Darr K, Longest B B, Rakich J S
Hosp Health Serv Adm. 1986 Mar-Apr;31(2):53-66.
Increasingly, administrative and biomedical ethical issues affect decision making in health services organizations. Although the ethics of biomedical decision making affect governance and management, this article is limited to administrative ethics: fiduciary duty, conflicts of interest, confidential information, resource allocation, and consent. Those who govern and manage health services organizations face an ethical imperative: They are moral agents with an independent duty to protect patients and further their interests. This duty is separate from any existing between care givers--such as physicians--and patients. It may complement other relationships, but it is always present. This imperative will become more difficult to attain. The potential conflict between economic and patient interests lies close to the surface in the patient care relationship, and maintaining it undoubtedly will be exacerbated by competitive pressures. The ethical implications of this conflict for those who govern and manage health services organizations are enormous.
行政和生物医学伦理问题对卫生服务组织的决策影响日益增大。虽然生物医学决策伦理会影响治理和管理，但本文仅限于行政伦理：信托责任、利益冲突、机密信息、资源分配和同意。治理和管理卫生服务组织的人员面临道德要求：他们是道德主体，负有保护患者并增进其利益的独立责任。这一责任有别于护理人员（如医生）与患者之间现有的任何责任。它可能补充其他关系，但始终存在。这一要求将越来越难以实现。经济利益与患者利益之间的潜在冲突在患者护理关系中已初现端倪，而竞争压力无疑会加剧这种冲突。这种冲突对治理和管理卫生服务组织的人员所产生的伦理影响是巨大的。
