Administrative Ethics: Advances in Lung Cancer Care

HCS/335

Tuesday, March 20th, 2012

Administrative Ethics: Advances in Lung Cancer Care

In this paper, there will be a description of what the newspaper article covers about Lung Cancer treatment plus the population this issue affects the most. Examples the article uses to argue or present facts supporting the treatment research of Lung Cancer Patients, explanation of ethical and legal issues do to the involvement this article is talking about, explanation of the managerial responsibilities related to administrative ethic issues, and identification of proposals to create solutions.
Description of Newspaper Article and Those It Affects “More Americans die from lung cancer each year than from breast, colon and prostate cancers combined, according to the National Institutes of Health. But it has long suffered from a stigma because of its association with smoking, receiving far less research funding than other forms of cancer.” (Thoms, 2012, para. 5-6) In reading the above quote it should inspire some to promote more research completion in the area of Lung Cancer. Factual information such as this is what makes the medical professionals working in the area of Lung Cancer Treatment want to bring this awareness to the general public. Each day these professionals go to their careers and have to witness his or her patients suffering from this horrible disease. Their hands are tied on providing more advancement in procedure that he or she could perform on the patient to get his or her patient closer to a recovery stage. Recently there is a breakthrough in Lung Cancer Treatment. First the article makes it known how important providing advancements in treatment are and then explains how the latest technology is valuable to progression in treatment. Arguments in Support of More Lung Cancer Treatment Research In order to most efficiently treat a person with Lung Cancer is to be able to detect it in the earlier stages. By doing more research it will increase the likelihood for a discovery of an instrument to detect an earlier diagnoses of Lung Cancer. “The breakthrough that generated the biggest buzz in the past year was a study that found screening heavy smokers and former smokers with CT scans reduced death rates by 20 percent. The study, reported in the New England Journal of Medicine in June, showed the value of an effective screening tool. Seventy-five percent of lung cancer cases are diagnosed after a patient has symptoms, when it is in stage 3 or 4, and surgery is not an option, VanOtteren said. Those cases diagnosed earlier, before the symptoms such as coughing and shortness of breath appear, often are detected by accident. Sometimes, a spot on the lungs shows up in a scan done for a different medical problem. As a screening tool, the CT scan has limitations, and doctors are not yet recommending them routinely, VanOtteren said. In the study, which involved 53,000 participants, an abnormality showed up in 39 percent of the patients. Of those, 96 percent did not have cancer. That means many patients had to undergo unnecessary follow-up scans or biopsies.” (Thoms, 2012, Early Diagnosis). “The tool used to perform the biopsy is a navigational bronchoscopy, which uses a GPS-like technology to guide physicians through a patient’s airway to spots on the lungs that are inaccessible to other scopes.” (Thoms, 2012, para. 3)
Facts in Support of More Lung Cancer Treatment Research
“Breast cancer
U.S. government research funding: $750 million per year
Results
Significant increase in five-year survival rates:
Early 1970s — 75 percent
Today — 90 percent
HIV/AIDS
U.S. government research funding: $3 billion per year
Results
AIDS was once a near-immediate death sentence
Today — With anti-retroviral drug therapy, the three-year survival rate is 90 percent
Lung cancer
U.S. government research funding: $267 million per year
Results
Very little change in five-year survival rates.
Early 1970s — 12 percent
Today — 16 percent
Source: National Lung Cancer Partnership.” (Thoms, 2012, By The Numbers) As a person can see by this chart there is a large gap in the amount of money that goes to research for Lung Cancer Research and that of Breast Cancer or HIV/AIDS. Yes the other two illnesses need the money for finding cures also but what does not make sense is the fact that not much distribution of money is towards Lung Cancer. Another fact of Research for lung Cancer in the article is: “Although smoking does increase a person’s risk of lung cancer, 15 percent of those who get the disease are non-smokers. And certainly other forms of cancer — and other diseases such as heart disease — also are affected by lifestyle choices, yet they receive more research dollars. The bias is frustrating for those who care for patients with the disease.” (Thoms, 2012, para. 7)
Ethical Issues in Trying to Accomplish More Research Mackillop (1990), “While cancer patients usually know their diagnosis, they frequently misunderstand the purpose of their treatment and overestimate its potential benefits. Thus, it is unreasonable to assume that every patient is able to carry out the kind of cost/benefit analysis required to reach a rational decision about participation in a clinical trial. This makes it all the more important for the profession to ensure that clinical experiments are ethically acceptable before patients are asked to participate in them. The definition of an ethical clinical experiment. Rules for the conduct of clinical research were first clearly delineated in the Nuremberg Code and subsequently in the Helsinki declaration of the World Medical Association. These rules are designed to maximize the societal gain from the experiment while minimizing the cost and risk to the patients involved, and are based on the related principles of beneficence and non-maleficence. In simplified form, they may be stated as follows: (a) The experiment should conform to accepted scientific principles; (b) It should be based on previous laboratory and animal experiments; (c) It should be carried out only by scientifically qualified persons; (d) The importance of the objective should be in proportion to the inherent risk to the subject. While the intent of these rules is clear, we believe that there are problems in the way they are interpreted and applied. Experts in the field need to be involved in the process because neither the quality of the science nor the potential value of the results can be assessed without specialized knowledge and experience.” (Ethical Aspects of Clinical Research)
