Articulate the problem: Deborah is a nurse practitioner that is instructed to falsify patient information, and deliberately constitute a diagnosis that is not accurate neither viable in the patients she might be seeing. The reason for this being is that the private owned clinic is not compensated for wellness services. Furthermore, the practice of falsifying diagnosis serves to provide revenue and allow for the clinic to continue to operate. The ethical dilemma Deborah faces is to either take part in the fraud, malpractice and secure her job in her current employment establishment, or speak out about the fraud being conducted by her colleagues and superiors. In turn, this will dramatically affect employment and the community. As a …show more content…
Malpractice is evident; failing to acknowledge the extent of inventing diagnosis will impact the individual, does not adhere to the code of ethics to care and not mislead any information. Deborah can accept to falsify records or question the methods of her supervisors. Explore strategies: Deborah can accept the years of fraud the private clinic has been conducting and take part. Putting herself at risk and her patients. Currently that we are aware of the only people facing an ethical dilemma is Deborah. However other healthcare providers could have taken part in the suggestion by their supervisors to maintain their job. It is clear that Deborah is not content with the information she received from her superior. We know this because she is hesitant to carry out the action. Inventing diagnosis to receive compensation on behalf of Medicaid is not acceptable for the patient and the government providing the funds. We can clearly see that the providers do not want to deliberately cause harm to the patients. If anything they want to keep the clinic open to help the community. However, this method of business will not be sustainable and is doing more harm than good. That is, saying patient medical records will affect the individual in the future. Or she can either
This is the case of benevolent deception as the information regarding the patient health conditions was not revealed. The healthcare professionals withheld the important health information to protect patient from harm i.e. stress and depression. In addition, they thought that it is not an act of lying and morally permissible as it was benefitting the patient. Fry et al. (2011) mentioned that the Hippocratic Oath and the Florence Nightingale Pledge tell us to do what will benefit the patient and protect
It is cited that the most common forms of fraud and abuse in today’s health care industry are false claims, submitting duplicate bills, upcoding services to receive higher reimbursements, as well as kickbacks from referrals (Buchbinder and Shanks, 2012). Health care fraud and abuse unfortunately are common occurrences. In the U.S., allied health care professionals target Medicare, Medicaid, even private insurance companies because of the lure of money without regard for moral, ethical and legal stances. It is a plague that not only affects the U.S. but the whole world in general. It
Today many nurses, doctors, and other health care professionals encounter ethical dilemmas on a daily basis. An ethical dilemma can be defined as when there is more than one reasonable solution to a specific scenario. No one solution is more right than the other. In fact, they may both feel wrong, but a decision must be made (Butts & Rich, 2016). In the healthcare setting, nurses should be prepared to think critically and make ethical decisions. There are many factors that contribute to the process of ethical decision making such as ethical perspectives, principles, theories, and guidelines. Ethical decision making is to be rational and systematic. The selected case to be discussed is the case of Jahi McMath,
Also, whether there was collaboration between facility members to ensure quality care. More issues would be whether examinations were thorough and tests were analyzed before discharging the patient. The moral issue at stake in this case is if the facility believes they did the right thing or not. For example, the physician could not recall what instructions he gave Kelly’s father, but he did nothing to clarify the situation, he just gave the father a business card as if that would suffice for his inability to remember the instructions he assigned (Pozgar,
Many other problems popped up the healthcare facilities where this individual previously work could be huge trouble because of the poor judgment of this individual. This problems could be results in lawsuits on top of lawsuits for this organization. Years can passed before all the lawsuits settle as a result a huge amount funds would gone to the patients and the lawyers. Because of the poor judgment, it can result in a great cause for the organization, it would be in violation of HIPAA policy and it can be shut permanently or charge of very high finders because of this problem. Also, if the facility doesn’t get shut down, many of the patients can remove themselves from this healthcare facility because of the fear
Fraud and abuse encompasses the actions of fraud, abuse, and waste in the health care system (McWay, 2014). It is a nationwide problem that affects all of us and can be committed by anyone. Schemes can be committed by a single person or a by an institution or group. The National Health Care Anti-Fraud Association (NHCAA) estimates that
Exploiting patients is also discussed and can be called into question. When presenting examples or discussing patient’s certain information should never be disclosed due to HIPPA laws as well as confidentiality.
