Gwen Moore

HMG-410 Healthcare Law and Ethics

Module 8 Assignment
December 1, 2014
2. Using the description of the Dalby v. Sisters of Providence decision on page 498 of the text, brief
the Dalby v. Sisters of Providence case. Pertinent facts of the case: Dalby, a pharmacy technician,
alleged that she was discharged for reporting to her supervisor on several occasions that there were
inaccuracies in the drug inventory and that recordkeeping regarding these inaccuracies was in violation
of Oregon administrative rules Dalby alleged that rather than comply with the regulations, her
supervisor retaliated against her because of her insistence that her employer comply with the rules.
Dalbys former employer argues that the allegations did not demonstrate constructive discharge by
deliberately creating difficult working conditions with the intention of forcing the employee to leave
employment and that the employee left employment because of the working conditions.
Procedural history of the case: The circuit court dismissed Dalbys claim, and she appealed.
The legal issue(s) presented to the Oregon Court of Appeals: Did the plaintiff state a cause of action
for wrongful discharge and emotional distress?
The Oregon Court of Appeals ruling: The Oregon Court of Appeals, assuming the plaintiffs
allegation to be true, reversed and remanded the case for trial, holding that the pharmacy technician
stated a cause of action for wrongful discharge and intentional infliction of emotional distress.
In your opinion, was the ruling of the Oregon Court of Appeals a sound decision? Why or why
not? I think the Oregon Court of Appeals ruling was a sound and good decision because as stated in the
reason Dalby made a good-faith report as to the hospitals noncompliance with the drug inventory and
recordkeeping requirements required under Oregon regulations. Her report fulfilled an important societal
obligation. An employer may not discharge an employee for making such reports. The conduct of the
employer, including false accusations that she had taken cocaine, gave rise to an action for the infliction
of emotional distress.
3. Review Questions on page 504:
1) Discuss the employment-at-will doctrine. This is a doctrine by which employment can be
terminated at any time by either the employee or employer. Exceptions to this doctrine include
employment contracts and issues involving public policy.
2) Is the employment-at-will doctrine appropriate in todays society? The text noted differences
regarding this doctrine and I agree that this doctrine is not appropriate in todays society. Discuss you
answer. The employment-at-will common law doctrine is not truly applicable in todays society and
many courts have recognized this fact. In the last century, the common law developed in a laissez-faire
climate that encouraged industrial growth and improved the right of an employer to control his own
business, including the right to fire without cause an employee at will. The twentieth century has
witnessed significant changes in socioeconomic values that have led to reassessment of the common law
rule.
3) What are the pros and cons of the employment-at-will doctrine? The text noted that there has
been a growing trend toward a restricted application of the at-will employment rule whereby the right of
an employer to discharge an at-will employee without cause is limited by either public policy
considerations or an implied covenant of good faith and fair dealing. The concept of the employment-atwill doctrine is embroiled in a combination of legislative enactments and judicial decisions. Exceptions
to the employment-at-will doctrine involve contractual relationships, public policy issues, defamation,
retaliatory discharge, and fairness. It would seem that the doctrine has little applicability in modern
society.
4) What are the public policy exceptions to the employment-at-will doctrine? Provides that
employees may not be terminated for reasons that are contrary to public policy. Public policy originates
with legislative enactments that prohibit, for example, the discharge of employees on the basis of

