There is a growing concern in health care leadership, which emanates from the increasing tenuous association amid the primary stakeholders; that is patients and providers. There is a motion toward patient-centered care that permits the providers to enhance the autonomy of patients and self determination. As such, health care leaders carry out crucial role in guaranteeing the success or failure of the association amid the stakeholders. This calls for the consideration of ethics, which are integrated to help promote the association and demonstrate quality health care leadership (Summers, 2012). These ethics are directed by the ethical principles of health care, which include the principle of autonomy and the principle of nonmaleficence. In this regard, the purpose of this paper is to apply the aforementioned ethical principles to the current leadership practices within healthcare.
The principle of autonomy relates with the respect for the freedom of patient. The common parlance of this principle is that the patient is in a position to act with intent and comprehension and without other forces that would influence voluntary and free acts of the patient (Flite & Harman, 2013). In other words, the physician or rather health care providers are expected to respect the dignity and uniqueness of the patient, which explains why this principle sets the basis for informed consent practice in the patient-physician transaction in health care. Informed consent is the situation in which the health care practitioner discloses the relevant information to a patient that is deemed competent so that the patient can take the voluntary choice to refuse or accept treatment (McCormick, 2016). This principle is applied in leadership to ensure that the patient understands the type of treatment that is being applied and is given an opportunity to make a rational decision on what needs to be done.
The other ethical principle in health care that is incorporated in leadership is the principle of nonmaleficence. It advocates that health care practitioners not to intentionally create incidences that will injure or cause harm to the patient, through acts of omission or commission (McCormick, 2016). In essence, it is considered negligence when a health care practitioner carelessly imposes unreasonable harm to the patient. This calls for the proper application of standard of care as it minimizes the danger of causing harm to the patient, which would result in moral convictions. Harm in this case is any condition that worsens the state of the patient and, therefore, the principle of nonmaleficence affirms the demand for medical competence (McCormick, 2016). This principle thereby applies the fundamental commitment from the health care practitioners to protect and improve the health of their patients and avoiding any instances of harm. The principle of nonmaleficence is applied in healthcare leadership by ensuring that the medical professionals comprehend their role which is to protect patients from harm. In other words, this principle directs health care practitioners in making sound decision during the treatment process of the patient.
The ethical principles of autonomy and nonmaleficence can be utilized in solving diverse leadership concerns within healthcare. The autonomy of patients should be respected (Bruning & Baghurst, 2013). However, this respect does not only align with issues of attitude but also with the recognition and promotion of the autonomous actions that the patients take. One leadership concern in health care that demands the application of the principle of autonomy is making decisions on the treatment process of the patient without their consent, for instance, when a health care practitioner is dealing with a patient who is a Jehovah Witness and believes that it is not right to accept blood transfusion, yet her illness demands immediate blood transfusion as it is life threatening. The health care practitioner is expected to save the life of the patient, but at the same time, he is required to understand and respect the beliefs of the patient (Wasserman et al. 2014). The patient must be made to comprehend the impact of not taking a blood transfusion, which includes the risk of death. Conversely, after compassionately informing the patient, then he will be offered an opportunity to freely make a decision whether or not to take the blood transfusion based on both his religious convictions and his wellbeing.
The other leadership concern that can be solved through the ethical principle of nonmaleficence is the rapidly increasing cases of medical error. According to Wasserman et al (2014) the leading cause of medical errors is communication problems whereby the health care practitioner fails to inform the patient about the treatment process. The ethical principle of nonmaleficence holds that the health care practitioner at all costs should not cause harm to the patient. For instance, some procedures might be too painful for the patient, but still be the best option of treatment. In this case, the health care practitioner should offer the patient all available options and explain their effectiveness then leave them to make a decision (Bruning & Baghurst, 2013). For example, when treating a patient suffering from intestinal carcinoma, the patient might request that she foregoes CPR in case of a cardiac arrest. The decision would align with the belief of the patient towards the treatment process while the health care practitioner has the authority to interpret whether the process will cause greater or lesser harm to the patient and thereby avoid medical errors, which are costly to both the healthcare facility and the health practitioners involved.
The two ethical principles discussed can be applied in leadership activities when an individual is in a position of power. For instance, as a nurse leader, I would ensure that the nurses in my unit comprehend what is expected of them and how they should incorporate ethical principles in their practice. In relation to the principle of autonomy, I would ensure that the nurses understand the rights of the patient including the need for informed consent and respect them. Issues related to decision making by a health practitioner who ignores the autonomy of the patient would be avoided, because they would end up causing legal issues on the part of the health facility. Similarly, in relation to the ethical principle of nonmaleficence, I would ensure that nurses in my unit understand the impact of causing harm to the patient. It is the duty of practitioners to prevent harm or the risk of it to the patient. In case the treatment process will be painful, the patient should be made to understand what it entails and be allowed to make a decision on whether it should be carried out or not. With this communication, the possible occurrence of medical errors would be avoided.
In conclusion, this paper sought to evaluate two ethical principles that are applicable in the leadership of health care. The ethical principles that were discussed include the principle of autonomy, which entails respecting the autonomy and rights of the patient as well as upholding informed consent. The other principle was that of nonmaleficence in which the healthcare practitioner should not intentionally cause harm to the patient. Ethical principles must be incorporated in the leadership process of healthcare because they act as guides of what needs to be done and how unwarranted incidences that can be costly to the patient, the healthcare practitioner, and healthcare facility can be averted.
Bruning, P., & Baghurst, T. (2013). Improving Ethical Decision Making in Health Care Leadership. Bus Eco J, 4, e101. doi:10.4172/2151-6219.1000e101
Flite, C. A., & Harman, L. B. (2013). Code of ethics: principles for ethical leadership. Perspectives in Health Information Management/AHIMA, American Health Information Management Association, 10(Winter).
McCormick, T. R. (2016). Principles of Bioethics. Retrieve from < https://depts.washington.edu/bioethx/tools/princpl.html >.
Summers, J. (2012). Principles of Healthcare Ethics. Retrieved from < http://samples.jbpub.com/9781449665357/Chapter2.pdf >.
Wasserman, M., Renfrew, M. R., Green, A. R., Lopez, L., Tan‐McGrory, A., Brach, C., & Betancourt, J. R. (2014). Identifying and preventing medical errors in patients with limited English proficiency: key findings and tools for the field. Journal for Healthcare Quality, 36(3), 5-16.
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