Balancing Legal and Ethical Obligations

 

A health services organization serves the patient population by providing a multitude of health services in the form of medical expertise for diagnosis, treatment, and long-term care for sustained positive health outcomes. However, as much as health services organizations are a service organization providing care and health service delivery, they too must meet business bottom lines, ensure positive account balances, and adhere to healthcare policies and law. What potential challenge might healthcare administration leaders face when balancing legal, ethical, business, and service obligations of a health services organization?
While a health services organization has as its client the patient population it serves, and the medical and healthcare staff engaged in healthcare delivery, it too must respond to and work within the guidelines of the board in day to day operations. In this way, healthcare administration leaders truly engage in a juggling act to balance the needs and interests of several stakeholders while delivering health services.
For this Discussion, reflect on the role of the board in resolving internal conflict between compliance, ethical obligations, and business needs. Think about how healthcare administration leaders might balance these conflicts and potential challenges for effective health services delivery.
Post an explanation of the role of the board in resolving internal conflict between compliance, ethical obligations, and business needs. Then, describe how you, as a current or future healthcare administration leader, might address these challenges for a health services organization. Be specific and provide examples.

Sample Solution

The known case of the ‘Conflict Diamonds’ in Sierra Leone demonstrates how a ‘greed’ perspective can be projected. This long war had many actors involved in it, including the Revolutionary United Front (RUF), the Republic of Sierra Leone Military Force (RSLMF), various splinter groups and civil defence forces and private companies. (Richards, 2003, page 9). Sierra Leone experienced true violence in the 1990s, when grievances clashed local authorities, and rebel groups took control of these grievances and use them for the illegal exploitation of diamonds in order to reach personal interests. “Both the composition of the initial force that crossed into Sierra Leone and Taylor’s motivations for supporting the RUF highlight the regional dynamics that underpinned Sierra Leone’s conflict” (Pugh, Cooper, Goodhand, 2004). The civil war started on March 23, 1991, when a group of 100 fighters from Sierra Leone and Liberia invaded east Sierra Leone. Foday Sankoh, an ex-army sergeant, leaded the RUF- with the argument that he represented the urban dispossessed and promised impoverished peasants a greater share in the mineral wealth misused by the government. The grievance was being used as a driver to alter the sense of the fight, and allow the greedy to take control of the situation and turning it into a 9-year war, concentrating it in the diamond districts. In 1999, Sankoh and Ahmad Tejan Kabbah, president of Sierra Leone at the time, signed the Lome Peace Accord (UNSC, 1999) under pressure of the United Nations and the US Government. As a concession to RUF, Sankoh was released from death sentence for his war crimes and was appointed as chairman of the Strategic Mineral Resources Commission, a position that controlled most of Sierra Leone’s diamond exports.
Corruption, impunity and a lack of fulfilment of civil grievances led to international agencies to intervene in the form of peacekeeping operations. The Kimberley Process Certification Scheme (KPCS), worked as the international response to conflict diamonds in Sierra Leone, Angola, Liberia and DRC. This strategy was focused on commodity sanctions imposed by the United Nations Security Council (UNSC), and aims to establish transparency in the whole process of the diamond industry. The effectiveness of the Kimberley Process is also very debatable; however, what is has been proved is that the framework has inspired to move forward in order to comprehend more the complexities of this conflict (and others in the Global South) that consequently, motivated the creation of the KPCS. (Ballentine and Nitzschke, 2004).

“Sierra Leone’s descent into conflict cannot be adequately understood as a manifestation of a nihilistic ‘new barbarism’. Nor should it be seen solely as a function of a greed-based warlordism that stands outside the ‘normal’ political economy of the state, the region, or indeed the globalized world” (Pugh et al. 2004, page 132).

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