Legal Issues in Trying to Accomplish More Research “The justification for all medical research is that the benefits must outweigh the risks. Many consider that this utilitarian, or benefit/cost, approach to decision making is a good model to use when examining medical research. Merely increasing knowledge is not considered an adequate justification for taking a risk with a human life. Medical researchers must abide by the standards for testing that have been established by their medical associations, such as the AMA and the ANA. The Department of Health and Human Services (HHS) implements government standards for research. The government requires that all institutions that receive federal research funds, such as hospitals and universities, establish an Institutional Review Board (IRB) that oversees any human research in that facility.” (Fremgen, 2009, p. 255) If these requirements do not follow protocol of AMA, ANA and Department of Health and Human Services requirements when conducting research procedures it can result in the researchers being shut down and/or legal action taken against all persons who have involvement in the research project.
Managerial Responsibilities Related to Administrative Ethical Issues Managers’ responsibilities to patients take precedence over their fiduciary duty to their organizations. Protecting the patient is more than providing safe surroundings and competent staff. It is more than licensure, accreditation, and compliance. It is more than a surplus at the end of the fiscal year. The manager is the organization’s conscience. This responsibility is exemplified by the organization’s willingness, prompted and led by management, to recognize the inherent human dignity of the patient and do so through effective programs that makes this recognition a reality. It means using effective consent forms and procedures and ascertaining that all who have contact with patients are qualified and work for the patient’s good. It means not considering patients as adversaries and not deserting them should something go wrong in the care process.” (Darr, 2005, para. 4) It is important that when doing research to develop other methods of treatment that the medical professional, especially the manager, takes in to consideration of what it is that the patient has to go through in order to get the most effective results. Making sure to respect a person’s believes and views on certain topics. To always make the patient knows and understands that at anytime that he or she no longer wants to be a part of it that he or she can exit the experiment with no questions or placing judgments on the person.
Identification of Proposals to Create Solutions It is a problem that needs immediate attention and a plan on how to increase the survival rate when a person seeks treatment for Lung Cancer. The Grand Rapids Michigan sector has devised a plan to have more individualized care for each patient that seeks care. “Treatment through a multidisciplinary clinic is improving care for patients fighting lung cancer, VanOtteren said. At Spectrum, each case is reviewed by a team that includes oncologists, a pulmonologist, and nursing and dietary staff. “It’s a more personalized approach, and it expedites care,” he said. “It’s not going from doctor to doctor and getting delays and different opinions.” Also, genetic analysis of tumors sometimes can identify specific gene mutations, which helps doctors tailor the chemotherapy. The developments in diagnosis and treatment have yet to yield large gains in survival rates. They have changed “probably a couple of percentage points in the last few years,” VanOtteren said. “It takes a while for those changes to make improvements. It’s still a dreadful disease.” (Thoms, 2012, A Team Approach to Treatment) In this paper, there was a description of what the newspaper article covers about Lung Cancer treatment plus the population this issue affects the most. Gave the examples the article uses in argument and presentation of facts supporting the treatment research of Lung Cancer Patients, there was explanation of ethical and legal issues do to the involvement this article is talking about, and an explanation of the managerial responsibilities related to administrative ethic issues, and there was identification of proposals to create solutions.

References
Darr, . (2005). Ethics in Health Services Management (4th ed.). Retrieved from http://www.healthpropress.com/store/darr-2998/excerpt.htm.
Fremgen. (2009). Medical Law and Ethics. Retrieved from Fremgen, HCS/335 - Health Care Ethics and Social Responsibility website.
Mackillop, W. J. (1990). Ethical problems in clinical research in non-small cell lung. Retrieved from http://qcri.queensu.ca/CCE_Pub_No_48_Mackillop_1990_6_pp_147-158.pdf
Thoms, S. (2012, January 30). Lung Cancer Advances. The Grand Rapids Press. Retrieved from http://www.mlive.com/health/index.ssf/2012/01/lung_cancer_advances_earlier_d.html