Ethical Issues in Health Administration

The National Center for Ethics in Health Care regards ethics as a "discipline that considers what is right and what should be done in the face of uncertainty or conflict about values." The field of health administration oversees the non-direct care aspects of medicine, and holds a great responsibility in navigating what can often be conflicting interests between the medical, economic, social and scientific issues that surround patient care.

Privacy and Records

• One of the major roles of health administrators is maintaining the confidentiality of patient records and other private documents. The federal Health Insurance Portability and Accountability Act of 1996 created a legal framework for protecting private health information in the United States. However, health administrators still have to find a balance between disclosure and confidentiality. As the American College of Healthcare Executives notes in its 2009 confidentiality statement, patients must feel safe in revealing highly personal information, while in return administrators and providers must create an environment that offers security and protection.

Clear Communication

• Translation and comprehension form a large component of health administration ethics. Administrators often occupy a position of having to translate technical, scientific and bureaucratic concepts to patients of diverse backgrounds, language abilities and beliefs. Part of the function of health administration is to ensure that all documents and forms that patients read or fill out are presented in a clear and concise manner, and do not contain any wording that is unexplained or misleading. One of the particular ethical challenges inherent to this role is to ensure that competing interests, for example, between scientific researchers or pharmaceutical companies, do not impinge on patients receiving adequate care and making informed decisions.

Research Ethics

• Research involving patients as subjects is a common way in which new treatments are tested and developed, and medical advances are made. Health administration plays a critical role in overseeing clinical trials and other forms of human subjects research. As a field, health administration is responsible for ensuring that patients are recruited into research studies in a voluntary capacity in which they have not been subject to pressure, deception or lack of choice. Medical research suffers from a grim legacy of coercion. However, the Belmont Report of 1979 created a legal and practical framework for ethics in health-related research. Health administration practices today play a vital role in upholding ethical standards in research that offers fair benefits to both investigators and subjects.

Economic Ethics

• From insurance concerns to soaring healthcare costs, economic considerations occupy a huge place in health administration and ethics. Health administrators often have to maintain a fine balance between attending to the financial well-being of an institution and the economic conditions of the patient population. One of the major ethical challenges facing administrators is designing health infrastructure that imposes a minimum of limitations to care based on cost and access.