Health care practitioners are ethically bound to respect the patient’s dignity and to make a positive effort to secure a comfortable and considerate atmosphere for the patient in such ways as providing appropriate gowns and drapes, private facilities for undressing, and clear explanations for procedures. There are guidelines to help all health care providers stay within the scope of their practices and operate within the law and the policies of any employing health care facility. (Judson & Harrison, 2021)
Consider the following case from the course scenario on St. Michael’s Medical Center.
Case III. Grandpa Peter and Grandma Lucy
An elderly patient, Grandma Lucy, had an advanced directive not to resuscitate (called DNR, which stands for do not resuscitate) even at the point of death. She had already willed some of her assets to her 20-year-old son Phillip. She gave her husband medical power of attorney (i.e., the sole right to decide action if she becomes incapacitated). Grandpa Peter has been making decisions since Grandma Lucy was diagnosed with Alzheimer’s disease. One day, a nurse named Andrea overheard Grandpa Peter discussing insurance benefits with a female friend. Nurse Andrea discussed the issue with a friend at home and felt that Grandpa Peter’s intent was unfair to Grandma Lucy and decided to ignore the DNR order. The next day, Grandma Lucy coded, and Nurse Andrea resuscitated her. Thinking nobody saw her, nurse Andrea denied her action. She failed to realize that she was on live camera. Aside from that, she called Phillip and revealed Grandpa Peter’s alleged intent and disclosed his mother’s medical records to him, hoping to stop Grandpa Peter’s actions. To avoid any suspicions, Nurse Andrea sent relevant patient information to Philip via e-mail and to others over the phone. Again, Nurse Andrea was caught in the act.
Grandpa Peter sued the hospital for Nurse Andrea’s actions. Additional issues of concern were raised when Grandma Lucy developed bedsores due to poor quality care. On investigation, the ethics committee discovered that the personal care assistants did not honor the rule of turning bed-ridden patients every 2 hours. Grandpa Peter became furious with the hospital staff and filed a lawsuit for denying patient autonomy and for abandonment. This type of patient neglect is an example of a lack of interdisciplinary teamwork.
In a 5-page paper, analyze the case by addressing the following issues:
- What is the present status on patient rights under the Health Insurance Portability and Accountability Act (HIPAA), and how were these rights violated in this case? Were Nurse Andrea’s actions right? Explain your comment.
- What is the present status on patient rights under the Affordable Care Act (ACA), and how do these rights protect Grandma Lucy and Grandpa Peter?
- What are the ACA mandates that providers must honor regarding patient rights and benefits and that Grandma Lucy and her son Phillip could benefit from?
- How do you use these mandates to resolve ethical dilemmas in healthcare?
- What are some relevant healthcare laws enacted in the last 2 decades that could be applied in this case?
- How could you, as the new chief executive officer (CEO) of St. Michael’s Medical Center, prevent these ethical violations from taking place?