1. 1

2. Rose, a public health nurse, is also the director of
the Primary Care Division, one of the highest level
positions in the City Health Department. Although
employed there for only 2 months, Rose was
responsible for monitoring millions of money of
the city appropriations specifically earn marketed
for pediatric disease prevention in District 10.
However, District 10 had two indigent populations:
young families with children and elderly persons
with chronic diseases.
2

3. Rose soon discovered that her predecessor Dr.
Jones – an elderly physician who had held the
position for 35 years-diverted much of the
appropriated pediatric funds to the indigent elderly.
She brought her concerns to Dr. Quack, the Director
of the City Health Department for the past 20
years.
3

4. He dismissed her concerns and reminded her of his
power and her lack of longevity with the agency. Rose
knew that the federal and state appropriations were
duly budgeted for pediatric disease prevention for the
indigent children in District 10. she also knew that the
indigent elderly in District 10 desperately needed
services too.
4

5. Who should be prioritized in this case? Justify your
answer.
What are the specific ethical issues that Rose could
encounter with this issue?
If you were Rose, who would you turn to for advice
regarding this matter?
5

6. Organizational Ethics
6

7. Organizational Ethics
Manner an individuals ought
to act in organizations.
7

8. How people behave
within the organization
How their decisions
affect others.
8

9. According to JCAHO
Operation of health care organization that
have to do with the ethical responsibility of
the organization itself to conduct its business
and patient care practices in an HONEST,
DECENT and PROPER manner.
9

10. FOCUS. . .
1. CHOICES of individual and the
organization
10

11. 2. Seeks to identify, educate,
facilitate internalization of
institutional values and beliefs.
11

12. 3. Organizational moral norms can be
identified and morally evaluated.
12

13. 4. It studies
personal
and
organizational norms
as they apply to activities and goals of an
organization.
13

14. 5. Moral norms of an organization is manifested in:
- mission statement
- policies and procedures
- code of professional conducts
- strategic objectives
14

15. Approaches in
Studying Organizations
Rational System
Natural System
Open System
15

16. Rational System
Org’l Purpose: Goal Attainment
16

17. Rational System
Structured
17

18. Formality is implied and behavior within the
organization is created because of the
limitations that are predefined
(Scott and Davis, 2007).
18

19. STRENGTH
1. Focus on employer-employee
relations, official rules and policies.
19

20. 2. Be use to study recent changes
in HC
20

21. 3. Focus on violation of rules
organizational norms
+/- outcomes that result from strict
adherence to rules.
21

22. Key Areas to monitor:
EMPLOYEE EVALUATION & DISCIPLINE
22

23. THE NATURAL SYSTEM'S
DUPLEX PYRAMIDS
23

24. THE NATURAL SYSTEM'S
Informal
Useful: examining clinical and
professional cultures and
work relationships.
24

25. OPEN SYSTEM APPROACH
25

26. OPEN SYSTEM APPROACH
Dependent on
Resources
Personnel
Legitimacy
26

27. Moral Status of Organizations
27

28. Organizations
Subunit of
larger society
28

29. Organizations
29

30. Health Care Moral Status
is geared towards…
30

31. Health Care Moral Status
Organizations set own goals
31

32. Health Care Moral Status
Organizations act and
decide
32

33. Policies
product of deliberation of possible actions to meet
organizational goals.
33

34. Health Care Moral Status
Organizations are normally
evaluated
34

35. How does an organization
encourage their employees to act
and make decisions ethically?
35

36. Leaders are responsible for the
achievement of org’l mission
To do this:
MUST HAVE EMPLOYEES WHO
ARE ETHICAL IN THEIR DAILY
WORK.
36

37. EMPLOYEES
ARE HIRED
WHO ARE
ETHICALLY
SOUND
37

38. EMPLOYEES
WOULD WANT TO
BE VALUED BY
ORGANIZATION
38

39. METHODS OF INSTILLING ETHICS:
1. Selection Method
39

40. METHODS OF INSTILLING ETHICS:
2. Training Method
40

41. How do you make an ethically
sounding decisions?
41

42. Ethical Decision Making
1. Gather information
And
Determine client’s ability to make
sound decision.
42

43. Ethical Decision Making
2. Identify ethical dilemma
May be legal issue
Or
On conflict of personal values
43

44. Ethical Decision Making
3. Identify options, risks, benefits and
consequences of each.
Then, present such to client, proxy,
family and HC team
44

45. Ethical Decision Making
4. Reach a consensus about the most agreeable
solution.
45

46. Models for Organizational Ethics
Program
46

47. 1. Existing Hospital Committees
1. Responsibility
2. Accountability
3. Economic costs
4. Efficacy
5. Role of committee in pt’s
care decisions
6. Privacy
7. Committee composition
47

48. 1. Existing Hospital Committees
1. DNR
2. Patient’s right
3. Professional practice
issues
4. Death and dying
5. Allocation of resources
48

49. 2. Ethics Officer & Consultant
49

50. 50

51. Board of
Directors
4. Governing Board
Committee
Governing
Board
Manage
ment
51

52. 5. Management Discussion
Group
More advisory than authoritative in nature
52