Medical Law and Ethics 1 Law and Ethics

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Medical Law and Ethics 1

Medical Law and Ethics 1

Law and Ethics o o Ethics – A set of moral principles or values

Law and Ethics o o Ethics – A set of moral principles or values that governs the conduct of an individual or a group. ﻣﺠﻤﻮﻋﺔ ﻣﻦ ﺍﻟﻤﺒﺎﺩﺉ ﺃﻮ ﺍﻟﻘﻴﻢ ﺍﻷﺨﻼﻗﻴﺔ ﺍﻟﺘﻲ ﺗﺤﻜﻢ . ﺳﻠﻮﻙ ﺍﻟﻔﺮﺩ ﺃﻮ ﺍﻟﻤﺠﻤﻮﻋﺔ What is lawful conduct is not always ethical conduct. n The law may permit something that would be ethically wrong. Copyright © 2004 by Prentice-Hall. All rights reserved. 2

Medical Law and Ethics o Knowledge of Medical Law and Ethics provides insight into:

Medical Law and Ethics o Knowledge of Medical Law and Ethics provides insight into: n The rights, responsibilities, and concerns of health care consumers. n The legal and ethical issues facing society; patients, and health care professionals as the world changes. n The impact of rising costs on the laws and ethics of health care delivery. ﺃﺜﺮ ﺍﺭﺗﻔﺎﻉ ﺍﻟﺘﻜﺎﻟﻴﻒ . ﻋﻠﻰ ﻗﻮﺍﻧﻴﻦ ﻭﺃﺨﻼﻗﻴﺎﺕ ﺗﻘﺪﻳﻢ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ 3

Medical Law and Ethics (cont. ) A law is a rule of conduct or

Medical Law and Ethics (cont. ) A law is a rule of conduct or action. Governments enact laws to maintain order and public safety. Criminal and civil laws pertain to health care practitioners. Ethics is a standard of behavior. Moral Values serve as the basis for ethical conduct Family, culture, and society help form individual’s moral values. 4

Medical Law and Ethics (cont. ) o Criminal Law n n n Involves crimes

Medical Law and Ethics (cont. ) o Criminal Law n n n Involves crimes against the state Criminal acts are classified as either a felony ����� or misdemeanor���� Examples include: o o Murder Arson Rape Burglary ﺳﻄﻮ o Civil Law n n n Involves crimes against the person Includes a general category of laws known as torts Torts are either: o o Intentional (ﻣﻘﺼﻮﺩ willful) Unintentional (accidental) 5

Medical Law and Ethics (cont. ) Intentional Torts Assault ﺍﻟﻬﺠﻮﻡ To cause another person

Medical Law and Ethics (cont. ) Intentional Torts Assault ﺍﻟﻬﺠﻮﻡ To cause another person to feel threatened. Invasion of privacy Interference with a person’s right to be left alone. Defamation of Character ﺍﻟﺘﺸﻬﻴﺮ Damaging a person’s reputation by making a public statement. Battery ﺍﻟﻀﺮﺏ An action that causes bodily harm to another. Even touching without permission. Fraud ﺧﺪﺍﻉ Depriving or attempting to deprive a person of his or her rights. False Imprisonment ﺍﻟﺴﺠﻦ Intentional, unlawful restraint or confinement of a person. 6

Medical Law and Ethics (cont. ) Unintentional Torts q Acts that are committed with

Medical Law and Ethics (cont. ) Unintentional Torts q Acts that are committed with no intent to cause harm but are done with a disregard for the consequences. q The term negligence is used to describe such actions when health care practitioners fail to exercise ordinary care resulting in patient injury. q Malpractice ������ is the negligent delivery of professional services. 7

Medical Law and Ethics (cont. ) Contracts A contract is a voluntary agreement between

Medical Law and Ethics (cont. ) Contracts A contract is a voluntary agreement between two parties in which specific promises are made for a consideration. 4 Elements of a Contract Agreement Contractual Capacity Consideration Legal Subject Matter 8

Medical Law and Ethics (cont. ) Contracts Types of Contracts o Expressed Contracts ﻋﻘﻮﺩ

