Are workarounds ethical? Managing moral problems in healthcare systems, by Nancy Berlinger (2015)

Summary

How work gets done in complex healthcare systems is ethically important. When healthcare professionals and other staff are pressured to improvise, fix structural problems, or comply with competing policies, the uncertainty and distress they experience have potential consequences for patients, families, colleagues, and the system itself.

This book presents a new theory of healthcare ethics that is grounded in the nature of healthcare work and how it is shaped by the ever-changing conditions of complex systems, in particular, problems of safety and harm. By exploring workarounds and other improvised practices in complex healthcare systems that are difficult for professionals to talk about openly, yet have unclear effects, including their value or risk to patients, this book offers a realistic look at our changing healthcare system and how we can improve the way we manage moral problems arising in the care of the sick.

Berlinger argues that healthcare ethics in complex and changing healthcare systems should reflect the moral complexity of healthcare work, analyse common ethical challenges with reference to behaviours and pressures driven by the system itself and support opportunities for healthcare professionals and staff at all levels to reflect on the problems they face and to take part in social change. The book's chapters include frameworks for looking at ethical challenges in healthcare as problems of safety and harm with consequences for patients. Are Workarounds Ethical? is designed to support clinician education in medicine, nursing, and interdisciplinary contexts and recommend methods for integrating ethics, safety, and justice in practice.