REPORT

On

Healthcare Industry: Ethical Decision-Making in Patient Care

Submitted to the Galgotias University in partial

fulfillment of the requirements for the award of the Degree of

MASTER OF BUSINESS ADMINISTRATION

Submitted by
MD.ASIF :- 23GSOB2010314
RAFIA SUZAIN :- 23GSOB2010411
MINNAT PERWAIZ :- 23GSOB2010434
ALTAF ALAM :- 23GSOB2010309
PRASHANT KUMAR :- 23GSOB2010368
SECTION:- 4 (Grp:- 5)
SCHOOL OF BUSINESS

Under the Supervision of

Dr. Sikha Goyal
(Assistant Prof.)

1
 DECLARATION

We, hereby certify that work which is being presented in this project titled “HEALTHCARE
INDUSTRY: ETHICAL DECISION-MAKING IN PATIENT CARE” submitted in the
School of Business at Galgotias University is authentic record of our own work carried
under supervision of Dr.Sikha Goyal (Assit.prof.) This work has not been submitted to any
institutions or university for the award of any degree. This report has been checked for
plagiarism by the college and similarity index is within the permissible limit set by the
college.

Signature of the Student

This is to certify that, above mentioned statement made by the candidate is correct, to the best
of my knowledge.

Signature of the supervisor.

SCHOOL OF BUSINESS

GALGOTIAS UNIVERSITY, GREATER NOIDA

2
 ACKNOWLEDGEMENT

We would like to express our profound gratitude to Mr./Mrs.__________________ (name of

the HOD), SCHOOL OF BUSINESS and Mr/Mrs. Dr. Sikha Goyal (Assit. Prof) of
Galgotias university for their contributions to the completion of our project titled
HEALTHCARE INDUSTRY: ETHICAL DECISION-MAKING IN PATIENT CARE

We would like to express our special thanks to our mentor Dr. Sikha Goyal (Assit.prof.) for
her time and efforts she provided throughout the year. Your useful advice and suggestions
were really helpful to us during the project’s completion. In this aspect, we are eternally
grateful to you.

We would like to acknowledge that this project was completed entirely by our team and not
by someone else.

3
 Content

Introduction

Ethics, Morals and Professional Standards

Principles of Ethics

Dealing with ethical dillemas in Healthcare

Ethical issue in Patient care

Ethical decision making in Patient care

Emerging Technologies and ethical implication

Healthcare policies and ethical standards

Case based analysis

Methodology
Healthcare industry profile
Cribs hospital profile

Graphs Representation
Question and Answer
Biblography

4
 INTRODUCTION
A clear responsibility of physicians is to make decisions regarding patient care in different
areas. These decisions involve more than choosing a treatment or intervention.

Ethics is an inherentand important part of medicine

1. because doctors have an ethical responsibility to

(i) help patients,

(ii) avoid or minimize, and

(iii) respect patients' interests and preferences. Can the doctor comply with these ethical
rules? Can their morals improve? Purposeful instructional program

2. Goals of ethics education have been shown to improve students' knowledge, attitudes,
knowledge, morality, and self-confidence.

Goals of ethics education

• To appreciate the ethical dimensions of patient care

• To understand ethical principles of medical profession

• To have competence in core ethical behavioral skills (Obtaining informed consent,

assessing decision-making capacity, discussing resuscitation status and use of life-
sustaining treatments, advanced care planning, breaking bad news and effective
communication)

• To know the commonly encountered ethical issues in general and in one's specialty

• To have competence in analyzing and resolving ethical problems

• To appreciate cultural diversity and its impact on ethics

Ethics, Morals and Professional Standards

Ethics is a broad term that refers to the examination of morality and the ethical choices that
should be made. Ethics attempts to answer the question: “What moral values should we
accept to guide and evaluate behavior and why?” [5]. Some moral values are common to all
people because they lead to moral values that transcend cultures, regions, religions, and other
groups (e.g., do not kill, do not harm others. Do not steal, , don't ring, , .). enjoining evil,
encouraging good, telling the truth, following rules and regulations, raising children, helping
the poor). Specific ethics, roles, goals, social norms, etc. It refers to the norms associated with
a group, including culture, belief and business. An example of ethics is a physician's

5
"recognized responsibility" to provide competent and reliable care to patients. To reduce
confusion about “responsible acceptance,” medical associations (local, state, and national)
have written their own standards. However, it should be understood that complying with
these standards may not always be ethical; because the rules "often arise from the protection
of professional interests rather than from providing broad and impartial moral advice or from
addressing issues important to patients and patients care.

