Problem: Conflict Between Ethics and Financial Incentives
Patient dumping or turfing is a systemic problem in our healthcare system. Usually associated with hospitals or providers refusing to treat certain patients, this frequently results from inadequate insurance, complex diseases and diagnoses, complex mental health issues without bed space, or inadequate social safety nets for those not fully fit to care for themselves. Patient dumping can occur within diverse healthcare settings, including emergency departments and long-term care health or rehabilitation facilities.
Healthcare organizations are often under immense financial pressure and commonly operate on narrow margins. When a hospital closes in a community it can have widespread negative impacts for that community's access to care and population health. While policies should be in place for proper discharge of patients, there have been numerous cases of inappropriate patient discharge that do not support patients' rights or sound ethical decision making. This has resulted in stories that run in the media and, ultimately, devastating financial penalties for hospitals and high-risk negative outcomes for patients.
Required Readings:
Pozgar, G. D. (2023). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.
Chapter 3, "End-of-Life Dilemmas" (pp. 103-133)
Chapter 4, "Health Care Ethics Committee" (pp. 135-147)
Chapter 8, "Organizational Ethics and the Law" (pp. 221-263)
American College of Healthcare Executives. (n.d.). Ethics toolkit.
American College of Healthcare Executives. (2023, December 5). Code of ethics
American College of Healthcare Executives. (2020, November 16). Creating an ethical culture within the healthcare organization
Enck, G. (2014). Six-step framework for ethical decision making
Görgens, S. (2023). Turfing USA
Krishnamurthy, K. B. (2023). Should physicians be able to refuse to care for patients insured by Medicare?
Roytman, M. (2023). AMA Code of Medical Ethics' opinions related to "turfing."
Required Media
NBC News. (2018, January 12). Video shows Baltimore hospital's 'patient dumping' | NBC Nightly News. [Video]. YouTube.
Optional Resources
Ethics & Compliance Initiative. (n.d.). ECI recent research
To prepare for this Discussion:
Watch the NBC News video Hospital Outrage, Patient Dumping in a Baltimore Hospital and reflect on the Learning Resources this week.
As a healthcare administrator, consider how policies, organizational culture, and other factors can lead to patient dumping. How does the professional code of ethics apply to this situation?
Post your Discussion, to include the following:
Explain the factors that contributed to the case of patient dumping presented in the video resource. Be sure to use an ethical framework for your analysis. Need Assignment Help?
From an organizational culture perspective, what could have been done to prevent this incident from happening again? As a healthcare leader at this facility, what would you have done to ensure patient's individual and legal rights, dignity, and safety were preserved?
Support your response by identifying and explaining key points and/or examples presented in the Learning Resources.