Introduction
If a patient does not have health insurance or receives services that the health care provider knows are not covered by the patient’s insurance, the health care practitioner faces ethical issues. The medical professional is responsible for caring for the patient and ensuring that the patient has been prescribed or recommended in the event of surgery. On the other hand, the medical professional is responsible to the medical facility or the patient’s insurance company to ensure that the services or drugs are not overcharged. The doctor must determine whether to provide the patient with a service that is not covered by insurance on credit or to ask the institution to lower the price of the service, taking into account the patient’s financial capabilities, which is the essence of ethics.
Urgent Care vs. Financial Constraint
The medical practice case considered for this study involves a patient who urgently needed treatment (a heart stent) but could not pay the hospital bills due to financial problems. The male patient has weak health insurance, which does not cover the needed service. The patient also cannot find a suitable job because of health issues and, therefore, does not have money for emergency medical care. However, the doctor cannot provide care for free, as each patient has his income, and the services require additional tools. Even if all patients deserve the same care and attention, the doctor will be careful about their varying ability to pay for the care and services they will receive.
Given the patient’s right to proper medical care and treatment, the healthcare provider would do what is morally right but would violate his right to payment for the service. In this way, he would provide the service on credit or with the option of paying for the service later. Ethics comes into play when a moral dilemma arises when a difficult decision must be made for both the patient and the doctor.
It also means that ethics is reduced to moral issues, and the ethical view as a reflection of the “good life” is not taken into account (Schuchter & Heller, 2018). Ethical reflection is primarily focused on a more or less instantaneous decision-making situation, which is relevant to this case (Schuchter & Heller, 2018). Thus, in this case, the doctor complied with ethics and assisted the patient by operating on the condition that the patient would pay for this service.
Ethics based on care takes into account the well-being of the person regardless of other factors in the situation. Therefore, in this case, this patient is offered treatment despite being unable to provide the required payment on time (Schuchter & Heller, 2018). A rights-based ethical system considers people as individuals with inherent rights. However, according to the mentioned scenario, not all patients are suitable for emergency treatment without paying for it on time. The decision is taken by the doctor and the treating institution separately and corresponds to the ethical principles in terms of all standards considering gender (Rachels, 2018).
Philosophical Theories Applied
A human rights approach to this case would need to be more convincing. Kant’s theory, considered a tool in this case, states that the rightness or wrongness of an action does not depend on its consequences but on whether it fulfills a human duty. Thus, the Kantian physician will work with a favorable solution for his/her institution and all those who will be directly or indirectly affected by the patient’s financial costs (Canning, 2020). The patient’s interests will be placed below the interests of the institution; therefore, the doctor did not act using this theory, as it contradicts ethics, but considered it one of the tools.
Utilitarians believe that their influence determines whether an action is right or wrong. In this case, the decision will be made by a benevolent, disinterested bystander who will benefit the patient. The disadvantage of this theory is that the medical worker will not get financial benefits from it on time, contrary to the work’s general purpose. Thus, this approach is likely to be more focused on the best economic outcome for the healthcare facility (Häyry, 2020).
Ethical egoism is the normative ethical belief that moral agents should act in their self-interest. In this case, the medical worker will make all decisions for their own benefit and their institution or place of work. This approach would be contrary to the wishes and rights of the patient and would not be perceived as a morally justified decision, considering ethics. Hence, for this case, it is not effective but is considered one of the options.
Social contract theory states that a person’s moral obligations depend on the contract or agreement that forms the society in which they live. A healthcare professional is expected to offer treatment and care to a patient regardless of their ability to pay medical bills. Such an approach would benefit the patient in question but would compromise the right of the healthcare professional to receive payment for the services rendered (Lemmens et al., 2022). Considered the most modern of the traditional social contract theorists, Rawls used the social contract approach to outline principles of global justice (Lemmens et al., 2022).
In this case, the patient must fulfill the conditions of the contract at the specified time, which means respecting the contract and obligations. From the medical side, the doctor fulfilled the second part of the theory, which includes respect for contracts and obligations, respect for human rights, and recognition of the duty to help others in unfavorable conditions.
Action Plan and Resolution
In this case, with the patient, the action plan consists of two alternatives. To conduct the service on credit is officially signed with the consent of the patient to pay it within a certain period or to make a request to the organization where he works, with a request to reduce the price of the service. The medical service provider chose to operate on credit, which does not contradict ethics.
The health worker explained the problem to the patient and helped him understand why he could not operate for free, considering the equipment and material costs. In such a case, the medical institution must inform the insurance company about this circumstance and help them realize the need to include such a vital service in the insurance package for an additional fee. To help the patient and the insurance company understand the problem and choose the best course of action, the healthcare professional must use social technologies such as blogs, crowd-sourcing, and online encyclopedias. Since such cases are not frequent, the doctor needed an additional resource to understand which tools to use.
Conclusion
The analyzed case shows that medical workers often face ethical problems in their practice. In this case, to fully help the patient and the insurance company understand the problem and choose the appropriate course of action, the medical professional should use such moral principles as utilitarianism, Kantian deontology, ethical egoism, and social contract ethics. With the help of such tools, they will be able to determine the relevance of the service for a loan with deferred payment.
References
Canning, U. P. (2020). Public health ethics: a flawed view of Kant’s argument from autonomy. Journal of Public Health. Web.
Häyry, M. (2020). Just better utilitarianism. Cambridge Quarterly of Healthcare Ethics, 30(2), 1–25. Web.
Lemmens, T., Ghimire, K. M., Perehudoff, K., Perehudoff, K., & Persaud, N. (2022). 3 Social contract theory: rights and responsibilities. World Health Organization. Web.
Rachels, J. (2018). Feminism and the ethics of care. In The elements of moral philosophy. McGraw-Hill Higher Education (US).
Schuchter, P., & Heller, A. (2018). The care dialog: the “ethics of care” approach and its importance for clinical ethics consultation. Medicine, Health Care and Philosophy, 21(1), 51–62. Web.