Ethical Dilemma Faced by a health care professional by applying ethical principles.

Healthcare professionals face ethical dilemmas regularly in their line of work. These dilemmas often involve balancing the principles of autonomy, beneficence, non-maleficence, and justice to make decisions in the patient’s best interest. Ethical dilemmas can arise from various situations, such as end-of-life care, confidentiality, and allocating scarce resources. The assessment examines a specific ethical dilemma a healthcare professional faces and how to apply ethical principles to analyze the situation and propose a course of action. By doing so, we can explore the complexities of ethical decision-making in healthcare and the importance of applying ethical principles to guide our actions.

Summary of the Facts in the Case Study

The selected case study is Incident 2: Emergency Department Repeat Admissions—A Question of Resource Use. The case study concerns the overuse of emergency department services at County General Hospital (CGH), a 300-bed acute care hospital in the south-central United States. The hospital is a not-for-profit hospital system that no longer receives tax subsidies from the county. The study data showed that a few patients were repeatedly admitted to the ED, accounting for hundreds of visits in the past year. The patients had minor, nonspecific medical problems, and most admissions involved persons known as the “worried well.” Although Medicaid covered most of the costs, CGH was not reimbursed over $200,000 yearly. The repeated admissions to the ED also contributed to crowding, treatment delays, and general dissatisfaction among other patients.

The ethical problem or issue that presents a dilemma is the overuse of emergency department services by a few patients, which consumes hospital resources and affects the hospital’s financial health. The hospital needs to address this issue as it affects the delivery of healthcare services and the quality of care provided to other patients. The dilemma is whether the hospital should continue to treat these patients or limit their access to emergency department services. The hospital’s obligation to provide care to patients who present at the emergency department conflicts with the need to manage resources efficiently and effectively.

The stakeholders involved or affected by the ethical problem or issue include the hospital administration, the staff, the patients who repeatedly use emergency department services, and others who may experience delays or reduced quality of care due to overcrowding. The hospital administration is responsible for managing resources effectively and ensuring financial viability. The staff is responsible for providing care to all patients in the emergency department. Patients who repeatedly use emergency department services have a right to healthcare, but their overuse of services affects the quality of care provided to other patients. Other patients who may experience delays or reduced quality of care due to overcrowding have a right to receive timely and appropriate care.

Analysis of Ethical Issues in the Case Study

The problem in the case study is a few individuals’ overuse of emergency services, resulting in repeat admissions to the Emergency Department (ED) and the consumption of hospital resources. The ED visits cost the hospital a significant amount of money. Even though Medicaid covers most of the costs, a substantial amount remains unpaid, resulting in financial strain for the hospital. Additionally, repeated admissions to the ED cause crowding, treatment delays, and general dissatisfaction among other patients.

Several factors contributed to this problem. Firstly, the individuals repeatedly admitted to the ED were described as worried well, meaning they had minor, nonspecific medical problems. They may not have had access to primary care or were unsure how to manage their medical concerns. Secondly, Medicaid’s reimbursement policy for eligible ED users incentivizes frequent ED use, as it covers most of the costs. Finally, the federal Emergency Medical Treatment and Active Labor Act (EMTALA) mandates that all patients who present at an ED that receives federal reimbursement for services must be treated and stabilized, regardless of their ability to pay.

According to Sharma et al. (2021), Medicaid expansion can lead to increased ED utilization and reduced hospital profitability. The article suggests that policymakers should consider alternative models to reduce unnecessary ED use and encourage primary care access. Moreover, Aboulafia et al. (2021) discuss the concept of frequent flyers, individuals who repeatedly use the ED for non-urgent medical issues. The article suggests that hospitals should identify these patients and implement interventions, such as care coordination or referrals to primary care, to reduce ED utilization and