A Codes of Ethics

A codes of ethics is the standards in which individuals and groups of people are supposed to act according to societial norms. The health of members of the public is very important for the development of any society. For the health care institutions to achieve the desired health related goals, they have to ensure that there are ethical practices within the system. The need for ethical practices in health care calls for an organizational code of ethics. While the need for ethical practices has been expressed at different levels of health care, many cases of unethical practices that compromise healthcare have been reported.

An institutional code of ethics is fundamental to quality health care in health institutions. This code, not only sets the table for quality health care, but it also serves as a guideline for patient interactions and service measures.

Standardization is the key in the health care environment, which is why the American Medical Association has ensured there is the code of ethics in the healthcare system. When you talk about the term ethical, it goes well beyond just practices and moral principles and policies, but also serves social implications as well. A code of ethics is all encompassing and covers everyone that works within the health care facility. Any violation of the standards set forth is considered to be unethical conduct and dealt with promptly. In addition to the organizational standards set forth, most medical professionals submit to their own personal code of ethics which usually mirror the organizational standards.
The main requirement of code of ethics is to have the display of ethical conducts in all forms of professional practices. The American Medical Association (2013) provides a standardized code of medical ethics. The association uses the term ethical to refer to the matters that involve moral principles and practices. Also, it refers to the social policy matters that involve issues of morality in the process of practicing medicine. It uses the term unethical to denote the professional conducts that are not conforming to the moral standards and policies. Since there is possibility of varied opinions about morals issues, the association has laid out specific obligations and duties that guide the operations of the physicians and the nurses. Any violation to the laid standards is considered to be unethical conduct that may result in disciplinary actions. According to American Medical Association (2013), the disciplinary actions against unethical conducts include; suspension, censure, or being expelled from membership of the medical society.

The American Medical Association (2013) identifies the relationship between ethics and the law by indicating that legal principles and ethical values are normally closely related. However, it further outlines that in many cases, the ethical obligations exceed the legal duties. There are cases where the law may mandate unethical conduct. Generally, where the physicians have the opinion that a given law is unjust, they have the responsibility of working together to change that law. In an exceptional circumstance of unjust law, it is appropriate if the ethical responsibility supersedes the legal obligation. The American Medical Association (2013) further explains that in a situation where a physician that had been charged with illegal conduct is exonerated in a criminal case may not mean that his/her action was ethical.

The American Nurses Association (2001) is a source of code of ethics to the nurses. The association offers the interpretation of the codes to ensure a clear understanding to its members. In its introduction, the association reports that the need for nursing practices that are consistent with the ethical responsibilities of the nursing practices and quality nursing care necessitated the development of the Code of Ethics for Nurses (American Nurses Association, 2001). The declaration identifies the role of code of ethics in provision of quality nursing care and ethical nursing practices at individual level or within the health organizations. The code of ethics for the nurses has many provisions that are clearly explained to help the nurses understand their mandate in relation to ethical practices. For example, the nurse owes the same individual duties to others (American Nurses Association, 2001). The duties include the responsibility of promoting health and safety, preserving integrity and character, maintaining competency, and continuous professional and personal growth.

Hospitals often operate under particular code of ethics that are made up and derived from organizational goals and outcomes. At the Skyline Medical Center, in Nashville, TN, the code of ethics aims at improving patient outcome by respecting the rights of the patients. These goals are met by ensuring quality patient care and maintaining positive working relationships. I personally worked for this facility and can honestly say that the code of ethics are not just words on paper at this facility. Each morning the nursing directors hold a morning huddle, prior to the meeting the staff recites the mission statement and code of ethics. Additionally, they will nominate an ICARE award winner. The hospital recognizes its ethical responsibility to the law, careful consideration of the patients' values and preferences, and to inform patients of their responsibilities in healthcare process.

Baptist Hospital, in Pensacola, FL, on the other hand has combined compliance with ethics. Its code of ethics seeks to foster the culture of accountability, integrity, and ethical conduct. The code of ethics requires that everyone in the institution to maintain ethical and transparent healthcare practices. Similarly, Jewish General Hospital's code of ethics emphasizes on the need to respect one another, responsibilities towards patients, and privacy and confidentiality (Hornstein, 2012).

According to Vernillo (2008), it is necessary to ensure that there is preventive ethics in the healthcare situations. The author suggests that the environment has an impact on the ethical practices that would be expressed by the health institutions within the environment. For instance, the rural areas have unique characteristics that can influence and shape specific ethical practices within the healthcare settings and affect how health professionals respond to health issues Vernillo (2008). As a result, the physicians and nurses are bound to encounter ethical dilemmas that are common to the fluctuating environmental impact on healthcare ethics. He proposes that preventive ethics is crucial in meeting the arising ethical challenges due to the environmental influence.

