BUSI 302 Week 8 Discussion Board Forum 3 Replies Example

Discussion Board Forum 3 Replies: Responding to Classmates on Public Duties

BUSI 302 Legal and Ethical Issues in Healthcare, Discussion Board Forum 3 Replies

Thread by [Student Name]

The classmates and their examples are composites; the textbook and the journal articles cited are real.

Reply to Gloria

Gloria, your story of the physician who wrote "cardiac arrest" as the only cause of death for a hospice patient with metastatic lung cancer shows how a routine public duty can be done carelessly. Cardiac arrest describes how every death ends, not why it happened. The certificate should have traced the chain from the immediate cause, perhaps respiratory failure, back through the conditions that led to it to the underlying disease, the lung cancer that started the sequence. Wellesley (2026) argues that inaccurate cause of death statements harm more than records: they distort mortality statistics that guide public health and misrepresent the deceased person's illness and life story to the family. Millares Martin et al. (2023) surveyed general practitioners and medical examiners in England and found common errors, including missing time frames, absent comorbidities, wrong underlying causes and incorrect sequences of events, and quality below international standards even after a new medical examiner system began.

Judson and Harrison (2016) treat completing the death certificate as one of the physician's public duties, and this week's chapter on death and dying reminds us that the record is also the family's last official account. Your hospice could help by giving physicians a short guide showing how to list the chain of causes from the immediate cause back to the underlying disease. Because hospice staff know the patient's history well, a nurse could also offer the certifying physician a brief summary of diagnoses when the death occurs. A death certificate is the last record a patient's care team writes, and it deserves the same accuracy as the first. Does your organization review death certificates before they are filed?

Reply to Darnell

Darnell, you wrote that your clinic sometimes reports positive chlamydia and gonorrhea results to the health department weeks late, or not at all, because staff fax forms when they have time. That problem is long-standing. Doyle et al. (2002) reviewed studies of notifiable disease reporting in the United States and found that completeness varied widely by disease, with AIDS, sexually transmitted diseases and tuberculosis reported more completely than most other conditions. Even so, many cases never reached public health. Dixon et al. (2020) tested a health information exchange that sent clinics prepopulated electronic report forms in Indiana. Reporting rates for chlamydia rose from 56.9% to 66.4% in intervention clinics and fell in control clinics, and completeness improved for several conditions.

Judson and Harrison (2016) explain that reporting communicable diseases is a legal duty that protects the public, even when it means sharing information patients consider private. Late reports delay partner notification and allow infections to spread. For chlamydia and gonorrhea, which often cause no symptoms, a partner who is never notified may carry the infection for months and pass it on, so a reporting delay in one clinic can affect many people outside it. Your clinic might ask the health department whether electronic case reporting is available through your record system, which could make reporting automatic rather than dependent on staff time. Even before that, assigning one staff member to send reports daily, with a backup, would end the problem of reports waiting until someone has time. Who is currently responsible for reporting in your clinic?

References

Dixon, B. E., Zhang, Z., Arno, J. N., Revere, D., Joseph Gibson, P., & Grannis, S. J. (2020). Improving notifiable disease case reporting through electronic information exchange-facilitated decision support: A controlled before-and-after trial. Public Health Reports, 135(3), 401-410. https://doi.org/10.1177/0033354920914318

Doyle, T. J., Glynn, M. K., & Groseclose, S. L. (2002). Completeness of notifiable infectious disease reporting in the United States: An analytical literature review. American Journal of Epidemiology, 155(9), 866-874. https://doi.org/10.1093/aje/155.9.866

Judson, K., & Harrison, C. (2016). Law and ethics for the health professions (7th ed.). McGraw-Hill Education.

Millares Martin, P., Allsop, M. J., & Carder, P. (2023). Will medical cause of death certifications data quality improve in the UK with the new medical examiner system? Journal of Forensic and Legal Medicine, 99, 102589. https://doi.org/10.1016/j.jflm.2023.102589

Wellesley, J. P. (2026). The final act of care: Accuracy in cause of death statements. Perspectives in Biology and Medicine, 69(1), 106-125. https://doi.org/10.1353/pbm.2026.a985817