Ethical Issues in Services

Defining what services are can be a challenge because many products we see today are a combination of goods and services. Pearson’s Operations Management textbook defines services as, “including repair and maintenance, government, food and lodging, transportation, insurance, trade, financial, real estate, education, legal, medical and entertainment” (Heizer, Render, & Munson, 2016). Services are intangible products, therefore the healthcare that we receive is a service. There are many ethical challenges that medical executives, patients and medical staff face in healthcare.

An ethical issue is defined as “a problem or situation that requires a person or organization to choose between alternatives that must be evaluated as right (ethical) or wrong” (businessdictornary.

com, 2018). Ethical issues in healthcare are quite common, typically every decision that is made has an ethical consequence, for providers, executives and patients. The healthcare industry is a business that provides services to people across the world. Ethical leadership is seen throughout healthcare services when managers make sure to prioritize ethics and communicate clear expectations to their employees on practicing ethical decision making.

If management can convey a culture of ethics, employee behavior is likely to follow. The healthcare industry makes up decent percentage of the United States’ gross domestic product and as the industry continues to grow it will need to utilize principles from operations management to ensure ethical issues within their services do not corrupt the business.

Current Ethical Issues

Ethical issues in services generate public controversy and conversation. There are different to understand the nature and process of decision making and the ethical deliberation that occurs within an organization and individual.

Actions that are taken regarding ethical issues in healthcare clearly distinguish what is right and wrong, these actions can have lasting effects on provided healthcare services and organizations.

In April 2016, Olympic doctor, Larry Nassar had multiple public statements made by previous athletes and patients who he had sexually abused throughout his professional career as a doctor. Nassar’s actions with ethically wrong and he used his power as a doctor to intimidate the young athletes that he was treating for pain. Nassar made his victims feel that they were in the wrong to believe what he was doing was abuse because he projected a sense of normality from his position of authority in the healthcare that they were receiving.

These aspiring athletes were not receiving the quality of care that they entitled when they receive medical services. Sexual relationships between medical practitioners and patients are beyond forbidden at a healthcare facility, let alone unwanted sexual advances. These incidents hurt the character and trust of medical leaders that Nassar worked with along with many others across the nation. Not only did it hurt the character of these leaders, but it created legal costs and caused a spike in malpractice insurance coverage. The minute that sexual misconduct occurs between doctor and patient or between medical professionals, the code of ethics engraved within their organization is shattered.

Healthcare leaders must have the courage to act ethically. Leaders must understand the success of the organization relies on their ethical behavior (Bruning & Baghurst, 2013). Building the trust of employees and patients earns money and funding for the organization and reduces liability costs of the organization because trust lies within it. Reforming an organization after an ethical scandal, like Nassar’s requires a lot of ethical decision making from various leaders of healthcare management. Leaders within healthcare services influence successful or unsuccessful changes within that organization. Re-instating ethical standards and principles to better transform leadership will help build healthcare relationships back up and alleviate any stress that was caused in trusting healthcare services because of sexual misconduct.

Having your privacy and confidentiality protected is something that we may take for granted because it is a basic right. Violating a patient’s privacy and confidentiality can have both legal and ethical consequences for healthcare professionals. In today’s world, smartphone usage is at an all time high and causing ethical issues in the healthcare services that we receive. The majority of nurses are using their personal smartphones for work and they could be violating federal laws and hospital security policies (Neese, 2016). A small data breach could comprise thousands of patients’ data leaving the patient vulnerable to identity theft. Even though technology is continuously advancing, certain precautions need to be taken to make sure the sensitive data of the patient remains safe and secure while they are receiving medical services.

Patients need to feel safe to tell their doctors intimate things about their own bodies and their lives. Trust needs to be established and maintained for the patient to receive the best medical care and physicians need to take extreme care to protect information from getting into the wrong hands. The minute that confidentiality is violated, the patient is in harms way as well is the relationship between the doctor and patient. Within any medical facility or practice, a policy for maintaining patient confidentiality needs to be developed and implemented. Management needs to make sure that all physicians and staff are trained and understand the ramifications of not following the privacy policy. Privacy and confidentiality in healthcare services will always be an ethical issue if breached.

