This document discusses contemporary ethical dilemmas faced by healthcare administrators, including abortion, sterilization, artificial insemination, surrogacy, and organ transplantation. It also covers end-of-life dilemmas like euthanasia, physician-assisted suicide, and advance directives. A case study is presented involving a patient who received radiation treatment as a child and later developed tumors, suing the hospital for failing to properly warn him of risks.

1. Contemporary Ethical Dilemmas
Contemporary Ethical DilemmasWhile a number of legal and ethical issues are present in
modern healthcare, there are some that are more commonly seen by administrators. In this
lecture, we will take out some time to reflect on various ethical dilemmas or scenarios in
which individuals may find it difficult to make decisions. Current healthcare ethics are
impacted by previous events ranging from the Tuskegee Syphilis Study to informed consent
legislation to sequencing of the human genome. As a healthcare administrator, you may
have a number of organizational policies, supported by enacted legislation, to support your
decision in various cases. The cases you will most likely contend with include:· Abortion:
Termination of a pregnancy before a fetus is viable; the term viability is hotly debated
between those who do and do not support the right to choose.· Sterilization: Termination of
the ability to have children via vasectomy or tubal ligation; voluntary sterilization poses
some ethical concerns, but the real issues stem from efforts at eugenic sterilization.·
Artificial insemination: Process to impregnate a female in a manner other than sexual
intercourse; ethical dilemmas, concern for the offspring, and risk of multiple births arise
over the process itself.· Surrogacy: Reproduction method where a woman agrees to give
birth to a child that will be given to a contracted party; primary concerns are the exchange
of a body for money and potential psychological impacts.· Organ transplantation: Procedure
to replace a failing organ with a viable organ from a donor; the National Organ Procurement
Act of 1984 makes it illegal to buy or sell organs, but there can be ethical issues with donor
families feeling pressured or perceptions of unfair selection processes.Each of these
scenarios presents unique challenges to healthcare administrators; however, guidance from
organizational and legislative policies helps to remove some of these challenges. Following
federal, state, and organizational regulations is a key aspect of the administrator position,
and knowledge of such information is imperative to your success in healthcare
organizations.Explore MoreDisplays a web link regarding current legislation on a variety of
cases.Under subject areas, review the topic “Health.” Narrow your focus and review “60
Subcategories” for current legislation on aging, healthcare finance, family planning,
coverage and access, technology, and more.Review the below link to learn more about the
current legislation on a variety of contemporary ethical dilemmas.Bills and Resolutions
opens in new windowAdditional MaterialsFrom your course textbook, Legal and Ethical
Issues for Health Professionals, review the following chapter:· Contemporary Ethical
DilemmasFrom the South University Online Library, review the following articles:· Moral
Distress in Physicians and Nurses: Impact on Professional Quality of Life and Turnover· The

2. Burden of Choice: A Qualitative Study of Healthcare Professionals’ Reactions to Ethical
Challenges in Humanitarian CrisesEnd-of-Life DilemmasWhile we have addressed some of
the main legal and ethical scenarios that you are likely to face as a healthcare administrator,
one deserves a bit more examination. End-of-life dilemmas include a myriad of different
topic areas ranging from euthanasia to assisted suicide to advance
directives.EuthanasiaEuthanasia is loosely defined as “mercy killing,” where individuals
with deteriorating health and with no hope of improvement are provided with some relief.
The primary area of contention is whether the patient is dying from his or her incurable
disease and to offer, only to the dying patient, the option of euthanasia. What this means is
that a patient with an incurable disease who is not dying should not have the option of
euthanasia. Due to changing societal norms and minimal legislative support for or against
euthanasia, the matter has become muddled and administrators often turn to whether the
patient is of sound mind to make end-of-life decisions.Physician-Assisted SuicidePhysician-
assisted suicide requires a voluntary physician to aid patients in killing themselves. Perhaps
the most famous name in physician-assisted suicide is Dr. Jack Kevorkian who developed a
device to bring about death quickly and without pain. He assisted an Alzheimer’s disease
patient to commit suicide and was subsequently charged with first-degree murder. Those
charges were later dismissed as there were no federal laws deeming assisted suicide as
illegal. As with euthanasia, there are shifting opinions regarding assisted suicide too.
Further, the Supreme Court maintains that assisted suicide of terminally ill patients is a
state decision.Advance DirectivesThe Patient Self-Determination Act of 1990 stipulates that
patients have the right to make decisions about their healthcare, including treatment
options and decisions that may need to be made in the future. Advance directive, also
known as living wills or durable power of attorney, gives the patient a voice in his or her
medical care should he or she becomes incapacitated at a later date. Such documents are
written when the patient is sound and competent and detail his or her wishes for treatment
should he or she becomes unable to communicate. This is a particularly important
document to healthcare professionals as it allows them to provide appropriate intervention
without interference from external parties.There are a number of legal and ethical issues
that you may come across if you pursue career in hospital administration. However,
following the directives set forth by patients via living wills, for example, and adhering to
state and federal regulations for end-of-life care ensure patient’s respect, death with dignity,
and protection from legal and ethical wrongdoings.Living WillDisplays an example of a
living will.Review the following example of a living will (Pozgar, 2018).Example of a Will
opens in new windowAdditional MaterialsFrom your course textbook, Legal and Ethical
Issues for Health Professionals, review the following chapter:· End-of-Life DilemmasFrom
the South University Online Library, review the following articles:· Recording Advance
Decisions to Refuse Treatment· Physicians, Specialised to Support and to Be Consulted in
Case of Euthanasia· Dying with Dignity-Physician Assisted Suicide in India: A Critical Review
of Legal FactsMHA6060 Week 2 Discussion Instructions Before beginning work on this
discussion forum, please review the link “Doing Discussion Questions Right” and any
specific instructions for this topic.Your initial posting should be addressed at 300–500
words. Make your post to this Discussion Area by the due date assigned.Before the end of

