HST 4770 – Test One
Instructor / Anita Sego / NameClass / Health Administration
Period / 1:00 p.m.
Date
Please type your answers. Make sure you answer questions completely and that you use proper spelling and grammar.
1. List and explain the five key features Max Weber believed were necessary if an organization were to achieve the maximum benefits of ideal bureaucracy. (Classical Theory) – 10 points
2. List and explain five of Henri Fayol’s 14 Principles of Management. (Classical Theory) – 10 points
3. Using the information presented in “A Few Pertinent Questions” and the “Changing Health Care Systems,” explain why you will make a good health care administrator. – 10 points
4. Define informed consent and explain why it is important in health care. – 5 points
5. Define ethics. – 5 points
6. Define competence and explain why it is important in health care – 5 points
7. List the components of “who is legally competent” and explain why it is important in health care—5 points
8. List and explain the four components necessary to prove negligence and explain why they are important.—10 points
9. Pick two articles from the Code of Ethics for Health Educators and discuss how they will pertain to you as a health administrator in the future. Why is the Code of Ethics for Health Educators important to you? – 10 points
10. Using the six steps from the Critical Thinking Presentation on presenting your ideas to others, write an essay on what you think about the death penalty.—20 points
11. Read and evaluate the following ethical situation:--20 points
University Hospital has a very active cardiac medicine service in its department of medicine. Over the years, it has treated thousands of persons with problems ranging from angina to congestive heart failure. A number of times, its patients have been included in special study programs, most often funded by either the National Institutes of Health or a national heart association.
As part of long-term patient follow-up, regular questionnaire surveys are conducted. In order to perform the surveys, an extensive mailing list is maintained by the cardiac medicine service. On one occasion, the development department of University Hospital used the mailing list to solicit general contributions. Once it had a special fund-raising effort to assist in converting and equipping a six-bed cardiac intensive care unit. Results of fund raising among the cardiac program’s present and former patients have been excellent, primarily because of the superior rapport and reputation it has with them.
The physician director of the program and her administrative assistant has been approached by a prominent national life insurance company that has been impressed with the results of the program. It wants to market life insurance among the program’s participants. The proposal is attractive because the opportunity to obtain life insurance will benefit present and former patients, because many of them are otherwise uninsurable except at very high premiums, and because any data obtained by the insurance company will be available to the hospital at cost if the mailing list is provided to the insurance company.
The physician director and administrative assistant are very enthusiastic about the clinical possibilities (in addition to helping the patients), and the director of development sees the sale of mailing lists as an excellent means of raising money for the cardiac program’s activities. They have just spent an hour making their arguments to try to convince the chief executive officer of the appropriateness of releasing the mailing list for such a worthy purpose.
A) Identify the issues/questions that arise from reading this case.
B) Should the patients have a voice in the decision? If so, how can their wishes be known and implemented?
C) Which interests are being balanced? How and by whom should the interests be weighed?
D) Which management skills were used in this case study?
12. Read and evaluate the following ethical situation:--20 points
An 18-year-old woman suffered severe head injuries in a car accident in early 1995. After a few weeks in a coma, she opened her eyes but was totally unresponsive for 15 months. Then, nurses noticed a hopeful sign when she twice seemed to obey their orders to move her leg or close her eyes. These responses were rare, but 2 months later her physicians administered drugs to improve alertness and she improved slowly. Over time, she learned to answer multiple-choice questions and do simple math using eye blinks. At one point, she wrote, “Mom, I love you.”
Three years after the accident, she was communicating regularly with eye blinks and could move her arms somewhat. After 5 years, she could mouth words and short phrases. Although her attention span was limited to 15 minutes, she liked pampering and took pleasure in teasing her nurses. Her favorite joke was pretending not to know who they were.
Her mother was overjoyed. She reveled in each small bit of progress. Five years and 2 months after the injury, the young woman was sent home, totally dependent upon others. Her rehabilitation had cost more than $1 million.
A) Should treatment have been withdrawn when the prognosis was certain? Is this a case of futile care? If so, who has the legal right to speak for the patient? Who has the moral right?
B) Who should be financially responsible for the care? Distinguish situations in which insurance is available and unavailable.
C) What is the role of the health services executive in solving the ethical issues posed by this case?
D) What is the role of the clinicians, such as physicians and nurses, in solving the ethical issues posed by this case? How do they differ from the role of the health services executive?
13. Read and evaluate the following ethical situation:--20 points
Stunned, Carolyn Aubrey, the CEO of the Metropolitan Hospital, sank into her chair and stared out the window for a very long time. She realized when Dr. Midmore’s wife had angrily insisted on seeing the CEO that something was afoot. But even in her worst nightmares, Aubrey had never imagined that Mrs. Midmore would tell Aubrey that she was suing her husband, an orthopedic surgeon, for divorce because he had given her AIDS. As Mrs. Midmore left Aubrey’s office, she turned back and said, “I was sure you’d want to know—surely you’ll have to do something.”
Fleetingly, Aubrey thought Mrs. Midmore’s statements might be nothing more than the ravings of an angry, vindictive wife, but that was not likely. As she considered what she had just learned, she recalled an incident several years ago involving Dr. Midmore and a male orderly. In retrospect, it suggested that Dr. Midmore might be bisexual. Aubrey thought, too, about the department of surgery meeting last year during which there had been a long discussion about the desirability of knowing the HIV status of all surgical patients. The special risks to surgeons of torn gloves and cuts during orthopedic surgery had been described in detail.
Now it seemed that Dr. Midmore’s patients might be at risk. Aubrey called operating room scheduling and learned the Dr. Midmore was maintaining a full surgical load. Aubrey asked her secretary to call the hospital attorney and the medical director and set up an emergency meeting for 7:00 the following morning. Mrs. Midmore had been right, though Aubrey. We’ll have to do something, but what?
A) Bearing in mind that HIV-infected caregivers seem to pose a very small risk of infecting patients, even when they engage in exposure-prone procedures, should Aubrey refrain from any action? What are the ethical and legal implications of your response?
B) What steps, if any, should Aubrey take in terms of previous patients who have been treated by Dr. Midmore at Metropolitan Hospital? Why? Is there any obligation in terms of the patients whom Midmore has treated in his office or at other HSOs?
C) Assume that you are a recent patient on whom Dr. Midmore has performed surgery. What would you want Metropolitan Hospital to do? Why?
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