Excerpt From Medical Ethics: Real-World Application By Afshin Nasser

Medicine and the Law

Risk management is used to minimize the incidence of problematic behavior that might result in injury to patients and employees, and to decrease liability for the physician or the facility. The key element in risk management is identifying problem behaviors and practices in an organization such as a hospital or medical office.

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Risk Management
Risk management is used to minimize the incidence of problematic behavior that might result in injury to patients and employees, and to decrease liability for the physician or the facility. The key element in risk management is identifying problem behaviors and practices in an organization such as a hospital or medical office. A plan should be formulated to eliminate these behaviors. Risk management factors across categories include wet floors, faulty equipment, clerical errors, poor record keeping, mishandling drugs and needles, poor patient follow up, and abandonment of patients.

Everyone in a healthcare facility is responsible for risk management.

Incident Report
An incident report is used to document problem areas within a medical facility.

Whenever there is an occurrence such as a fall, error in medication dispensing, potential contamination from a used needle, flood, fire, hazardous material leak, a patient or employee complaint must be documented within an incident reportby a physician, employee, or a manager.
The purpose of the report is to document exactly what happened, when it happened, and what was done to resolve the incident. This practice aims to prevent recurrences of such incidents.

Q36 You are a second-year resident on the general medical floor towards the end of your shift. After reviewing the chart for one of your patients, Tom, an insulin-dependent diabetic with heart failure, you forget to document administering his dose of insulin. During the night the patient receives another dose of insulin by the night shift staff. The following day while rounding on your patient he complains of having a very difficult night with profuse sweating headaches and feeling dizzy. You realize your error after reviewing the chart. You consult your attending physician who advises you to fill out an incident form. What should you tell Tom?……
A-claim that the nursing staff made an error
B-advise the patient of your mistake
C- apologize to the patient for the hardship and admit to making a mistake and assure him that you will take measures that this type of error never happens again.
D- request to meet with the ethics committee of the hospital

Q37 An 88-year-old man was admitted to the ICU one week ago with multiorgan failure and severe pneumonia. Weaning the patient off the ventilator has been futile as he continues to be unresponsive. His past medical history is significant for chronic kidney disease, hypertension, congestive heart failure, dementia, and diabetes type II. The medical team approaches the family and informs them that the patient will not have a meaningful recovery. The patient has no advance directives and his children insist on ICU level care.
Which is the most appropriate management?
A-Discontinue ICU care in 24 hours if no improvement.
B-Transfer patient to hospice
C-Refer the case to hospital ethics committee
D- Ask the patient’s children to reconsider the facts

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State Medical Boards

The medical board’s duty is to protect the public, not the physician. State medical boards today focus on licensed physicians who violate professional ethics, and their mandate has significantly evolved to focus on disciplining physicians.

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Boundary Violation

Boundaries create a therapeutic distance between physician and patient and clarify their respective roles and expectations. Boundaries define limits of the therapeutic relationship.

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Medical Ethics: Real-World Application By Afshin Nasser

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?”

In that case, I hope that this book answers some of your questions and guides you with regards to any future quandaries you may encounter.


If you are a healthcare worker seeking to understand the subject of medical ethics, then I hope this book helps you acquire the clarity you seek.
If you are an individual simply curious about medical ethics, then I raise my hat to you for your pursuit of knowledge.