methodology? (refer to week 1.) (1 paragraph including in-text citations and references in proper APA format) The manager's problem-solving methodology, as outlined in Week 1, involves a six-step approach: 1. Problem identification: Clearly define the issue at hand. 2. Information gathering: Collect relevant data and insights. 3. Problem analysis: Analyze the causes and factors influencing the problem. 4. Alternative solutions: Generate potential solutions based on the analysis. 5. Solution evaluation: Assess the feasibility, effectiveness, and ethical implications of each solution. 6. Solution implementation and monitoring: Choose the optimal solution, implement it, and monitor its effectiveness (Heerkens & Arnold van Winden, 2021). 4. When might an ethics audit be necessary? Briefly describe the three steps associated with it. (1 paragraph including in-text citations and references in proper APA format) An ethics audit is a systematic assessment of an organization's ethical practices and policies. Such audits are necessary when: • Red flags arise: Concerns about unethical behavior, conflicts of interest, or non-compliance with regulations emerge. • Proactive evaluation: Organizations seek to proactively assess their ethical climate and identify potential areas for improvement. • Changes occur: Significant changes in leadership, policies, or operations necessitate review of ethical implications. The three steps involved in an ethics audit typically include: 1. Planning and design: Defining the scope, objectives, and methodology of the audit. 2. Information gathering: Conducting interviews, reviewing documents, and observing practices to assess adherence to ethical standards. 3. Reporting and recommendations: Analyzing findings, identifying areas of improvement, and recommending corrective actions (Agheorghiesei et al., 2013).

5. The American College of Healthcare Executives (ACHE) is a well-know health services management professional association. According to the ACHE, explain the responsibility/ obligation of a health care executive. (2 paragraphs including in-text citations and references in proper APA format) The American College of Healthcare Executives (ACHE) outlines several key responsibilities and obligations for health care executives: • Ethical leadership: Upholding the highest ethical standards, promoting integrity, and fostering a culture of ethical decision-making throughout the organization. • Patient-centered care: Ensuring quality care that prioritizes patient safety, well-being, and dignity, while respecting patient autonomy and informed consent. • Fiduciary responsibility: Acting in the best interests of the organization and its stakeholders, managing resources effectively and transparently, and avoiding conflicts of interest. • Community engagement: Collaborating with stakeholders and the community to address healthcare needs and contribute to the overall well-being of the population (American College of Healthcare Executives, 2023). 6. What is the fiduciary responsibility of health care executives and managers. (2 paragraphs including in-text citations and references in proper APA format) Fiduciary responsibility refers to the legal and ethical obligation of individuals entrusted with managing the assets or interests of others to act in their best interests (Peregrine, 2023). In the context of health care, this translates to several key duties: • Duty of care: Exercising reasonable care and diligence in fulfilling their responsibilities, ensuring the quality and safety of healthcare services provided. • Duty of loyalty: Acting solely in the best interests of the organization and its stakeholders, avoiding conflicts of interest, and disclosing any personal interests that may influence decisions (Peregrine, 2023). • Duty of obedience: Complying with applicable laws, regulations, and ethical standards governing healthcare practices. • Duty of confidentiality: Protecting the privacy and confidentiality of patient information Conflicts of Interest and Ethical Dilemmas Conflicts of interest arise when personal interests or relationships clash with professional responsibilities or the interests of the organization one serves. These conflicts can pose significant ethical dilemmas for managers and executives, creating situations where personal gain or loyalty to individuals could potentially come into conflict with their duty to act in the best interests of the organization and its stakeholders (National Academies Press (US), 2023). 7. Describe at least three examples of conflicts of interests. Explain how conflicts of interests can present ethical dilemmas for managers/ executives. (3 paragraphs including in-text citations and references in proper APA format)

