The Professional Case Manager and Social Justice, Inclusion, and Equity: A Time for Reflection and Action.

Social justice, inclusion and equity are everyone's responsibility. We achieve these values when we recognize and accept the characteristics of every person as a unique individual. Professional case managers, or other healthcare practitioners and leaders, have an obligation to advance the health, human and social outcomes of the people they serve, regardless of the social group they belong to and irrespective of their determinants of diversity. It is time to address social justice, inclusion and equity as ethical principles of practice for the professional case manager.

Addressing Spiritual and Religious Influences in Care Delivery.

PURPOSE: The impact of spiritual and religious factors on health and care delivery has been identified in case management field research. The purpose of this article is to examine how case managers, taking a holistic, patient-centered approach, are required under professional and ethical standards to address the spiritual and religious influences that may impact the individual's health, care choices, and care delivery. PRIMARY PRACTICE SETTINGS: Case managers across health or human services must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery. This includes case managers in acute care, primary care, workers' compensation, hospice, mental health counseling, and other practice settings. Regardless of their professional discipline, specialization, or practice setting, case managers must ensure that the voice of the individual is heard and that each person receives the support that is most relevant and meaningful. IMPLEMENTATIONS FOR CASE MANAGEMENT PRACTICE: The impact of spiritual and religious factors on health and care delivery has been identified in case management field research, known as role and function studies, which are conducted every 5 years, and which set the blueprint for the Certified Case Manager (CCM) certification examination. The most recent role and function study affirmed the knowledge domain of multicultural, spiritual, and religious factors that may affect the health status of the individual receiving case management services. Essential activities of case management include identifying multicultural, spiritual, and religious factors that may affect the client's health status and incorporating the effects of the client's multicultural, spiritual, and religious factors in the development of the plan of care and service delivery (). To demonstrate competency in the required knowledge domain and essential activities, case managers must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery.

Case Managers on the Front Lines of Ethical Dilemmas: Advocacy, Autonomy, and Preventing Case Manager Burnout.

PURPOSE: The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). PRIMARY PRACTICE SETTINGS: The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care. IMPLEMENTATIONS FOR CASE MANAGEMENT PRACTICE: This discussion acknowledges the ethical dilemmas that case managers routinely confront, which empowers them to seek support, guidance, and resources to support ethical practice. In addition, the article seeks to raise awareness of the effects of burnout and moral distress on case managers and others with whom they work closely on interdisciplinary teams.

Care-managers' professional choices: ethical dilemmas and conflicting expectations.

BACKGROUND: Care-managers are responsible for the public administration of individual healthcare decisions and decide on the volume and content of community healthcare services given to a population. The purpose of this study was to investigate the conflicting expectations and ethical dilemmas these professionals encounter in their daily work with patients and to discuss the clinical implications of this. METHODS: The study had a qualitative design. The data consisted of verbatim transcripts from 12 ethical reflection group meetings held in 2012 at a purchaser unit in a Norwegian city. The participants consist of healthcare professionals such as nurses, occupational therapists, physiotherapists and social workers. The analyses and interpretation were conducted according to a hermeneutic methodology. This study is part of a larger research project. RESULTS: Two main themes emerged through the analyses: 1. Professional autonomy and loyalty, and related subthemes: loyalty to whom/what, overruling of decisions, trust and obligation to report. 2. Boundaries of involvement and subthemes: private or professional, care-manager or provider and accessibility. CONCLUSIONS: Underlying values and a model illustrating the dimensions of professional responsibility in the care-manager role are suggested. The study implies that when allocating services, healthcare professionals need to find a balance between responsibility and accountability in their role as care-managers.

An ethical analysis of a home visit case study.

This article will explore a clinical case study of a home visit carried out by the case manager nurse. In this case, we will discuss the dilemma of finding the balance between autonomy and beneficence from the perspective of principlist ethics, virtue ethics and the 'ethics of care'. The main conflict in this case study deals with all proposals are unsuitable and it is not necessary for a nurse to pay him a home visit, whereas for the healthcare system it is considered necessary. We could conclude that, during the home visit, the case manager aspires to achieve excellence, and throughout his clinical relationship with Francesc, searches for a series of virtues, respecting certain fundamental principles. In this way, the case managers ensure that Jaume's care is more humanised. The case has been anonymised and confidentiality maintained.

What ethics for case managers? Literature review and discussion.

BACKGROUND: Little is known about case managers' ethical issues and professional values. OBJECTIVES: This article presents an overview of ethical issues in case managers' current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics. RESEARCH DESIGN: A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers' national codes of ethics. FINDINGS: Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client's interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas. DISCUSSION: We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested.

Moral decision-making among assertive community treatment (ACT) case managers: a focus group study.

The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational awareness, but there was a risk of supporting paternalistic interventions and denying the clients' right to autonomy.