Ethical Standards Within the Healthcare Industry Essay

ABSTRACT   Ã‚  Ã‚  Ã‚   This research functions as an analysis of the essential similarities and differences between the ethical standards upheld by the health care sector and the non health care sector. The health care sector includes hospitals, clinics, and private practices while the non-health care sector includes commercial, technological, industrial and other sectors. The paper discusses regulations and legislation of ethical practices and finds that the extent to which ethics and law overlap is dependent on such factors as the type of harm that can be done to citizens as a result of an action. The paper also discusses the extent to which the administration of ethical rules takes place within the sectors in question.   Ã‚  Ã‚  Ã‚   It posits that the health care sector maintains a high standard in ethical practice, especially in the medical, pharmaceutical and a few paramedical fields. It distinguishes as well as defines clearly the concept of ethics and law and how they are legislated in a few selected establishments. Meticulous care has also been taken to probe and illuminate the nuances of the controversial disclosure law and to give insight into the strong ethical question that it addresses in the health care industry. Equally, the issues concerning the consent and privacy rules were also dealt with in an in-depth and comprehensive manner. In addition to this, the paper explains the several ways in which information can be protected from physical and electronic abuse. It also delves into the areas of weakness and threat faced in technological security.   Ã‚  Ã‚  Ã‚   The ethics of the health care and the non health care sectors were also examined through these lens of technological security, and analysis was done of the methods used by each sector to secure information. Finally, the implications of this research outlined at the end of this report and recommendations are then given for improving ethical practice. The researcher suggests ways of improving the quality of ethical standard in the major health sector as well as other branches like the paramedical. Furthermore, the recent developments in electronic assessment and the dissemination of business information are shown to create a need for both regulation and legislation. There is a demonstrated need for simplification of all ethical legislating and regulating information so that such might be made available to everybody who desires to learn and abide by ethical standards. Chapter 1 INTRODUCTION BACKGROUND   Ã‚  Ã‚     Ethics is a philosophy of life and became a part of the business world. The complexity and critical needs of the health care industry are more prone to medical errors which could cost human lives. The quality of care is measured by ethical factors related with the medical industry. However, ethics go beyond quality of care and include many other areas in the health care industry. The role of health care administration in the organization is to ensure that customers are protected completely and that their privacy are not violated.   Ã‚  Ã‚  Ã‚     The practice of ethics is also one of the duties and responsibilities of the Health Care Administrator and as such, the present paper aims to identify the position and practice of ethics in the health care industry with other non health care industries. In doing so, the paper intends to gain insights of ethical practices of non-health care industries and tries to recommend the best practices for the health care industry if gaps are found. In order to evaluate the key issues of ethical practices in both sectors, the paper considers the Information Security aspect of business Information.   Ã‚  Ã‚     Thus, the paper aims to compare the ethical practices mainly concentrating in the primary areas of information Privacy and Security from health care and the E-commerce sectors. Every responsible activity in any organized sector of human endeavor requires some form of regulation. Whether it is written or unwritten, legally documented or morally documented, the study also tries to observe the ethical practices against the industry specific ethical standards and legal policies.   Ã‚  Ã‚  Ã‚   Ethics can be defined as learning of what is right or wrong and then doing the right thing. Generally, ethics are aimed at the employees of organizations whose management experienced problems. LAW AND ETHICS   Ã‚  Ã‚  Ã‚   The Legal Information Institute (1999) defines â€Å"law† as a set of rules that are considered universal and that show both internal and external consistency. They are publicized and are usually accepted by the society in which they are published. They should also be enforced. Such laws are regulations that govern how persons in a given society are expected to behave toward others, who make up the society, and standards the persons who live within that environment are required (and not just expected) to adhere to. The government is responsible for enacting such laws, and is empowered to use security forces to ensure these laws are enforced. Sue Anstead (1999) has identified five following criteria that must exist for laws to be considered as such: consistency, universality, publication, acceptance, and enforcement. First, Consistency refers to the idea that contradictory requirements cannot be considered law, as it would be impossible for people to obey both. Second, universality demonstrates that the requirements should apply to all who share similar situations within a given society. Third, publication promotes the idea that the requirements should be available to all via some method of written publication. Fourth, acceptance means that the requirements must be generally considered appropriate. When acceptance of the law occurs, it will be nearly universally obeyed. Finally, the enforcement criterion reflects the idea that the members of the given group must be forced to comply with the regulation and punished should they choose to disobey.   Ã‚  Ã‚  Ã‚  Ã‚   Anstead (1999) has also noted that the Greek word ethos is that from which the English word â€Å"ethics† is derived. The Greek word is one that means character, and the Latin equivalent of same words adds the idea of custom to the meaning of the term. The combination of these ideas reflects the choice that people within a society make regarding their mode of interaction. The philosophical rendering of the word â€Å"ethics† gives the definition as that which is good or wholesome for the person as well as his social environment and it also describes the duties that should be performed from one person to another.   Ã‚  Ã‚  Ã‚  Ã‚   Ethics has many philosophical traits that one might describe as â€Å"common† to all forms of the term. It is concerned with the apprehension of things considered acceptable—or the distinguishing of right from wrong. Furthermore, ethics are designed compel the individuals to choose the right over the wrong. Decisions that are considered ethical are generally attended by consequences that extend over a discernible period. There are also generally several options regarding behavior, so that a person must make a choice to be ethical in his/her behavior.      Ã‚  Ã‚  However, ethics are not considered to be the same as morality. The difference that lies between them is delicate but important to learn   and understand. Judgment is at the heart of morality, as it has to do with certain â€Å"standards of behavior by which individuals are judged, and [†¦] which people in general are judged in their relationships with others (Anstead, 1999).