Ethics as a Leadership Responsibility
HIM leaders frequently face ethical dilemmas involving patient privacy, data integrity, and resource allocation. The RHIA exam tests knowledge of core ethical principles and structured decision-making approaches drawn from the AHIMA Code of Ethics.
Core Ethical Principles
- Autonomy: respecting an individual right to make decisions about their own information
- Beneficence: acting in ways that benefit patients and the organization
- Nonmaleficence: avoiding actions that cause harm
- Justice: ensuring fair and equitable treatment of all individuals
- Veracity: being truthful and transparent in professional conduct
The AHIMA Code of Ethics
The AHIMA Code of Ethics outlines professional obligations including protecting patient privacy, maintaining data integrity, refusing to participate in fraudulent coding or documentation practices, and advocating for changes when policies conflict with ethical standards.
An Ethical Decision-Making Framework
- Identify the ethical issue and the parties affected
- Gather relevant facts and applicable policies or laws
- Identify possible courses of action
- Evaluate each option against ethical principles and organizational values
- Select and implement the best course of action
- Reflect on the outcome and document the decision process
Common Ethical Dilemmas in HIM
Pressure to Upcode
A coder may face pressure from a physician or administrator to assign a higher-paying code that is not supported by documentation. Ethical leaders must reinforce that coding accuracy takes precedence over financial pressure and provide staff with support to resist such pressure.
Inappropriate Access to Records
Staff may be tempted to access records of family members, celebrities, or coworkers out of curiosity. Leaders must enforce minimum necessary access policies and apply consistent consequences for violations.
Creating an Ethical Culture
Leaders build an ethical culture by modeling ethical behavior themselves, providing clear policies, offering a safe reporting mechanism for concerns, and ensuring consistent accountability regardless of an individual position within the organization.
Exam Tip
Be familiar with the five core ethical principles and recognize scenario questions involving upcoding pressure or inappropriate record access as classic ethics test cases.