Bioethics and Clinical (Medical) Ethics

In research, medical treatments without consent. Many atrocities against human subjects took
place in the experiments carried out in the camps during World War II, the effectiveness of
the treatment of disease and technology, and social change, and these situations were
pioneered. A shift in bioethics from a focus on current state practices and policies to a shift in
bioethics, with its broad scope including social justice studies, public health policy,
organizational culture, and clinical practice.

I will use the following short phrases when discussing the principles of clinical leadership
and their application in clinical practice.

Basic Principles of Ethics

Benevolence, non-maleficence, autonomy and justice are the four basic principles of ethics.
The origins of the first two can be traced back to Hippocrates' "help others and do no harm"
period, while the other two changed later. Thus, Percival's code of ethics, written in the early
1800s, emphasized the importance of aiming to protect the patient's best interests without
debating freedom and justice. However, over time, both freedom and justice were accepted as
fundamental principles of justice. Today,and Childress's book Principles of Biomedical
Ethics has become a classic with the definition of 4 principles and their application, but also
discusses other method experiments.

Beneficence

The fundamental principle of health care is the duty of doctors to serve their patients and to
protect and protect the rights of others by law, to prevent disasters, to eliminate the conditions
that lead to disasters, and to promote the ethical process of helping people. illness. Disabled

6
people, save the poor. It's worth mentioning that the message here is one of good wishes, as
opposed to doing no harm. This principle should not only prevent injury, but also benefit
patients and improve their health. Although the doctor's philanthropy is moral and selfless, it
can often be viewed as giving back to society for education (often government-funded), rank
and privilege, and the debt owed to the patients themselves (education and research).

Nonmaleficence

Nonmaleficence is one of the fundamental principles in bioethics and medical ethics. It is

often expressed in the Latin phrase "primum non nocere," which means "first, do no harm."
The principle of nonmaleficence emphasizes the ethical obligation of healthcare professionals
to avoid causing harm to their patients. This principle guides medical practitioners to
prioritize the well-being and safety of the patient above all else.

In the context of healthcare, nonmaleficence involves not only refraining from intentionally
harming the patient but also taking proactive steps to prevent and minimize potential harm.
This includes carefully assessing and balancing the risks and benefits of medical
interventions, providing accurate information to patients to enable informed decision-making,
and continually monitoring and reassessing the patient's condition to avoid or address any
potential harm that may arise during the course of treatment.

Nonmaleficence is closely linked with other ethical principles such as beneficence

(promoting the well-being of the patient) and autonomy (respecting the patient's right to make
decisions about their own care). Together, these principles form the foundation of ethical
medical practice and guide healthcare professionals in delivering patient-centered care while
minimizing harm.

Autonomy:-

In ethics, autonomy is a foundational principle that emphasizes the moral agency and
independence of individuals. Autonomy in ethics is often associated with the idea that
individuals have the right to make their own decisions, set their own goals, and determine
their own actions without undue external influence or coercion. This principle is deeply

7
rooted in the ethical philosophy of autonomy and is a key element in many ethical theories,
including deontology and Kantian ethics.

Key aspects of autonomy in ethics include:

1. Respect for Persons: Autonomy is closely tied to the concept of respecting

individuals as moral agents. Respecting autonomy means acknowledging and valuing
individuals as capable of making their own rational decisions, even if those decisions
differ from what others might consider the best choice.

2. Informed Consent: The principle of informed consent is a practical application of

autonomy in various fields, particularly in medical ethics and research. It emphasizes
the importance of providing individuals with sufficient information to make voluntary
and informed choices about their own healthcare or participation in research studies.

3. Self-Determination: Autonomy recognizes the right of individuals to determine their

own course of life and to pursue their own values and goals. This principle is often
contrasted with paternalism, where decisions are made on behalf of individuals for
their supposed well-being.

4. Decisional Capacity: Autonomy assumes that individuals possess the capacity to

make rational decisions. In situations where individuals may lack decisional capacity,
ethical considerations often involve identifying a surrogate decision-maker who can
act in the person's best interests.

5. Cultural Sensitivity: Recognizing autonomy also involves being sensitive to cultural

differences and diverse perspectives on individual decision-making. Different cultures
may place varying emphasis on collective decision-making versus individual
autonomy.