† Ethics, however, differs from this as it encircles the entire belief system upon which a certain version of morality rests. The values connected with ethics and those principles one finds in conjunction with the law are generally related to each other. However, ethical responsibilities are often greater than legal ones. However, the opposite is also true at times. As a matter of fact, it might be said that â€Å"although law most times embodies ethical principles, law and ethics are far from co-extensive (Ibid).†   One finds that no laws exist against certain actions that may be considered even by many as unethical. On the other hand, the law does prohibit some acts that are not considered unethical but may just be dangerous. Examples of these abound, but just to name a couple: making false claims about a certain situation or betraying the trust of a friend is, in most cases, not considered illegal. However, such an act is almost universally considered unethical. Similarly, speeding is against the law, though many would agree that most people do not find such an action unethical (AMA, 1994; Anste ad, 1999).   Ã‚  Ã‚  Ã‚   McNamara (1999) has described a scenario in which the relationship between law and ethics is depicted. When setting up a set of criteria or guidelines that help in the detection, resolution, and the warding off or discouragement of breaches to ethical codes, an organization is often secured against involvement in further legal problems. According to Anstead (1999), â€Å"Federal sentencing guidelines passed in 1991, for example, permit judges to reduce fines and jail time for executives proportionate to the ethical measures a company has taken (Ibid).† This makes it a wise decision for any company to take time to develop a code of ethics. If an organization develops positive methods for dealing with situations concerning ethics, this will give them the opportunity to extend mitigated punishments, in the event that legal violations do occur.   Ã‚  Ã‚  Ã‚   Guidelines or codes that govern the conduct of individuals, and which are of the sort that is universally agreed upon as good actions, should be provided to the public in written form within a document. Such a document must be observed and upheld as one containing principles that are designed to guide the public (Anstead, 1999). At this point, the document should then be transformed into law. In several contexts, and especially in non-healthcare situations, one finds that the law contains no real documented types of ethical legislation. A person is generally viewed as being capable of and willing to exercise ethical conduct within a given scenario as the need arises. However, no general effort is usually placed into predicting the types of scenarios in which ethics might play a part, as well as the types of ethical behaviors that might be required. As a result, no systematic code of ethics has been captured and written down for several industries outside of the healthcare industry (Anstead, 1999). Many laws have been drafted and put into place, guarding against harm to employees and other modes of unethical conduct in the working environment. The Department of Labor is responsible for the administration of such laws within the United States. However, they are generally reflective of ethical benchmarks adhered to by most persons and organizations within society. Laws that perform such duties include the Americans with the Disabilities Act of 1990 (ADA). The ADA (1990) has stipulated the following: No covered entity shall discriminate against a qualified individual with a disability because of the disability of such individual with regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment (ADA, 1990).   Ã‚  Ã‚  Ã‚   It would not be against the ethical standards of most to admit that the denial of employment, promotions, or other benefits to a person with a disability would be wrong once that denial is based only on the fact that the person carries that handicap. This is especially true when the disability in question poses no impediment to the proper completion of the task required by the job. Ethics in the workplace also extends to the business person who finds himself under no legal obligation to refrain from divulging information given to him in private by a colleague. This is in direct opposition to the kind of confidentiality required in the healthcare system. Medical professionals must adhere to strict guidelines concerning the sharing of information about patients’ medical conditions (Agelus, 2004; AMA, 1994). In doing this, these professionals adhere both to ethical as well as legally binding guidelines. ETHICAL RULES FOR EMPLOYEES   Ã‚  Ã‚  Ã‚   Employees that work within corporations and at executive levels are held to guidelines that are usually termed â€Å"ethics standards† (Anstead, 1999). The sources from which these guidelines are obtained as statutes concerning â€Å"criminal conflict of interests† and those concerning â€Å"administrative standards of ethical conduct† (Ibid). It is by way of such statutes that the government itself has become involved in the enforcement of ethical behavior within the corporate world (Budd, 2005).   Ã‚  Ã‚  Ã‚   The United States has a Criminal Conflict of Interest Statute, and the ethical nature of this law can be reflected within the United States Code. This statute bans such behavior as employees performing such actions that show their own interests to be given priority over that of the Federal government itself. It is known that obtaining information within a business setting is for the purpose of protecting the interested parties equally. In the healthcare industry, this refers to the doctor and the patient. In these scenarios, it becomes in the interest of all persons involved that information divulged in private remains confidential (AMA, 1994). Part 2635 of the Code of Federal Regulations exemplifies standards of administration as stipulated by the Ethical Conduct Regulation. According to Anstead (1999), â€Å"The standards of conduct regulation establish principles of ethical conduct for employees within the executive branch and the regulation not only identifies the principles but also provides easy to understand examples of how the principles apply (Ibid).† These guidelines that govern conduct refer to such actions as how to handle the receipt of gifts obtained from sources outside the organization; how to regulate the exchange of gifts between one employee and another; how to mediate conflicts of interests in financial situations; the removal of biases when conducting official business; how to go about finding alternate employment; the proper handling of a position of authority; how properly to balance activities outside and inside the organization. CODE OF ETHICS   Ã‚  Ã‚  Ã‚   Companies and organizations within the private, non-health sector often set up their own ethical guidelines in addition to the already established guidelines provided by the government. These guidelines may be written in a formal manner, or just informally understood among those persons involved. It is usually up to these private bodies to enforce such codes, as the government is generally not capable. When these codes are violated, employees or members within the organization or group may have their employment terminated.   Ã‚  Ã‚  Ã‚   Within the healthcare industry, as well as in any related sector in which humans are heavily involved in research, strict rules generally govern the actions of the professionals involved. One example of the strictness of such rules is found in the ethics that govern the carrying out of experiments that involve human subjects. Such research is carried out in hospitals, clinics, and even in universities around the world. In such cases, ethics and law work hand-in-hand, and the idea of consent (which shall later be discussed in further detail) form a large part of that research.   