The processes of purchasing and supplying health care materials and products are under extreme financial pressure. Purchasing processes are also being revolutionized by computerization, the internet, and mergers. A complex and increasingly computerized struggle takes place among insurers, purchasers, suppliers, and regulators. Product-dispensing machines and inventory control calculations are resulting in increasing surveillance of clinical processes. The power of large organizations distant from the bedside—such as wholesalers, warehousers, group purchasing organizations (GPOs) and out-sourced purchasing agents—is increasing. There is a constant strain in balancing the triad of quality of care, environmental impact, and financial costs. Is there an ethically proper balance of these factors? Who should be involved in making purchasing decisions? Should patients be involved? Current changes in purchasing business practices may be undermining the ability of clinicians and patients to control important material aspects of care. This study addresses these questions by means of a series of case studies of varied health care products. These products have been chosen deliberately to focus on everyday, widely used materials, in contrast to the usual bioethics approach, which tends to treat new and complex therapies and equipment. Case studies include such items as rubber gloves, adult ventilator circuits, patient controlled anesthesia, stethoscopes, and shaving cream (in patient toiletry kits). This study is partly observational, and raises questions asked by staff and administrators; but, it is also normative in that it treats several ethical questions which the observers believe should be considered more widely. See www.unmc.edu/green
Learning Objectives:
Keywords: Ethics, Quality Improvement
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.