Two of the ethical principles can be applied to this case, veracity and societal trust. We as Dental Hygienists are obligated to be always truthful, not only to our patients and associates, but also with ourselves. We must value our knowledge and express treatment options in an honest and fair way. Societal trust is an obligation and it is very important to remember that patients trust on us as health care professionals, and this trust has to be earned based on our actions and behaviors. In my opinion Sally’s behavior is considered fraud, even though she has good intentions.
There are a few key issues in this case. Due to the unethical nature, health-care professionals should not be allowed to receive kickbacks for any health care needs of patients. What is the recourse for the involved health-care providers? Housing complexes should not allow group medically related meetings to vulnerable senior citizen residents. Due to the potential state of mind of
In the case study, there has been fraudulent activity in this office that would warrant criminal sanctions. There have been claims filed in which patients were seen by an NP but billed as though they had seen a physician, at times, even when that physician was not in the office that day. This is a
Anyone in the medical field may seem trustworthy because most of the time they are. Unfortunately, there are those individuals who seek financial gain and are no longer trustworthy. There is no exact amount of how much fraud has been committed within the health care system, because it usually is never detected. Like in the case of Dr. Guerrero who committed a healthcare fraud scheme against his patients, employees of the health care system, and health care insurances. According to Vivek Pande and Will Maas, Dr. Guerrero was able to commit fraud against clients and the health care system and insurance providers; it is an ingenious crime, because the public considers them intelligent and high achieving individuals. (Pande & Maas, 2013) Overall, health care providers have a choice
Case 2 refers to the incident of a physician known as Dr.Ben and his 74 year old patient known as Mrs.Alma Norfleet. Who complained to Dr. Ben about a pain she felt in her chest during her previous ER visit. Unfortunately, Dr. BEN ignored the symptoms and referred to it as a mere chest pain that shouldn’t be taken seriously, even though she had suffered from chronic illnesses in the past such as diabetes, heart disease, and arthritis. Later, Mrs Alma arrived to the ER, chronically ill to Dr. Ben’s surprise, he ran some tests on her, and found out that she was indeed sick and suffered from heart failure. Confronted with this issue, by one of the nurses, he denied that the patient ever reported such issues to him.
Ethical principals are the seed of which nursing flourishes from. Many ethical principals were involved and dishonored in this case such as, justice, autonomy, beneficence, non-maleficence, confidentiality and fidelity (Burkhardt et al., 2014). I believe justice was the main principal involved as the entire ethical predicament was revolved around unjust behavior and treatment of the residents. The residents were treated poorly and given unequal rights as a causation of their illnesses. Autonomy, an essential piece of human rights was also being violated in this ethical dilemma. The residents did not have any choice or independence in their care or how they were being treated. Beneficence and non-maleficence are significant dynamics of this ethical situation, as the health care providers needed to reflect on how they can have the maximum benefit while diminishing possible damage to the residents (Burkhardt et al., 2014). Our actions as nurses should always be beneficent and non maleficent, continuously being kind, compassionate and doing what is in their best interest as well a removing and preventing harm. Confidentiality is a key component of nursing and it was blatantly being violated as the health care
Karrie, it is evident in this case study that the three basic ethical principles were violated. Those principles include: respect for persons, beneficence, and justice. I believe justice is the one we should comply with the most. Justice is defined as treating all individuals fairly (LoBiondo-Wood & Haber, 2014). This is something that I believe that should be innate in all of us. I would like to think that we all should treat everyone that way that we would want to be treated. To me this is just human nature and a part of who I am. I cannot understand how the healthcare members treated these men with such disrespect and injustice.
I agree health care fraud is a major issue and determining how to handle that can be difficult especially because of HIPPA. When it comes to gaining information from health care industry many of these companies become extremely concern about violating patient’s person identity. As you stated having a fraud investigator take the lead during an investigation is a better approach to obtaining all the necessary information to better resolve the case.