Financially Motivated Transfers and Discharges: Administrators' Ethics and Public Expectations
Spielman, Bethany J.
Journal of Medical Humanities and Bioethics. 1988 Spring/Summer; 9(1): 32-43.
In response to a competitive environment, hospital administrators are pressuring physicians to discharge Medicare patients "sicker and quicker" and to transfer indigent patients from their emergency rooms. This paper compares health administrators' ethics to public expectations regarding financially motivated hospital transfers and discharges. Health administrators use balancing strategies: code morality, survivalism, mission dependency, and tithing. Public expectations, exemplified in P.L. 99-272, P.L. 99-509, and recent case law, are based on norms of potential for patient harm and patient occupancy. These norms are morally preferable to those of health administrators; they reinforce the value of identified lives and the reliability of the health care system.
Administrators; Conflict of Interest; Economics; Emergency Care; Environment; Ethics; Financial Support; Harm; Health; Health Care; Health Care Delivery; Hospitals; Indigents; Institutional Ethics; Institutional Policies; Law; Legal Aspects; Moral Obligations; Morality; Patient Admission; Patient Discharge; Patient Transfer; Patients; Physicians; Professional Ethics; Public Policy; Selection for Treatment;
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Bioethics and Law: Bridging the Divide. Review of Law and Bioethics: An Introduction, by Jerry Menikoff; Principles of Biomedical Ethics, by Tom L. Beauchamp and James F. Childress; Medical Ethics: Analysis of the Issues Raised by the Codes, Opinions, and Statements, by Baruch A. Brody, Mark A. Rothstein, Laurence B. McCullough, and Mary Anne Bobinski Spielman, Bethany J. (2002-03)