Medical Law and Ethics Flashcards
(57 cards)
1
Q
Ethics
A
deals with social and moral definitions of right and wrong
2
Q
Law
A
system of rules and regulations set by a gov or institution
3
Q
Statutes
A
laws created by fed, states, local legislators. Upheld by law enforcement, cases may end up in local/state/fed court systems. MCare, MCal, FDA are agencies that create health-care-related statutes
4
Q
Administrative Law
A
also called regulatory law, passed by gov agencies such as IRS, addresses issues of taxation, public transport, manufacturing, environment, public broadcasting
5
Q
US judicial system: Public Law
A
focuses on issues between gov and citizens, such as criminal law, constitutional, administrative, international
6
Q
US judicial system: Private/Civil Law
A
focuses on issues between two or more citizens
7
Q
Criminal / Penal Law
A
focuses on public’s safety and welfare, addressing people who commit crimes/legal offenses. Classified by severity as felonies vs misdemeanors, laws vary from state to state
8
Q
1st Degree Felony
A
Committed the crime
9
Q
2nd Degree Felony
A
Was at the scene and assisted
10
Q
3rd Degree Felony
A
Assisted in the crime before it occurred
11
Q
4th Degree Felony
A
Assisted the person who committed the crime after the fact
12
Q
Misdemeanor
A
Petty theft, prostitution, simple assault, disorderly conduct
13
Q
Civil Law:
A
deals with contract law, commercial law, tort law
14
Q
Contract / Commercial Law
A
address the rights and obligations one has to another [dr px relationships]
15
Q
Tort Law
A
deals with injuries one has suffered at the hands of another [malpractice]. Unintentional [mistake, negligence] vs Intentional [tort]
16
Q
Negligence
A
defined as an act that a reasonable healthcare provider would not have done or the omission of an act that a reasonable healthcare provider would have done
17
Q
Assault
A
Unauthorized attempt or threat to touch another person.
18
Q
Battery
A
Actual physical touching of another person without the person’s consent.
19
Q
Defamation of character
A
Making and publishing false or malicious statements about another person’s character or reputation.
20
Q
Duress
A
Act of coercing someone into an act.
21
Q
Fraud
A
Deceitful act made to conceal the truth.
22
Q
Invasion of privacy
A
Releasing private information about another person without their consent.
23
Q
Tort of outrage
A
Intentionally inflicting emotional distress on another person.
24
Q
Undue influence
A
Intentionally persuading people to do things they do not want to do
25
Consent form: must include, written in language patient speaks
* Name of the procedure to be performed.
* Name of the physician who will perform the procedure.
* Name of the person administering the anesthesia.
* Any potential risks to the patient from the procedure.
* Any accepted alternative treatments and their risks.
* Any exclusions the patient has requested.
* A statement indicating that all the patient’s questions have been answered.
* The patient’s and witnesses’ signatures and the date signed
26
Consent form: who can sign
* Any mentally competent adult over age 18
* Parent or legal guardian of child, mentally incompetent adult, or temp incapacitated adult
* Emancipated minors: under 18 BUT married/self supporting and responsible for own debts; have received a court order declaring them emancipated
* A minor who is: In the armed forces; being seen for treatment for sexually transm diseases; pregnant; being seen for info re: birth control or abortion; being seen for tx re: drug/alc
27
Implied Consent
IE told they need to give a blood sample, rolls up sleeves and offers arm but says nothing
28
Expressed Consent
Verbally or in Writing
29
Medical Malpractice: Malfeasance
performing incorrect treatment [operating on wrong px]
30
Medical Malpractice: Misfeasance
performing treatment incorrectly [operating on px arm and accidentally severing a nerve, leaving px unable to use arm]
31
Medical Malpractice: Nonfeasance
delaying or failing to perform treatment [telling px tumor does not need to be removed and px later has bad outcome due to non-removal of tumor]
32
Medical Malpractice: Office sued, filed against Dr
doctrine of Respondeat superier: latin for let the master answer
33
Malpractice insurance policies: claims-made
protect policyholders from malpractice claims only when the insurance co insuring at the time of the alleged malpractice is the same company at the time the claim is filed in court
34
Malpractice insurance policies: occurence
covers holders regardless of when claims are filed provided the policies were in effect at the time of the alleged malpractice events
35
To prove med malpractice, px must prove all Four D's of Negligence
* Duty: physician has duty to care for px once they have taken those px on
* Dereliction of duty: dr must meet standard of care guidelines for healthcare provider with same training in same location under same circumstance
* Direct cause: px must prove that dr actions/lack of action directly caused px injuries
* Damages: px must prove they sustained damages due to negligence
36
Px win case: Nominal Settlement
small award or payment that are made when negligence is proven but damages are minimal
37
Px win case: Compensatory Settlement
this is money that is awarded to the px or px's family to compensate for the cost of medical care, the disability, mental suffering, any loss of income, loss of future income
38
Px win case: Punitive Settlement
awards like these are made when judge/juries feel the healthcare providers should be punished for their actions. Courts may feel the providers were reckless or purposefully ignored signals that should have alerted them to the injuries. Punitive damages are typically high dollar amounts. Several states don’t allow for punitive damages
39
Contributory negligence defense
dr may have been at fault, but can prove px aggravated their injuries or somehow worsened then -- also called comparative negligence
40
Feres doctrine from 1950
prevents members of the armed services from suing us fed gov, its officials, ts facilities, unless an intentional tort was committed. Lawsuits derived from person acting within their scope of practice and discharged military personnel are examined on individual basis
41
Res Judicata
[latin: the thing has been decided]: if px loses their malpractice suit, they cannot bring other suits against the physician for same injuries
42
Res ipsa locuitur
[latin: the thing speaks for itself]: dr must prove what they did was correct, in all other cases px must prove dr was wrong. Mostly only used for wrong amputation etc
43
Standard of care
the care a reasonably prudent person, in the same circumstances, with the same level of training, would perform. Expert witnesses called.