Ã‚  Ã‚  Ã‚   The principle concern of all ethical research done on humans is the offer of informed consent to the subjects who participate in that research. This is defined by the researchers’ granting respect and justice to those being studied (Schrag, 1979). Such research methods that include deception, covert observation, or any other type of concealment regarding the use of information or purpose of the research is considered to be unethical. In some cases, however, it might be necessary that participants be recruited, who are unaware of certain aspects of the processes involved in the study. In such cases, an institutional review board or ethics committee must be approached, and accommodations made, to satisfy the committee’s stipulations of certain aspects of the project that may require deception (NHMRC, 2001). STATEMENT OF THE PROBLEM   Ã‚  Ã‚  Ã‚   In the main, this paper seeks to examine from a manager’s point of view, the ethical standards of securing business information in the healthcare industry and in comparison with the ethical standards of securing business information in the non-healthcare industries. As such, this paper intends to answer the following specific questions: What are the ethical standards of securing business information in the healthcare industry? What are the ethical standards of securing business information in the non-healthcare industries? and What is the comparison between the ethical standards of securing business information in the healthcare industry and the non-health care industries? HYPOTHESIS   Ã‚  Ã‚  Ã‚   The ethical standards of securing business information in the healthcare industry are more rigid and standardized compared with the ethical standards of securing business information in the non-health care industries. OBJECTIVES OF THE STUDY   Ã‚  Ã‚  Ã‚   This paper is written in order to achieve the following objectives from a manager’s point of view: To determine the ethical standards of securing business information in the healthcare industry; To determine the ethical standards of securing business information in the non-healthcare industries; To compare and analyze the similarities and differences between the ethical standards of securing business information in the healthcare and non-health care industries; and To recommend for policies or managerial improvements based upon the analysis and implications of the comparison of ethical standards in the healthcare industry, and non-health care industries.   METHODOLOGY   Ã‚  Ã‚  Ã‚   In this study, the literature search is considered to eliminate the possibility of needless duplication of the outcome of the study. The study found that there is no evidence that a comparative analysis of ethical practices was conducted in the health care and e-commerce industries. Hence the study started analyzing the ethical practices in both the industries to make a recommendation to the health care professionals.   The study found that literature review saves considerable time by building on what is already known as well as using tested methodology, including instruments. The study progresses by assessing the merit of previous studies: their soundness, relevance, design quality, findings and conclusions.   Ã‚  Ã‚  Ã‚   The literature research, especially in the findings and recommendations of others, often provides more and more persuasive justification for research on the problem. Previous researchers often identify gaps or areas where more research is needed. Besides enlarging the knowledge about the topic, the method allows to gain and demonstrate skills in areas such as: Information seeking: the ability to scan the literature efficiently, using manual or computerized methods, to identify a set of useful articles and books, and Critical appraisal: the ability to apply principles of analysis to identify unbiased and valid studies.   Ã‚  Ã‚  Ã‚   The Literature is collected from Journal articles, books, Government reports, Theses, Internet articles and online magazines. Each of the sources has its own contribution to the paper. Journal articles were used for their up-to-date and concise information. Books were reviewed to have a basic ground theory and to collect facts on ethical practices. Government and corporate reports were studied to understand the relevant policies and legal frameworks for the ethical practices of the industries considered for the study. Theses and research papers were reviewed to understand and compare the knowledge gained in similar fields by authors and scholars.   Internet articles and online magazines were studied to review the application areas of the study in recent times to gather different opinions and illustrations. ORGANIZATION OF THE STUDY   Ã‚  Ã‚  Ã‚   This paper is organized and structured in accordance with the American Pyschological Association (APA) format. Chapter one discusses the introduction and background of the study including the statement of the problem, hypothesis, and its objectives, and methodology. Chapter two reviews the literature which is also the main research method in data gathering as well as in the preparation for analysis and discussion.   Ã‚  Ã‚  Ã‚   Chapter three analyzes and discussed the ethical standards of gathering information in the healthcare and non-health care industries. Finally, Chapter four concludes and make recommendations. Chapter 2 REVIEW OF LITERATURE DISCLOSURE LAW AND SECURING INFORMATION   Ã‚  Ã‚  Ã‚   It must be agreed that the health sector is one of the most delicate and even complicated sectors of the national economy, and that it requires handling with utmost care. It is intimately concerned with handling the most delicate areas of personal information, as it is involved in the documentation of health records, and the treatment and handling of all ailments suffered by persons within society. So, the management of healthcare data requires competence and very high standard of ethics (Agelus, 2004). So here what must also inevitably be considered is the question of drafting laws and regulations to govern how this information can be secured in the best interest of the stakeholders (Morejon, 2006). Of importance is the question of what the ethical rules are which govern security of these data and information. Also of importance is the protection of the rights of all concerned, and this is what shall be explored here. Sage (2000) has identified the fact of the extreme popularity of laws that require physicians, hospitals, and other healthcare organizations to give extensive disclosure privileges to patients and customers.   He continues: The reason for this lies in politics, not policy: disclosure laws suggest a less intrusive role for government and greater reliance on individual choice and free markets than do other oversight mechanisms. This strikes   responsive chord in today’s anti-regulatory political climate. At a policy level, however, few healthcare disclosure laws have been carefully designed to achieve specific objectives (Sage, 2000).   Ã‚  Ã‚  Ã‚   An interesting and important way in which this process in which regulations are diversified is able to manifest itself is though the popularity of these disclosure laws. (Morejon, 2006). Researchers have expounded on this matter by showing how patients have been requesting extensive information about their health records in direct response to the widening scope of managed healthcare (Marshall et al., 2000).   