As a healthcare ethics motivational speaker, ethics consultant and book author, in my more than 25-years in the field, I have learned a number of truths. While I could never publish my research using “real names,” I will share as an ethics consultant that in most every case of poor healthcare ethics, the perpetrator (sounds harsh, doesn’t it?) is completely aware that they have been unethical. It took them a while to admit to poor healthcare ethics, but they ultimately confessed.
Healthcare Ethics: Drilling Down to the Truth
Without mentioning names or locations, I will offer several examples of what unethical healthcare ethics behavior looks like:
- The primary care physician who ordered unnecessary genetic testing, knowing full-well it was not covered by insurance plan.
- During the worst of COVID-19, an R.N. who did not believe in vaccinations filling out fake vaccination cards for patients (at $500 per record).
- A dentist who groped patients after they were “put under” for dental surgery.
- A compounding pharmacy that did a thriving business honoring forged prescriptions for opioids and then dispensing same for exorbitant amounts of money.
- An elder care facility knowingly employing care providers who were abusers and, in addition, creating unhealthy environments such as faulty HVAC systems and substandard foods.
While healthcare ethics should be based on the age-old statement of “at least do no harm,” in each of the cases I present above (and they are actual), harm was intentionally done. Sometimes the harm was financial, sometimes the harm was abuse – and a huge breach of trust, and sometimes the harm intentionally led to injury or death.
In each case, the healthcare provider was, at first, adamant that they committed no damage or that “everyone does it,” or that they were unaware they had committed a crime. Indeed, they always managed to find lawyers or public defenders to agree with them.
However, as a healthcare ethics motivational speaker, healthcare ethics consultant and book author, I carefully followed each case. Ultimately, there was an admission of guilt or in the least, the payment of massive fines and/or a loss of licensure.
For the most part, what follows the bluff and bluster, is truth. Throwing oneself on the mercy of the courts or Medicare or families or all three.
What happened to healthcare ethics?
What has happened to healthcare ethics in our society? Why is drilling down to the ethical truth so difficult? If I view the five examples from above, there are patterns that are common to all frauds. For example, a lack of oversite. What could be more obvious an example than a sexually abusive dentist who anesthetizes an unaccompanied patient or a healthcare provider in a nursing home who strikes an elderly patient in dementia?
The matter of need is also obvious. The need for money by prescribing unnecessary tests (often with kickbacks) or the need for power.
Then there is rationalization. The rationalization perhaps that “I don’t believe in vaccinations and therefore they don’t work,” or, “Even though you tell me the prescriptions are clearly forgeries, there was no way for me to know at the time, so I never checked.”
In other words, once we get past the medical terminology, HIPAA laws and erudition of the defending arguments, poor healthcare ethics essentially is no different than a dishonest mechanic, a crooked accountant or an abusive baseball coach.
Low standards lead to poor healthcare ethics outcomes
Ethical training and its reinforcement, in healthcare has somehow been obfuscated by professional smokescreens – and it has often been happening out in the open in favor of expediency.
As a healthcare ethics keynote speaker and healthcare ethics consultant, I am unimpressed by any profession that proclaims its practitioners are too busy, too well-trained or “too professional” to submit to ethical training. It is precisely within those ranks that unethical behavior is the most egregious.
It is time for healthcare to take a close look at its own house and to consider that unethical behavior has been doing great harm.
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