Are workarounds ethical? : managing moral problems in health care systems

225 Pages·2016·1.505 MB·English

by  Berlinger, Nancy

ARE WORKAROUNDS ETHICAL?

Are Workarounds
Ethical?
Managing Moral Problems
in Health Care Systems
NANCY BERLINGER
1
1
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Library of Congress Cataloging-in-Publication Data
Berlinger, Nancy, author.
Are workarounds ethical? : managing moral problems in health care
systems / Nancy Berlinger.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–026929–6 (pbk. : alk. paper) — ISBN 978–0–19–026930–2
(ebook (updf)) — ISBN 978–0–19–026931–9 (ebook (epub)) —
ISBN 978–0–19–026932–6 (online content)
I. Title.
[DNLM: 1. Ethics, Clinical. 2. Delivery of Health Care—ethics.  WB 60]
R724
174.2—dc23
2015018150
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
To David Anderson Weigel and
the memory of Eric Anderson Weigel

CONTENTS
Preface  ix
1. Should You Wash Your Hands?  1
2. Are Workarounds Ethical?  27
3. Turfing, Bending, and Gaming  74
4. Dirty Hands and the Semiclear Conscience  106
5. Problems of Humanity  134
6. Ethics without Heroics: Foreseeing Moral
Problems in Complex Systems  162
Notes  177
Index  205

PREFACE
In her memoir The Owl of Minerva, British moral philosopher
Mary Midgley describes how she writes books:
My habit has always been, if possible, to develop what I write
out of a previously successful talk, using the suggestions that
have begun to develop in discussion with an actual audience,
rather than writing an article to be printed in a journal and
then reading it out at a meeting. And in preparing the talk
in the first place I would first look for a subject that I myself
thought was really important, and then, in working on it,
I would try to make the reasons for its importance clear at
once to the people hearing about it for the first time. This
means sticking as close as possible to everyday language, not
in the interests of dumbing-down but so as to show how the
topic arises out of its context.
Once I have prepared the talk, I then use it, if I can, for
a number of different audiences. I start to write it down only
when I am fairly satisfied that the point of it is getting over to
those who hear it, and I have digested their comments. If, at
that stage, there still seems to be plenty more to be said on the