Ethical Challenges in Healthcare Administration Term Paper

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Ethical Challenge Scenarios in Healthcare Administration

Scenario 1: You have withdrawn an offer at the last minute (due to poor references) to an ICU nurse manager candidate who has moved across the country to accept the job. The only way you will avoid a lawsuit is if she is hired somewhere else soon. A close colleague calls to ask you frankly why you withdrew the offer. What do you say?

This particular scenario seems like more of a legal issue than an ethical question. An ethical dilemma would be about whether to talk to the friend or not. It seems that there are a few separate issues with regard to the overall scenario. First, of course is the legality of talking to the friend at all. Why does she want to know? Did she recommend the employee? Next, what does an offer of employment mean? Another point to expound upon is that the company did not have to fulfill the offer of employment. A discussion of what a bad reference means is also needed. Finally, the ethical dilemma has several parts which need to be separated from the legal questions.

The response to the friend would matter only if the friend was not supposed to be party to a privileged communication. If the person doing the hiring were to talk to a trusted colleague about why they did or did not hire someone, they could be in for legal trouble (Long, 1997). Talking about confidential employment records with someone who is either not involved in the process, or has no reason to have that information, could not be told about the reasons for the rescinding of the offer of a job (Long, 1997). There could be sensitive reasons why this decision was made and the "trusted colleague" has no business knowing the extent of the references.

However, the case changes if the colleague does have a reason for wanting to know other than being nosy. It is permissible both legally and ethically to talk to her about the reasons then. The woman may have been a friend of hers or she may have been a former employee. She may have information about the person who gave the bad reference and now that there is something between the two of them which caused that person to give a bad reference. Whatever the reason, before anyone can divulge confidential information they have to be very careful regarding their legal culpability.

But, there are other issues than whether the person doing the hiring should tell the colleague about the references or not. Does an offer of employment mean that the person is guaranteed the job? This seems to be the overriding question. There was a verbal agreement between the two parties, but from the scenario it does not seem like there was any legally binding agreement drawn up between the two people that would make the offer binding (Yoder, 2008). This is the crux of the argument. A verbal agreement means absolutely nothing in a court of law.

An offer of employment is always contingent on the fact that the person who gets the job will pass both the scrutiny of any background checks that are required by the position and a predetermined probationary period. Probably the most important of these two is the fact that she may have had to go through background checks prior to having to an actual document drawn up for the hire. If the background checks were not critical to the hiring, then she would have been able to start employment at that time. After she was hired, the performance of the nurse would have been evaluated during the probationary period, and she may have lost her job then. A normal probationary period is approximately 90 days. Some employers require more and some less, but there is generally a period during which the employee's ability to perform the job is examined in more detail than can be learned from a resume or interview. After that time the actual period of employment begins. But, she did not even make it that far. Because the offer was rescinded due to the poor background checks, the nurse did not even meet the initial requirements of the job.

It also does not matter what the reason was for the offers being rescinded. Most states operate under an at will agreement. This means that a person can be fired from a job without cause and that the person can leave the job with no reason given.

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Of course, there have been many cases in which this has been challenged, and the unions do not like them very well either. At will basically means that if the person does not have good performance then they can be discharged without the employer giving them a reason. However, most employees will not fire an employee at will unless there is a very just cause for the firing. Since the woman was not hired by the company she does not even meet the requirements for this law to go into effect. Also, a union would probably not have been engaged if there was the possibility of a union being involved.

The next question with regard to this scenario is whether a reference should be a reason for an employer's not hiring someone. If the bad reference came from a manager at her previous place of employment, then she may have a case against them, but she does not have any case against the people who offered her a job (Baker, 2005). Most employers will not allow managers and supervisors to give out any references because they are afraid of the liability which is possibly implied by the poor reference. This does not mean that there is any law which forbids an employer from giving a bad reference, but the courts have also sided with employees most of the time when a wrongful termination case comes before them (Baker, 2005; Long, 1997). For this reason, employers are very cautious about giving references of any kind. They will generally tell a new potential employer the employee's job description and that is all.

Also, she could probably call on a union representative to help her fight that case if she was an employee. Unions are active in working for people when they are wrongfully terminated. But in this case she would have been a manager anyway, so the union avenue would not have applied.

The biggest conundrum in the scenario is why is there the threat of a lawsuit? It does not make any sense that there would be an impending lawsuit based on the fact that she moved across the country, of her own volition, to take a job that she had offered, but had not yet legally accepted. The fact that the person moved across the country has no bearing whatsoever other than that the person was inconvenienced to a high degree. This may cause her to file suit, but it would be a moot action because she has no legal grounds on which to pursue the case.

However, there are the ethics that are involved with the scenario. The woman had the expectation, supposedly, that she was going to have a job when she arrived in her new city of residence, and when she gets there she finds out that she does not. She had an ethical obligation to a former employer to be a good employee. Apparently, either she was not a good employee from the standpoint of that employee, or one of the people she worked with. Either way, because she failed in her original ethical obligations she is now without a job.

There is also an ethical consideration on the part of the hiring manager who offered the job in the first place (Hindera & Josephson, 1998). That person should have made sure that this person was qualified, in all ways, for the employment before it was offered. Because the hiring person did not check everything before the offer was given, that individual should face some censure. However, ethical dilemmas do not often end up in court. The person doing the hiring may have learned the lesson that you need to check all of the facts before an offer of employment is made, but that does not matter to the nurse who moved all the way across the country.

The third person who needs to understand ethical considerations is the trusted colleague. Ethics demands that certain information be kept confidential. Demanding that the hiring manager tell the reasons for the rescinding of the offer is in poor ethical taste. One colleague should not put her interest over the rights of another. Meaning, when the friend demanded that the hiring manager tell why she had dropped the offer, the colleague had crossed a boundary. Of course, she did not have to be heeded, but just asking for the information crosses ethical lines.

In the end, the woman who traveled across the country is without.....

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