Medical Law and Ethics (cont. ) Contracts Types of Contracts o Expressed Contracts ﻋﻘﻮﺩ ﺗﻌﺒﻴﺮﻳﺔ ﻣﺨﺘﺒﺮﺓ n n o Clearly stated in written or spoken words A payment contract is an example Implied Contracts ﻋﻘﻮﺩ ﺿﻤﻨﻴﺔ n n Actions or conduct of the parties rather than words, create the contract ﻣﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﺘﺼﺮﻓﺎﺕ A patient rolling up his or her sleeve to receive an injection is an example 9

Medical Law and Ethics (cont. ) Terminating Care of a Patient o A physician

Medical Law and Ethics (cont. ) Terminating Care of a Patient o A physician who no longer wants to manage a patient’s care must withdraw in a formal, legal manner by: n n Providing written communication to the patient Recommending that patient seek another physician as soon as possible Mail letter by certified mail with return receipt requested Summarize all communication in patient chart and place copy of all documentation in chart 10

Medical Law and Ethics (cont. ) Terminating Care of a Patient o Typical Reasons

Medical Law and Ethics (cont. ) Terminating Care of a Patient o Typical Reasons Physicians May Terminate Care of a Patient: n n n Refusal to follow physician instructions Personality conflicts Failure to pay for services rendered Repeated failure to keep appointments Patient family member complaints Disagreement regarding medication orders 11

Medical Law and Ethics (cont. ) Malpractice o o Malpractice ﻣﻤﺎﺭﺳﺔ ﺧﺎﻃﺌﺔ claims are

Medical Law and Ethics (cont. ) Malpractice o o Malpractice ﻣﻤﺎﺭﺳﺔ ﺧﺎﻃﺌﺔ claims are lawsuits by a patient against a physician for errors in diagnosis or treatment. Negligence cases are those in which a person believes a medical professional’s actions or lack thereof, caused harm to the patient. 12

Medical Law and Ethics (cont. ) Malpractice o Examples of Negligence: n n o

Medical Law and Ethics (cont. ) Malpractice o Examples of Negligence: n n o Abandonment ﻫﺠﺮ Delayed treatment Legal Terms used to classify Negligence n n n Malfeasance (ﺍﻟﻤﺨﺎﻟﻔﺎﺕ unlawful act or misconduct) Misfeasance ( ﺍﺳﺎﺀﺓ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺴﻠﻄﺔ lawful act done incorrectly) Nonfeasance (failure to perform an act that is one’s required duty or that is required by law) 13

Medical Law and Ethics (cont. ) Malpractice The 4 Ds of Negligence amages erelict

Medical Law and Ethics (cont. ) Malpractice The 4 Ds of Negligence amages erelict uty Patients must prove that they suffered injury. Patients must show that the physician failed to comply with the standards of the profession. Patients must show that a physician-patient relationship existed. irect Cause Patients must show that any damages were a direct cause of a physician’s breach of duty. Patients must be able to prove all 4 Ds in order to move forward 14 with a malpractice suit.

Medical Law and Ethics (cont. ) Malpractice Settling Malpractice Suits o Arbitration ﺍﻟﺘﺤﻜﻴﻢ n

Medical Law and Ethics (cont. ) Malpractice Settling Malpractice Suits o Arbitration ﺍﻟﺘﺤﻜﻴﻢ n o Persons outside the court system with special knowledge in the field listen to the case, and decide the dispute. Court n n Written court orders (subpoena) ﻣﺬﻛﺮﺓ ﺍﺣﻀﺎﺭ are delivered to involved parties. Subpoena duces tecum is a court order to produce documents like patient records. 15

Medical Law and Ethics (cont. ) Malpractice o Law of Agency n n Employees

Medical Law and Ethics (cont. ) Malpractice o Law of Agency n n Employees are considered to be agents of the physician while performing professional tasks. Physicians are thereby responsible or liable for the negligence of employees. Employees are also legally responsible for their own actions and they can be sued directly. 16

Medical Law and Ethics (cont. ) Standard of Care According to the AAMA, medical

Medical Law and Ethics (cont. ) Standard of Care According to the AAMA, medical assistants should uphold legal concepts by: o Maintaining confidentiality. o Practicing within the scope of training and capabilities. o Preparing and maintaining medical records. o Documenting accurately. o Using proper guidelines when releasing information. 17

