Identify moral and ethicalissuesyou may face when caring for an uninsured or underinsured patient.

Identify moral and ethical issues you may face when caring for an uninsured or underinsured patient.
3. Choose an ethical dilemma you might face in caring for this population.
4. Apply the MORAL model of ethical decision-making, Guido (2014) p. 44, to the chosen ethical dilemma.
M. Massage the dilemma:: Identify and define issues in the dilemma. Consider the opinions of the major players-patients, family ,members, nurses, physicians and other health care members.
O. Outline the options::Examine all options fully, including the less realistic and conflicting ones. Make two lists identifying the pros and cons of all the options identified. This stage is designed to fully comprehend the options and alternatives available to make a final decision.
R. Resolve the dilemma:: Review the issues and options, applying basic ethical principles of each option. decide the best option based on the views of all those concerned in the dilemma.
A. Act by applying the chosen option::This step is usually the most difficult because it requires actual implementation, whereas the previous steps had allowed for only dialogue and discussion.
L. Look back and evaluate::The entire process includes the implementation. NO process is complete without a thorough evaluation. Ensure that all those involved are able to follow through on the final option. If not, a second decision may be required and the process must start again at the initial step.
Mini-cases: Good Examples
During the merger of BB&T Financial Corporation and Southern National Corporation, redundant positions were eliminated through the strategic use of a hiring freeze.
Hewlett-Packard implemented a so-called fortnight program in which all employees were asked to take one day off without pay every two weeks until business revenue increased.
Mini-case: Bad Example
Scott Paper conducted a layoff of 10,500 employees in the mid-1990s. In the years that followed Scott was unable to introduce any new products and saw a dramatic decrease in profitability, until it was eventually bought out by competitor Kimberly-Clark.
Making it Happen
Downsizing successfully is immensely difficult. The following ideas can help to focus thinking for anyone considering such a move.
• Treat all employees with respect. Communicate too much rather than withhold information.
• Research applicable laws and follow the spirit of the legislation.
• Afterward, give employees the psychological space to accept, and discuss, what has happened.
There are two important factors to keep in mind when planning a layoff: respecting employee dignity and business planning. No one, from the mail room to the board-room, enjoys downsizing; but when the need for a reduction in staff is unavoidable, a layoff can be accomplished in such a way that the problem is fixed and the organization excels.
**Alan Downs is a management psychologist and consultant who specializes in strategic human resources planning and helping business executives reach their maximum potential. He has authored several books, including AMACOMs Corporate Executions (1995), the much-acclaimed expose on downsizing, The Seven Miracles of Management (Prentice Hall,1998), and The Fearless Executive (AMACOM 2000).
Downs is widely sought for interviews by newspaper, TV, and radio broadcasts. He has also written on management topics for numerous national newspapers and trade publications, including Management Review and Across the Board.
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