Please see response attached (also below) (i.e. Posting 103036.doc), as well as one supporting document.

RESPONSE:

1. What ethics do you believe should guide continuing change in the American health care delivery system? (1 to 2 Paragraphs)

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient, and this must continue to guide continuing change in the American health care delivery system. Each group of the health care professionals (Nursing, Counselling, Physicians, etc.) has his or her own Code of Ethics, but the common theme is that it is for the benefit of the patient (see a number of Codes of medical Ethics at http://ethics.iit.edu/codes/health.html).

For example, as a member of the medical profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct, which define the essentials of honorable behavior for the physician.

I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
IX. A physician shall support access to medical care for all people.
Adopted June 1957; revised June 1980 revised June 2001(from http://www.ama-assn.org/apps/pf_new/pf_online?f_n=browse&doc=policyfiles/E-0.00.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/HnE/H-525.998.HTM&nxt_pol=policyfiles/E-1.00.HTM&).

Also see http://www.ama-assn.org/apps/pf_new/pf_online?category=CEJA&assn=AMA&f_n=mSearch&s_t=&st_p=&nth=1&.

2. Why? (1 Paragraph)

Thus, the guiding ethics and the related ethical principles of the continuing changing in the American health care delivery system must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. However, the patient is of the utmost important. This is because this meets the mission and vision of all health care systems. Delivery systems are intended for the benefit of the patient (versus profit driven). However, there has been some recent controversy within the present market-driven health care system, with some proponents arguing that patient care is sometimes compromised with the cost containment goals of the managed care implementation. However, this should not be.

For example, Weinstein (2001) reports the pitfalls of managed care (attached chapter). He reports that consumers and medical practitioners completing the form provided many dramatic examples of compromised health/mental health care. Social workers in every area of practice documented numerous examples of denied, limited, or inadequate care. Some denial of access to care is blatantly contrary to the law such as consumers being misled to believe that they need prior approval for emergency room care. Other reports document real problems with accessing specialty care. A sample of the horrific incidents reported include:

- A patient discharged from the hospital remained in a wheel chair for a number of days while the fight for approval of a hospital bed was waged.
- A social worker treating a suicidal client reported, "(the) psychiatrist at the MCO was...appearing to seek reasons why the client shouldn't be hospitalized rather than understanding the seriousness of the situation...He agreed that the client could be hospitalized for one day for an assessment."
- A consumer with multiple sclerosis reported, "None of the MS are on my plan. I called the plan. And they said I didn't need a specialist, any neurologist would do. They are wrong" (http://www.naswnyc.org/mc39.html).

Therefore, it is important more now than ever, to keep the guiding ethical principles focused on benefiting the patient first and foremost at the forefront, as the present system has the potential to be market driven. However, because the patient lives in the larger society, the health care system has an ethical responsibility to society and to other health professionals so the health care system also benefits them. It is also important to ethically take care of the self, so that the health care professional is in a healthy state in order to successfully meet the needs of the patient and health are system.

Does this fit with your present understanding?

FINAL REMARK I HOPE THIS HELPS AND TAKE CARE.

Source: http://www.naswnyc.org/mc39.html Retrieved November 3, 2006.