Sample Literature Review Paper on Health Ethics


The health care field is a very complex area of practice since the physicians or the administrators
are faced with the challenge of making decisions, which can lead to conflict; therefore, high
ethical standards are required. Most of the patients are also confronted with ethical challenges in
a health care setting. At the top of the list of the ethical challenges is balancing between care,
quality, and efficiency. This is a difficult and critical challenge that is prompted by the increase
of pressure in the hospitals to cut the cost of providing health care while at the simultaneously
improving on quality. Health resources, either financial or human, are scarce and limited, and
therefore using these resources for the best outcome requires immense and appropriate planning
so that resources are allocated to areas that may bring out the best result. Health care providers
are faced with the need to make decisions so that funds are used prudently to satisfy the needs of
the majority of the community and hence may be met by ethical conflict concerning resource
allocation (Lee, 2017).
Hospitals and general health care focus on efficiency as an ethic of justice. Hospitals recognize
limits in resources, and hence willing to balance the needs of many patients against each other.
For example, the number of beds may be limited in a hospital, and the scarcity may persist. In
the short term, the number of available beds is fixed since the need for increasing more beds is
subject to a lot of infrastructural costs. When beds are available, the number of nurses may be
limited too. Adding more nurses is financially prohibitive due to wages. Because of this problem
of resource allocation in achieving quality and efficiency, a model of medical practice should be
introduced that responds and reflects on real practice. Quality care is, therefore, a key component
in the right to health and should, therefore, meet the highest quality criteria (Vayena,, et al 2017)

There are many viable solutions to improving quality and efficiency while at the same
time considering affordable care to all patients. Since attaining health, equity is very urgent for
all groups, and especially those that feel marginalized and discriminated, physicians caring
directly for an individual client should understand the full needs of a patient and balance those
wants against the requirements of other patients. The first step towards solving the issue of
balancing care, quality, and efficiency is equitable distribution of outcomes of health so that
everyone gets the benefit of attaining optimal health ability and that no person should be left out
from achieving full potential. According to the social justice approach, public health should
improve any condition that may prevent people from attaining the whole good health standard
adequate to maintain life. An example of this action was taken by World Health Organization
(WHO) in the year 2008 that when it tried to gather evidence on actions that can be taken to
bring health equity and foster global movement in achieving it.
The other solution to this critical issue is freeing up resources that are unnecessarily used
so that they can be of benefit to others. According to research, some experts estimated as much
as 30 percent of medical spending is unnecessary and that given significant variations in
healthcare expenditure seen across geographical areas with little benefits in high expenditure
areas (Lee, 2017). Growth in the number of hospitals has helped in stemming the rise of hospital
costs, which have, in return, decreased the cost of medical expenditure despite an increase in
admission and complexity of patient’s illness. So that efficiency can be achieved, health care
should be delivered in a manner that maximizes the resources and avoids wastage. Efficiency in
health care should result in having effectiveness where services ar5e provided on the basis of
scientific knowledge and evidence-based guidelines
Ethical Issue Overview

Health care systems in the modern are world seek to focus on efficiency and quality health care
as it is rooted in the principle of justice, and cost has become an inescapable part of modern
practice. Hospitals and health care centers have accepted and embraced the responsible use of
resources as a core principle in this profession. Activities that improve on quality can improve
health care and must be done ethically. Improvement of quality is an intrinsic part of good health
care; efforts to improve the quality of care have always existed in the context of social justice. In
paper research done in Canada in the year, 2008 show that there was an acute shortage of
physicians in the rural parts as compared to the urban areas. There was a high imbalance in terms
of resource allocation in the country against the urban hence it was considerable concern in
improving quality in the rural parts. Attention should be focused on providing good care, quality,
and efficiency health systems in all parts of the country. There is a great need in every society
and government to create building a sustainable healthcare workforce for the future, improving
health care and allocating limited medication and donor organs (Jenning, 2015).
A medical shortage occurs because there is no enough economic incentive for hospitals.
For example, most of the intravenous medications are generally tend to be the ones in scarce
since there is no profit made from them and a continuous shortage of donor organs. A constant
increase in health care cost has led to the need for curtailing expenditures, and guidelines can be
used to reduce unnecessary expenses. These guidelines should be aimed at achieving an
increased use of effective care. Policymakers should come with a measure of cost reduction and
quality improvement. According to the World Health Organization (WHO), quality of care is the
extent to which care is, and health services are provided to individuals and improved population
so that it can achieve desired health outcomes (Kanamori, et al). Health care should be people-
centered so that it can provide care with preference and aspiration of individual service users and

