Corporate Governance and Ethical Responsibility

CORPORATE GOVERNANCE AND ETHICAL RESPONSIBILITY

1. Determine at least three (3) different internal and external stakeholders that Dr. Do Right might have to deal with on a daily basis at the hospital. Discuss the duty of loyalty owed to each internal and external stakeholder.

Hospital stakeholders are the people, businesses or organizations who benefit from the good governance and quality services of a hospital. Stakeholders are patients, employees, physicians, businesses and other healthcare providers, all of which have an interest in the hospital's success. Stakeholders such as medical staffs, patients, nurses, management people, and health specialists are usually categorized as internal stakeholders; individuals or groups who have relationship with the hospital such as some vendors, related businesses, laboratory regulators, and referring physicians can be examples of external stakeholders. All stakeholders, both internal and external, have more or less expectations from the hospital executives. A well planned and maintained ethics program and performance goals help business executives to develop standards, procedures to fulfil these expectations (Subramanian& Kamalesh, 1998).

There are some duties which are called "fiduciary duties" for executive level administrators. A fiduciary responsibility means that one acts to the best of one's ability in the interest of another, not in self-interest. Fiduciary obligations are classified in three primary legal duties (1) the duty of loyalty, (2) the duty of care, and (3) the duty of obedience. (bet)

Each member of the board of directors of an organization is a fiduciary who owes these duties of loyalty, care and obedience in the organization. The duty of loyalty requires a director to act solely in the best interests of the organization rather than in his or her own personal, financial or professional interests. He or she also cannot favor the interest of any other corporation or associates (itadocs.gov).

In this case, there are some illegal procedures, negligent supervision, oversight incidents were going on in the hospital. Even if he was delegating and giving responsibility and supervising duties to some staff on a daily basis; the unwanted situations, omissions and deceases were continuing. Dr DoRight expounded these facts to the Executive Committee and Regional Director Compliance Manager; assigned them to investigate, find the blame-worthies and report the evidence to start an action. After two years everything remains the same and deceases, due to the negligence and oscitation were still exist. Dr DoRight was trying to be hero by himself and striving to solve the problems with a meddlesome approach. Even if the hospital was being convulsed because of the illegal procedures, deceases, derelictions, he was meeting the goals and winning awards. On the top of it, in 2011, he was named of "Medical Business Executive of the Year". As being a top executive of the hospital, he has obligations to everyone from every individual patient (internal stake holder) to community organizations and corporations (external stakeholder) which make business with the hospital. Because of his position, due to the duty of loyalty, he should put the stake holders' interests onto the top of his priorities list.

2. Compare and contrast potential conflicts of interest that may exist between duties of loyalty owed to an internal stakeholder vs. an external stakeholder.

Conflicts of interest occur when the encumbrances of individuals (or organizations) are appeased by other, external obligations. The flaw of fiduciary duty creates conflict of interest situations. If physicians, nurses and/or medical organizations compromise their responsibilities towards the patients, by pursuing private financial gain for instance, it is called "conflicts of interest". In medicine, there is no room for any kind of compromises. They cannot threaten health and well-being of the patients. Nevertheless as external stakeholders, the pharmaceutical industry and medical device manufacturers are vital entities which collaborate with the health care providers to diagnose and cure the patients. Their primary targets of these entities are maximizing returns to their shareholders. In contrast, the medical professional's primary target is- regardless of financial considerations-, taking a good care of his/her patient and putting patients' interests to the first place. Intrinsically there is a conflict of interest in industry-medicine relationships. Relationships and cooperation must be regulated attentively in case of protecting patients' well-being, promoting scientific integrity and ensuring the public trust (Imapny.org).

3. Determine whether Dr. DoRight has fulfilled his ethical duty by reporting the illegal procedures. Recommend additional steps Dr. DoRight should have taken to prevent further harm to current and future patients and reduce liability for his employer

Dr. DoRight has not fulfilled his ethical duty by reporting the illegal procedures. Two years after his reporting, things were still same. He was already late for whistle blowing. He should take the necessary action; force the circumstances for serious investigation to stop the illegal procedures, and deceases. After the legal procedures, all the preventive measures should be put in place to stop reiteration of those terrible conditions. He should reorganize and restructure the hospital with discipline, designate standards, strict rules and regulations, hire professionals for critical points. He should take into consideration every individual patient's rights and preferences, recognize their responsibilities under the law and ethical codes as a healthcare provider, and conduct the business and all operational relationships with internal and external stakeholders in an ethical manner.

4. Describe the deontology principle and apply it to the ethical dilemma that Dr. DoRight faces in this case.

Deontology is a Greek based compound - Deon-, which means duty, and -Logos-, which means science. Deontology is the "science of duty." In another definition: The ethical study of duties, obligations, and rights. Deontological moral systems are conceptualized by adherence to independent moral rules or duties.

For the correct moral choices, an individual have to be aware of what moral duties are correct and where his /her moral duty understanding stands on this scale. He or she also has to know how to regulate the correct rules to follow those duties. The simple "expression logic" below which is