44
Assumption of risk defense
px cannot sue dr because they were made aware of the risk that occurred
45
Good Samaritan Act
protects healthcare workers from being sued when they render first aid in emergency situations outside their medical setting -- grocery store -- px died or had poor outcome, healthcare worker is protected
46
National Childhood Vaccine Injury Act 1986
vaccine injuries must be reported by physicians’ offices to alert other physicians to possibly contaminated batches of vaccine. To report a vaccine injury, the medical administrative assistant should obtain the patient’s name and age, as well as the name and lot number of the vaccine. The call must be documented in the patient’s chart.
Public Duties of the Physician
47
Public Duties of the Physician: Birth
Issuing of a legal certificate, which will be maintained during a person's life as proof of age. Many benefits and documents, including Social Security, passport, and driver's license, depend on having a valid birth certificate.
48
Public Duties of the Physician: Death
Physicians sign a certificate indicating the cause of a natural death. Check with your state public health department to determine specific requirements. For example, in the case of a stillbirth before the 20th week of gestation, the medical assistant will have to determine if both a birth and death certificate are required. A coroner or health official will have to sign a certificate in the following cases:
* No physician present at the time of death
* Violent death, unlawful death
* Death as a result of criminal action
* Death from an undetermined cause
49
Public Duties of the Physician: Reportable Communicable Diseases
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Physicians must report all diseases that can be transmitted from one person to another and are considered a general threat to the public. The list of reportable diseases differs from state to state. The report can be either by mail or phone. The following childhood vaccines and toxoids are required by law (National Childhood Vaccine Injury Act of 1986):
• Diphtheria, tetanus toxoids, pertussis vaccine (DTP)
• Pertussis vaccine (whooping cough)
• Measles, mumps, rubella (MMR)
• Poliovirus vaccine, live
• Poliovirus vaccine, inactivated
• Hepatitis B vaccine
Tuberculosis test
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50
Public Duties of the Physician: Wounds of Violence
Certain injuries are reportable according to state requirements. These injuries include gun or knife wounds, rape and battered persons injuries, and spousal, child, and elder abuse.
51
Public Duties of the Physician: Child Abuse
Questionable injuries of children, including bruises, fractured bones, and burns, must be reported. Signs of neglect, such as malnutrition, poor growth, and lack of hygiene, are reportable in some states.
52
Public Duties of the Physician: Elder Abuse
Physical abuse, neglect, and abandonment of older adults is reportable in most states. The reporting agency varies by state but generally includes social service agencies.
53
Public Duties of the Physician: Drug Abuse
Abuse of prescription drugs is reportable according to the law. Such abuse can be difficult to determine because the abuser may seek prescriptions for the same drug from several different physicians. A physician will want to see a patient before prescribing a medication.
54
Controlled Substances Act 1970
regulates manufacture, distribution, dispensing of non/narcotics that have high potential for abuse. Enforced by DEA Drug Enforcement Agency. Designed to limit illegal use of controlled substances & prevent substance abuse by healthcare professionals. Law req any provider who dispenses, administers, rx narcotics/other controlled must be registered with the DEA - violation is criminal offense punishable by fines/imprisonment
55
Compliance of Controlled Substances Act includes
* Healthcare providers who keep a supply of controlled substances in the office for dispensing or administration must use a triplicate order form from the DEA.
* A record of every controlled substance transaction must be kept and maintained for 2 to 3 years and must be available for inspection by the DEA at any time.
* All controlled substances must be kept in a locked cabinet out of the patients’ view and only those staff members who need access should have it.
* Any theft of controlled substances must be reported to the local police and the nearest DEA office.
* Prescription pads must be kept in a safe place to avoid theft.
* Any healthcare provider who ceases practice must return all unused order forms to the DEA.
* Keep only a limited supply of prescription pads in the office. Rather than ordering enough pads last a year, order just enough for a month or two so missing pads will be more easily and quickly noticed.
* Keep no prescription pads in the examination rooms or any other location where they are unattended and could be stolen.
* Inventory the prescription pads in the office regularly so theft will be quickly noticed.
Notify local law enforcement and the DEA when a prescription pad is stolen.
56
AAMA [assoc med assist] has code of ethics that addresses 5 areas
1. Render services with respect for human dignity
2. Respect patients' confidentiality, except when the law requires information
3. Uphold the honor and high principle set forth by the AAMA
4. Continually improve knowledge and skills for the benefit of patients and healthcare team
5. Participate in community services that promote the good health and welfare of the general public
57
Blanchard and Peale Ethical Model
Is this action legal? Is this action ethical? How will the action make me feel? How would I feel if the action and my involvement was published locally? If I had to explain it to my partner/parents/children?