The list of rules, laws and ethical standards present in today’s healthcare were developed to protect patients and so that healthcare workers and facilities were not sued for negligence and malpractice. Doctors and hospital management work hard to take care of their patients but unfortunately, we all are human and human error and miscommunication can have negative lasting effects. Ethical issues arise when failure to maintain hospital equipment, keep a clean environment and administrators failure to train doctors and staff sufficiently (Bergham, 2016). Hospital administrators may fail to put the proper procedures and systems in place so that every member of the healthcare team has the information they need to care for their patients. Healthcare management teams are responsible for making many ethical decisions that can impact both their direct organization and the care that is received by the patient.

Healthcare Ethics In Regards to Quality Management

Ethical decision making encourages a leader’s ability to act and improve on healthcare decisions and relationships. “For operations managers, one of the most important jobs is to delivery healthy, safe, and quality products and services to customers” (Heizer, 2016). When poor-quality services are developed and an inadequate design of the services are streamlined to the public the organization is at risk of higher production costs as well as lawsuits from unethical decision making. Every company must develop core values that are ingrained in everyone’s day to day structure from the chief of staff to the janitorial crew.

Healthcare managers mainly have focused on the quality of care those that walk into the facility receive. Now, they are expected to review their own overall management practices to measure the effectiveness of the services they are producing (Hellström, 2010). The outcome of care can be improved upon when providers base decisions on ethical principles that help the patient feel understood. This type of management practice increases the likelihood of better reported value of care for the organization. If the operations managers of the hospital do not help facilitate quality economic decisions this can lead to a potential loss for the services of the healthcare organization. Patients, providers and the organization itself could individually be effected by poor internal failure costs when the cost of quality fails the organization.

Ethical issues can come into question involving quality improvements because one decisions may have a negative effect on the outcome of that decision. Early efforts to have a cancer screening may cause useless and expensive tests in those sick patients who are too near of death to benefit from these screenings (Lynn, 2007). Administrators are hoping to bring out an immediate improvement to health right out of the gates for the patient, but is providing risky or unnecessary testing for a sick patient ethically and financially sound? The cost of quality is the cost to the organization of doing things wrong. When risky and unnecessary tests are performed on patients, not only is it unethical but from an operations management standpoint you are attributing to the appraisal cost, which is related to the evaluating of services, such as these tests.

Working within the service industry in the operations department and working close with my operations manager has helped me understand the ethical leadership values that he must have in his tool kit as a manager to mange ethical issues that arise. Although, the services that Johnson Controls provides versus the healthcare industry are vastly direct the core of ethical values remains constant. Whether it be through healthcare services or fire alarm programming in the fire alarm safety world, an operations manager must bestow a ethical leadership to ensure success their department. When ethical issues arise, it must be handled with care and the operations manager must assist in dealing with the issue that has presented itself.

Continuous Improvement

There will always be many changes that healthcare leaders need to stay up to speed with and help impact their team around them. They must continue to create the best systematic approach to meet the needs of their staff and their patients. Since one of the main jobs of an operations managers is to deliver quality services to their customers, they must explore all different avenues to tackle different ethical issues that will come into play in their organization. They must build trust with other leaders that they can work with, help develop themselves and their staff and make sure to always implement proper training programs and resources for their teams. Promoting awareness and the tools needed for ethical decision making is key in the job of an operations manager to deliver a healthy and safe service.

An improvement for protecting patient privacy and confidentiality is when healthcare professionals use their own smartphones to assess patient needs they follow a strict regulation policy that was developed by the organization. These regulations that will be implemented can help prevent any exchanging of data form devices that might not be secure or the networks not equipped with proper firewalls to protect patient information. Management needs to also, if they have not already have an onsite information technology specialist to provide support for the network and devices to ensure proper security protocol is being followed to protect the patients’ information.

