Analysis of Ethical Failures: Gosport War Memorial Hospital Case Study

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Table of Contents
Executive Summary...................................................................................................................1
Introduction................................................................................................................................2
Analysis......................................................................................................................................3
Using your case study as an example, discuss to what extent ethics play a part in the
success or demise of an organisation.....................................................................................3
What measures can an organisation take to ensure ethical practice?.....................................6
Conclusion..................................................................................................................................8
Recommendation........................................................................................................................9
References................................................................................................................................10

Executive Summary
Ethics and values are important for every organisation, especially the organisation indulge in
health and care practices. In the present case, wrongful acts of the Dr Barton in Gosport War
Memorial Hospital towards the patients not only impact the business practices, but also
influence the performance of other staff members. The opioid drugs given to the patients by
the Dr Barton has steal their lives and left their family members in grievances. The report has
discussed how the code of ethics and standards can improve the current performance of the
hospital and the measures along with recommendations that can be implemented to ensure
that such unethical acts does not repeat in any situation.
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Introduction
The lack of quality services in the health care organisation affects the relationship between
patient and professionals there. Therefore, the ethical code must be developed to make the
professionals, doctors, and nurses realise their ethical responsibility in practical application.
Ethical codes play an important role in shaping the structure and moral environment of the
Gosport War Memorial Hospital. The hospital is the part of NHS Foundation Trust situated in
England. The present report has examined the internal functioning of the hospital in which Dr
Jane Barton was giving opioid drugs to the patients since 1990 during their treatment. The
continuous dose of drugs has resulted in the loss of 456 patient’s lives. Such act of Dr Jane
Barton was supported with the other staff members as they do not take the initiative to report
against their acts.
When senior nurses report such acts to the Royal College of Nursing, they were advised not
to make such issue big and do not take such matte further. However, the continuous efforts of
patient’s families have resulted in disciplinary actions against Dr Barton. The current report
has concluded some of the basic principles in relation to an ethical and standard code of
practices for all the staff of Gosport War Memorial Hospital along with some measures that
can help the organisation in preventing any malpractices within the hospital.
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Analysis
Using your case study as an example, discuss to what extent ethics play a part in the success
or demise of an organisation.
Organisational ethics in health care organisation play a crucial role in influencing the
employees' behaviour, organisational working environment and growth. Ethics cannot be
considered as optional, especially in the field of medicine. Ethical environment reflect the
characteristics and business practices of Gosport War Memorial Hospital. Due to high
sensitivity in the medical arena, linked with life and death stakes, ethical practices in the
professional work are of the utmost importance. Hence, it is essential for the senior board of
directors of the Gosport Hospital to integrate ethical code of practices with the working
practices to ensure every individual gets responsible for ethical practices (Frith, 2013). There
are various professionals, and experienced people who work for the patients in the hospital,
like doctors, nurses, specialists, technicians, etc. that drive their efforts towards organisational
success. However, lacking ethical practices in their work adversely affect the image of the
hospital in the eyes of people.
In the present case, Dr Jane Barton is giving opioid drugs to the patients since 1990 which
has affected the lives of more than 400 patients in the Gosport Hospital (Gosport War
Memorial Hospital, 2019). This is the result of a lack of effective, ethical practices and strict
disciplinary code by the leaders and managers. In the hospital, all the professionals at a
different hierarchical level are responsible for complying with ethical practices, failure of
which organisational efficiency and practices are challenged (Sandman et al., 2017).
To drive the organisation towards success, there is a national code of ethics prescribed to
develop a strong sense of ethical responsibilities among nurses and doctors towards their
duties for the patients. The code acts as the foundation for the nurses and other health care
professionals in making ethical decisions.
The ethical guidelines for health care professionals can be understood with the following
points:
Ethical practices towards people:
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 Nurses, doctors, administrative staff and other professionals at Gosport Hospital are
required to make their efforts for the prevention of diseases, restoration of health, and
reduce pain sufferings of the patients.
 Educate people in relation to disease prevention and health promotion, considering the
prime and ethical responsibilities towards the patients (Vollmann, 2013.).
 Address the ethical issues in the health care professions in cooperation with other
colleagues and team members to best health care services to the patients without
compromising any health and care services.
