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Ethics and Decision in Healthcare Essay

Ethics are standards that govern a person’s behavior, particularly a member of a given profession. This can be towards a particular individual or to the society thus, philosophical morals. Ethical dilemmas are common in every workplace including healthcare in particular. Ethical decision-making is essential in helping people make cumbersome and hard choices when slapped with ethical dilemmas. Clearly outlined ethical principles forms a basic foundation for the decision-making process in all levels. The decision-making process in ethics looks at various perspectives; ethic pertaining to care, reason, obedience, and social dimension. The whole process is founded on ethical principles which include; autonomy, non-maleficence, beneficence, and justice. Ethical leadership can be well defined as the activities executed by leaders with the aim of fostering a culture and conducive environment that uphold ethical practices in an organization.

Leaders in the healthcare system of veteran affairs have a sensitive obligation flowing from roles as; healthcare providers, public servants, and managers in charge of both staff and care professionals. This is motivated by veterans’ mission to serve the nation in the armed forces. VA leaders are responsible for good management of resources, giving duty the first priority, keeping public trust, meet veteran’s health demands, and creating of good workplace culture founded on fairness, respect, accountability, and integrity (van Gils, Hogg, Van Quaquebeke, & van Knippenberg, 2017). Some decision-making processes can raise ethical concerns. Leaders are faced with challenges daily in wise decisions as far as healthcare is concerned. With leadership turnover and understaffing in the VA healthcare system, people failed to understand their roles, system processes, and responsibilities, poor program coordination, and eventually a failing health system. Challenges faced by the veterans as a result of bad leadership included; delayed medical care, patient deaths, long and manipulated waiting times, and, poor scheduling practices. The ethical crisis that has overwhelmed the Veteran’s Health system cannot be solved by the employment of many nurses and doctors nor by increasing resources. This is because the problems are perceived to be fundamentally ethical and cultural. The leadership structure is not responsive and lacks the ability to effectively communicate and manage the employees or veterans. The culture has led to outdated technology, lousy management, retaliation toward veterans, inadequate physical space for patient treatment, and a shortage of staff. Restructuring is the only way to enhance accountability and transparency.

Around 2000, veteran affairs were the leading in excellent care and at the frontline of academic achievements in education, specialized research, and clinical activities in spinal injury, geriatrics, prosthetics, rehabilitation, infectious disease, substance abuse, post-trauma disease, and pulmonary disease (Bolman & Deal, 2017). Later on, the programs started failing due to a lack of accountability. Ethics was overlooked. It was seen as a hindrance to outstanding patient care. For instance, patient-doctor visiting was normally within the duration of 14 days, this demonstrates timeliness in attending to the patient which is, in turn, a good measure of evaluating performance quality. But whenever it became difficult to meet the very requirement, local foremen and administrators that were bribed to reduce waiting time changed the records. This form of corruption eventually leads to long waiting times and deaths. This is very unethical. Different patients suffered from different illnesses of which some are emergent while others are not.

If I was to come up with policies or standards to ensure ethical leadership practices with due respect to enhancing coordination of the electronic wait list and primary care appointments in the VA health system it would be; Integrated Ethics Strategic policy. it will be aimed at ensuring good ethical leadership practices are adhered to by laying out various strategies such as outlining the roles and responsibilities of the people involved. Good channeling communication in healthcare which in cooperates with the very first service providers is the hospital setup to the highest service providers. The policy ensures transparency and accountability among its members. Every patient will receive special and equitable care irrespective of gender or ethnic origin. For instance, adherence to the rule of patient-doctor intervention strictly within 10 days and only patients with prior booked appointments registered electronically. A manager is appointed to account for the number of people attended to in the hospital daily, and their dates of appointments, and ensures the registration process system is up-to-date. Power will be distributed to an individual at each level of hospital management and everyone assessed roles and responsibilities. Another policy would be; Healthcare Ethical promotion initiative (Johnson, 2017). This will be aimed at ensuring the roles stipulated in the integrated ethics strategic policy are implemented. It will also issue penalties to medical practitioners whose behaviors are unethical and violate patient rights. It will also put in place and ensure the equipment involved to perform particular procedures are in place and computers are updated technologically. So as to ensure a continuous smooth workflow of activities and in turn promote good coordination among the workers and quality care to the patients.

