Medical Law and Ethics Chapter 3 Importance of

Medical Law and Ethics Chapter 3 Importance of the Legal System for the Physician and the Healthcare Professional Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Medical Practice Acts • Establish examining boards • Provide baseline for practice of medicine • Determine prerequisites for licensure • Forbid practice of medicine without a • • license Specify conditions for renewal, suspension, and revocation of licenses Vary from state to state Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Licensure of Physician • Examination – – – National Board Medical Examination (NBME) Federal Licensing Examination (FLEX) U. S. Medical Licensing Examination (USMLE) Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Licensure of Physician • Endorsement: an approval or sanction • Reciprocity: cooperation of one state in granting license to practice medicine to a physician already licensed in another state Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Licensure of Physician • Registration: • Occurs annually or biannually • Physicians must pay a fee • Physicians are required to complete seventy five hours of CME in a three year period Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

When Valid License Is Not Needed by a Physician • When employed by federal medical • • • facilities (but must be a licensed physician to practice medicine in some state) In an emergency While establishing residency When engaged solely in research Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Revocation and Suspension • Unprofessional conduct: falsifying • • records, gross immorality Commission of a crime: Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction Personal incapacity: physical or mental incapacity Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Licensure and Certification of Allied Health Professionals • Licensure: graduate from accredited • school and pass national exam of competency Certification: meet standards set by accreditation body and pass national exam of competency Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Accreditation • Voluntary request of official review by • • • accrediting agency Examine policy and procedures of agency Must demonstrate that the institution maintains high standards Examples: JCAHO and CAAHEP Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Standard of Care • Ordinary skill and care that must be used • • by medical practitioners Must provide same knowledge, care, and skill that similarly trained physician and/or medical professional would provide under same circumstances Perform as “reasonable and prudent” person would perform Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Physicians Are… • Not obligated to treat everyone in case of • • • emergency Expected to use reasonable, ordinary skill and care (not extraordinary) Expected to exhaust all resources available to them for patient care Not to expose patients to undue risk Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Prudent Person Rule (also called the “reasonable person standard”) • Must provide following information to patient: – – – – Diagnosis Risk and consequences of treatment Expected benefits of treatment or procedure Alternative treatments Prognosis if no treatment Cost and expected pain Follow acceptable standard of care Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Confidentiality • Keeping private all information about • • patient No disclosure without written consent Medical Patient Rights Act: a federal law that gives all patients right to have privacy respected and records held confidential Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Statute of Limitations • Period of time patient has to file lawsuit • Usually one to three years • Discovery Rule: begins when problem discovered or when the patient should have known of the injury Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Good Samaritan Laws • State laws help protect health care • professionals and ordinary citizens from liability while giving care in emergency No one is required to provide aid – Except in Vermont Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Good Samaritan Laws • Only required to act within limits of • acquired skill and training Once you start you must continue until help arrives or you physically cannot continue Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Respondeat Superior • “Let the master answer” • Employer liable for acts of employee within scope of employment Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Employee’s Duty to Carry Out Orders • Duty to interpret and carry out orders • Duty to clarify ambiguous or erroneous • orders Duty to decline orders that appear dangerous for patient and to notify physician Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Scope of Practice • Must understand work within scope • • of practice for discipline Must understand practice within guidelines of profession Must understand follow chain of command so no employee makes decision he or she is unqualified to make Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Employer’s Duty to Employees • Responsibility to provide safe • • • environment for employees and staff Most have liability insurance to cover accidents and unforeseen incidents May bond employees who handle money Some have liability insurance for auto if used for work-related business Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Risk Management • A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer – – – Identify risk behaviors and practices Develop and follow plan of action to eliminate problem behavior Address corrective actions in policy and procedure books and employee handbooks Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright © 2012 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.