Ethical practices in Professional practices
 While taking clinical and, medical decisions take into account the ethical practices as
well as professional and legal liabilities
 To ensure a safe and healthy environment to the patients in the hospital with efficient
performance, quality and timely services, along with the complete record of the care
 Keep the personal information of the patients confidential, and take the informed
consent before going on any life staking medical services (Francer et al., 2014)
 In case of any mistake, accept it with honest to the patients and perform the job with
fairness and truthfulness in all the circumstances.
 Before introducing any new product in the health care treatment, must consider the
risks associated with it and provide the complete information of the products to the
patients regarding its benefits and risks.
Ethical practices with Co-workers
 The senior professionals are required to act as a role model for the subordinates in
Gosport Hospital
 Senior officials are required to put their best efforts into transferring the ethical and
legal information to other staff
 To resolve ethical issues and dilemmas, consult ethicist along with the participation of
all the staff at Gosport Hospital.
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 Behave in a fair, equitable and respectable manner with other nurses, doctors, and
specialists (Mullick et al., 2013).
 Discuss with the senior officials, if there is any conflicts of interest arises among the
staff at the hospital to ensure patients rights are preserved
 Develop a professional relationship with all the staff working at different levels, like,
head nurses, leaders, supervisors, directors, departmental heads, etc.
The board of directors of Gosport Hospital are required to consider above code of ethics so
that the wrong and ethical act can be prevented and high efforts can be devoted to treat and
save the lives of the patients.
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What measures can an organisation take to ensure ethical practice?
The ethical culture within the Gosport Hospital is required to be established to control the
malpractices prevalent since the 1990s. The unethical act of Dr Jane Barton has resulted in
the loss of lives of around 456 patients. Other nurses and pharmacist have not taken any
appropriate step to prevent such malpractices. Hence, the General Medical Council is
required to take the following measures to ensure ethical practices are followed at the
Gosport Hospital:
Create policies and practices: Gosport Hospital is required to research, develop and
implement policies and procedures in relation to the identification, defining, and reporting of
all the ethical violations within the hospital (Faden et al., 2013). It is essential to integrate
such ethical practices into the employees' handbook, and appropriate protective measures
must be provided for those nurses and health care aids who report for ethical violations. The
General Medical Council is required to implement the ethical code of practices for the entire
professional in the hospital to ensure high satisfaction to the patients.
Hire Right: The ethical practices within the Gosport Hospital can be improved with the
hiring of a competent and qualified person from day one. Hence, it is essential for the hospital
to ensure background checks, conduct behaviour based interviews, purchase screening tools,
etc. while hiring persons for the hospital. For example, in the present case, Dr Barton has
violated the ethical practices of the hospital, hence recruiting such type of resources affect the
quality of services to the patients. Therefore, to judge the employees, recruitment panel must
ask questions to them regarding the situations where they acted ethically or faced any ethical
dilemmas.
Develop People's Understanding: It is required to make sure that people at the Gosport
Hospital must be well acquainted with the developed ethical code of practices and the
disciplinary actions of violating it. This helps to develop an ethical environment within the
hospital (Fox, 2013).
Put Controls in Place: The Gosport Hospital is required to appoint risk management
professionals that devote their energy towards periodical auditing to reduce the opportunities
of unethical acts. It supports the hospital in reconsidering the present ethical policies to make
necessary changes to mitigate the malpractices.
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Build a Culture of Transparency, Openness, and Communication: The management of
culture in the health and care organisation is difficult, as different profession work and
cooperate with each other that belong from different backgrounds and profession. For
example, specialists, doctors, nurses, etc. work with each other to effectively treat the
patients. Hence, to ensure true success in Gosport Hospital, it is essential to integrate the
organisation culture with ethical standards (Runciman et al., 2017). The working environment
must be transparent and open where employees can identify what is going around there and
feel comfortable to speak about any unethical acts within the hospital.
