Ethics of Distribution: What You Need to Know

Promoting access to care is one of the key obligations of healthcare providers. They are required to ensure that all members of society are able to access quality and affordable care (Baillie et al., 2013). Despite the best efforts of medical facilities, the goal of accessible care for all seems unattainable. Cost constraints and other limitations have made it difficult for medical service providers to ensure equitable distribution of care. Therefore, making considerations for these limitations, the failure of the providers to ensure that care is accessible to all does not amount to unethical conduct.

Various theories have been developed to shed light on the distribution of health services. Need and the contribution that the society needs to make are some of the key issues that these theories examine (Baillie et al., 2013). It is understood that the needs of communities keep evolving and that it is nearly impossible to meet all these needs. The medical community also understands that it does not shoulder all the responsibility for providing healthcare. The wider community must also contribute to ensure equitable distribution of care (Baillie et al., 2013). Considering these themes, it is clear that the Community Hospital acted ethically. It appears that other stakeholders have abandoned their mandates and are expecting the Community Hospital to attend to all the needs of the community. This expectation is both unfair and unrealistic. Therefore, this hospital’s decision to close the emergency room is in line with ethical principles.

Society has an obligation to attend to the medical needs of its members (Baillie et al., 2013). This obligation particularly applies to such facilities as the Community Hospital. However, as the discussion above reveals, this obligation is only valid when the society contributes to the provision of care. Another issue that one should consider are the steps that healthcare providers take to safeguard the welfare of patients. The mere fact that a hospital is on the brink of bankruptcy does not justify failure to deliver care. One also needs to consider the measures that the hospital is taking to minimize the inconvenience and harm that patients could suffer. The Community Hospital has clearly demonstrated that it is dedicated to preserving the welfare of its patients. The emergency room will only be closed between 10 pm and 6 am. This means that the patients will still be able to access services during the other hours. Moreover, the hospital has advised its patients to seek care at the State Hospital which is merely 7 miles away. Granted, these solutions are not ideal but what other option can the hospital implement in the face of the threat of bankruptcy? Considering the issues that the hospital faces and the initiative that it has demonstrated, it is clear that its decision is ethical.

It can be argued that the Community Hospital’s decision to close its emergency room and refer its patients to the state hospital amounts to indirect dumping. Dumping is said to have occurred when a facility refuses to offer treatment to patients who are unable to pay for the treatment (Winton, 2016). Another situation that amounts to dumping is when a facility refers its patients to another facility despite possessing the capacity to adequately treat these patients. When one examines these definitions of dumping, they cannot in right conscience accuse the Community Hospital of dumping, direct or otherwise. This hospital has only closed its emergency room service doors for a couple of hours. It has advised patients to seek treatment elsewhere and it is not turning away patients because they cannot afford treatment. Furthermore, the hospital is limiting emergency services because of cost constraints. The decision that the hospital has taken is justified and necessary for continued operation.

As they seek treatment at the state hospital, patients will undoubtedly endure inconvenience and other troubles For example, the services that they receive at this hospital may be inadequate or ineffective. This is because public health facilities are notorious for delivering services of poor quality. It is also likely that poor members who do not own cars will suffer challenges in their efforts to reach the state hospital. It is also likely that the emergency room at the state hospital is not sufficiently spacious or equipped to adequately address the needs of the patients. Given these possibilities, there is a need for the general community to help solve the problem. Just and equitable distribution of care can only be achieved when the society makes a contribution as a “society that does not strive to supply what a person really needs attacks the dignity of that person” (Baillie et al., 2013). The healthcare community should challenge the community to become involved in solving the problem. Healthcare practitioners could well-to-do members of the community to facilitate the transport of the poor to the state hospital. They could even help to foot the cost of treatment. Healthcare practitioners could also try to convince the local community to agree to pay higher charges for emergency services. Perhaps this solution will allow the community hospital to keep the emergency room open and avert bankruptcy.

Ensuring that care is accessible to all is a goal that the healthcare community strives to achieve. This goal has proven elusive. The healthcare community has an obligation to turn to the community for support in enhancing access to care. As they engage the community, healthcare practitioners help to fix maldistribution of care. However, one should note that there are some limits to the obligation of the practitioners. Cost concerns are among the limits of this obligation. Healthcare facilities are only obligated to address maldistribution to the extent that their financial endowment allows. Despite these limits, medical facilities should work tirelessly to ensure that all individuals enjoy access to affordable and quality care.

Summary 

Ethics of distribution is the main subject that the fourth chapter focuses on. This chapter explores the dilemmas that healthcare providers are confronted with. On one hand, they have an obligation to safeguard the health of their patients. On the other hand, they face financial and other constraints that compromise their capacity to deliver care. The fourth chapter begins with an exploration of the key goals that healthcare seeks to serve. The authors state that the healthcare system is required to preserve the health of individuals and communities (Baillie et al., 2013). An examination of various theories that shed light on the ethics of distribution is also offered. Here, the authors describe a number of theories that have been presented to explain why healthcare facilities are often unable to deliver care to all. These theories also underscore the needs of patients and communities. The theories also examine issues of contribution and the need for members of the community to take part in the delivery of healthcare (Baillie et al., 2013). The role of delivering medical services cannot be left to healthcare providers alone.

In addition to the issues presented above, the chapter also explores the allocation and rationing of resources (Baillie et al., 2013). This discussion is intended to make it clear that healthcare facilities are limited in resources. This means that they are forced to ration. They develop different criteria for determining the patients to prioritize. For example, patients who are in desperate need of care receive urgent attention. The chapter also highlights how difficult it is to determine the patients to prioritize. As practitioners focus their efforts on a particular group of patients, they are effectively risking the lives of other patients. The chapter concludes with a call to practitioners. They are reminded that they should embrace the value of justice as they make decisions regarding how to distribute medical services.

References

Baillie, H. W., McGeehan, J., Garrett, T. M. & Garrett, R. M. (2013). Principles of

Beneficence and Non-Maleficence. In Health Care Ethics. Sixth Edition. Upper

Saddle River, NJ: Pearson Education Inc.

Winton, R. (2016). Patient Dumping Accusation Leads to $450,000 Settlement from 

Good Samaritan Hospital. Retrieved 10 th October 2017 from

http://www.latimes.com/local/lanow/la-me-ln-patient-dumping-20160421-story.html