Ã‚  Ã‚  Ã‚   It has also been applied to regulation ensuring the quality and safety of hospitals and physicians as well as to the laws that are responsible for the decisions made by patients concerning their treatment. The main issue that is currently being faced in the healthcare sector with the laws concerning disclosure is that they are not focused. In the words of Sage (2000), they are â€Å"scattershot, reflecting short-term political compromises or the equities of individual lawsuits rather than a coherent understanding of the purposes served by mandatory disclosure and the conditions necessary to achieve desired effects.† So it is obvious that managing and securing business information is a whole lot of serious issues. In spite of this fact, persons who advocate disclosure are usually quick to point toward such laws issued concerning federal securities as models for healthcare disclosure laws. Their argument is that Congress should carve out for the healthcare industry ethical regulations that are similar to those drafted and enforced by the Securities and Exchange Commission (SEC) or by other financial agencies, such as the Financial Accounting Standards Board (FASB). Sage (2000) agrees that these boards do have the ability to illuminate some of the issues regarding ethics that face the healthcare sector. However, Sage goes on to point out that â€Å"well-designed information requirements can serve therapeutic goals regarding openness, trust, and participation and can remind physicians and other health professionals of the tensions between their daily practice environment and their overarching ethical obligations (Sage, 1999).† Therefore, in order to design fitting ethical standards and reg ulations, the particular idiosyncrasies of the healthcare industry must be taken into consideration.   Ã‚  Ã‚  Ã‚   It is the job of the government to collaborate with the healthcare personnel to establish a hierarchy of actions through which ethical standards might be met. This will necessitate the prioritizing of such issues as education of the public and overall improvement of performance in as far as social issues may have a bearing on decisions made in healthcare. Furthermore, financial considerations should not have too great a bearing on the privacy and self-determination rights of citizens (Hsinchun et al., 2005). These are some of the basic issues that must be kept in mind in understanding the important role the healthcare sector is playing in securing and managing information. Another dimension of ethics exists in the form of economic theory, and in this dimension, no rule exists which stipulates that all consumers must necessarily be completely informed in order that efficiency exist in the sector (Baird et al., 1994). In fact, according to Sage: The SEC has had to accept the fact that the meaning of intricate corporate disclosure may elude unsophisticated recipients, especially as larger segments of the population purchase securities. It has become obvious that, the absence of a secondary market pricing mechanism in healthcare reduces the ability of a few sophisticated parties—such as large employers or government purchasers—to discipline the entire market and those few have smaller incentives to achieve informational superiority (Sage, 2000).   Ã‚  Ã‚  Ã‚   In the opinion of Baird et. al. (1994), â€Å"overcoming the current degree of public ignorance is [still] a weighty challenge for a disclosure regime. This is particularly true because the least educated users of healthcare often have the greatest health needs and are vulnerable both to risk-selection in insurance and to substandard provision of care (Baird et. al., 1994).† The federal security laws establishing disclosure law, as pointed out by Sage (1999), has suggested three core reasons for its necessity, which are to (1) Facilitate market competition; (2) Monitor agents and intermediaries; and (3) Improve corporate governance. The researcher has seen fit to take the time to explain what these disclosure law is as it is considered the basis upon which rests a healthcare officer’s ability to comply with his ethical demands. Again, â€Å"it can serve varied and sophisticated purposes, but only if objectives are clearly articulated and laws carefully designed to achieve them (Sage, 2000).† Dealing with the science of human even veterinary medicine without properly enabling regulatory laws will only lead to frustrations and conflicts (Agelus, 2004; AMA, 1994). This is the foundation and   understanding upon which this research is based. ETHICS IN BOTH INDUSTRIES Every sector in the health delivery field has governing ethical standards that regulate its operations, be it theoretical, clinical, paramedic or even veterinary sectors. Regardless of the different departments, the governing ethical rules are basically very similar. Therefore, bodies exist for the purpose of overseeing and managing, as well as securing the interest, survival and maintenance of these ethical standards. In the same way, the non healthcare sector (covering such fields as technology, law, business, commerce and sports) have their own ethical standards by which all companies are expected to act (Agelus, 2004; Budd, 2005). The stringency of laws that back these ethics, however, tends to differ between the two sectors. Every one who operates in the field of life has a moral or compulsive obligation to play by the rules, and every organized body is governed by sets of rules. These might be rules concerning financial management, training, membership, and qualification for certification in certain fields. These rules all involve the regulation of standards of practice and may be as diverse as the scope of the organization itself. The fact and reality to be noted here is that every member, and all those who desire to be responsibly associated with such a body, must abide by the ethics of such profession in good conscience, and may even be willing to be reprimanded and disciplined when the need calls for it (Baird et al., 1994). For example, lawyers believe that advertising their profession will have dire consequences (David, 2005). So it is expected that no lawyer will be so hungry for patronage as to put up an advertisement to improve his number of cases handled. Professionally that would be unacceptable. In instances such as this, a violation of an ethical standard does not constitute a punishable offence, but would be regarded as a moral burden on such an individual. If it is agreed that lawyers must appear noble, if a â€Å"deviant† lawyer decides to publicly put up an advertisement in the papers or electronic media, there is no law that recommends prosecution. Colleagues, however, may look down on him, or at least see his actions as contemptuous. On the other hand, a civil engineer who opts to carry out an inferior job for a client may go unnoticed for a while. But if, by chance, such a building collapses over time, he may be sought out and may face possible prosecution. However, the reality is that certain ethical standards hardly have strong backing from the law enforcement agencies. The reason for this is that many are merely regulations and unwritten codes of understanding (Anstead, 1999). On the other hand, most health sector fields are very strict in adherence and implementation of their ethics of practice (AMA, 1994). The reason is quite obvious. The health sector has very strong relationship with maintaining human life, human health, hygiene, animal life, environmental concern, etc. So laxity, negligence, deliberate omission and commission may lead to casualties and unintended sad consequences. It could be conceded, therefore, that the ethics in the healthcare sector has a much stronger backing than its counterpart in the non-healthcare sector. For instance, a doctor who violates his code of practice, or carries out action that is not in conformity with the rules of practice will stand the risk of having his license withdrawn In his preface to his book, The Ethics of Human Resources and Industrial Relations, J.W. Budd, had this to say: In the business and economic spheres, many of the most pressing ethical issues involve the employment relationship, such as the rights of employees versus ER shareholders, employee privacy and monitoring, whistle blowing, pay equity, discrimination, employee safety, anti-union campaigns, and minimum labor standards. Since the field of human resources and industrial relations is ultimately about people and quality of life, there is a pressing need to develop applications of business ethics for the employment relationship in the context of research, practice, and teaching (2005, p. 1).   