Justice

Justice is a fundamental concept in ethics that concerns the fair and impartial distribution of
benefits, burdens, rights, and responsibilities within a society or a specific context. It involves
treating individuals equitably and ensuring that they receive what is due or owed to them.
Justice is a key principle in various ethical theories and plays a crucial role in guiding moral
decision-making and societal organization. There are several perspectives on justice within
the realm of ethics:

8
 1. Distributive Justice: This aspect of justice focuses on the fair distribution of
resources, opportunities, and goods within a society. It seeks to address questions
about how wealth, income, and other resources should be allocated to ensure a just
and equitable society. Philosophers like John Rawls proposed theories of justice, such
as the difference principle, which suggests that social and economic inequalities are
permissible only if they benefit the least advantaged members of society.
2. Retributive Justice: Retributive justice is concerned with the fair punishment of
wrongdoers. It seeks to ensure that individuals who violate ethical or legal norms
receive punishments that are proportionate to the severity of their offenses. The
concept of "an eye for an eye" is often associated with retributive justice, although
modern legal systems aim to balance punishment with rehabilitation and societal
protection.
3. Restorative Justice: In contrast to retributive justice, restorative justice focuses on
repairing harm caused by wrongdoing and restoring relationships. It involves bringing
together offenders, victims, and the community to address the consequences of the
wrongdoing and work towards reconciliation. The emphasis is on healing and
rehabilitation rather than solely on punishment.
4. Procedural Justice: Procedural justice is concerned with the fairness of the processes
and procedures used to make decisions. Even if the outcomes are not entirely
favorable, procedural justice ensures that the methods employed in reaching those
outcomes are fair, transparent, and impartial. This aspect is crucial in legal and
organizational contexts.
5. Social Justice: Social justice is a broader concept that encompasses the fair
distribution of resources and opportunities, as well as addressing systemic inequalities
and advocating for the rights of marginalized groups. It involves a commitment to
creating a just and inclusive society that respects the dignity and rights of all
individuals.
Striking a balance between ethical decision making and medical decision
making:-
Many ethical considerations come into play in medical decision making. Some of these
include:

 Informed Consent: Ensuring that patients know all the necessary information about
their treatment before making a decision.
 Privacy: Protect patient privacy and personal information.
 Allocation of resources: Decide how to allocate resources such as medicine or
hospital beds.
 Hospice care: Decisions regarding end-of-life care when a patient is terminally ill.

Ethical evaluation along with clinical decision making can be difficult. Physicians must
balance their professional responsibilities to provide quality care with the ethical standards

9
that guide their decisions. Consider these tips to make honest decisions that align with your
professional values and patient needs:

Participate in continuing professional development: This can help you stay informed about
ethical issues and best practices.

 Talk to your colleagues: Discussing ethical issues can build consensus and consensus.
 Using the decision-making process: This can help you evaluate all relevant
information and weigh the pros and cons of each option.
 Consider your own biases: Knowing your own biases can help you make more
objective decisions.
 Effective communication with patients: Effective communication ensures that patients
understand their treatment and participate in decision-making processes.

Improve ethical decision making:

You must develop many skills to make ethical decisions in healthcare. These include:

 Critical thinking to analyze complex situations and identify ethical dilemmas.

 Legal knowledge to understand the laws that govern health care decisions.
 Communication skills to communicate effectively with patients, colleagues and
other stakeholders.
 Emotional Intelligence, to understand and manage your own and other people's
emotions.

How did you develop these skills?

 One way to do this is to examine health management. These courses can give you
the knowledge and skills you need to make informed and ethical decisions.
Healthcare management programs, such as the MBA in Hospital and Healthcare
Management, are designed to help you better understand the ethics involved in
making healthcare decisions.
 Additionally, attending regular professional development, attending conferences,
and receiving training can improve your ethical
judgment.is lost when rewards are removed

Dealing with Ethical Dilemmas in Healthcare:

Ethical dilemmas are common in healthcare decisions. This occurs when values conflict or
there is no solution consistent with any ethical principles. Some of the ethical issues
encountered in health care decision making include:

10
  Hospice care: Deciding whether to continue life-sustaining care when a patient is
terminally ill and will recover.
 Allocation of resources: Decide how to allocate resources such as medicine or
hospital beds.
 Privacy: Balancing the patient's right to privacy with the need to share information
with other providers.
To solve the ethics problem, consider the following tips:

 Define ethical principles: This can help determine relevant consequences.

 Gather all relevant information: Make sure you have all the facts before making a
decision.
 Consider all options: Weigh the pros and cons of each option before making a
decision.
 Talk to your colleagues: Discussing ethical issues can lead to positive outcomes and
insights.
 Seek guidance from ethics committees: These committees can provide guidance on
ethical issues.
 Different views on ethics may not be compatible. This being the case, it is
important to solve these problems with understanding and understanding. It is
important to listen to other perspectives, find common ground, and work together to
find solutions that respect all ethical standards.

