Paul Bruning and Timothy Baghurst
Purpose: The purpose of this articles discussion is to describe the application of ethical decision-making and
the three primary relationships within health care leadership. Healthcare change occurs rapidly and increases tension
and mistrust between payers, providers, and patients. Application of ethical standards to decision-making and change
decreases healthcare cost and improves trust in change processes.
Approach: Health care challenges occur among three primary relationships. These relationships include the patient
and provider, patient and payer, and provider and payer. A plethora of leadership models exist with regard to leading
change; however, these models do not consider that leaders are not always concerned with the ethical decision-making
process. Evaluation of the ethical principles, healthcare relationships, and recent healthcare changes found in the
Patient Protection and Affordable Care Act guide the articles discussion.
Findings: Application of ethical principles to transformational leadership improves healthcare relationships
and alleviates stress and tension produced by change. Healthcare leaders have an expectation to provide ethical
considerations during change management and the decision-making process which influences the various relationships
found in healthcare.
Value: Healthcare leaders are in the unique position to improve healthcare using ethical principles. Because health
care reform requires ethical decision-making from leaders, the application of ethical principles to the various relationships
health care leaders’ influence creates fundamental and successful change in health care.
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