Ã‚  Ã‚  Ã‚   In following the media coverage of the many scandals which have plagued countries throughout the world, the public has gained a greater understanding of what can happen when businesses do not adhere to ethical practices. Many scholars of business ethics consider that it is now time for the human resources and industrial relations communities to explore the application of ethics to the employment relationship and to discover the importance of treating employees, not just numbers, properly. This goes to show that the issue of observing ethics in profession is gradually taking a more serious dimension (Marshall et. al., 2000; Sage,   2000). POSSIBLE CONFLICTS   Ã‚  Ã‚  Ã‚     It has already been emphasized that certain beliefs and actions may be perfectly legal, but might yet be considered unethical. One organization, the Marriot Corporation, holds itself and its employees to some very high ethical standards (Anstead, 1999). In fact, certain aspects of the company’s standards might be said to be overdone. However, in the pursuit of comprehensive ethical standards, the dress code, for example, had once included certain stipulations that might today even be considered unethical. This had to do with the appearance of its employees while on the job, and on some level extends itself into areas that differentiate the sexes in what might be considered inappropriate ways today.   Some stipulations were (1) Prohibition of women from wearing skirts that go higher than about four inches above knee level; (2) Prohibition of women from showing bare legs and the requirement that they wear panty hose or long pants always; (3) Prohibition of women from wearing clothing that exposed their shoulders; (4) Prohibition of men from wearing their hair at a length that touches or goes beyond the collar without having express religious reasons for doing so; and (5) Prohibition of men from wearing certain types of jewelry, such as earrings. Despite the fact that such rules were considered binding within the confines of the company itself, nothing regarding them had anything to do with legal status at a judicial level. Still, within the culture of the Marriot Corporation, behaviors that went against the established codes were considered unethical (Anstead, 1999).   Ã‚  Ã‚  Ã‚   There is also no law exists that prohibits companies from outsourcing their manufacturing jobs for the sake of profit. Furthermore, though minimum wages might differ greatly between the host country and the United States, corporations are not bound to meet anything more than the minimum wage requirement of the host country in order to remain unsusceptible to legal action.    Succinct with to the two aforementioned examples, other practices (though lesser in degree by comparison) demonstrating illegal actions might be considered ethical by the majority of the public. The removal of office supplies at ones place of employment for personal use is one such example. Another is the installation of a copyrighted program on multiple computers within a company. Technically, such an action is in violation of intellectual property and other copyright laws (Budd, 2005; Software Use, 1999). Despite this, â€Å"the piracy of software is widespread, even in corporations that con sider themselves ethical† (Anstead, 1999). Like the healthcare industry, the software community has plenty of legal backing when it comes to the proper use of its products. Unlike the healthcare community, however, many breaches to the legal guidelines take place and little is (or can be) done to prevent this. One reason for this is that such illegal conduct is difficult to detect and control, and such widespread software knowledge exists that hackers may be able to get around security measures, further complicating the matter.   Ã‚  Ã‚  Ã‚   Copyright law enacted by the Federal government seeks to protect software creators as soon as the product has been developed. Title 17 of the United States Code concerns the Copyright Act, see 17 U.S.C.A.  § 102, and accords exclusively to the developers and owners of software the right to reproduce and disseminate the work in question. Anyone found to encroach upon the rights of the owner of the copyright is subject to penalties, and those who purchase a copy the software has license only to put the software on one computer and create a back-up copy for the purposes of archiving it.   Ã‚  Ã‚  Ã‚   The discrepancy one finds between the sentiments of different persons concerning software piracy is akin to the delicate difference between what is legal and what is ethical. Many people are adamant in their belief that certain illegal uses of software are indeed ethical. Yet, the financial impact that such piracy has globally is significant. One study has shown that in 1998, approximately 38% of all software installed in businesses worldwide was pirated, and this amounted to a reduction in profits of approximately $11 billion (SILA, 1999).   Ã‚  Ã‚  Ã‚   When one considers the management of a non-healthcare businesses, it becomes clear that rules governing ethical practices are less stringent than those within the healthcare industry. Ethics are not compulsory, though it usually benefits the company to demonstrate ethical practices. The relationship between law and ethics becomes evident here again, and such a relationship is of immense importance in the area of management. It is one of the duties of managers to assess both what is considered legal and what is considered ethical in the running of their businesses. It is the job of managers, therefore, to ascertain whether employees and the company as a whole abide by the legal statutes and societal standards concerning ethics. Also important here is the evaluation of what is considered acceptable and ethical behaviors by customers—as they also must be satisfied as much as managers and employees are with the ethics of the company (Budd, 2005). It is of course true that no policy developed to secure ethical standards will be satisfactory to all concerned. However, managers have the responsibility of establishing the most comprehensive code of ethics possible given the information currently available to him or her. The code will have the advantage of demonstrating to employees, customers, and society alike that the company is at least concerned with the ethical practices of those who do business in and with it. In this way, businesses outside the health industry do themselves a favor by demonstrating ethical practices above and beyond their legal obligations. However, within most non-healthcare sectors, such attention to ethics is not mandatory (Budd, 2005).   