This case study presents us with several ethical issues throughout the presentation. Some of the issues are related to Mary’s behavior and her exercising of powers, whereas others pertain potential solutions to the problem and medicine as an industry. These issues should be reviewed based on one of the three ethical criteria in decision-making: utilitarian, justice, and rights criteria. Here are the ethical issues as defined by this case study.
Ethical Issue 1
John’s department is being asked to cut costs at the same level as other departments even though they are already controlling costs and meeting revenue targets.
Is this equitable and fair? (Criterion of justice).
Ethical Issue 2
Mary is threatening John with job loss should he not comply with her demands.
Does she have the right to do so? (Criterion of rights).
Ethical Issue 3
John is contemplating laying off the problem staff and increase the workload on the rest in order to have ends meet.
Is the decreased quality and performance worth saving costs? (Criterion of utilitarianism).
Ethical Issue 4
In addition, John is contemplating cutting non-personnel costs, thus potentially increasing chances of accident and reducing the medical efficiency of his department.
Is the decreased quality and performance worth saving costs? (Criterion of utilitarianism).
Are patients to suffer potential consequences? (Criterion of rights).
Ethical Issue 5
One of the possible solutions to John’s dilemma is presenting the issue to the staff in hopes of them understanding the situation and be willing to comply with wage cuts and increased workload for the sake of the patients and the company.
It is just of John to ask his employees to bear this burden when they have already exceeded the performance of other departments? (Criterion of Justice).
Ethical Issue 6
Lastly, John is contemplating presenting the issue to the COO and refusing to make cuts at the cost of patient expenses and quality of care.
What is better for the patients – to receive lower quality of treatment for some time, or be forced to seek other healthcare providers? (Criterion of Utilitarianism).
Is the cause worth it to go over Mary’s head, violating the chain of command, and presenting her in a bad light before the COO? (Criterions of Utilitarianism and Rights).