Applying health care law and ethics in the workplace

Identify a contemporary legal issue within the health care industry or within a selected organization. Describe potential ethical issues associated with the law. Use the Organizational Ethics Decision-Making Process in Health Care media piece from your Studies in this unit (link attached) and analyze your issue using the eight steps. Provide a brief summary of your deliberation process and recommendations. Include a minimum of one resource from a peer reviewed journal to help support your recommendations.



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Workplace Law/Ethical Situation:

A new staff surgical technician in the operating room learns that the daughter of an employed orthopedic surgeon is married to the implants rep for the total joint replacement components which are now being used as the sole implant company under contract by the hospital.

This surgical tech employee had been coached by this top volume orthopedic surgeon during his their orientation for not paying attention during the surgical cases. The surgeon told the new employee he would speak to his supervisor if his work did not improve.  

Upon picking up on this surgeon/ rep / daughter relationship, the employee ‘dropped an anonymous dime’ to one of the board of trustees of the hospital to let them know of the improper relationship of a surgeon and a contract with goods sold to the hospital that benefited this surgeons family.

Using the Organizational Ethics Decision-Making Process:

Step One: Clarify the Ethical Conflict – The Ethical conflict being perceived was one of compliance in relation to a perceived conflict of interest with respect to granting a contract to a surgeons relative.

Step Two: Identify All of the Affected Stakeholders and Their Values:

  1.  The employee would like to stay employed, and senses if he can get this surgeon in trouble it may take the heat off of him. He knows something about compliance and this seems wrong to him that he is related to the rep.
  2. The surgeon would like to be perceived as adhering to regulatory rules around compliance.
  3. The implant rep is doing his job to sell products and does not want trouble for his father in law.
  4. The business manager who must exercise due diligence in exploring contracts in the best interest of the hospital and uphold the compliance rules.
  5. The board member who is acting on good faith there may be a compliance issue with the hospitals largest margin contributor (orthopedic surgeon)

Step Three: Understand the Circumstances Surrounding the Ethical Conflict –As stated above, the board member tipped off to a potential compliance issue and is compelled to investigate this allegation of potential impropriety with respect to a contract.

Step Four: Identify the Ethical Perspectives Relevant to the Conflict- Any perception of favoritism towards a family member or awarding a contract at a higher rate to benefit a family member would have a negative impact for the hospital.

Step Five: Identify Different Options for Action- The board member could do nothing, he could call the surgeon and report this employee who is tattling on him, he could call the business or finance manager of the operating room and ask the question around compliance with this information.

Step Six: Select Among the Options – The board member calls the business manager of the operating room to ask if there is some compliance issue with the relationship of the surgeon and the rep and his contract with the hospital.

In this case the business manager is able to communicate to the board member the relevant history that this contract had gone out to bid prior to this particular rep taking this territory for a job. That the contracts went out without any disclosures to the surgeon as to the incoming bids. The bid was awarded by the finance/business office to company with the best price with best service contract, and that upon learning his son-in-law was taking a job with this company some year later, the surgeon and rep immediately disclosed to the compliance officer that there was contracted service and product / surgeon / relationship to a contract holder of the hospital.

Step Seven: Share and Implement the Decision – The Business Manager does not know who this anonymous tip came from, so they do a general informational announcement during staff meeting recounting the history and compliance of the situation to avoid further misperceptions. This must be done without any inference of a punative attitude for reporting of what a staff person percieves as a conflict of interest. 

Step Eight: Review the Decision to Ensure it Achieved the Desired Goal- Educate staff around compliance definitions and encourage open surveillance and go to manager if perceive any issues.




American College of Healthcare Executives’ Organizational Ethical Decision Making Process (ACHE, 2010)


Steinbrook, R., M.D. (2008). Disclosure of industry payments to physicians. The New England Journal of Medicine, 359(6), 559-61. doi:


United States Health and Human Services (HHS) Federal Register / Vol. 65, No. 194 (2000) Agency: Office of Inspector General (OIG) Compliance Program for Individual and Small Group Physician Practices

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