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Ethical Issues

Are We Falsifying Records?
By Burt Danet, 2/96:
This is an interesting question. When preparing for a review for accreditation by JCAHO, hospitals often request the transcriptionist to change the date of transcription to match the date of the report when the dictation may occur days, weeks, months later, to keep the record "looking good" in time for the review. This flurry of activity does involve falsifying the facts.
Changing Date of Transcription
3/14/96, from Mary Morken
While researching this issue, we have learned that state regulations determine some of these standards for date of dictation. In regard to date of transcriptoin, I talked with two physicians and about eight MTs from different states; all agreed that MTs should not change the date of transcription. If requested to do so, it is recommended that the MT respectfully decline and ask that the policy be reconsidered.
3/6/96 from Tillie Horak,
According to the JCAHO 1996 Comprehensive Accreditation Manual for Hospitals, Section IM 7.6, Pg 432, records must be completed within at most 30 days. The hospital must measure delinquency at least every three months. They must also have a method for the author to "acknowledge the document after it is transcribed."
From Liz Hugger:
I've been asked to do this also but told them I am legally prevented from changing records. Since the work is sent to them by modem, let them change the dates if they feel they must, but my archived records for my digital dictation system will show when the report was dictated and when it was transcribed anyway, so they're not really fooling anyone should this be further investigated.
Abortions, Pro and Con
4/96, From Cynthia Lewis
Have any of you experienced MTs run into an ethical problem while working for an OB/GYN concerning abortion? Specifically, have you had to address the problem of not wanting to transcribe an abortion procedure?

From Bill Bentsen
We are transcribing the doc's dictation, not performing or condoning abortion. As a professional, that is our job, transcribing.

From Mary Morken
Regarding the question of transcribing abortions, I've heard different views on this among MTs. Whatever our beliefs ethically about the right or wrong of different kinds of abortions, it is not always clear in the dictation just which kind it is, or whether it even complies with state laws or not. Reasons for procedures are sometimes stated with finesse for insurance purposes.

Whatever unethical practice we might feel a certain procedure to be, we are typing the legal record, not performing the operation, and the record could eventually become part of a case against the doctor, so it is unclear which side we would be helping by typing it anyway.

Here's my question: Is there anything we wouldn't type? Are we implicated morally at all just by having our initials on it? What if we could tell it was an assisted suicide? What about the doctors who constantly slant their diagnoses for insurance and Worker's Compensation purposes, depending upon which side they are on? What do you think?

4/96, From Alisha,
It is not my place to judge what the doctor and patient decide - in other words, it is none of my business. I am merely trying to accurately transcribe what is dictated. If it is a problem for any transcriptionist, she/he should immediately inform the physician, perhaps even change jobs or clients - that is her/his decision and none of my business either.

4/96, from Mary Booth,
Our job is to do medical transcription. Whatever the issue, we are not performing the procedure, we are just transcribing the legal document. Period. I worked in a Catholic hospital where many docs did tubal ligations. We didn't do abortions but an awful lot of tubal ligations. It was obvious to us what was happening, but my job was to transcribe the report. I believe my personal opinions should not be a factor when I do my job.
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