Pains have been taken to go through the above details for the purpose of making it possible for readers to appreciate what and how ethics apply in other aspects of life. However, this study will be limited to the healthcare and non healthcare industries, focusing on their ethical standards in securing information. ETHICS AND PRIVACY   Sometimes, people may act deliberately to defy the written and unwritten codes of ethics within their line of work in the organizations. This may be done through deviant means, such as sophisticated electronic devices that facilitate the bugging or taping conversations that were never meant to be recorded. It appears that such actions occur more in the business world than in the health world. It is not, for example, common to hear of health workers engaging in such extreme activities in order to gain access to information of a delicate and private nature. However, one does hear of other forms of ethical breaches in the health sector and the pharmaceutical industry. Some scientists may also attempt to misrepresent the results of clinical trials for similar reasons. Such actions are unethical as they may eventually prove harmful to the public at large (Bassett, et al., 1992; Girotra, Terwiesch & Ulrich, 2006).   Ã‚  Ã‚  Ã‚   The issue of consent according to the Privacy Rule, states that workers and establishments in the healthcare sector, such as physicians, hospitals and clinics must receive consent from patients or other clients before compromising or turning over to a third party information concerning that person’s state of health. Such permission must be given in written form prior to the disclosure and before any form of treatment or other operation can be performed (Sage, 2000). Currently, it is the practice of healthcare providers to â€Å"obtain a patient’s consent for disclosure of information to insurance companies or for other purposes (DHHS, 2001, p. 4).† This is done for reasons having to do with ethics and professionalism. The Rule itself has as its foundation these said practices, and these rules are eventually expanded for the purpose of having a uniform system by which workers in the healthcare sector can systematically gain consent for the procedu res necessary to ensure the proper treatment of patients (DHHS, 2001; Hsinchun et al., 2005). GENERAL PROVISIONS   Ã‚  Ã‚   According to McNamarra (1999), the general provisions for ethical standards in the healthcare industry are as follows:  Ã‚   It is necessary for patients to give consent prior to being treated by health care provider that offers direct treatment to that patient. Such a health care provider may utilize or share protected health information (PHI) only for purposes of TPO. Exceptions to this standard are given subsequently; When an emergency arises (such as in the event of life-threatening accidents or communication barriers), it is possible for health care workers to use and disclose information concerning a patient without first having obtained his/her consent. This is especially true in the health care sector, where laws require that workers treat patients that come into their care; Certain members of the healthcare community whose employees have very minimal contact with patients, such as persons who work in laboratories, may use or disclose information concerning those patients without first obtaining their consent. Other organizations within the health care sector, such as health insurance agencies and clearinghouses also have the privilege of using or divulging patients’ information without gaining consent. These agencies do have the option of getting this consent if they wish to do so—but it is left to their discretion; Health care providers have the right to refuse treatment to any patient who fails to grant permission for disclosing their protected health information. It is not necessary for such consent to be obtained by more than one provider at any given time; and There is no real need for the document that gives consent to be an in-depth one. Such permissions may be given in very general language. The language must, however, be plain enough to be easily understood. It must also contain all that is necessary to make it clear to the patient that any information that is provided might be shared and that he/she does have the right to refuse, impose restrictions, and to peruse the privacy statement of the organization. The consent may be a brief document in written from with general terms. Any such statement must then be signed and dated by either the patient himself or the patient’s proxy (McNamara, 1999). INDIVIDUAL RIGHTS   Ã‚  Ã‚  Ã‚     Individuals have the right to revoke statement of consent except when the health care provider has already acted in response to the consent. Restrictions may be imposed upon the permissions for disclosures and uses of protected information. The provider is not obligated to agree to these restrictions, but must abide by those to which it does agree (McNamara, 1999).   Ã‚  Ã‚     Patients must be privy to the privacy codes of the entity to which he/she gives permission to use or disclose information—and such access to the privacy code must occur before signing consent forms (Ibid). ADMINISTRATIVE ISSUES According to the Department of Health and Human Services (DHHS), any consent form that is signed by a patient must be kept by the health care provider (or other entity) for a period of six years following its last effective date. The forms may be retained in paper form, electronically, or otherwise—this is left to the discretion of the provider.   Ã‚  Ã‚  Ã‚   Further provisions for privacy and consent have been issued, which stipulate that if a covered entity obtains consent and also receives an authorization to disclose PHI for TPO, the covered entity may disclose information only in accordance with the more restrictive document, unless the covered entity resolves the conflict with the individual. CONSENT VERSUS AUTHORIZATION â€Å"Consent† is the name given to any document that accords to health care personnel the permission regarding the usage and disclosure of delicate information regarding a patient. This permission is granted solely to the particular health personnel (Sage, 2000). It is not necessary that the consent form be specific about the type of information that will be used included in the disclosure (Sage, 2000). It is generally only the â€Å"direct treatment provider† that has the legal right to obtain consent from the patient, and such a person should be â€Å"one that treats a patient directly, rather than based on the orders of another provider, and/or provides health care services or test results directly to patients.   Ã‚  Ã‚  Ã‚   An authorization differs in that it offers requests for permissions to patients in a fashion more tailored to suit them and their health needs. This offers permissions to use specific portions of a patient’s PHI for detailed and specific purposes. Such purposes are usually for things that are unrelated to the TPO or for disclosure to be done with a specified third party. Authorizations expire, while consent forms are more open concerning the time-frame in which information might be used or disclosed. Further stipulations include the fact that â€Å"covered entities may not condition treatment or coverage on the individual providing an authorization† and that it â€Å"states the purpose for which the information may be used or disclosed† (DHHS, 2001, p. 6). PRIVACY RULES IN THE HEALTH CARE SECTOR   Ã‚  Ã‚  Ã‚   It is highly necessary to have a deeper understanding of what privacy rule entails as a basis for sustaining quality ethical standard especially for someone working in the healthcare sector. In the healthcare industry, privacy is a more delicate issue than other sectors and its workings are very intricate. The background information released from the Office for Civil Rights, (DHHS, 2001; OCR, n.d.) indicates the intricacy of the Privacy Rule, which became effective on April 14, 2001. The Privacy Rule, according to the Department of Health and Human Services, â€Å"provides the first comprehensive federal protection for the privacy of health information† (DHHS, 2001, p. 1).   