When a patient lacks adequate health insurance, their financial circumstance becomes tightly entangled with medical contemplations in the clinical and operational decision making process. Is it ethical to deny those in need of healthcare to care merely based on their ability to afford healthcare? Is it ethical for hospitals and providers to bend billing and reimbursement rules and lower standards in order to provide free care to the indigent population? While at face value, it may seem that the hospital has a “clear-cut” ethical responsibility to offer free, or reduced-cost care for medically necessary procedures, this ethical issue brings about much debate. Hospitals responses to this ethical dilemma impacts the quality of care, continuity, safety net providers, and liability risk of committing billing violations or offering nonstandard care. In order to properly address the ethical issue of providing free care, one must understand organizational social responsibility, which is the hospitals and providers obligation to the public, societal well-being and environment.
There is an ethical obligation for hospitals and healthcare providers to provide free care to those in need. The hospital, as an organization devoted to the health of the local community, has an ethical obligation to help despite one’s financial circumstances (Welter, 2009). Organized medicine recognizes healthcare providers having an ethical obligation to treat the medically underserved. The first Code of Ethics of the American Medical Association in 1847 stated that "to individuals in indigent circumstances, professional services should be cheerfully and freely accorded." In 1993, the American Medical Association Council on Ethical and Jud...
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...d stay dedicated to the organization’s social responsibility (Welter, 2009).
American Academy of Orthopaedic Surgeons. (2002, May). Care and Treatment of the Medically Underserved. Retrieved from Opinions on Ethics and Professionalism: http://www6.aaos.org/news/PDFopen/PDFopen.cfm?page_url=http://www.aaos.org/about/papers/ethics/1210eth.asp
Farrand, E. (2010). Providing Chronic Care for the Uninsured: The Role of Free Hospital and providers. Retrieved from University of Virginia: http://www.virginia.edu/humanbiology/new_site_files/class_2004_papers_pdf/Erica%205%20page.pdf
Welner, D. S. (2001). I Can 't Afford That. Journal of General Internal Medicine, 412-418.
Welter, N. (2009, July). A Hospital 's Ethical Obligation to the Uninsured. Retrieved from Santa Clara University: http://www.scu.edu/ethics/practicing/focusareas/medical/hospitals-uninsured.html
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