Ethical issues in patient care

Ethical issues in healthcare are complex and arise from the need to balance the well-being of
patients with other considerations, such as the allocation of resources, respecting autonomy,
and addressing societal values. Here are some common ethical issues in healthcare:
1. Informed Consent: Ensuring that patients are fully informed about their medical
condition, proposed treatments, potential risks, and alternatives is a cornerstone of
medical ethics. Obtaining valid and voluntary informed consent can be challenging,
especially when patients may not fully understand the information or when decision-
making capacity is compromised.
2. End-of-Life Care: Decisions surrounding end-of-life care, such as the withdrawal or
withholding of life-sustaining treatment, advance care planning, and decisions about
when to transition from curative to palliative care, can be ethically complex.
Balancing the patient's wishes, family preferences, and the medical team's obligations
can be challenging.
3. Resource Allocation: The allocation of limited healthcare resources, including
organs for transplantation, expensive treatments, and medical personnel, raises ethical
concerns. Decisions about who receives certain treatments or interventions may
involve considerations of distributive justice, fairness, and the overall benefit to
society.
4. Healthcare Disparities: Disparities in healthcare access and outcomes based on
factors such as race, ethnicity, socioeconomic status, and geographic location are

11
 ethical concerns. Addressing these disparities requires a commitment to justice,
equality, and the elimination of barriers to healthcare.
5. Confidentiality and Privacy: Safeguarding patient confidentiality and privacy is
crucial in healthcare. The use of electronic health records, data sharing, and
information exchange between healthcare providers introduces new challenges in
maintaining patient privacy while ensuring effective and coordinated care.
6. Genetic Testing and Screening: Advances in genetics and genomics raise ethical
issues related to the use of genetic information. Questions about privacy, the potential
for discrimination, and the ethical implications of genetic testing for various purposes,
including pre-implantation genetic diagnosis and gene editing, must be addressed.
7. Access to Healthcare: Ensuring equitable access to healthcare is an ongoing ethical
challenge. Issues such as affordability, availability, and cultural competence in
healthcare services can impact the ability of individuals and communities to receive
appropriate care.
8. Professional Integrity: Healthcare professionals may face ethical dilemmas related
to conflicts of interest, honesty with patients, and maintaining professional
boundaries. Balancing the interests of patients with external pressures, such as
financial considerations, can be ethically challenging.
9. Emerging Technologies: The rapid development of medical technologies, including
artificial intelligence, telemedicine, and robotic surgery, introduces ethical
considerations related to safety, accountability, and the responsible integration of
these technologies into healthcare practice

Ethical decision-making in patient care

Ethical decision-making in patient care is a critical aspect of healthcare practice, involving
healthcare professionals, patients, and sometimes their families. The following steps can
provide a framework for ethical decision-making in patient care:

1. Recognize the Ethical Issue:

 Identify the specific ethical dilemma or issue at hand. This might involve
conflicting values, principles, or interests.

2. Gather Relevant Information:

 Collect all relevant information related to the patient's medical condition,

preferences, and values. Consider the medical facts, prognosis, and potential
treatment options.

3. Identify Stakeholders:

 Recognize all stakeholders involved, including the patient, family members,

healthcare providers, and other relevant parties. Each stakeholder may have
different perspectives and concerns.

12
 4. Understand Legal and Institutional Guidelines:

 Be aware of legal and institutional policies that may influence the decision-
making process. This includes understanding the scope of informed consent
and any legal restrictions on certain treatments.

5. Consider Ethical Principles:

 Apply ethical principles such as autonomy, beneficence, non-maleficence, and

justice to the specific situation. Consider how these principles might conflict
or complement each other.

6. Engage in Shared Decision-Making:

 Involve the patient (and family, if appropriate) in the decision-making process.

Encourage open communication, discuss treatment options, and address the
patient's values and preferences.

7. Explore Alternatives:

 Identify and evaluate alternative courses of action. Consider the potential

benefits, risks, and outcomes associated with each option.

8. Make a Decision:

 Based on the information gathered, ethical principles considered, and input

from relevant stakeholders, make a decision that is ethically sound and aligned
with the patient's best interests.

9. Implement the Decision:

 Put the chosen course of action into practice. Communicate the decision to the
patient and involved parties, ensuring that everyone understands the plan and
its rationale.

10. Document the Decision:

 Clearly document the ethical decision-making process in the patient's medical

records. This documentation is essential for maintaining transparency,
accountability, and continuity of care.

Emerging Technologies and Ethical Implications

Emerging technologies in healthcare bring about significant advancements, but they also raise
various ethical considerations. Here are some examples of emerging technologies and their
associated ethical implications:

1. Artificial Intelligence (AI) and Machine Learning:

13
  Ethical Implication: Bias and fairness concerns may arise when AI
algorithms are trained on biased datasets, leading to disparities in diagnosis
and treatment. There are also concerns about the lack of transparency in some
AI decision-making processes.
2. Telemedicine:

 Ethical Implication: Ensuring patient privacy and data security in

telemedicine encounters is crucial. Healthcare providers must establish secure
communication channels and protect patient information from unauthorized
access.
3. Genomic Medicine and Genetic Testing:
 Ethical Implication: Issues related to privacy, consent, and the potential for
genetic discrimination can emerge. The responsible use and protection of
genetic information are essential to prevent unintended consequences.
4. Robotics in Surgery:

 Ethical Implication: Balancing the benefits of robotic-assisted surgery with

concerns about patient safety and the potential for dehumanization of the
patient-doctor relationship. Surgeons must maintain responsibility for
decisions made during robotic procedures.
5. Blockchain Technology:

 Ethical Implication: While blockchain can enhance security and transparency

in healthcare transactions, issues related to data ownership, consent, and the
right to be forgotten need careful consideration to protect patient privacy.
6. Virtual Reality (VR) and Augmented Reality (AR):

 Ethical Implication: Ensuring informed consent and minimizing

psychological harm in therapeutic applications of VR and AR are important.
There may be concerns about the blurring of virtual and real-world
boundaries.
7. Implantable Technologies:

 Ethical Implication: Concerns about consent, privacy, and potential misuse

of implantable devices, such as brain-computer interfaces or RFID implants,
need to be addressed. Ensuring that individuals have control over their own
bodies and data is crucial.
8. Health Monitoring Wearables:

 Ethical Implication: Issues related to data ownership, security, and the

potential for discrimination based on health data may arise. There's a need for
clear policies regarding the use and sharing of health-related data collected by
wearables.
9. 3D Printing in Medicine:

14
Ethical Implication: Balancing the potential benefits of personalized medical devices with
concerns about safety, quality control, and the potential for unauthorized production of
medical equipment

Healthcare Policies and Ethical Standards

Healthcare policies and ethical standards play a crucial role in shaping the delivery of healthcare
services, protecting patient rights, and guiding the behavior of healthcare professionals. These policies
and standards are established to ensure quality care, patient safety, and ethical conduct. Here are key
aspects of healthcare policies and ethical standards:
1. Patient Rights:
 Policies: Healthcare organizations often have policies outlining patients' rights,
including the right to privacy, informed consent, confidentiality, and the right to be
treated with dignity and respect.
 Ethical Standards: Respecting patient autonomy, promoting shared decision-
making, and obtaining informed consent are ethical principles that underpin patient
rights.
2. Confidentiality and Privacy:
 Policies: Healthcare institutions have policies in place to protect patient
confidentiality and privacy. This includes safeguarding electronic health records and
ensuring secure communication channels.
 Ethical Standards: Respecting patient confidentiality is a fundamental ethical
principle. Healthcare professionals are obligated to maintain the privacy of patient
information.
3. Informed Consent:
 Policies: Informed consent policies outline the process for obtaining patient consent
before medical procedures, treatments, or participation in research.
 Ethical Standards: Informed consent is an ethical requirement to ensure that patients
have adequate information to make decisions about their care and participation in
medical activities.
4. Quality of Care:
 Policies: Healthcare organizations establish policies related to quality assurance,
continuous improvement, and adherence to evidence-based practices to ensure the
delivery of high-quality care.
 Ethical Standards: Providing competent and effective care is an ethical obligation of
healthcare professionals. They are expected to stay current with best practices and
strive for excellence in patient care.
5. Conflict of Interest:
 Policies: Policies address conflicts of interest among healthcare professionals,
administrators, and other staff to ensure that decisions are made in the best interest of
patients rather than personal gain.
 Ethical Standards: Healthcare professionals are ethically obligated to prioritize
patient welfare over personal or financial interests and disclose any potential conflicts
of interest.

15
6. End-of-life Care and Advanced Directives:
 Policies: Healthcare facilities often have policies regarding end-of-life care, including
the implementation of advance care planning and respecting patients' wishes
expressed in advance directives.
 Ethical Standards: Respecting patients' autonomy in end-of-life decisions and
honoring their expressed preferences aligns with ethical principles.
7. Cultural Competence:
 Policies: Healthcare organizations may implement policies to promote cultural
competence among staff, recognizing and respecting diverse cultural backgrounds of
patients.
 Ethical Standards: Cultural competence is aligned with ethical principles of respect
for patient autonomy and non-discrimination. Healthcare professionals should
provide care that is sensitive to patients' cultural values and beliefs.
8. Resource Allocation:
 Policies: Policies related to fair and equitable distribution of healthcare resources,
such as organ transplants or critical care during emergencies, help guide decision-
making.
 Ethical Standards: Ethical principles of justice and fairness guide decisions about
resource allocation. Healthcare professionals should strive for equitable distribution
of resources and advocate for policies that address disparities.
9. Research Ethics:
 Policies: Institutional review boards (IRBs) oversee and enforce policies related to
the ethical conduct of research involving human subjects.
 Ethical Standards: Ethical research practices include obtaining informed consent,
minimizing risks to participants, and ensuring the scientific validity and integrity of
the research.
10. Health Equity:
 Policies: Policies that address health disparities and promote health equity aim to
ensure that all individuals have access to quality healthcare regardless of their socio-
economic status, race, or other factors.
 Ethical Standards: Advocating for health equity is rooted in ethical principles of
justice and the obligation to reduce disparities and promote equal access to healthcare
services.

