Ethics management in healthcare institutions for respecting human rights in the provision of health services: Summary of the thesis of habilitated doctor in medical sciences: 331.03 - Social medicine and management

Abstract

Structure of the thesis: the thesis consists of introduction, 8 chapters, conclusions and recommendations, bibliography (275 sources), 11 annexes, 270 pages of basic text, 146 figures, 8 tables. The results are published in 50 scientific papers. Keywords: ethical culture, ethical safety, ethical climate, organizational ethics, institutionalization of ethics, ethics programs, ethical leadership, business ethics, ethical decisions, ethics management, ethics committees, ethical audit, patient rights, human rights, dual loyalty, moral responsibility. The goal of the study: Multidimensional evaluation of the ethics management of healthcare facilities in the health system of the Republic of Moldova to determine the level of ensuring the conditions that lead to the respect of human rights in the organization and provision of health services. Research`s objectives: (1) To study the ethics management theories and the international experience in the institutionalization of ethics. (2) Evaluating the ethical context of healthcare facilities through the lens of human rights values. (3) Analysis of factors that influence the decision-making process in institutions (4) Identification of the level of respect for human rights in the organization of healthcare services. (5) Identification of ethical tools for organizing the process of institutionalization of ethics. (6) Development of the ethical audit grid and recommendations for the application of ethics management tools to reduce the risk of human rights violations in the provision of healthcare services. Scientific novelty and originality: 1. Innovative formulation of the ethics management concept applied to healthcare facilities. 2. Proposing the specific tools for the institutionalization of ethics in healthcare facilities. 3. Proposing the values of fundamental human rights as a benchmark for the analysis of the organizational ethical context in the healthcare facilities of the country. 4. Differentiating the concept of patient rights from that of human rights applied in patient care. 5. Identifying the factors that influence the ethical decision-making process of medical workers and the risk of double loyalty. 6. Proposing the ethical audit concept for healthcare facilities. The scientific problem solved in the thesis: The study presents a new direction, scientifically based, on the analysis of the ethical environment of healthcare facilities in the Republic of Moldova as a precondition for the respect of human rights. The tools proposed for the institutionalization of ethics in the management of medical institutions are innovative solutions for increasing quality and reducing the risk of violating the patients’ rights and employees in provision of medical services. Theoretical significance: The thesis represents a comprehensive study of the management process of healthcare facilities from the perspective of the ethical dimension, which is promoted as a necessary context to ensure respect for human rights in the provision of medical services, focusing on the effective tools and mechanisms that should be applied for the institutionalization of ethics. Applicative value: The results of this study can form the basis for the implementation of a new set of quality criteria to be applied in the process of evaluation and accreditation of healthcare facilities in the country. The ethical tools proposed in the thesis can serve as methodological support for managers of healthcare facilities interested in increasing the quality of medical services and reducing the risk of human rights violations in the institutions that manage them. Implementation of the scientific results: The research results were integrated into the teaching process (development of new courses) within the "Nicolae Testemițanu" SUMPh; were applied in the development of the CNEAS criteria for accreditation of healthcare institutions; were implemented in the practical activity of the IMSP "Sfânta Treime" Municipal Clinical Hospital.