Consider the following case from the course scenario on St. Michael’s Medical Center.
Case III. Grandpa Peter and Grandma Lucy
An elderly patient, Grandma Lucy, had an advanced directive not to resuscitate (called DNR, which stands for do not resuscitate) even at the point of death. She had already willed some of her assets to her 20-year-old son Phillip. She gave her husband medical power of attorney (i.e., the sole right to decide action if she becomes incapacitated). Grandpa Peter has been making decisions since Grandma Lucy was diagnosed with Alzheimer’s disease. One day, a nurse named Andrea overheard Grandpa Peter discussing insurance benefits with a female friend. Nurse Andrea discussed the issue with a friend at home and felt that Grandpa Peter’s intent was unfair to Grandma Lucy and decided to ignore the DNR order. The next day, Grandma Lucy coded, and Nurse Andrea resuscitated her. Thinking nobody saw her, nurse Andrea denied her action. She failed to realize that she was on live camera. Aside from that, she called Phillip and revealed Grandpa Peter’s alleged intent and disclosed his mother’s medical records to him, hoping to stop Grandpa Peter’s actions. To avoid any suspicions, Nurse Andrea sent relevant patient information to Philip via e-mail and to others over the phone. Again, Nurse Andrea was caught in the act.
Grandpa Peter sued the hospital for Nurse Andrea’s actions. Additional issues of concern were raised when Grandma Lucy developed bedsores due to poor quality care. On investigation, the ethics committee discovered that the personal care assistants did not honor the rule of turning bed-ridden patients every 2 hours. Grandpa Peter became furious with the hospital staff and filed a lawsuit for denying patient autonomy and for abandonment. This type of patient neglect is an example of a lack of interdisciplinary teamwork.
In a 5-page paper, analyze the case by addressing the following issues:
- What is the present status on patient rights under the Health Insurance Portability and Accountability Act (HIPAA), and how were these rights violated in this case? Were Nurse Andrea’s actions right? Explain your comment.
- What is the present status on patient rights under the Affordable Care Act (ACA), and how do these rights protect Grandma Lucy and Grandpa Peter?
- What are the ACA mandates that providers must honor regarding patient rights and benefits and that Grandma Lucy and her son Phillip could benefit from?
- How do you use these mandates to resolve ethical dilemmas in healthcare?
- What are some relevant healthcare laws enacted in the last 2 decades that could be applied in this case?
- How could you, as the new chief executive officer (CEO) of St. Michael’s Medical Center, prevent these ethical violations from taking place?
Please cite learning resources in APA format.
Reference
Judson, K., & Harrison, C. (2021). Law & ethics for health professions (9th ed.). McGraw-Hill Education.
Expert Solution Preview
Introduction:
This paper analyzes the case of Grandma Lucy, who had an advanced directive not to resuscitate, and how her patient rights under the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA) were violated. The actions of Nurse Andrea, who resuscitated Grandma Lucy against her DNR, order and disclosed her medical records, will be evaluated based on HIPAA regulations. Additionally, the paper will discuss the ACA mandates that were violated with regards to providing quality care and protecting patient rights. Furthermore, relevant healthcare laws enacted in the last two decades that could be applied to this case will be discussed, and recommendations on preventing ethical violations will be given to the new CEO of St. Michael’s Medical Center.
Answer:
HIPAA laws state that a patient’s health information is confidential and must be protected. In this case, Nurse Andrea violated HIPAA regulations by disclosing Grandma Lucy’s medical records to her son Phillip and others. Furthermore, she accessed and performed a medical procedure against the patient’s DNR order, which is not acceptable under HIPAA laws. Nurse Andrea’s actions violated HIPAA regulations, and therefore she was not right.
The Affordable Care Act (ACA) mandates that patients have the right to quality healthcare services and have autonomy on their medical decisions. In Grandma Lucy’s case, she had the right to refuse resuscitation, and that should have been honored. Therefore, the ACA protects Grandma Lucy’s right to autonomy and quality care.
ACA mandates state that providers should provide quality care, honor patient’s decisions on medical treatments, and provide accurate information about the services they offer. Grandma Lucy and her son Phillip could benefit from these mandates if they had been honored. Therefore, the provider was being unethical by failing to honor patient rights and provide quality care.
Ethical dilemmas may arise when patient rights are violated, and providers are not providing quality care. In such situations, the provider must prioritize patient rights and not compromise quality care. By applying the ACA mandates, providers can resolve ethical dilemmas and promote quality care.
The Health Information Technology for Economic and Clinical Health (HITECH) Act and the Patient Protection and Affordable Care Act (PPACA) are some healthcare laws enacted in the last two decades that could be applied to this case. HITECH Act requires healthcare providers to ensure that patient information is protected, while PPACA mandates providers to provide quality care and honor patient’s choices.
As the new CEO of St. Michael’s Medical Center, I would set up a monitoring system that would ensure healthcare providers honor patient rights and apply ethical principles in their practices. Furthermore, I would provide regular training to staff on HIPAA and ACA regulations, and establish a disciplinary system for unethical practices.
References:
Judson, K., & Harrison, C. (2021). Law & ethics for health professions (9th ed.). McGraw-Hill Education.