16
 Application of principles of ethics in patient care
Table 1

Case-Based Analysis
Case 1
A 20-year old college student living in the college hostel is brought by a friend to the
Emergency Department (ED) because of unrelenting headache and fever. He appeared
drowsy but was responsive and had fever (40°C), and neck rigidity on examination. Lumbar
puncture was done, and spinal fluid appeared cloudy and showed increased white cells; Gram
stain showed Gram-positive diplococci. Based on the diagnosis of bacterial meningitis,
appropriate antibiotics were begun, and hospitalization was instituted. Although initial
consent for diagnosis was implicit, and consent for lumbar puncture was explicit, at this
point, the patient refuses treatment without giving any reason, and insists to return to his
hostel. Even after explanation by the physician as to the seriousness of his diagnosis, and the
absolute need for prompt treatment (i.e., danger to life without treatment), the patient is
adamant in his refusal.

17
Solution:- Because of this refusal, the medical indications and patient preferences (see
Table 1) are at odds. Is it ethically right to treat against his will a patient who is making a
choice that has dire consequences (disability, death) who gives no reason for this
decision, and in whom a clear determination of mental incapacity cannot be made
(although altered mental status may be presumed)? Here the principle of beneficence and
principle of autonomy are in conflict. The weighing of factors: (1) patient may not be
making a reasoned decision in his best interest because of temporary mental incapacity;
and (2) the severity of life-threatening illness and the urgency to treat to save his life
supports the decision in favor of beneficence (i.e., to treat).

Case 2
A 56-year old male lawyer and current cigarette smoker with a pack-a-day habit for more
than 30 years, is found to have a solitary right upper lobe pulmonary mass 5 cm in size on
a chest radiograph done as part of an insurance application. The mass has no calcification,
and there are no other pulmonary abnormalities. He has no symptoms, and his
examination is normal. Tuberculosis skin test is negative, and he has no history of travel
to an endemic area of fungal infection. As lung cancer is the most probable and
significant diagnosis to consider, and early surgical resection provides the best prospects
for cure, the physician, in consultation with the thoracic surgeon, recommends
bronchoscopic biopsy and subsequent resection. The patient understands the treatment
plan, and the significance of not delaying the treatment. However, he refuses, and states
that he does not think he has cancer; and is fearful that the surgery would kill him. Even
after further explanations on the low mortality of surgery and the importance of removing
the mass before it spreads, he continues to refuse treatment.

Solution:- This case presents a challenging situation where the patient, despite being at
high risk for lung cancer and having a potentially curable mass, refuses recommended
treatment. Respecting patient autonomy is a fundamental ethical principle in healthcare.
However, healthcare professionals also have a duty to ensure patient well-being and
address potentially life-threatening conditions. Here are some steps that can be considered
in managing this case:

1. Establish Rapport and Understanding:

 Spend time discussing the patient's concerns, fears, and reasons for refusing
treatment. A patient-centered approach involves understanding the individual's
perspective, values, and priorities.

2. Educate and Provide Information:

 Offer detailed information about the risks and benefits of the recommended
treatment. Address misconceptions and provide evidence-based data on the
benefits of early surgical intervention in lung cancer.

18
3. Involve a Multidisciplinary Team:

 Consult with a multidisciplinary team, including a thoracic surgeon,

oncologist, and a medical ethicist if available. This team can provide a
comprehensive assessment and offer different perspectives.

4. Explore Alternative Approaches:

 Discuss alternative diagnostic and treatment options that might be more

acceptable to the patient. For instance, minimally invasive procedures or
biopsy techniques with lower perceived risk.

5. Emphasize the Importance of Early Intervention:

 Clearly communicate the potential consequences of delaying treatment,

including the increased risk of the mass spreading and becoming less curable.

6. Involve Family or Support System:

 If appropriate and with the patient's consent, involve family members or a

support system in discussions. They may provide additional insights and
support the patient in understanding the importance of timely intervention.

7. Address Fear and Anxiety:

 Acknowledge the patient's fears and anxiety about surgery. Discuss the
advancements in surgical techniques, anesthesia, and postoperative care that
contribute to lower mortality rates.

8. Explore Decision-Making Capacity:

 Assess the patient's decision-making capacity. If there are concerns about the
patient's ability to make informed decisions, a comprehensive evaluation may
be necessary.