Ã‚  Ã‚  Ã‚     The different departments within the health care sector have all joined in support of the aims advocated by this rule to protect the privacy of the patient. However, these departments also understand how necessary it is that privacy not interferes with the treatment of patients (DHHS, 2001; OCR, n.d.). The delicacy of the privacy problem becomes even more apparent for other reasons. Though privacy consents and authorizations are generally granted to primary care providers, health care clearing houses and health insurers, it is usually the case that such entities require the aid of yet other entities (such as contractors) in order to provide the best care possible to the patient. To make allowance for the possibility of divulging PHI to such associates, conditions and stipulations are included in the privacy rule for ensuring that the provider obtain satisfactory assurances that the business associate will use the information only for the purposes for which they were engaged by the covered entity, will safeguard the information from misuse, and will help the covered entity comply with the covered entity’s duties to provide individuals with access to health information about them and a history of certain disclosures. Therefore, personal health information can only be shared with contractors and associates when such information is necessary for the providers to do their jobs accurately and thoroughly. To facilitate the usefulness of this regulation to the health care officer as well as the individual in securing information in compliance to the ethical requirements, most health care providers must know that they are covered by the new rule and therefore must comply with the new requirements. Analysts have wondered whether these requirements for consent have not presented barriers to the proper treatment of patients, as this often necessitates open consultation with other specialists and health care providers. However, the stipulations of the consent requirements should not hinder such comprehensive treatment, as those providers who had at one time treated the patient would have also been required to obtain such consent. Furthermore, since necessary consultations with other health personnel are considered part of the â€Å"treatment of an individual, it is considered within consensual boundaries to engage in such consultation. Such actions are therefore considered ethical.   Ã‚  Ã‚  Ã‚   The ethical practices in the commercial, technological and other industrial sectors are governed by corporate regulations and social responsibilities. The issues of these sectors differ from those of the health care sector, which deals with the more serious issues of providing medication for human and veterinary sciences, and as such, requires more serious and stringent ethical standard compliance (Hsinchun et al., 2005). PRIVACY IN THE CONTEXT OF E-COMMERCE   Ã‚  Ã‚  Ã‚   The ethical difficulties associated with e-commerce revolve around privacy and identity, both with reference to the human subject involved in the transaction and transaction non refutability (Baum 1998, p.65; Suprina 1997, pp.8–12; Joyanes, 1997, pp.277–281).   Ã‚  Ã‚  Ã‚   The online e-store Amazon (Linden, G., Smith, B. & York, J. as cited in Teemu Mutanen) uses consumer data on cross-selling growth and the   information about buying patterns is transformed into recommendations. Chris Anderson as cited in Teemu Mutanen argues that this combination of good-quality recommendations with huge inventory of items is a real business advantage. The advantage is gained only if the customer can be targeted with relevant recommendations, the variety of items is not sufficient. Hence E-commerce organizations tend to use the consumer data they have collected from their visitors through online transactions.   Ã‚  Ã‚  Ã‚   However, the online consumers expect ethics from the e-commerce traders in protecting the privacy of their details.   They want the e-commerce sites to have and to display a highly visible privacy policy, which can be easily understood. They want a prominent page where corrections of past mistakes are available. Berman & Mulligan highlights that an internet-user possesses three expectations when online: (1) an expectation of anonymity, (2) an expectation of fairness and control over personal information, and (3) an expectation confidentiality (Berman & Mulligan 1999).All three expectations are eliminated through three critical cyberspace practices that are (Gindin, 1997): 1) personal information provided on the Internet, (2) online transactions, and (3) government record keeping. Although each practice provides only a minute description of an individual’s personal life, the slow accumulation of such descriptive material may eventually expose a detailed profi le (Mason 1986).   Ã‚  Ã‚  Ã‚   The consumers’ experiences on the Net concerning their privacy lists several themes. Beth Givens in his presentation, ‘Privacy Expectations in a High Tech World’ outlined the following themes on consumer experiences regarding privacy concerns: The first theme is the invisibility of data capture.   Ã‚  Ã‚  Ã‚   A second theme is the potential ubiquitousness of data gathering, and the ability of data from several sources to be merged to create massive electronic dossiers on individuals. A third theme is invasion. Web sites can capture and track visitors’ clickstream data by placing small text files called â€Å"cookies† onto their hard drives. Unless users are savvy enough to set their browsers to notify them about the pending placement of a cookie, it is done without the user’s consent, and it’s an invisible process. A fourth theme is the fear of harm befalling Internet users – fear, and a fifth theme is confusion over their privacy rights.   Ã‚  Ã‚  Ã‚   The problem of privacy in e-commerce is concerned with the difficulty of securely conveying the information required for online transactions (Suprina, 1997 as cited in A.J.G. Sison).   Ã‚  Ã‚  Ã‚   Information technology and computer professionals began seriously considering the long-term effects of computer ethics in the late 1980s and early 1990s. They recognized the need to organize professionally through such bodies as the Association for Computing Machinery and the Institute of Electrical and Electronics Engineers to devise professional codes of conduct. However, the increasing proliferation of powerful computers in the hands of nonprofessionals widens the scope of potential problems. PRIVACY AND ETHICAL INFORMATION AMBIGUITY Ethical ideologists have confusing opinions most of the time, and such problems can actually undermine ethical practices (Budd, 2005). In one profession, an action which is not ethically sound may not even be considered an offense in law. In many cases, there is no clear demarcation as to what is ethically wrong and what is legally offensive.   Ã‚  Ã‚  Ã‚   These are some problems encountered by those who practice in the healthcare field, and there exists by no means a consensus on what should be done in such cases (AMA, 1994). For example, economic ethical theorists believe it is the right of every citizen of a country to access health and medical opportunities, irrespective of his financial status (Budd, 2005).   