the community at large. World Health Organization developed benchmarks for quality
improvement on maternal and newborn health care facilities. These standards were critical in
strengthening health systems.
Accountable Care Organizations (ACO) is a new form of health care organization in which a
network of health providers are given financial incentives to reduce total cost while maintaining
high standards of quality for a defined patient group. This organization was developed to take
care of patients with chronic illness, which accounts for 75% of all patients in the United States.
Most health facilities and hospitals have come up with social purpose programs to have a
positive impact on patients and coworkers. There has been an expansion of primary care and a
range of services provided to outpatient (Morgan, Ensor, & Waters, 2016).
In the late 1980s in the United States, an increase in healthcare cost, brought the
emergence of systems of management in the views on healthcare quality in both nursing and
medicine. Despite the concentrated efforts for the past two decades, the issue of care and quality
remains an impending issue. Lack of consistency and uniformity in the definition of this problem
has made it difficult to solve this problem. Thematic analysis guided by the strategy of
categorization can be of great use in solving this ethical issue. By providing precise theoretical
definition of quality healthcare will provide a critical foundational component research driven by
theory, and it is necessary development of knowledge and provision of quality care. An example
is the joint commission of 2015 that utilized accountability measures that were identified as
quality to determine the care process had improved health outcomes and its effectiveness. Good
health ethics should emphasize having care, quality, and efficiency as key pillars as they result in
the desired health outcome (Torchia, Calabrò, & Moaner, 2015).


Examine Alternative Action

Quality improvement in health discipline has evolved from an individual concern towards
a collective and professional concern driven by systematic matters involving many stakeholders.
Ethical commitment to improving the quality of care patients receive and commitments to
accomplish require systematic approaches. A category of research under common care and
quality should be appreciated. Balancing care, quality, and efficiency is equitable distribution of
outcomes of health so that everyone gets the benefit of good health care. In addressing the issue
of care, quality, and efficiency rule should be created to comprise activities designed in
increasing enduring knowledge about the nature of people and their sorrounding. New models of
individual health care should be developed and supervision of quality health activities as well as
creating practical rules to ensure appropriate review of quality activities.
Standards should be developed for improving quality healthcare and efficiency so that there is
improved health care experience hence freeing up resources that are unnecessary used so that
they can be of benefit to others (Morgan, Ensor, & Waters, 2016). There should be effective
communications on the resources required as well as community engagement.
Using the five approaches, i.e., the utilitarian approach, rights approach, fairness of
justice approach, common good approach, and virtue approach, using resources efficiently and
prudently is the best in ensuring quality health care and efficiency. Resources are used
maximally while achieving the objective of social justice. The utilitarian approach that suggests
the least harm should occur is also followed by using resources efficiently. As per rights
approach, use of resources maximally to achieve quality health care it does not contravene this
fundamental principle since resources are allocated in such a way that all individual do not

merely receive treatment but gets quality healthcare by reallocating resources through
distribution in order of urgency and priority.

In summary, the issue of utmost quality health care and efficiency is fundamental and critical,
especially to the women and children. Quality of care for children and their mothers is the level
of which maternal and health services increase the possibility of appropriate care to achieve
desired results that are consistent with the preference of individual women and their families.
Government and health institutions should take up the responsibility of ensuring quality health
care is provided for all in a very efficient way.



Lee, L. M. (2017). A bridge back to the future: public health ethics, bioethics, and environmental
Ethics. The American Journal of Bioethics, 17(9), 5-12.
Vayena, E., Salathé, M., Madoff, L. C., & Brownstein, J. S. (2015). Ethical challenges of big
data in public health. PLoS computational biology, 11(2).
Jennings, B. (2015). Relational liberty revisited: membership, solidarity and a public health
ethics of place. Public Health Ethics, 8(1), 7-17.
Morgan, R., Ensor, T., & Waters, H. (2016). Performance of private sector health care:
implications for universal health coverage. The Lancet, 388(10044), 606-612.
Torchia, M., Calabrò, A., & Moaner, M. (2015). Public–private partnerships in the health care
sector: a systematic review of the literature. Public Management Review, 17(2), 236-261.
Kanamori, S., Sow, S., Castro, M. C., Matsuno, R., Tsuru, A., & Jimba, M. (2015).
Implementation of 5S management method for lean healthcare at a health center in
Senegal: a qualitative study of staff perception. Global health action, 8(1), 27256.