Medical Law and Ethics (cont. ) Standard of Care (cont. ) o o o

Medical Law and Ethics (cont. ) Standard of Care (cont. ) o o o Follow employer’s established policies dealing with the health-care contract. Follow legal guidelines and maintain awareness of health-care legislation and regulations. Maintain and dispose of regulated substances in compliance with government guidelines. Follow established risk-management and safety procedures. Recognize professional credentialing criteria. Help develop and maintain personnel, policy and procedure manuals. 18

Medical Law and Ethics (cont. ) Administrative Duties and the Law o Examples of

Medical Law and Ethics (cont. ) Administrative Duties and the Law o Examples of duties related to legal requirements: n n n n Vital statistics (births & deaths) Abuse (drug abuse & child abuse) Violent Injuries STD’s (sexually transmitted diseases) Patient consent forms Insurance billing Appointment books Patient records and information 19

Medical Law and Ethics (cont. ) Controlled Substances and the Law Medical Assistants must

Medical Law and Ethics (cont. ) Controlled Substances and the Law Medical Assistants must follow the correct procedure for keeping and disposing of controlled substances. • Be familiar with correct dosages, potential complications, and refill rules. • Keep prescription pads secure and out of reach. 20

Medical Law and Ethics (cont. ) Communication and the Law o o o Medical

Medical Law and Ethics (cont. ) Communication and the Law o o o Medical assistant’s are not allowed to decide what information is to be disclosed to the patient. The role of the medical assistant is to foster supportive, respectful communication with patients. Good, clear, nonjudgmental communication can prevent misunderstandings and legal confrontations. 21

Medical Law and Ethics (cont. ) Legal Documents and the Patient A legal document

Medical Law and Ethics (cont. ) Legal Documents and the Patient A legal document stating types of treatment the patient does and does not want in an event of terminal illness, unconsciousness or comatose state. (LIVING WILLS) A legal document that states a person’s wish to donate one or more organs as a gift. Even total body anatomical gifts are made. Uniform Donor Card 22

Medical Law and Ethics (cont. ) Confidentiality Issues o All patient information must be

Medical Law and Ethics (cont. ) Confidentiality Issues o All patient information must be kept confidential and shared only with the appropriate staff involved in the care of the patient. • Keep records out of sight so night workers and other patients can not view it. • Do not discuss the case with anyone outside the medical office. 23

Medical Law and Ethics Confidentiality Issues (cont. ) o Use and Disclosure are two

Medical Law and Ethics Confidentiality Issues (cont. ) o Use and Disclosure are two important concepts under HIPAA that must be understood. Information is used when it moves within an organization. Information is disclosed when it is transmitted between or among organizations. Examples of Use • Sharing • Employing • Applying • Utilizing • Examining • Analyzing Examples of Disclosing • Release • Transfer • Provision of access to • Divulging in any manner 24

Medical Law and Ethics Confidentiality Issues (cont. ) the provider is allowed to use

Medical Law and Ethics Confidentiality Issues (cont. ) the provider is allowed to use health care information for: reatment Providers are allowed to share information in order to provide care to patients. ayment Providers are allowed to share information in order to receive payment for the treatment provided. perations Providers are allowed to share information to conduct normal business activities, such as quality improvement. 25

Medical Law and Ethics Confidentiality Issues (cont. ) o The following information may be

Medical Law and Ethics Confidentiality Issues (cont. ) o The following information may be disclosed without authorization: • Medical researchers • Emergencies • Funeral Directors/Coroners • Disaster Relief Services • Law enforcement • Abuse and Neglect • Organ and Tissue Donation Centers • Work related conditions that may affect employee health • Judicial/administrative proceedings at the patient request or as directed by a subpoena or court order 26

Medical Law and Ethics Confidentiality Issues (cont. ) Security Rule This rule specifies how

Medical Law and Ethics Confidentiality Issues (cont. ) Security Rule This rule specifies how patient information is protected on: q Computer networks q The internet q Disks and other storage media and extranets Other Security Avenues to Consider q Chart security q Reception area security q Fax security q Medical Assistant clinical station security 27

Apply Your Knowledge A 36 -year old patient comes to her initial office visit

Apply Your Knowledge A 36 -year old patient comes to her initial office visit and the medical assistant begins to register the patient. While the patient is completing her paperwork, she passes out in the waiting room lobby. She is carried to the local hospital and diagnosed with a severe stroke. As the patient recovers, she verbalizes a desire to bring a malpractice suit on the physician. Are all the elements required for malpractice present? 28