9. Offer Psychological Support:

 Provide access to counseling or support groups that can help the patient cope
with anxiety and fear associated with the diagnosis and treatment.

Although the treatments recommended by doctors are the removal of the mass, which
may lead to cancer, is the best treatment, delaying its removal risks the mass
metastasizing and reaching an incurable stage - this is the choice of the well-known man
who can afford the patients. dignity Here autonomy trumps courtesy. But doctors are not
allowed to abandon their patients and are required to visit doctors regularly and advise
against decisions made through fear, examination, constant testing and encouragement to
seek a second opinion.

19
 METHODOLOGY
To conduct the study " Healthcare Industry: Ethical Decision-Making in Patient Care" at
CRIBS HOSPITAL, descriptive method was applied and data was collected from primary
and secondary sources.

Primary Data:
 Data collected directly from respondents is called primary data. Primary data was
collected from employees using a repeated survey.
 There were a total of 50 interviewees, 35 of whom were male workers and 15 of
whom were female workers.

Secondary data

 Service information is existing information, which can be called prior information.

Secondary data comes from publications, journals, search engines and books. Use
statistical tools and applications to analyze and analyze collected data.

Data collection tools:

 We collected primary data through interviews and observations.
 The sample size is 50 participants, 35 of them are male and the remaining 15 are
female.
 They come from different age groups and different departments. Because each
department has a team to complete the activities of the department.
 The tools used to collect important data are surveys and personal interviews with
subordinates and superiors.The main tools were questionnaires.

Plan of analysis:
i. The sample survey given to participants was designed to obtain the most important inf
ormation about the target.

ii. All responses have been reviewed.

iii. Data on different characteristics of the study were also tabulated.
iv. Uses statistical techniques to analyze data.
v. Graphs are presented where necessary to understand the employee distribution.

20
 HEALTHCARE INDUSTRY PROFILE
The healthcare industry is a vast and complex sector that encompasses a wide range of
organizations and professionals dedicated to maintaining or improving the health of
individuals and communities. It includes various sub-sectors such as pharmaceuticals,
biotechnology, medical devices, hospitals, clinics, health insurance, and healthcare
services.

Key components of the healthcare industry:

1. Providers:

 Hospitals and Clinics: These facilities provide medical care and treatment to
patients. They can vary in size and specialize in different medical fields.

 Physicians and Allied Health Professionals: Doctors, nurses, therapists, and

other healthcare professionals who directly deliver patient care.

2. Payers:

 Health Insurance Companies: These organizations provide coverage for

medical expenses, helping individuals manage the financial aspects of
healthcare.

3. Pharmaceuticals and Biotechnology:

 Pharmaceutical Companies: Involved in the research, development,

manufacturing, and marketing of drugs and medications.

 Biotechnology Companies: Focus on using biological systems, organisms, or

derivatives to develop new medical technologies and treatments.

4. Medical Devices and Equipment:

 Medical Device Manufacturers: Produce a wide range of equipment, from

diagnostic machines to surgical instruments, that aid in patient care and
treatment.

21
 CRIBIS HOSPITAL PROFILE
Cribs Hospital is a pioneer in medical industry offers the most personalized healthcare to our
patients from different sphere of life. We do offer a wide spectrum of medical services under
one roof. Our service range includes 24×7 emergency care, world-class Cath-labs, radiology,
pharmacy, ambulance facility, well equipped diagnostic and many more. We perform all of
our medical investigations using advanced equipment and the latest technologies. Our
thorough tests and strict quality c heck ensure more reliable test outcomes.

The medical facilities that make us stand out:

 24×7 Emergency

 World Class Cath-Lab

 Pharmacy

 Fully Computerized Lab

 Radiology

 Ambulance

 TMT

 ECHO

 Holter Monitoring

 ICU

 PICU

 NICU and many more

Along with these services, our dedicated staff provides round-the-clock medical coverage. As
a result of compassionate efforts and hard work, we become one of the leading healthcare
facility provider of the Society. Our qualified and experienced staff make the patient feel at
home thus making CRIBS a name to identify with.

Graph No: 1 shows that the ages of the respondents.

22
 35%
32% 38%
40%
30%
26%
35% 24%
25%
30% 18%
20% 24%
25%
15% 20% 18%
20%
10%
15%

5%
10%

0%
5%
20-30 31-40 41-50 51 and above
0-8 15-Sep 16-24 25 and above

Analysis: From the above graph it shows that 18% are between 20 and 30 of age, 24% are
between 31 and 40, 32% are between 41 and 50 and the rest of 26% are 51 and above of age.

Graph No: 2 show that the experience of respondents of the company.