The preventive ethics can improve the quality of healthcare by identifying, giving priority, and addressing the ethics issues in healthcare on a systematic level (Vernillo, 2008). More specifically, preventive ethics aims at producing measurable changes in ethical healthcare practices within the system to minimize the gaps in quality of ethics.

While the American Nurses Association provides the code of ethics for the nurses, Fowler (2008) gives an interpretation of the provided code of ethics, as well as, their application. The author confirms that code of ethics is a critical and necessary tool in any profession. The tool serves as the general guide to the members of the profession and a social agreement with the communities that the members of the profession are serving. Fowler explains that at the initial development of the American Nurses Association Code of Ethics, nursing organizations across the world adopted it as the model to be used (Fowler, 2008). She emphasizes on the role of the code of ethics by providing the history of the ANA Code of Ethics from the Florence Nightingale Pledge in 1893 to the current version. Many revisions have been made to the provisions of the code of ethics to reflect the prevailing conditions of healthcare and the entire society. Ethical issues may be interpreted differently hence resulting in different application of ethics in executing nursing practices. This is the situation that made it necessary to provide a standard way of interpreting and applying the code of ethics for the nurses.

The study by McCullough (2005) provides an emphasis on the role of physician leaders in the implementation of ethical practices through preventive measures. The author has identified that there is the need for the management to respond to ethical conflicts rapidly and effectively in the event that an ethical situation has developed. The physician leaders may wait for a possible unethical practice to surface and provide a response. However, if the situation develops over a long period without the knowledge of the physician executives, there can be a tremendous and sometimes irreversible damage to the culture of the health institution. Therefore, it is prudent for the executives to exercise prevention rather than reaction to unethical practices in the healthcare situations (McCullough, 2005). Through prevention, the doctor executives have a leading role in the development of policies and practices in the healthcare to prevent the occurrence of ethical problems. According to McCullough (2005), the doctor executives should address issues that create conflict of interest within their organizations because such conflicts are potential brooding areas of unethical practices. He proposes that conflicts of interest are a great threat to integrity of professionals individually and collectively in organizations.
A literature search was useful for this study because of the many available studies on code of ethics and the impact on the quality of healthcare. The study used literature review to determine the crucial role of institutional code of ethics in helping the health professionals to deliver quality services. Several forms of materials are used in this review such as institutional reports, research study reports, and publications on code of ethics within the context of healthcare the method is less expensive for collecting information, and it yields a lot of data in a given area of concern (O'Leary, 2013).

From the literature reviews, there is a pool of knowledge that applies to the area of institutional code of ethics within the context of healthcare professionals and organizations. The literatures identify crucial elements of ethics as it regards professional practices in healthcare. This section identifies and explains the different findings from the literature reviews and connects them to the role of code of ethics in provision of quality healthcare.

The code of ethics identifies different requirements. There are three requirements that can be identified from the code of ethics; the integrity of the profession and client's interest be above personal interests. Action with integrity, respect, and competence. Maintaining and developing competence. There are many elements of the AMA's code of ethics. Amongst the most important include; the patient having the right to information from the physicians and to discuss the benefits, consequences, and the costs of the alternative treatments. The patient has the right to respect, dignity, courtesy, timely attention, and responsiveness to his/her needs. The right to confidentiality.
Physician leaders play a significant role in the process of improving quality healthcare by ensuring the implementation of recommended health practices. They have the duty of ensuring that conflicts that may compromise the integrity of the health workers and the quality of their services is avoided. The executives create a working environment that promotes team work, consultation and commitment to quality services within their organizations. Bellin & Dubler (2001) confirms that the medical executives play a leading role in ensuring ethical practice and quality service.

Considering the findings of the study, it is clear that the various aspects of the code of ethics target the delivery of quality healthcare services. In the first case, the code of ethics must meet the quality standards that the community expects. Secondly, the professional associations lay out ethical standards that can be used in realizing quality service within the health institutions. On the other hand, the basis of developing the code of ethics laid on the need to improve service delivery to patients and the communities. Furthermore, the physician executives are supposed to ensure that they avoid conflicts in their organizations because the conflicts can compromise the quality of service and integrity of the health workers. This is achieved by promoting ethical practices within the organizations. Therefore, the code of ethics is fundamental to quality healthcare in health institutions.

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