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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Ethical Practice Under Accountable Care.

Abraham D Graber1, Asha Bhandary2, Matthew Rizzo3

  • 1Philosophy & Religious Studies, Western Illinois University, 456 Morgan, Macomb, IL, 61455, USA. agraber@gmail.com.

HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
|May 24, 2015
PubMed
Summary
This summary is machine-generated.

Accountable Care Organizations (ACOs) present new ethical challenges for physicians, impacting patient care decisions. This framework guides providers through conflicts related to autonomy, beneficence, and justice within ACOs.

Keywords:
ACOEthicsPPACAPrinciplism

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Area of Science:

  • Bioethics
  • Health Policy
  • Medical Economics

Background:

  • Accountable Care Organizations (ACOs) are integral to the Patient Protection and Affordable Care Act (PPACA).
  • ACOs reshape provider incentives, necessitating a clear understanding for informed clinical decision-making.
  • Physicians face evolving ethical considerations within these new healthcare models.

Purpose of the Study:

  • To define an ethical framework for physician decision-making and actions within ACOs.
  • To identify and categorize novel ethical pressures encountered by providers in ACOs.
  • To offer recommendations for navigating these emerging ethical dilemmas.

Main Methods:

  • Analysis of ethical conflicts through the lens of bioethical principles: autonomy, beneficence, and justice.
  • Classification of emerging ethical pressures.
  • Development of a guiding framework and actionable recommendations for providers.

Main Results:

  • Identified ethical conflicts under autonomy, beneficence, and justice principles.
  • No novel conflicts with non-maleficence were identified.
  • Specific conflicts include bias against transient populations, undertreatment of conditions without performance measures, and life intrusions for population health.

Conclusions:

  • Physicians must anticipate and address unique ethical challenges within ACOs.
  • The proposed framework and recommendations support ethical navigation for providers.
  • Understanding these ethical dynamics is crucial for well-considered treatment decisions in ACOs.