You have just assumed command at the MHS Community Hospital and you notice that an ethics program is not in place. The only component in evidence is consultation: When an ethical issue arises, a member of your pastoral care office responds to the provider of family member. You would like to see a comprehensive program established at MHS. Of the following, what is the first thing you would do?

Appoint an Ethics Officer

You have put a structure in place at MHS, appointing both an Ethics Officer and establishing an Ethics Committee. Of the following, what would be the most logical next step?

Conduct an ethics climate survey

You have taken the actions recommended in Questions 1 and 2. What is your next course of action?

Review and develop policies

You are still the Commander of MHS Community Hospital, having survived the trying first six months of command. During this time, you successfully implemented an ethics program. You now face the ethical dilemma of whether or not to eliminate orthopedic care for family members and retirees, The dilemma has arisen following the transfer of one of you two orthopedic surgeons. The remaining orthopedic physician is expected to continue for at least another year due to the large number of military deployments. There is no money in the budget to hire a civilian replacement.

Prior to the transfer, you were able to provide care to family members and retirees (although backlogs were approximately three months for these groups). You are now concerned about the ethical implications of any decision you make. Of the options below, which tool would be most helpful at this point.

Nash's 12 Questions

Using Nash's 12 Questions, you have identified the key questions and principles involved in the case. You are now considering various options (for example, providing care only to active duty, limiting care to active duty and family members, etc.). Which tool would be most appropriate given this situation just described?

Decision Matrix

What ethical principle would best apply as you prepare to make a decision about limiting orthopedic care?

Justice

As the Chair of the Ethics Committee, in which of the following circumstances would you consider an audit or evaluation of the healthcare organization's ethics program?

Sudden increase in problems and conflicts with vendors and suppliers

During an interview with a reporter, you are asked to provide an overview of Ethics Committees. The next day, you glance over the article in the newspaper, and under the heading, Roles of the Ethics Committee, you notice the following error in the sub-heads of the article:

Providing value in product and service

As a member of the healthcare organization Ethics Committee, you have been asked to speak to medical students and residents at a local hospital about ethical decision making. Of the following, which is considered a basic ethical principle in resolving ethical dilemmas?

Beneficence

As the senior leader of a healthcare organization, you have concerns regarding the effectiveness of the ethics committee group interactions. This stems from an incident in which one of the members angrily stormed out of the room during a previous committee meeting because they felt dismissed by other members. What would be an appropriate action to improve committee membership and functioning?

Appointing a Committee Chair with commitment, time availability, and strong facilitation, listening, and conflict-management skills

As a member of the healthcare organization committee, you have been asked to help develop a comprehensive educational plan for all members of the organization. Which of the following components should be addressed in the plan?

Code of conduct

As the leader of the Ethics Committee, you decide to conduct an annual evaluation/audit of the healthcare organization's ethics program. What method would you use to obtain in-depth information from senior administrative and clinical managers?

Interview or focus group

What ethical principle should be applied when a healthcare provider is balancing the risks and benefits of a particular procedure?

Beneficence

Which of the following is considered one of the major components of an ethics program?

Policy on ethical issues and codes of conduct

As a new member of the healthcare organization Ethics Committee, you do a mental check of Baylor's 7-Step Model for Ethical Decision Making prior to entering the conference room for the afternoon committee meeting. The seven steps include all of the following except:

Setting a time limit for a decision

What should be the first step in an ethical decision-making approach?

Frame the question

Mrs. Patts is a 60-year-old lady who recently came into hospital for acute renal failure. The doctors have told her that she will need dialysis on a long-term basis until an appropriate kidney donor can be found. She is understandably upset by the news. She tells her doctor that she will give him and the hospital millions of dollars if her name is placed first on the kidney donor list. The doctor agrees to her request. In this case, which basic ethical principle has been breached?

Justice