Tuesday, April 1, 2014

Patient Safety Scandal (2012)

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. Charles Denham is a patient advocate who was born in 1955 in San Bernardino, California. Mr. Denham graduated from the University of Alberta and is a co-founder of the global Patient Safety forum. Denham and his family live in a waterfront home in Laguna Beach, California, which is estimated to cost around $10.5 million. 
The government allegations include 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, that 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. Other NFQ members felt Denham was inappropriately involved in the process to push ChloraPrep as a recommended product from NFQ. Denham states that the allegations were "blatantly false", saying that the contracts were signed before a positive study of ChoraPrep was published. Denham has not been charged with any crime.
Texas Medical Institute of Technology (TMIT) was Denhams'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. 
CareFusion logo
Many people, however, who worked with Denham, had absolutely no idea where his money came from. When asked about his money, Denham would reply with something about his wife's family. Many of Denham's videos raised questions of, "Is this guy for real?" People would still work with Denham because he appeared to be a good guy and produced results. People could not think of a reason 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.

Patient Safety propaganda image
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 Denham did this because he was consumed with making money and was selfish. Denham was not fulfilling his role as a business person to maximize profit for the owner or the stockholders, which in the eyes of an individualist is unethical.

The major goal of Utilitarianism is to maximize the overall happiness. It seemed like the only person that received happiness was Denham himself. Utilitarianism also states that all actions are aimed at something good. In this situation, however, nothing good came out of this scandal. Many of the stakeholders, which consisted of providers, suppliers, and the patients themselves were affected negatively from this experience. Since none of the stakeholders' were happy with this scandal and only Denham was happy, an individualist would consider this unethical. This is because the stakeholders happiness should outweigh Denham's  happiness. If the stakeholder's were happy and Denham was not happy, an individualist would consider it ethical. 

Kantianism states to act rationally, do not act inconsistently in your own actions or consider yourself exempt from the rules. I do believe that Denham did not act inconsistently in his own actions but did consider himself exempt from the rules by following through with this scandal. Denham did not act rationally by collecting kickbacks even though he knew it was wrong. Kantianists would say this is unethical because Denham treated people as a means to an end. Denham would only care about the profit and what he is making out this situation and would not care about the stakeholders being affected. 

Virtue Theory
Lastly, the Virtue Theory states that if a business acts in a way that fits the virtue characteristics it is acting rationally. 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 while justice represents hard work and fair practices. CareFusion, Denham, and Patient Safety had none of these qualities, making it unethical. There was no courage being displayed because nobody took a stand for the right idea and just Denham receive the kickbacks. They showed no honesty by not telling people what was happening, even though they knew what was going on. There was no self-control on Denham's part because it was not a good decision to receive the kickbacks and wanted to collect as much as he could. Finally, there was no justice because receiving kickbacks from a company is underhanded, and not considered fair practices. 


1. Millenson, Michael. "The Money, the MD and a $12 Million Patient Safety Scandal." Forbes. Forbes Magazine, 14 Feb. 2014. Web. 01 Apr. 2014.
2. "Inside the First Scandal in Patient Safety." KevinMD.com. N.p., n.d. Web. 01 Apr. 2014.
3. "Charles Denham." Wikipedia. Wikimedia Foundation, 30 Mar. 2014. Web. 01 Apr. 2014.

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