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• Financial conflicts: Accepting gifts, payments, or other benefits from pharmaceutical companies or medical device manufacturers in exchange for prescribing their products, even if those products are not the most effective or cost-efficient for the patient. • Non-financial conflicts: Hiring family members or close friends for positions within the organization, even if they are not the most qualified candidates. • Self-dealing: Engaging in financial transactions or business ventures that benefit the manager or executive personally, while using their position within the organization to gain access to advantageous deals or information. • Conflicts of conscience: When a manager's personal beliefs or values clash with the policies or practices of the organization, such as in issues related to abortion, end-of-life care, or genetic testing. These conflicts of interest can present ethical dilemmas for managers and executives in several ways. Firstly, they can compromise fairness and transparency within the organization, creating perceptions of bias or favoritism. Secondly, they can erode public trust in the organization and its leadership, potentially damaging its reputation and legitimacy (National Academies Press (US), 2023). Thirdly, they can lead to poor decision-making, as personal interests may cloud judgment and compromise the ability to make objective and ethical choices in the best interests of the organization and its stakeholders. 8. Read the case study below and answer the following questions. (1 1/2 – 2 pages including in-text citations and references in proper APA format). Your answers to each question should be based on your reading of Darr. If necessary, you may refer to the text. Your answers should demonstrate your understanding of the terms as well as your ability to apply them to the case of Baby K (given the limited facts provided.) 1)Discuss what makes this an ethical dilemma. 2)Discuss the implications of this study in terms of the moral principles described in chapter 1. Respect for persons: Did the hospital/ physicians allow the parents to be autonomous in their decision-making? Do you see any elements of paternalism on behalf of the physicians? Beneficence: Did the hospital/ physicians act beneficently? Nonmaleficence: Did the hospital/ physicians consider nonmaleficence? Justice: Did the hospital act in a just way? Baby K was born at Fairfax Hospital in Northern Virginia on October 13, 1992. Although her face was beautiful, the top of her head was flat. She had no brain The baby’s mother knew from the 16th week of her pregnancy that Baby K’s brain had not developed. Baby K had no cerebrum and no cerebellum, but she did have a normal brain stern. The mother was told that babies with “anencephaly”- from the Greek words for negative (an) and brain (enkephalos) – cannot see, hear, or feel anything no matter how long they live. Baby K would have no thoughts, and she would never achieve “personhood.” If she were born alive, her brain stem would prompt her heart to beat and her lungs to pump air in and out of her body. Baby K, like other babies with anencephaly, would be “born dying” but would not be technically brain dead. Anencephaly is one condition, perhaps the only one, that all doctors agree is futile to treat. The general consensus among medical, legal, and other experts is that heroic measures should not be used to keep such babies alive. But Baby K’s mother balked. She wanted to keep her baby alive no matter what the cost. She was motivated by a strong and sincerely held religious

belief that “all life is precious” and that a higher being, rather than herself or the doctors or the law, should decide how long her baby would live. Baby K held on (most babies with anencephaly die within the first few days of their lives) and finally left the hospital when she was seven weeks old. No neonatal intensive care unit (NICU) would accept her, so she went to a nursing home. In the case of Baby K, several potential conflicts of interest and ethical dilemmas arise: • Conflict between parental autonomy and beneficence: The mother's strong religious beliefs and desire to keep Baby K alive, regardless of her medical condition and lack of "personhood," may clash with the hospital's and physicians' professional duty to act in the best interests of the child, which in this case involves considering potential suffering and the futility of treatment (Levy Guyer et al., 2000). • Conflict between nonmaleficence and respect for autonomy: The decision to keep Baby K alive on life support could be seen as causing unnecessary suffering, potentially conflicting with the principle of nonmaleficence. However, respecting the mother's autonomy and religious beliefs also needs to be considered. • Conflict between resource allocation and justice: Providing extensive medical care and resources to Baby K, who has no chance of recovery, could raise concerns about fair allocation of limited resources within the healthcare system, potentially impacting the care of other patients with greater needs and prospects for improvement. Navigating these complex ethical dilemmas requires careful consideration of various factors, including the specific facts of the case, the principles of medical ethics, and the legal and regulatory framework surrounding end-of-life care (National Academies Press (US), 2023). Open communication and collaboration between the medical team, the parents, and any relevant ethical committees are crucial in reaching a decision that respects all parties involved while upholding ethical principles and avoiding potential conflicts of interest. In conclusion, conflicts of interest and ethical dilemmas are common challenges faced by managers and executives in various professions, particularly in healthcare. Understanding these conflicts and their potential implications is crucial for making informed decisions and upholding ethical leadership. By employing sound ethical reasoning, seeking guidance from relevant stakeholders, and prioritizing the well-being of the organization and its beneficiaries, managers and executives can navigate these complex situations and strive to act with integrity and responsibility References Agheorghiesei, D. T., Iliescu, L., Gavrilovici, C., & Oprea, L. (2013). What is to be expected from an ethics audit integrated within the accreditation process of hospitals from romania? Iranian Journal of Public Health, 42(7), 737-747. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881619/ American College of Healthcare Executives. (2023). Ache.org. https://www.ache.org/ Bhattacharyya, R., PrasadRao Gundugurti, Sandeep Kondepi, Chakraborty, K., & Mukherjee, A. (2022). Ethics and law. Indian Journal of Psychiatry, 64(7), 7-7. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_726_21 Darr, K. (2011). Ethics in Health Services Management. (5th Edition). Baltimore, MD: Health Professions Press, Inc. https://www.scribd.com/document/201727406/Ethics-in-Health-Services- Management-Fifth-Edition-Darr-5e-Excerpt

Heerkens, H., & Arnold van Winden. (2021). Solving Managerial Problems Systematically. In Routledge eBooks. https://doi.org/10.4324/9781003186038 Levy Guyer, R., Dillon, M., Anderson, L., & Szobota, L. (2000). Social Education, 64(7), 410- 414. Retrieved December 27, 2023, from https://highschoolbioethics.georgetown.edu/archive/resources/BioethicsCasesAndIssues2000.p df National Academies Press (US). (2023). Conflicts of Interest, Bias, and Ethicshttps://www.ncbi.nlm.nih.gov/books/NBK50715/ Peregrine. (2023). The fiduciary duties of healthcare directors in the "zone of insolvency." Journal of Health Law, 35(2). https://pubmed.ncbi.nlm.nih.gov/12125883/

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