Secretary Eric Shinseki had to resign his position because as a leader he had failed terribly. The VA health administration had taken a bad route that even its trials to reverse or change were effortless. Everything was a mess. Rampant scheduling manipulation, fraud, and delayed treatment days had claimed many peoples’ life with no singleton possibility of coming to an end. 1700 veterans in Phoenix were kept in line waiting for medical care. They took an average of 115 days from their previous visit to the hospital. An example for the reason for scheduling schemes was pressure to reach the expected VA’s performance. Systemic complaints about the allocation and distribution of healthcare resources were too much for Sec. Shinseki’s leadership. He failed to fix the issues of accountability. Secretary Shinseki seemed to be unaware of the challenges that worked against the healthcare department.

Some of the possible solutions that sec Shinseki could have taken to resolve the unethical decision-making practices include; ethical consultation. This is a healthcare service provided by the ethics committee or team to assist patients, parties, and providers to iron out ethical issues amicably in a health setup. The patients or family involved can be demoralized when they realize there is nowhere they can express their ethical concerns. Ethical consultation helps in collecting information, listening to peoples’ issues, classifying people’s responsibilities in decision-making, and identify justifying ethical options (Watts, Ness, Steele, & Mumford, 2017). It is also used to educate people on how to handle issues ethically. Another method is ethics education and communication. He could have ensured that the staff meet the required medical standards through training, outreach and teaching forums. He could have also responded promptly to the challenges people were facing.

Veterans’ health administration in the first place exposes itself to conflicts of interest. The interests can be conflicting with employment-related punishment, criminal penalties, governmental laws, and civil sanctioning. Under these circumstances, the American College of Healthcare Executives (ACHE) Code of Ethics may apply to the VA Health System case study. The Code of ethics of the American college of healthcare aims at serving as standard behavior for every member. It constitutes healthcare executives’ conduct in their profession. The relationships comprise; patients, colleagues, organization members such as healthcare executives, the community and society at large. A Code of ethics encompasses standards of morals governing one’s conduct especially when it directly affects the healthcare executives’ roles and identity. The core aims of medical care management are as follows; to enhance the quality of life, well-being, and dignity of every person in dire need of health services and also to create an effective, equitable, and accessible healthcare system. Health executives on the other hand are responsible for acting in a manner that will earn the confidence, respect, and trust of the general public and medical professionals (Bolman & Deal, 2017). A Code of ethics is applied in the VA healthcare sector to ensure all veterans are well treated and given gratitude for working toward the protection of the country. Health executives being advocates of good morals, should evaluate the outcomes of every decision they make carefully. They must work toward safeguarding, and fostering the rights and prerogatives, and interests of the patient.

To sum up, envisaging new approaches to ethical issues in HealthCare, new ways of analyzing their complexity, and channels to achieve integration, can be of much help in promoting good ethical leadership and decision-making process. Ethics in organizations is a task in progress. Its success is dependent on leadership commitment and perseverance. And concerning moral courage, Gibson states, “each VA employee who assists to improve and adhere to procedures and policies at all organizational levels, invents a culture of commitment, advocacy, respect, and integrity”. It is the initiative of the VA to go back to the drawing board, review its ethical programs, and point out their potency and weaknesses so as to discern whether to adhere to, replace of discontinue the programs (Watts et al., 2017). It is the desire of everyone to be treated equally like anybody else whether in the right mind and Soul or when sick. It should happen anytime and anywhere, be it in an organization, company, health center, in a group of people among others. It instills a sense of belonging when one fits in a category either socially, economically, mentally, spiritually, or politically. Therefore, leaders in the healthcare system of veteran affairs have a sensitive obligation flowing from roles as; healthcare providers, public servants, and managers in charge of both staff and care professionals. This is motivated by veterans’ mission to serve the nation in the armed forces. VA leaders are responsible for good management of resources, giving duty the first priority, keeping public trust, meet veterans’ health demands, and creating of good workplace culture founded on fairness, respect, accountability, and integrity.


Bolman, L. G., & Deal, T. E. (2017). Reframing organizations: Artistry, choice, and leadership. John Wiley & Sons.

Johnson, C. E. (2017). Meeting the ethical challenges of leadership: Casting light or shadow. Sage Publications.

van Gils, S., Hogg, M. A., Van Quaquebeke, N., & van Knippenberg, D. (2017). When organizational identification elicits moral decision-making: A matter of the right climate. Journal of Business Ethics, 142(1), 155–168.

Watts, L. L., Ness, A. M., Steele, L. M., & Mumford, M. D. (2017). Learning from stories of leadership: How reading about personalized and socialized politicians impacts performance on an ethical decision-making simulation. The Leadership Quarterly.



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