Gwen Moore
HMG-410 Healthcare Law and Ethics
Module 8 Assignment
December 1, 2014
disability, age, race, color, religion, sex, national origin, pregnancy, filing of safety violation complaints
with various agencies (e.g., the Occupational Safety and Health Administration), or union membership.
Any attempt to limit, segregate, or classify employees in any way that would tend to deprive any
individual of employment opportunities on these basis is contrary to public policy.
5) Discuss what questions an employer (supervisor) should consider before terminating an
employee. Before termination of an employee, the employer should ask, was the termination: a violation
of public policy; a violation of any policy or procedure outlined in an administrative manual, the
employee handbook, the human resource departments policies and procedures, or any other healthcare
facility policies and procedures or regulations; retaliatory in nature (e.g., refusal to perform an illegal act
or a questioning of a management practice); arbitrary and capricious; discriminatory on the basis of age;
disability; race, creed; color; religion; sex; national origin; or marital status; a violation of any contract,
oral or written; consistent with the reasons for discharge; discriminatory against the employee for filing
a lawsuit; fixed before any appeal actions could be taken; and an interference with an employees right
as secured by the laws or Constitution of the United States (e.g., right to freedom of speech).
6) Discuss legitimate reasons for terminating an employee. The termination of employees for
financial or other legitimate business reasons does not constitute a breach of employment contract. An
employee with a hostile attitude toward leadership and/or supervision is a legitimate reason for
termination. Improper billing practices of a physician, administrator, or other staff, poor work
performance, alcoholism, and insubordinate behavior of an employee are all legitimate reasons for the
termination of an employee.
7) Discuss why employment disclaimers are important to the employer. This is the denial of a right
that is imputed to a person or that is alleged to belong to him or her. Although a disclaimer is often a
successful defense for employers in wrongful discharge cases, it should not be considered a license to
discharge at will and at the whim of the supervisor in an arbitrary and capricious manner.
8) Discuss what actions an employer can take in order to help reduce the necessity for discharging
an employee. The best way for the human resources manager to prevent negligent hiring litigation for
the employer is to become familiar with the risks and avoid hiring workers who are likely to become
problematic employees.
9) Discuss under what conditions unemployment compensation can be denied to a claimant. A
claimant can be denied unemployment compensation as a result of the following situations: profanity;
threatening coworkers; theft; poor work performance; voluntary termination; and violation of the
smoking policy.
Review Questions on page 537:
1) Should there be limits placed on malpractice awards? Yes, I think there should be limits placed on
malpractice awards. Support your opinion. Frivolous and unscrupulous malpractice actions have
caused physicians to place limitations on their scope of practice. Many OBGYNs, for example have
dropped the high-risk obstetrics portion of their practices to reduce their malpractice premiums. There is
also an ever-increasing reluctance by physicians to perform heroic measures on accident victims because
of the high risks of malpractice exposure. The impetus for malpractice caps is, in part, because jury
awards often vary substantially from one jurisdiction to the next within the same state. As a result,
negligence attorneys often prefer to try personal injury cases in those jurisdictions in which a jury is
likely to grant a higher award.

Gwen Moore
HMG-410 Healthcare Law and Ethics
Module 8 Assignment
December 1, 2014
2) How does a structured award work? They are placed in a trust and set up to provide compensation
over a plaintiffs lifetime. They are set up for the periodic partial payment of judgments rather than
paying the injured party a lump-sum payment. It would eliminate an unwarranted windfall to the
plaintiffs beneficiaries in the event of death.
3) Which of the schemes for tort reform discussed previously do you consider most helpful in
addressing the malpractice insurance crisis? Continuous quality improvement (CQI) is an approach
to improving on a continuing basis. CQI is introduced because of its value in reducing the risks of
malpractice. The benefits of CQI are well documented and include reduced customer complaints and
turnover; increased ability to attract new customers; and improved productivity, services, and quality.
4) Describe how the risk management process can be helpful in reducing the number of
malpractice claims. The purpose of a risk management program is to reduce the number of patient
injuries and minimize the exposure of an organization to lawsuits. An effective risk management
program includes a monitoring system that identifies potential risks to patients and staff. Risk
management must include a heightened sensitivity to providing a safe environment and addressing the
emotional needs of patients. Good relationships with patients are very important in preventing
malpractice suits.
5) Describe the continuous quality improvement process as it applies to healthcare organizations.
The implementation of CQI in healthcare organizations will improve the quality of patient care and
reduce the untoward events that results in lawsuits. Success will come with true commitment by each
organizations leadership. Such commitment requires the full participation of all caregivers. The
evolution of a truly successful CQI program involves the transition from CQI as a plan to CQI as a
process and ultimately, to CQI as an organizational culture.