Ethics Case Study

Scenario 6 When Duty to One’s Employer Conflicts With a Duty Owed to the Public

 “Should Mary take it upon herself to notify the health authorities? Assume that Mary lives in a state with a law similar to that of Colorado, which re­quires “persons or employees having knowledge of exposure of large num­bers or specific groups of persons to a known or suspected public health hazard [to] report such disease, outbreak or epidemic” (State of Colorado Rules and Regulations Pertaining to the Detection, Monitoring, and Investigation of Environmental and Chronic Diseases, 6 CCR-1009-7).

In my opinion, I believe that it is an ethical obligation for Mary to report the matter to the relevant federal authorities. Per the medical ethics of non-maleficence, a medical practitioner should ensure that patients are not harmed (Jalal et al., 2017). Assuming that Mary lives in a state where the law demands that persons or employees having information regarding the exposure of people to public hazards should report it, it is absolutely criminal for her to remain silent, despite the challenges associated with releasing such information.

What if Mary’s state does not have that kind of law on the books? Should Mary still take it upon herself to notify the health authorities? Are there any actions that Mary can take to fulfill her conflicting obligations to the HMO’s patients, to her employer, to the automotive company, and to the public?

However, if the law in her state does not provide guidelines to follow in such a case, Mary should still take the initiative to notify the authorities. People’s health is more important than anything else, and any exposure to health hazards should be reported to the relevant authority by any citizen. Moreover, for Mary to fulfill the conflicting obligation to her employer, HMO patients, the automotive company and the public, she ought to report the issue to the authorities to protect the population’s health. In this scenario, the health of people is paramount and supersedes any other person, company, employment, and public interest.

Does the HMO have an ethical duty to report the situation to governmental authorities?

The HMO has an ethical obligation to report the issue to federal authorities since they can be liable for serious medical malpractice if sued by either the patients or any other concerned stakeholder. According to the medical ethics of beneficence and patient safety, health facilities should ensure that patients are not at risk of harm by reporting any cases that harm the health of patients and the public (Roberts & Siegler, 2017).

Does Mary have an ethical obligation to come forward with the evidence, even though she was told not to by her supervisor? What are the consequences if Mary does so? If she fails to do so?

Mary further has an ethical obligation to come forward with the evidence despite being compelled by her supervisor to remain numb. However, the fact that Mary works in the health department complicates the issue since patient data should be confidential, and hence leaking the information could lead to a confidentiality lawsuit. Unfortunately, if she decides to keep quiet regarding the matter, she will have committed medical malpractice by failing to provide patient safety information.

How would you resolve Mary’s ethical dilemma?

In summation, if I were Mary, I would take the initiative to report the matter to relevant authorizers rather than ensure patient data confidentiality. It is more ethical to safeguard the health of patients than to secure the confidentiality of their medical data.

References

Jalal, S., Imran, M., Mashood, A., & Younis, M. (2018). Awareness about Knowledge, Attitude and Practice of Medical Ethics pertaining to Patient Care, among Male and Female Physicians Working in a Public Sector Hospital of Karachi, Pakistan-A Cross-Sectional Survey. European Journal of Environment and Public Health, 2(1), 04.

Roberts, L. W., & Siegler, M. (Eds.). (2017). Clinical Medical Ethics: Landmark Works of Mark Siegler, Md. Springer.

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Ethics Case Study – Scenario 6: When Duty to One’s Employer Conflicts With a Duty Owed to the Public

“Mary Ruiz is the HIM manager for an HMO in Autotown, Indiana. In 1999, she noticed an unusually large number of recorded cases of neurologic damage to the bladders of patients who were seen by several of the group’s physicians. Mary alerted her supervisor, Mr. King, about the apparent increase in cases and proposed that she create a special database to track the occurrence of this condition. Mr. King told her not to waste her time.

Ethics Case Study Scenario 6

Against her supervisor’s directives, Mary developed the database. Upon analyzing the data, Mary realized that all the affected patients worked in the same plant – a facility that manufactured automobile and truck seats. Alarmed by this discovery, Mary again approached her supervisor, this time with the suggestion that health authorities be notified of the increased incidence of this rare form of bladder disease. Again Mr. King rejected her suggestion. He reminded Mary that her primary responsibility was to provide data management services to the HMO healthcare team and to protect the confidentiality of patient records. He also reminded Mary that the manufacturing facility had the largest employee enrollment of any of the HMO’s clients and that the company was one of Autotown’s largest employers.”

Questions

1. “Should Mary take it upon herself to notify the health authorities? Assume that Mary lives in a state with a law similar to that of Colorado, which re­quires “persons or employees having knowledge of exposure of large num­bers or specific groups of persons to a known or suspected public health hazard [to] report such disease, outbreak or epidemic” (State of Colorado Rules and Regulations Pertaining to the Detection, Monitoring, and Investigation of Environmental and Chronic Diseases, 6 CCR-1009-7).
2. What if Mary’s state does not have that kind of law on the books? Should Mary still take it upon herself to notify the health authorities? Are there any actions that Mary can take to fulfill her conflicting obligations to the HMO’s patients, to her employer, to the automotive company, and to the public?
3. Does the HMO have an ethical duty to report the situation to governmental authorities?
4. Does Mary have an ethical obligation to come forward with the evidence, even though she was told not to by her supervisor? What are the consequences if Mary does so? If she fails to do so?
5. How would you resolve Mary’s ethical dilemma?”