Employee health and safety oversight failures at Universal Human Care Hospital

¶ … Employee's Rights to Health and Safety in the Workplace

The objective of this study is to analyze the rights of employees to health and safety in the workplace in regards to the scenario as follows:

DoRight has recently been hired as the President of the "Universal Human Care Hospital," where he oversees all departments with over 5,000 employees and over 20,000 patients at the medical facility. He has been provided with a broad set of duties and oversight of numerous departments, including business development, customer services, human resources, legal, patient advocacy, to name a few. He has managers in each department that he supervises and who work with him to address the needs of the various internal and external stakeholders of the hospital. Dr. DoRight discovers that some patients within the hospital have been dying as a result of a variety of illegal procedures by doctors and nurses, and negligent supervision and oversight on their part. This was brought to his attention in a few meetings and he told his Regional Director Compliance Manager and Executive Committee in January 2009. He was told by them that the matter would be investigated and they would report any findings to him as soon as possible. After two (2) years, there have been no results from the investigation and some patients are still passing away due to the negligent activities. He also answers to a board of trustees and interfaces with numerous community organizations and corporations who have various reasons for doing business with the hospital. Dr. DoRight continues to win awards for his leadership of the hospital and meeting business goals. He was recently named "Medical Business Executive of the Year" in 2011.

I. Introduction

There are three different internal and external stakeholders that Dr. DoRight deals with on a daily basis at the hospital. These include the internal stakeholders of patients, employees, and legal advocates of the hospital. External stakeholders include regulatory and legal authorities as well as the community in which the hospital is situated. There are conflicting interests existing between internal and external stakeholders of the hospital.

As noted in the work of Rabinowitz (2012) there are often conflicts among stakeholders and for example some stakeholders "may have economic concerns" while other concerns may include such as "universal health care or regulation" which wile being good for the society-at-large may result in hurting some businesses. (Rabinowitz, 2012) Stakeholder interests are further driven by such as "ideological as well as cultural differences." (Rabinowitz, 2012)

Legislators and policy makers are often concerned with the perception of the public and the organizational employees interests are focused on their work processes. Rabinowitz writes that a stakeholder analysis involves "determining who among stakeholders can have the most positive or negative influences on an effort, who is likely to be most affected by the effort and how you should work with stakeholders with different levels of interest and influence." (2012) Stakeholders can be classified as follows according to Rabinowitz:

Promoters have both great interest in the effort and the power to help make it successful (or to derail it).

Defenders have a vested interest and can voice their support in the community, but have little actual power to influence the effort in any way.

Latents have no particular interest or involvement in the effort, but have the power to influence it greatly if they become interested.

Apathetics have little interest and little power, and may not even know the effort exists. (Rabinowitz, 2012)

Stakeholder influence can be interpreted in the following ways:

An individual or group can wield official power in some way -- as a government official or agency, for example.

As an administrator, board member, or funder, an individual or group has some power over the organization conducting the effort.

Another possibility is influence as a "community leader" -- a college president, hospital CEO, clergy member, bank president, etc. These people are often listened to as a result of their positions in the community, and may hold one or more actual or honorary positions that give them even more influence: chair of the United Way campaign, officer of one or more corporate or non-profit boards, etc.

Key stakeholders are often connected to large networks, and thus can both reach and sway many community members. Such connections can be through work, family, long generations or years of residency, membership in many clubs and organizations, or former official status.

Great influence can be exercised by people (or, occasionally, organizations) that are simply respected in the community for their intelligence, integrity, concern for others and the common good, and objectivity.

Some people and organizations exercise influence through economics. The largest employer in a community can exert considerable control over its workforce, for example, or even over the community as a whole, using a combination of threats and rewards. (Rabinowitz, 2012)

II. Deontology and Utilitarianism

The work of Grush (nd) reports that the basic utilitarian view when presented with a choice of a morally relevant decision "between a number of options" can be determined as the right decisions by the decision that should be made based on that which results in the "greatest good for the greatest number of people." (Grush, nd) The deontological principles "do not give anyone, including the person making the decision…any special status." (Grush, nd) Secondly, "it quite avoids a number of other ethical outlooks, such as divine command (which would maintain that you do what God tells you, regardless of what good or bad comes from it), or deontological views that prescribe certain duties (e.g. respect the dignity of all people) regardless of the results. Third, it makes no immediate distinction between acting and failing to prevent an action: and so accordingly pushing someone off a building is exactly as bad as failing to help someone from falling off (assuming that one is in a position to help without putting oneself at risk)." (Grush, nd) Grush reports that the basic idea of utilitarianism "is easy and plausible enough: the morally right thing to do is to make the world a better place. Thus what makes some act right or wrong is its utility in bringing about good consequences, and not, for example, the intentions behind the act. So when presented with some decision one does one's best to calculate the expected utility of the different options, and then implements the option that has the highest expected utility." (Grush, nd)

Grush (nd) writes that the "deontological orientation in ethics had its first major proponent in Immanuel Kant. This approach is broad, but to a large degree can be seen as based on the concepts of duties and rights." Grush states that duties are often thought of as "things granted by external powers. When we speak of human rights, for example, we speak of rights that human beings have not because of some external power, this or that government, granted them this right. In such a case, this power could take that right away. Rather, we mean rights that a human being has simply in virtue of being a human being, not because of any external license was granted to them for the purpose, but simply because they are people. And the duty to respect human rights is not derived from some law that we have to follow, but rather, the deontologist argues, is derived from within, from the nature of reason and morality itself." (nd)

Laws that are "written, adopted and enforced by governments are designed in part, to protect such rights and enforce these kinds of duties. But the deontologist claims that even in these cases, the law is not creating the rights and duties. These were there all along. The law is simply codifying these rights and duties in an enforceable way." (Grush, nd) For Kant the ethical regulation defines the duty of all people and the rights of all people and states, "we all have the duty to treat all people with respect." (nd) Kant holds that these core duties and rights "are duties for all and rights held by all." (Grush, nd) Grush writes that in many cases utilitarian views and deontological principles result in "conflicting answers to ethical questions." (nd) The deontological view "claim that there is a very morally significant difference between causing something, and failing to prevent something" known as the distinction between "acts of commission and acts of omission." (Grush, nd)

Summary and Conclusion

Dr. DoRight, while attempting to meet his ethical obligations in reporting negligent behavior on the part of hospital staff, upon realizing that no actions had been taken to resolve the problem, is once again under ethical obligations to ensure that the problem is addressed. Therefore, Dr. DoRight must necessarily report the situation to higher authorities than he originally reported the problem to so that he can ensure that the problem is effectively addressed and to prevent any further loss of patient life due to the illegal procedures of hospital staff and physicians.