Monday, March 31, 2014

Patient Safety: Scandal (2014)

Patient Safety logo

Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical errors that often leads to adverse healthcare events. Patient Safety recently got in trouble when Dr. Charles R. Denham allegedly took $12 million in kickbacks from CareFusion Corp. to influence a national guideline for product hospitals to prevent infections during surgery. Denham and his family live in a waterfront home in Laguna Beach, California, which is estimated to cost around $10.5 million. the governments allegations involve CareFusion, a publicly held company with products in the patient safety and quality improvement area. Denham signed two contracts with CareFusion, that paid Denham $11.5 million over three years to research and develop specialized software, this is not in dispute.
However, the government says the payment was inflated so Denham would influence a standard that affected sales of CareFusion's ChloraPrep antiseptic skin wipes. At the same time, Denham served as co-chair of the safe practices committee of the Washington-based National Quality Forum (NFQ), a national standards group. ChloraPrep was cited as a recommended product in 2010 after what some of Denham's NFQ's colleagues perceived as inappropriate involvement in the process. Denham said the allegations were "blatantly false", saying that the contracts were signed before a positive study of ChloraPrep was published. Denham has not been charged with any crime.
Texas Medical Institute of Technology (TMIT) was Denham's pride and joy of his numerous profit and non-profit companies. As chairman, TMIT produced documentaries and co-founded the Global Patient Safety Forum in Switzerland. CareFusion sponsored one of those documentaries, however, blogger and former hospital executive Paul Levy questioned the documentary. Levy questioned about product placement favoring CareFusion. Since, TMIT is a non-profit company none of its directors received compensation. However, the tax return states that the company paid out salaries and
wages of less than $104,000  in 2012 and non-profit management fees of about $28,000. 
At the fall meeting of the Clinton Global Health Initiative, Denham provides a two-minute video that states he is leading a partnership that includes Google, Sesame Street, the World Health Organization, the Cleveland Clinic and the Conrad Foundation. One portion of the video says, "a million kids competing with new innovations that can save lives." Denham also says there are pilot programs underway in the United States and Gabon in Africa to teach coordination skills to the underpriveleged. However, a Google search of partner websites and a general description of the programs turned up no hits. 
Many people, however, who worked with Denham, had absolutely no idea where his money came from. Many of Denham's videos raised questions of, "Is this guy for real?" People who still work with Denham because he appeared to be a good guy, good to his word, and produced results. People could not think of any reasons why to not work with him. 

In all four major ethical theories, including Individualism (Friedman's Economic Theory), Utilitarianism, Kantianism, and the Virtue Theory, the kickbacks that Charles Denham received were unethical based on the following information.

Dr. Charles D. Denham, allegedly took
$12 million in kickbacks from CareFusion Co.
According to Individualism (Friedman's Economic Theory), Friedman says, "The only goal of business is profit, so the only obligation that the business person has is to maximize profit for the owner or the stockholders." With this being said, it was unethical for Denham to receive the kickbacks because he was not maximizing profit for the company or the stockholders. Denham was only maximizing profit for himself and did not care about anybody else. I think that Denham did this because he was consumed with making money and was selfish. Denham was not worry about anybody in this situation and only cared for himself.

UtilitarianismAccording to Utilitarianism, states that all actions are aimed at something good. In this situation, however, nothing good came out of it. It seems like the only person that received happiness from this was Denham himself. Many people were hurt because they thought all of these products were safe. It actually turned out that none of these products were safe and were actually harmful. In the end, only Denham is happy with what happened and nobody else is.

KantianismKantianism states to act rationally, do not act inconsistently in your own actions or consider yourself exempt from the rules. In this situation, it appears that Denham did not act inconsistently with his own actions but he did consider himself exempt from the rules. If Denham did not receive the kickbacks, everybody would have been fine. Denham in this situation did not act rationally. Collecting the kickbacks even though he knows is wrong, is not acting rationally.

Virtue Theory
CareFusion Company logo
The Virtue Theory, states that if a business acts in a way that fits the virtue characteristics, it is acting ethically. The four characteristics are courage, honesty, self-control, and justice. Courage represents risk taking and willingness to take a stand for the right ideas. Honesty is represented in agreements and falling through with those agreements. Self-control represents good decisions and reasonable expectations. Justice represents hard work and fair practices. CareFusion, Charles Denham, and Patient Safety had none of these qualities. They did not have any courage when they knew what was going on and did not do anything about it. They showed no honesty by not telling people what was happening, there was no self-control on Denham's part because he wanted to collect as much as possible and there was no justice because nothing was fair about this.

Millenson, Michael. "The Money, the MD and a $12 Million Patient Safety Scandal." Forbes. Forbes Magazine, 14 Feb. 2014. Web. 31 Mar. 2014.

"Inside the First Scandal in Patient Safety." N.p., n.d. Web. 31 Mar. 2014.

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