3. the week, begin commenting on at least two of your classmates’ responses. You can ask
technical questions or respond generally to the overall experience. Be objective, clear, and
concise. Always use constructive language, even in criticism, to work toward the goal of
positive progress. Submit your responses in the Discussion Area.REASONABLE
WARNINGReview the following case study and address the questions that follow:From
1930 to 1960, about 5,000 patients at Michael Reese Hospital and Medical Center, located in
Chicago, Illinois, were treated with x-ray therapy for some benign conditions of the head
and neck. Among them was Joel Blaz, now a citizen of Florida, who received this treatment
for infected tonsils and adenoids while he was a child in Illinois from 1947 through 1948.
He has suffered various tumors, which he now attributes to this treatment. Blaz was
diagnosed with a neural tumor in 1987.In 1974, Michael Reese set up the Thyroid Follow-
Up Project to gather data and conduct research among the people who had been subjected
to the x-ray therapy. In 1975, the program notified Blaz by e-mail that he was at increased
risk of developing thyroid tumors because of the treatment. In 1976, someone associated
with the program gave him similar information on a phone call and invited him to return to
Michael Reese for evaluation and treatment at his own expense, which he declined to do.Dr.
Arthur Schneider was placed in charge of the program in 1977. In 1979, Schneider and
Michael Reese submitted a research proposal to the National Institutes of Health stating
that a study based on the program showed “strong evidence” of a connection between x-ray
treatments of the sort administered to Blaz and various sorts of tumors: thyroid, neural, and
others. In 1981, Blaz received but did not complete or return a questionnaire attached to a
letter from Schneider in connection with the program. The letter stated that the purpose of
the questionnaire was to “investigate the long-term health implications” of childhood
radiation treatments and to “determine the possible associated risks.” It did not say
anything about “strong evidence” of a connection between the treatments and any
tumors.In 1996, after developing neural tumors, Blaz sued Michael Reese’s successor, Galen
Hospital in Illinois, and Dr. Schneider, alleging, among other things, that they failed to notify
and warn him of their findings and that he might be at a greater risk of neural tumors in a
way that might have permitted their earlier detection and removal or other treatment.
There is a clear duty to warn the subject of previously administered radiation treatments
when there is a strong connection between those treatments and certain kinds of tumors.
The harm alleged, neural and other tumors would here be reasonably foreseeable as a likely
consequence of the failure to warn and was in fact foreseen by Schneider.A reasonable
physician, indeed any reasonable person, could foresee that if someone was warned of
“strong evidence” of a connection between treatments to which he or she had been
subjected and tumors, he or she would probably seek diagnosis or treatment and perhaps
avoid these tumors, and if he or she was not warned, then he or she probably would not
seek diagnosis or treatment, increasing the likelihood that he or she would suffer from such
tumors. Other things being equal, therefore, a reasonable physician would warn the subject
of the treatments.Tasks:1. Discuss the ethical and legal principles violated in this case.2.
Discuss the preventative measures that should be taken to prevent recurrence of such cases.