Training is a major part of improvement of staff and directors. Having all different sectors of the staff in the hospital or healthcare facility undergo confidentiality training will not only be a refresher for older employees but also a constant reminder of the importance of the trust the patient has granted you to keep their information safe. A supportive managerial environment encourages ethical decision making. Establishing ethical training can create a strong culture within the organization that betters the employees and benefits the services that the patients receive. Multiple research studies have been conducted that indicate when code, ethics training and other programmatic approaches can positively alter the perceptions of organizational ethics and the social responsibility it holds, which in turn encourages individuals to behave ethically (Valentine, 2012).

Every operation has something that can be improved upon, perfection is the goal but we know that perfection is never truly achievable. Continuously improving the quality of service that is administered while emphasizing leadership within the departments of the healthcare organization will provide the support and structure needed when an ethical decision is needed to be made. The healthcare world is unlike any other in the sense that the service they provide varies from facility, to patient, to leadership team. Healthcare services are not standardized, so applying a tool, such as process management is a daunting task. Process management in healthcare would help streamline the environment, help deliver better quality and reducing cost, but since healthcare services is not a standard environment implementing a single system process would cause challenges, more often than not, ethical challenges (Helfert, 2009).


Decisions made by an individual manager affect the organization as a whole. Leaders must develop strategies to overcome the ethical challenges that surface every day while servicing the healthcare industry. Staying on top of the newest developments and training will help create success in managing healthcare organizations. An environment must be established within the organization where support, help and improvement is a top priority. When an organization is filled with staff that feels supported, helped and knows their self-improvement is important they are more likely to have the right tools to make ethical decisions during the hard and not so hard times on the job.

Being accountable for someone’s ethical decision making abilities and standards are the part of the duties that the operations manager of each healthcare facility has. The operations manager of each healthcare facility has an ethical responsibility to ensure the care of the patients and staff are accounted for. Not only must they care for the staff and patients but also provide quality management to their team and make sure that the resources to continuously approve individually and as a team are available. Ethical issues in services will never go away, choices will always need to be made, big or small, but making sure the solution is ethical can be the challenge. Ethical and non-ethical decisions are made daily within healthcare services that can affect the organizational structure of the healthcare system and the health of the patient.


  1. Bergman, H. (2016, April 15). Most Common Causes of Medical Malpractice Claims | DGM&S.Retrieved from claims/#Causes_Of_Medical_Malpractice
  2. Bruning, P., & Baghurst, T. (2013). Improving Ethical Decision Making in Health Care Leadership. Business and Economics Journal,04(02). doi:10.4172/2151-6219.1000e101
  3. ethical issue. Retrieved November 2, 2018, from website: issue.html
  4. Heizer, J., Render, B., & Munson, C. (2016). Operations Management Myomlab With Pearson Etext Access Card Sustainability and Supply Chain Management, Student Value Edition (12th ed.). Pearson College Div.
  5. Helfert, M. (2009). Challenges of business processes management in healthcare. Business Process Management Journal, 15(6), 937-952. doi:10.1108/14637150911003793
  6. Hellström, A., Lifvergren, S., & Quist, J. (2010). Process management in healthcare: Investigating why its easier said than done. Journal of Manufacturing Technology Management, 21(4), 499-511. doi:10.1108/17410381011046607
  7. Lynn, J. (2007). The Ethics of Using Quality Improvement Methods in Health Care. Annals of Internal Medicine, 146(9), 666. doi:10.7326/0003-4819-146-9-200705010-00155
  8. Neese, B. (2016, July 08). Ethical Issues in Nursing: The Impact of Smartphones on Patient Care. Retrieved from
  9. Valentine, S., & Hollingworth, D. (2012). Moral Intensity, Issue Importance, and Ethical Reasoning in Operations Situations. Journal of Business Ethics, 108(4), 509-523.
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