This comprehensive and much-needed resource helps health care ethicists to meet the demand of challenges such as managed care, medical technology, and patient activism. Through a review of core principles and a rich selection of cases, practitioners and students will learn to apply ethics in the day-to-day administration of health care organizations. The authors are from the Park Ridge Center, the nationally acclaimed consulting and research firm.

PHILIP J. BOYLE is chief operating officer at The Park Ridge Center for the Study of Health, Faith, and Ethics.

EDWIN R. DUBOSE is research associate at The Park Ridge Center for the Study of Health, Faith, and Ethics in Chicago, Illinois.

STEPHEN J. ELLINGSON is a post-doctoral fellow in sociology, religion, and health care and director of the Lilly Program for Congregational Ministry at Pacific Lutheran Theological Seminary.

DAVID E. GUINN is research associate and editor at The Park Ridge Center for the Study of Health, Faith, and Ethics.

DAVID B. MCCURDY is research associate and director of consultation and education services at The Park Ridge Center for the Study of Health, Faith, and Ethics.

Foreword xiii
Laurence J. O'Connell

Preface xv

Acknowledgments xix

The Authors xxi

Part One

1 The Moral Ecology of Health Care Organizations 3

2 Organizational Theory, Culture, and Psychology: Tools for Organizational Ethics 29

3 Organizational Support for Ethical Behavior 52

4 Corporate Compliance and Integrity Programs: The Uneasy Alliance Between Law and Ethics 97

5 Managing Human Resources 112

6 Conflicts of Interest 146

7 Discretion and Control 178

8 Evaluating the Moral Life of an Organization: The Case of Resource Allocation Policies 204

9 Resource Allocation and Utilization: Structural Issues 221

10 Mission and the Bottom Line 247

Part Two: Cases

1 The Waiting Room 277

2 Nursing Strikes 279

3 A Gift, or an Obligation? 283

4 Obligations for Adequate Health Care Coverage 288

5 A Managers Dilemma in Hiring 292

6 Conflict of Interest, or Just a Great Lunch? 296

7 Organizations and Spousal Equivalent Benefits 299

8 Organizational Teflon: Making Sure the Case Doesnt Stick 303

9 Investment Policy 306

10 Compassionate Sedation, or Euthanasia? Compassionate Communication, or Deceit? 309

11 Ethical Considerations in Charting 315

12 Executive Use of Discretionary Funds: The Bonus Pool 317

13 Integrating Spirituality in the Health Care Setting 320

14 Alternative and Complementary Medicine 323

15 Overstepping the Bounds of Expertise 326

16 Marketing Products and Practicing Medicine 329

17 Following the Rules, or Using Them as a Smokescreen? 333

18 Organizational Advancement and Corporate Compliance 337

19 The Compliance Officer and the Ethics Committee 341

20 Aggressive Accounting 344

Part Three: Appendixes

Appendix One: Joint Commission on Accreditation of Healthcare Organizations 349

Appendix Two: Sample Ethics Statements 361

Appendix Three: American College of Healthcare Executives: Code of Ethics 377

Appendix Four: Partnership Health Care: Conflict of Interest Policy 387

Recommended Reading 393

Index 401