Leadership Must Walk the Talk: Leaders are the main individual within the organisation that
can drive the efforts of subordinates in align with the ethical practices. Hence, it is essential
that leaders pursue ethical practices as they are the ideals for their subordinates. For example,
if in the present case, leaders acted ethically, then Dr Barton cannot proceed with the
malpractices at the Gosport War Memorial Hospital. Hence, the General Medical Council is
required to develop an ethical code of practices for the leaders also so that all their activities
can be regulated in an efficient and ethical manner (Kodish et al., 2013).
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Conclusion
From the above discussion, it is identified that health care organisation not only requires to
focus on their quality services but also have to conduct them ethically. Whether performing
the role of a doctor, or any other health care aids, working in the field of medicals is very
challenging and rewarding. Ethics is an integral part of such challenging roles. Health care
professionals are expected to adhere to all the provisions and practices of ethical codes while
treating their patients. In the present report, the significance of ethical practices within
Gosport War Memorial Hospital is identified. Some of the measures are provided that can
help the hospital in preventing any malpractices followed since 1990 due to the act of Dr Jane
Barton there.
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Recommendation
In the present case, the disciplinary actions taken against Dr Jane Barton has reflected other
staff at the hospital that taking the lives of patients at stake will result in disciplinary actions
against them. However, the doctor was getting retired in coming years; therefore, his name
was not struck off from the register. This may impact other staff members at the hospital. The
hospital is indulging in sensitive activities and therefore, a mistake in the performance of any
person may take the life of an individual there. Hence, it is recommended that the General
Medical Council is required to frame policies and procedures which includes strict
disciplinary actions against any malpractices at the Gosport hospital. It is also recommended
that a seminar must be conducted in which all the staff are required to inform about such acts
of Dr Jane Barton and their contribution in supporting it so that a sense of individual
responsibility can be developed. The seminar must entail the developed code of ethics and
how it can be practised in the profession of medicine.
It is also recommended that the hospital must create a team that put all its efforts in
identifying any unethical practices in the hospital and report it to the General Medical
Council so that strict control over the hospital activities can be made. In addition, those
employees who report against unethical practices in the Gosport hospital must be provided
with appropriate protection so that they can freely perform their professional services.
Leaders must be encouraged to develop a cooperative and ethical working culture at the
hospital so that high-quality services can be provided to the clients. It is also recommended
when the senior official identify any unethical practices within the hospital then the principle
of justice must be followed to ensure justice to the victim.
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References
Books & journals
 Faden, R.R., Kass, N.E., Goodman, S.N., Pronovost, P., Tunis, S. and Beauchamp,
T.L., 2013. An ethics framework for a learning health care system: a departure from
traditional research ethics and clinical ethics. Hastings Center Report, 43(s1), pp.S16-
S27.
 Fox, E., 2013. Evaluating ethics quality in health care organizations: looking back and
looking forward. AJOB Primary Research, 4(1), pp.71-77.
 Francer, J., Izquierdo, J.Z., Music, T., Narsai, K., Nikidis, C., Simmonds, H. and
Woods, P., 2014. Ethical pharmaceutical promotion and communications worldwide:
codes and regulations. Philosophy, Ethics, and Humanities in Medicine, 9(1), p.7.
 Frith, L., 2013. The NHS and market forces in healthcare: the need for organisational
ethics. Journal of medical ethics, 39(1), pp.17-21.
 Kodish, E., Fins, J.J., Braddock III, C., Cohn, F., Dubler, N.N., Danis, M., Derse,
A.R., Pearlman, R.A., Smith, M., Tarzian, A. and Youngner, S., 2013. Quality
attestation for clinical ethics consultants: A two‐step model from the American
Society for Bioethics and Humanities. Hastings Center Report, 43(5), pp.26-36.
 Mullick, A., Martin, J. and Sallnow, L., 2013. An introduction to advance care
planning in practice. Bmj, 347, p.f6064.
 Runciman, B., Merry, A. and Walton, M., 2017. Safety and ethics in healthcare: a
guide to getting it right. CRC Press.
 Sandman, L., Molander, U. and Benkel, I., 2017. Developing organisational ethics in
palliative care: A three-level approach. Nursing ethics, 24(2), pp.138-150.
 Vollmann, J., 2013. The implementation process of clinical ethics consultation:
concepts, resistance, recommendations. Revista Romana de Bioetica, 11(3).
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