Apply Your Knowledge -Answer A 36 -year old patient comes to her initial office

Apply Your Knowledge -Answer A 36 -year old patient comes to her initial office visit and the medical assistant begins to register the patient. While the patient is completing her paperwork, she passes out in the waiting room lobby. She is carried to the local hospital and diagnosed with a severe stroke. As the patient recovers, she verbalizes a desire to bring a malpractice suit on the physician. Are all the elements required for malpractice present? No, for starters, duty has not yet been established which is the first required element. 29

OSHA Regulations o o The Occupational Safety and Health Administration (OSHA) is a division

OSHA Regulations o o The Occupational Safety and Health Administration (OSHA) is a division of the U. S. Department of Labor. Regulations describe precautions that must be taken to protect workers from exposure to infectious diseases such as: n n Human immunodeficiency virus (HIV) Hepatitis B virus (HBV) 30

OSHA Regulations (cont. ) o o Hospitals are required to follow Standard Precautions were

OSHA Regulations (cont. ) o o Hospitals are required to follow Standard Precautions were developed by the Centers for Disease Control and Prevention (CDC). 31

OSHA Regulations (cont. ) • Disposable gloves • Masks • Goggles/Face Shield • Gowns

OSHA Regulations (cont. ) • Disposable gloves • Masks • Goggles/Face Shield • Gowns The law requires that the employer provide all necessary protective clothing to employees free of charge. 32

OSHA Regulations (cont. ) o Decontamination n o Sharp Equipment n o All exposed

OSHA Regulations (cont. ) o Decontamination n o Sharp Equipment n o All exposed work surfaces must be sprayed with a 10% bleach solution or other agent approved by the Environmental Protection Agency (EPA) To prevent exposure, sharps are to be placed in a leakproof, puncture-resistant, color-coded, labeled container Exposure Incidents n n Incidents are to be reported immediately Current procedures may need to be modified 33

OSHA Regulations (cont. ) o Postexposure Procedures n n Employers must offer a free

OSHA Regulations (cont. ) o Postexposure Procedures n n Employers must offer a free medical evaluation to exposed employee Employers must also refer employee to a licensed health-care provider for blood sampling, appropriate treatment and counseling Employees may refuse treatment by signing a waiver When a medical worker is first employed, the employer must offer at no cost the opportunity to have the HBV vaccination within 10 days 34

OSHA Regulations (cont. ) o Laundry n o Hazardous Materials n o All laundry

OSHA Regulations (cont. ) o Laundry n o Hazardous Materials n o All laundry must be labeled and bagged appropriately. Employers must keep an inventory of all hazardous materials in the workplace (MSDS Sheets. ) Training Requirements n All employees that may be exposed must be given free, annual training during work hours. 35

Apply Your Knowledge A medical assistant working in a local medical office has a

Apply Your Knowledge A medical assistant working in a local medical office has a severe allergy to latex. What should she do when handling potentially hazardous materials? 36

Apply Your Knowledge -Answer A medical assistant working in a local medical office has

Apply Your Knowledge -Answer A medical assistant working in a local medical office has a severe allergy to latex. What should she do when handling potentially hazardous materials? The physician, according to OSHA, must supply the necessary protective equipment so latex free gloves should be on hand in such situations. 37

Apply Your Knowledge A 26 -year old patient is very upset about her proposed

Apply Your Knowledge A 26 -year old patient is very upset about her proposed treatment plan and refuses to be taken to the hospital as the physician has suggested. The patient attempts to leave the office but the physician instructs the medical assistant to give the patient a sedative so she can wait until her husband arrives. What are implications of this situation? 38

Apply Your Knowledge -Answer A 26 -year old patient is very upset about her

Apply Your Knowledge -Answer A 26 -year old patient is very upset about her proposed treatment plan and refuses to be taken to the hospital as the physician has suggested. The patient attempts to leave the office but the physician instructs the medical assistant to give the patient a sedative so she can wait until her husband arrives. What are implications of this situation? Even though the physician believes he is acting on the best interest of the patient, the patient refused care and has the right to do so as long as she is competent. The administration of the sedative could be classified as a form of false imprisonment. 39

End of Chapter 40

End of Chapter 40