A patient in your rural community that you have treated for COPD for several years missed her last two appointments. When you speak with her after church, she indicated her husband lost his job as a logger and no longer has family health insurance to cover the cost of the treatments. She refuses to accept charity but does indicate she will be willing to clean your home and office as “payment” for your healthcare services.

  • Should a healthcare professional accept bartering as payment?
  • What ethics issues should be considered here?
  • How are these ethics issues affected by the rural context?
  • Should the health of the patient take precedence over compliance with your organizational policy and/or your professional code of conduct?
  • What other creative solutions are there that will allow the patient to receive the treatments?

 

Some Values and Ethics Issues to Consider

  • Social justice
  • Professional boundaries
  • Duty to provide care
  • Community and family relationships
  • Respect for human dignity
  • Respect for professional integrity
  • Compliance with policies and procedures
  • Respect for privacy and confidentiality
  • Overlapping roles and responsibilities
  • Patient-provider relationships
  • Equality of access