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All manner of medical practitioners have had their scruples
dissected ad infinitum. In spite of the attention paid to medical
ethics and bioethics, little has been paid to the ethical roles and
responsibilities of those who are ultimately in charge of hospital
governance: hospital trustees. Deriving from a Hastings Center
research project involving meetings with a national task force of
experts and extensive interviews with 98 nonprofit hospital
trustees and CEOs over a two-year period, The Ethics of Hospital
Trustees shows that the decisions made by these often overlooked
members of the health community do raise important ethical issues,
and that ethical dimensions of trustee service should be more
explicitly recognized and discussed.Practical as well as
theoretical, The Ethics of Hospital Trustees uncovers four basic
principles: 1. Fidelity to mission; 2. Service to patients; 3.
Service to the community; and 4. Institutional stewardship. In
delineating the extremely important functions of hospital trustees,
from patient safety to financial responsibility, the contributors
outline not only how hospital trustees do perform -- they give a
fresh understanding to how they should perform as well.
According to a recent Institute of Medicine report, as many as
98,000 Americans die each year as a result of medical error--a
figure higher than deaths from automobile accidents, breast cancer,
or AIDS. That astounding number of fatalities does not include the
number of those serious mistakes that are grievous and damaging but
not fatal. Who can forget the tragic case of 17-year-old Jesica
Santillan, who died after receiving a heart-lung transplant with an
incompatible blood type? What can be done about this? What should
be done? How can patients and their families regain a sense of
trust in the hospitals and clinicians that care for them? Where do
we even begin the discussion? Accountability: Patient Safety and
Policy Reform brings the issue to the table in response to the
demand for patient safety and increased accountability regarding
medical errors. In an interdisciplinary approach, Virginia Sharpe
draws together the insights of patients and families who have
suffered harm, institutional leaders galvanized to reform by tragic
events in their own hospitals, philosophers, historians, and legal
theorists. Many errors can be traced to flaws in complex systems of
health care delivery, not flaws in individual performance. How then
should we structure responsibility for medical mistakes so that
justice for the injured can be achieved alongside the collection of
information that can improve systems and prevent future error?
Bringing together authoritative voices of family members, health
care providers, and scholars--from such disciplines as medical
history, economics, health policy, law, philosophy, and
theology--this book examines how conventional structures of
accountability in law andmedical structure (structures
paradoxically at odds with justice and safety) should be replaced
by more ethically informed federal, state, and institutional
policies. Accountability calls for public policy that creates not
only systems capable of openness concerning safety and error-but
policy that also delivers just compensation and honest and humane
treatment to those patients and families who have suffered from
harmful medical error.
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