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Editor's note: Medical Ethics Advisor is beginning an occasional series with articles designed to help provide useful information in the organizing and administration of ethics committees.
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Editor's note: In the August 2008 issue, Medical Ethics Advisor reported on a new requirement by The Joint Commission to become effective January 2009 that hospitals monitor and correct so-called "disruptive behaviors" by health care professionals at their institutions. This month, MEA spoke with Laurie Zoloth at Northwestern University's Center for Bioethics, Science and Society. To discuss how physicians should address either incompetent or other bad behavior by other physicians.
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Occasionally, reports of physician misconduct while a patient is sedated make headlines sometimes locally, sometimes nationally, and sometimes internationally.
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The above quote from an article published in the Journal of the American Medical Association (JAMA) in June demonstrates the challenges that physicians can have with certain patients who, in everyday language, refuse to give up the fight to continue with their life, even if a prognosis suggests that is not possible.
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Medical ethics is at the center of a case in the state of North Carolina, whereby the state Department of Corrections is at odds with the North Carolina Medical Board (NCMB) over physician participation in executions.
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ISO certification is process-, customer-, and improvement-focused, says Jerilyn Yama, RN, BS, CPHQ, president of Audi-Qual, an Ohio-based firm specializing in quality auditing and consulting.
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Organizations are taking a close look at their policies for addressing disruptive physicians, in order to comply with new Joint Commission standards for 2009 that will require accredited health care organizations to create a code of conduct and formal process for managing unacceptable behavior.
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"As physicians, we respond to data. That is a very powerful way to convey performance against expectations," says David A. Snyder, MD, vice president of patient care quality and safety at MCG Health in Augusta, GA.
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With the 2009 National Patient Safety Goals (NPSGs) just announced, it's an ideal time to perform a self-assessment for all of the existing goals, including the requirements for improving recognition and response to changes in a patient's condition and improving safety of anticoagulation medications, which are being phased in right now, says Paula Swain, MSN, CPHQ, FNAHQ, director of clinical and regulatory review at Presbyterian Healthcare in Charlotte, NC.
