The complexity of healthcare fraud - ethical and practical considerations

Autores

DOI:

https://doi.org/10.5007/1677-2954.2020v19n2p367

Palavras-chave:

Ethics, Healthcare fraud, Whistle-blower, Complexity

Resumo

When healthcare professionals suspect that healthcare fraud is being committed, they almost always find themselves in a new, unknown situation. They have many questions and feel unable to act adequately. With a growing attention on healthcare fraud, research was done on What is the right thing to do in case of presumed healthcare fraud and how to do this right? We started with a search of the literature on healthcare fraud, and the characteristics of a fraudster and a whistle-blower. For ‘doing the right thing’ we used Hannah Arendt and her distinction between labor, work and action. According to Arendt, the right thing to do is action. With action, the whistle-blower opens up space for other perspectives and discussion. For ‘doing things right’ we used the Cynefin Framework from Dave Snowden, which is based on complexity sciences. The decision model of the Cynefin Framework gives advice on how to respond. Still, revealing healthcare fraud and doing things right will always be a path of painful uncertainty.

Biografia do Autor

Dineke Smit, Social Sciences, Radboud University Nijmegen, The Netherlands.

PhD candidate Radboud University Nijmegen, Netherlands European Forum for Primary Care, working group Mental Health Director Steunpunt GGZ (Fulcrum Mental Health), Utrecht, Netherlands. 

Jan Derksen, Radboud University Nijmegen, Department Social Sciences, Netherlands.

Emeritus Professor Clinical Psychology and Pschotherapy - Radboud University Nijmegen, Department Social Sciences, Netherlands. 

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Publicado

2020-09-21

Edição

Seção

Artigos - Fluxo Contínuo