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Table 3 Categories of ethical CIRS cases: conflicting economic and medical interests (focus on organization, staff and patients)

From: Enhancing patient safety by integrating ethical dimensions to Critical Incident Reporting Systems

Potential issue/subcategory

Example

Potentially related ethical principles

Economic incentives on medical decisions

The management of a hospital pays a bonus to senior physicians if they perform enough surgeries. Several patients have spine surgery because of lower back pain without preceding alternative conservative options

Non-maleficence

Justice

Allocation decisions, spatial and staff resources

The management of a hospital puts the scarce staff resources to the department with the best financial return of investment. Other departments are understaffed, although they have to provide care for patients with even higher needs

Justice

Beneficence