Here for the people: The argument for making clinical ethics more patient-centred.

Healthcare organizations aim to provide excellent, patient-centred care. Many departments within a hospital excel in achieving this goal, but clinical ethics service providers would benefit from becoming more patient-centred. This article considers how ethics services can add a patient-facing component to their strategic direction and work portfolio. Through a case example, suggestions to guide ethics service providers in expanding their duties and responsibilities are provided, including consultation with families and education sessions. This reframing would include clarifying the role of ethics within a healthcare organization, making services more accessible to patients, families and the community, as well as engaging with other disciplines to provide well-rounded patient care. While the work currently being done by clinical ethics services is important and ought to be continued, ethics service providers should strive to achieve the goal of improving patient experiences and directly contribute to the excellent care being provided.

A principle-based framework for improving health equity in the Champlain region of Ontario, Canada.

The purpose of this column is to present an action-oriented health equity framework derived from Beauchamp and Childress' four ethical principles (ie, autonomy, beneficence, nonmaleficence, and justice) and centred around the specific needs of marginalized and excluded communities of the Champlain region of Ontario. It describes the conceptual underpinnings of the framework, defines its components, and demonstrates how it can be applied. The principle-based health equity framework is a useful tool to reduce health disparities within healthcare organizations; it is designed to promote the incorporation of health equity objectives, strategies, principles, and measurements into healthcare organizations' strategic planning processes and operations.

The importance of a positive moral culture within healthcare organizations.

Organizations possess a moral agency that affects all aspects of the care they provide and reflects the perception of morality within the organization. In practice, the method in which moral agency is applied and maintained within an organization directly influences its moral culture. Organizations function through a series of systems that work dynamically to achieve success. In order to implement the systems effectively, all employees, at every level, are responsible for cooperating and working together to uphold the mission, vision, and values of an organization, thereby contributing to a positive moral culture. Considerations must be made at a high organizational level, as well as at each individual level within an institution. This ensures that at its core, a healthcare organization is considered ethical, and all staff, students, and volunteers within it are acting in accordance with the established moral belief system. By creating and maintaining a positive moral culture, everyone benefits: patients receive effective and compassionate care, employees experience a feeling of pride in their work, and the community being served develops a relationship of trust with their local healthcare institution.

Should influenza vaccination be mandatory for healthcare workers?

Each year, many healthcare organizations deal with low influenza immunization rates among staff. Mandatory influenza vaccination programs may be considered in order to address this issue. These types of programs have caused controversy in the past, as staff has argued that they infringe upon their liberties and right to autonomy. However, if viewed from a public health perspective, mandatory vaccination programs are beneficial for both employees and patients and can be justified. When individuals make the decision to work in the medical field, it is assumed that their values align with those of the organization for which they work. This overrides their right to autonomy, since they are expected to put the safety of their patients ahead of their own personal interests. Although some may argue that receiving a flu shot is unsafe, evidence has demonstrated the opposite, and the minimal discomfort that may result from a vaccine is not enough to negate the responsibilities that healthcare workers have toward the patients they serve.