Management ethics

Health services management ethics encompass the myriad ethical issues, virtually all of which directly or indirectly affect clinical services, faced by the managers of organizations that deliver health services and the moral context in which these decisions are made. Health services managers plan, organize, control, direct, and staff health services organizations (HSOs) and lead, coordinate, and integrate their activities so that clinical care can be provided. In essence, by managing the HSO, managers provide the workshop and wherewithal that enable clients and patients to receive health services. These preventive, acute, restorative, and supportive services may be provided in and through a variety of organizational settings that include inpatient services, outpatient (clinic) care, and home health services. The most intensive or acute services are provided to hospitalized inpatients; the least acute are provided in the home and in hospice, where the emphasis is comfort care and pain control. The types of health services management ethical issues that arise in the various settings are similar and run a gamut that includes macro-level resource allocation, conflicts of interest, staffing levels, and providing the structure and support for patients and families as they decide whether to withhold or withdraw life-saving treatment.

Health services managers are commonly educated in professional masters degree programs where there is emphasis on the skills of business and the ethics of medicine. In other words, these programs socialize health service managers to understand that they are entering a field in which they manage a social enterprise with business dimensions, rather than a business enterprise with social dimensions. This fact in itself makes the HSO and those working in it unique and unlike any other type of service organization. The persons served by the HSO have a unique relationship with it. This relationship is expressed through a level of trust in the organization and implicitly in its management that is rarely found in the service industry.

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