23
Analysis: From the above graph it shows that 20% are have between 0 and 8 years of
experience , 18% are between 9 and 15, 24% are between 16 and 24 and the rest of 38% are
between 25 and above

Yesbelieve No, 4%
90% that ethical
Graph No: 3 To what extent do you decision-making is prioritized in
patient care within the healthcare industry?. Can't Say, 6%

Analysis: The above graph shows that 90% of the respondents say that they have a team and
the rest 10% could not tell whether they have a team or not.

Graph No: 4 In your experience, transparency is the communication about ethical

decision-making processes within your healthcare organization?

24
 Can't Say, 4%

No, 6%

Yes 90%

Analysis: The above table shows that 90% of the respondents prefer to work under a team,
6% do not prefers and the rest of 4% could not say anything about it.

Graph No: 5 In your opinion, should healthcare organizations establish clear policies
and guidelines to support ethical decision-making in patient care?.

Can't Say, 10%

No, 6%

25
Yes,84%
Analysis: It is interesting to know that 70% of respondents agree

that the team work help in personal growth, 20% disagree and the

rest of 10% could not say anything about it.

26
 QUESTION AND ANSWER
1. What are the factors which help in making the team effective?
Ans. Effective communication, collaboration, and empathy are crucial for healthcare
teams. Clear communication ensures accurate information exchange, reducing errors.
Collaboration fosters a supportive environment where diverse skills contribute to
comprehensive patient care. Empathy enhances teamwork, promoting understanding and
unity among healthcare professionals. Regular team meetings, open dialogue, and mutual
respect are vital for addressing challenges and fostering a positive work culture.
Prioritizing these aspects enhances overall team effectiveness, leading to improved patient
outcomes and a healthier work environment for healthcare employees.

2. What are the factors which hinder the team’s effectiveness?

Ans. Healthcare teams may face hindrances like communication gaps, insufficient
training, and varying work styles. Limited resources, high workload, and time constraints
impact collaboration. Hierarchical structures can hinder open communication, affecting
information flow and decision-making. Staff turnover and burnout compromise team
cohesion, leading to reduced effectiveness. Additionally, external factors like changing
healthcare policies and technology can pose challenges. Overcoming these obstacles
requires fostering a supportive culture, promoting open communication, and investing in
ongoing training to enhance teamwork and ultimately improve patient care.

3. How have they dealt with social loafing?

Ans. Health care organizations combat social loafing by fostering teamwork, emphasizing
individual accountability, and promoting a culture of shared responsibility. Team-building
activities, regular communication, and clear role definitions help mitigate this issue.
Establishing a sense of purpose and recognizing individual contributions also contribute to
a more engaged and collaborative healthcare workforce. Additionally, performance
evaluations and feedback mechanisms address any instances of social loafing, ensuring a
high standard of care and accountability among employees.

4. How have they dealt with groupthink?

Ans. Healthcare organizations combat groupthink by fostering open communication,
encouraging diverse viewpoints, and implementing regular team assessments. Employee
training emphasizes critical thinking and independent decision-making to prevent
conformity. Multidisciplinary teams enhance collaboration, reducing the risk of
groupthink. Leadership promotes a culture of constructive dissent, ensuring all
perspectives are valued. Continuous quality improvement processes further mitigate
groupthink, emphasizing evidence-based practices. Regular debriefings and reflective
practices encourage self-awareness, fostering a resilient and adaptable healthcare
workforce that prioritizes patient safety over conformity.

5. w have they dealt with groupshift?

Ans. Healthcare organizations combat groupthink by fostering a culture that values diverse
opinions and encourages open communication. Regular team discussions, feedback
mechanisms, and anonymous suggestion channels are implemented to ensure all

27
employees feel heard. Training programs on critical thinking and decision-making help
staff recognize and challenge groupthink tendencies. Leadership actively promotes a
supportive environment where individuals feel empowered to voice concerns without fear
of retribution. By prioritizing a culture of inclusivity and intellectual diversity, healthcare
providers enhance decision-making processes and ultimately improve patient care.

28
 BIBLOGRAPHY
Data Collection and Analysis:
Primary data-Interview/interaction with HR & lower level
management in Cribs Hospital and Employee.
Secondary data- Google website, companies official Page,Research
Paper etc.

https://cribshospital.com/shaheen-bagh/
https://www.scribd.com/document/209941850/

//efaidnbmnnnibpcajpcglclefindmkaj/4ee8839e-bcdb-429e-aabf-
232a8725db28
efaidnbmnnnibpcajpcglclefindmkaj/cf00bf3a-ff3c-4040-87b2-
de5c727e910d
file:///F:/MBBA/New%20folder/OB%20reportDownloded.pdf
https://karger.com/mpp/article/30/1/17/204816/Principles-of-Clinical-
Ethics-and-Their
https://publichealth.tulane.edu/blog/ethics-in-healthcare/

29