DISCLOSURE LAW IN HEALTH CARE   Ã‚  Ã‚  Ã‚   It must be agreed that the health sector is one of the most delicate and even complicated sectors of the national economy, and that it requires handling with utmost care. It is intimately concerned with handling the most delicate areas of personal information, as it is involved in the documentation of health records, and the treatment and handling of all ailments suffered by persons within society. So, the management of healthcare data requires competence and very high standard of ethics (Agelus, 2004). So here what must also inevitably be considered is the question of drafting laws and regulations to govern how this information can be secured in the best interest of the stakeholders (Morejon, 2006). Of importance is the question of what the ethical rules are, that govern security of these data and information. Also of importance is the protection of the rights of all concerned, and this is what shall be explored here. Sage (2000) has identified the fact of the extreme popularity of laws that require physicians, hospitals, and other health care organizations to give extensive disclosure privileges to patients and customers.   He continues: â€Å"The main issue that is currently being faced in the health care sector with the laws concerning disclosure is that they are unfocussed†. In the words of Sage (2000), they are â€Å"scattershot, reflecting short-term political compromises or the equities of individual lawsuits rather than a coherent understanding of the purposes served by mandatory disclosure and the conditions necessary to achieve desired effects.† So it is obvious that managing and securing business information is becoming a serious issue from the standpoint of ethics and law. In spite of this fact, persons who advocate disclosure are usually quick to point toward such laws issued concerning federal securities as models for healthcare disclosure laws. However, Sage goes on to point out that â€Å"well-designed information requirements can serve therapeutic goals regarding openness, trust, and participation and can remind physicians and other health professionals of the tensions between their daily practice environment and their overarching ethical obligations† (Sage, 1999).   Ã‚  Ã‚  Ã‚  Ã‚  Therefore, in order to design fitting ethical standards and regulations, the particular idiosyncrasies of the health care industry must be taken into consideration. This will necessitate the prioritizing of such issues as education of the public and overall improvement of performance in as far as social issues may have a bearing on decisions made in health care. Furthermore, financial considerations should not have too great a bearing on the privacy and self-d etermination rights of citizens (Hsinchun et al., 2005). These are some of the basic issues that must be kept in mind in understanding the important role the health care sector is playing in securing and managing information.   Ã‚  Ã‚  Ã‚   Certain practices that may be acceptable in a health care setting are included below under the condition that measures are taken to keep   minimum disclosures and other ways of exposing delicate information (Sage, 2000):   Health care personnel are at liberty to coordinate actions orally for the service of patients when located at nursing stations within a hospital;   Doctors, nurses, and others responsible for patients are allowed to converse about the condition of a patient currently under their care, whether on the phone, in the presence of the patient, with a provider, or with another (authorized) family member;   Doctors and nurses are allowed to converse concerning test results from a   laboratory. They may do so with the patient or just amongst themselves in an area for joint treatment; and   Health care personnel are also allowed to discuss the condition of a patient when involved in rounds dedicated to training when in an institution that facilitates the training of health care workers (Sage, 2000).   Ã‚  Ã‚  Ã‚   Also necessary are ethical measures that govern the language that might be used during the care of a patient. When talking in elevated tones becomes necessary in a less-than-private location, the language used should be carefully tailored and then reinforced as the proper method of oral communication among colleagues.   In the same way, businessmen who may be discussing classified information may not be aware of the ability of a person in another room to hear the details of their private conversation. Nothing forces this hearer to block his ears or otherwise ignore the delicate information being transmitted to him, and as a result he becomes privy to privileged information (Budd, 2005; Sage, 2000).   Ã‚  Ã‚  Ã‚   Self-protection mechanism can be described with the online users when they decide on the choices provided for them without any assistance.   When individuals chooses not reply to â€Å"Spam† e-mail even to request removal from a mailing list since replies indicate to a company that individual’s e-mail account is active and marketable (Navrette, 1998). Such measures protect privacy information by providing steps that may prevent the transmission of personal information to business and criminals. In this protective mechanism, individuals remain in control of their own personal information without the assistance of other groups. ROLE OF HEALTH CARE ADMINISTRATOR   Ã‚  Ã‚  Ã‚   Health care industry is also a business industry including management and administrative responsibilities. The managers of the health care industry are called as health care administrators who take responsibilities for planning, direction, coordination, and supervision and the delivery of health care. Unlike the administrators in other industries, health care managers include specialists and generalists. Generalists manage or help manage an entire facility or system, while specialists are in charge of specific clinical departments or services.   Ã‚  Ã‚  Ã‚   Due to the rapid changing in the structure, technology adaptations, evolving integrated health care delivery systems, an increasingly complex regulatory environment, restructuring of work, and an increased focus on preventive care, the role of the health care administrator is also changing and modifying according to the situation. They are responsible to improve efficiency in health care facilities and the quality of the health care provided.   Ã‚  Ã‚  Ã‚   The health care administrators are responsible for the maintenance of patient records, health plans etc., along with the regular Information System managers. In order to maintain authentication and privacy of such key records, the Healthcare administrators should be flexible with the technology, requirements and the developments in and around the industry. The accurate and continuous maintenance of patient record database lies in the hands of the health care administrator and he should maintain the patient record database accurately and completely.   In addition,   as the health care data is also being shared with others for the purpose of research and compliance practices, the expertise and skill levels of health care administrators have become more crucial in maintaining privacy and ethical practices of the industry.   Ã‚  Ã‚  Ã‚   In this context the health care administrators are often called on to maintain and develop professional standards, procedures, and policies for their institutional activities. The expanding role of the health care administrator includes management of preventive medicine and health care programs, medical and vocational rehabilitation, community health and welfare etc. which needs good leadership and managerial skills along with sound knowledge of policy and protection regulations. CONCLUSION   Ã‚  Ã‚  Ã‚  Ã‚   The review of the literature is also the main research method in this study. As such, it was found in the review that ethical standards in acquiring business information in the healthcare industries are much more rigid and organized compared to the ethical standards in the non-health care industries. Thus, the review   affirms the temporarily the hypothesis of this study. Thus, the next chapter would further discuss and analyze the ethical standards of both industries so as to make a conclusive finding regarding the hypothesis of this study.