Medical Treatment and Difficult Ethical Decisions in Interdisciplinary Hospital Teams

Medical Treatment and Difficult Ethical Decisions in Interdisciplinary Hospital Teams

Anna Rosiek (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland), Krzysztof Leksowski (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland & Military Clinical Hospital No. 10, Poland), Aleksander Goch (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland & Military Clinical Hospital No. 10, Poland), Aleksandra Rosiek-Kryszewska (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland) and Łukasz Leksowski (Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland)
DOI: 10.4018/978-1-5225-2237-9.ch066
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The chapter focuses on organizational culture and ethics, and authors refer to some studies on organizational climate. Authors analyze the relationship between organizational culture and types of performance indicators, which include key concerns of policy makers and the public regarding of hospital behavior. The indicators include resource use per patient (communication process and treatment method, technology, ethical behavior), productivity in resource use (by improving the teamwork and staff education), short-term profitability, patient satisfaction with medical care, and employee satisfaction with improved work culture.
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Medical leadership improved hospitals’ performance and treatment method by using medical knowledge and personal skills. Sometimes the medical treatment process requires making difficult ethical decisions.

Building knowledge and skills in bioethics creates a mutual understanding between professionals and health care practitioners in the classroom and in the workplace. Both sets of professionals have ethics in their education. Ethics courses in the health professions typically involve several key areas. These areas are:

  • End-of-life decisions;

  • Allocation of scarce resources, such as organs;

  • Reproduction, abortion, and genetics;

  • Euthanasia and sterilization;

  • Patient informed consent and patient’s autonomy.

During the ethics cancer various ethical philosophies are explained, such as teleology, beneficence, utilitarianism, deontology, principles of justice, virtue, and caring. A working knowledge of these topics 'levels the playing field' for medical students and graduates (physician, nurses, physiotherapies) when they begin to work in healthcare teams in hospitals.

Mutual understanding of ethical decisions in medical treatment is especially important when physicians are members of interdisciplinary teams. When discussing ethics, health practitioners use a verbal shorthand - a code. Without the decoder, team members may feel somewhat intimidated by clinical healthcare professionals and, consequently, be less likely to contribute. The verbal code in ethical issues prepares medical staff for ethical discussions in healthcare organizations. The verbal code also involves major documents that set standards for ethics, ethical decisions of each team member and notorious cases of breaches of ethics. To solve the difficult ethical decisions in hospital environment by using advanced methods is necessary from patients’ and doctors’ points of view.

Both of those groups agree that hospital, as an organization dealing with health care, in the service of improving the quality and comfort of patient’s life, takes responsibility for the medical services being offered on the hospital grounds. By the same token, the organization is responsible for all the processes taking place there. Ethical realization of a medical service is the outcome of many processes within the organization efficiency, and they are often very complicated and related to one another. The organization of processes connected to medical service on the hospital grounds is focused on: therapeutic processes, administrational processes, communication processes and logistical processes. Internal connections and influence of those processes on offered medical service can be presented on a simple scheme (see Figure 1).

Figure 1.

Connections of processes influencing the offered medical service and teamwork

Source: Author's own study

The common area where all the processes within the organization converge defines the area characteristic for medical service offered by a health care unit. Therefore, for the processes to work efficiently and without problems, it is important for the organization to clearly state organization’s mission and constantly strive for perfection via eliminating existing imperfections, striving for optimalizing reserves and solving problems that arise in hospitals. As we can see, each process in healthcare needs an efficiency indicator. The relationship between that and good teamwork of the hospital team is a guaranty for not only perfect service, patient satisfaction and high quality of health care provided by hospital, but also a healthy proportion between personnel team management and all processes in an organization. Taking responsibility for the correct realization of medical procedure and all the processes involved in it, boils down – in the simplest terms – to detailed analysis of Walter Shewart cycle which involves Planning, Doing, Checking and Action. Ethical behavior of physicians during treatment process can also be perceived as a part of Shewart cycle.

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