DDBA 8562 Week 11 Conflicting Duties Seminar Paper Example

The Party With Fewer Protections Prevails, Except Where It Does Not: A Seminar Paper Proposing One Rule for the Term's Conflicting Duties, Testing It Against Three Earlier Cases and Reporting the Case Where It Fails

Student Name

Walden University

DDBA 8562: Seminar in Law and Ethics in Healthcare Management

Instructor Name

Month Day, Year

The Party With Fewer Protections Prevails, Except Where It Does Not: A Seminar Paper Proposing One Rule for the Term's Conflicting Duties, Testing It Against Three Earlier Cases and Reporting the Case Where It Fails

Introduction

Across the term, each analysis chose between two binding obligations on grounds fitted to its case. This paper asks whether those grounds share a rule, and proposes one: when two binding obligations conflict, the obligation owed to the party with fewer alternative protections prevails. The rule is tested against three earlier analyses, the returning patient in the emergency department, the threat disclosed in therapy and the rural noncompete, and then against the governance case, where it fails.

Literature

Ross (1930) argued that we owe several prima facie duties, each binding unless outweighed, and that the actual duty is found by judgment, without a method for weighing. Beauchamp and Childress (2019) adopted that structure for their four principles and offered two ways to resolve conflicts: balancing, which weighs principles in the case, and specification, which narrows a principle's scope by adding conditions until the conflict dissolves. Both leave the weight of competing considerations to judgment.

Goodin (1985) argued that our special responsibilities, to family, clients, employers and others, are grounded in the vulnerability of those who depend on us, and that responsibility is strongest where others are most vulnerable to our actions and choices. His account explains why vulnerability might matter in weighing duties, but he did not propose the rule this paper tests. The rule is this paper's own: it converts vulnerability into a comparison of the alternative protections each party has, which can be examined case by case.

Application One: The Returning Patient

The emergency case set the screening duty owed to a man with chest pain against the employer's duty to protect staff from a recognized hazard. The patient's alternative protections at midnight were few: the nearest other emergency department was distant, and the statute's purpose is to ensure he is not turned away (Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd). Staff had more: the employer's security, the ability to call police, training and the right to refuse unsafe tasks in extreme cases. The rule says the screening duty prevails, which matches the earlier verdict. It also explains the earlier analysis's insistence on precautions: the rule identifies which duty prevails, not that the other disappears.

Application Two: The Threat in Therapy

The privacy case set confidentiality owed to a patient against a duty to protect a supervisor he had threatened. The supervisor had almost no protection: she did not know of the threat. The patient had many: the records law confined disclosure to what the statute required, and the federal floor permitted only disclosure needed to avert the threat. The rule says the duty to protect prevails, matching the earlier verdict, which grounded the duty in the California line of cases (Tarasoff v. Regents of the University of California, 1976).

Application Three: The Rural Noncompete

The employment case set the system's contractual right against the profession's concern for patients' access. Patients in a town with no other cardiologist within 70 miles had few alternatives; the system had several, including repayment of its recruitment support. The rule says the access concern prevails, matching the earlier decision to negotiate a buyout rather than enforce the covenant.

The Failure: Governance

The governance case set the board's oversight duty against peer review confidentiality. Applied mechanically, the rule asks which party has fewer protections. Patients of an outlier surgeon have few: they cannot see outcome data. Surgeons under review have many: confidentiality statutes, due process in the bylaws and federal immunity for reviewers. The rule therefore says oversight prevails without limit, and the board should receive named surgeon data and peer review files.

That is not what the earlier analysis concluded, and the earlier conclusion was better. Peer review confidentiality protects not only surgeons but future patients, because candid review of cases improves care. The party served by confidentiality is partly the same party the rule says has fewer protections. The rule fails because it assumes each obligation is owed to a distinct party; where one obligation serves the same vulnerable group by a different route, the comparison collapses.

What the Failure Teaches

The rule works when each obligation is owed to a different party, as in the first three cases. It fails when an institutional protection, such as confidentiality, serves vulnerable people collectively. A revised rule would add a condition: compare alternative protections only after asking whom each obligation ultimately serves. That revision is a form of specification in Beauchamp and Childress's sense, narrowing the rule to the cases it fits.

Limits

Three successful applications drawn from the same author's analyses are weak evidence; the earlier verdicts may have been reached with the rule's logic already in mind. The rule also requires judgments about protections that reasonable people could make differently.

Conclusion

The term's analyses share a pattern, captured by the rule that the party with fewer protections prevails. The governance case shows the rule's boundary, and that boundary is where the rule must give way to judgment about whom an obligation serves.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd (2018).

Goodin, R. E. (1985). Protecting the vulnerable: A reanalysis of our social responsibilities. University of Chicago Press.

Ross, W. D. (1930). The right and the good. Clarendon Press.

Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 551 P.2d 334 (1976).