13: Legal vs Ethical

Question 1

T/F Providers must explain every possibility that might occur to protect themselves.

Answer 1

False. Providers do not have to explain every possibility that may occur but isn’t anticipated by equipment use. Providers must only disclose known drug-related events, not predict what might happen.

Question 2

Makes financial decisions for patient.

Answer 2

Conservator

Question 3

Is this legal or ethical?

Failure to obtain informed consent.

Answer 3

Both

Question 4

What limiting factors to informed consent does the court recognize (3)?

Answer 4

1. Medical matters are complex.
2. Communication of scientific information by a trained health care provider to an untrained patient may be difficult.
3. The remote possibility of risk is almost limitless; there should be a limit to what a provider is held to.

Question 5

Is this legal or ethical?

Failure to follow the chain of command.

Answer 5

Legal

Question 6

T/F Legal and ethical responsibilities are identical.

Answer 6

False. They are not identical. Ethical responsibility to obtain informed consent may be to do no harm but legal responsibility encompasses multiple criteria.

Question 7

Physical ability to make and communicate decisions.

Answer 7

Capacity/Incapacity

Question 8

Doctrine of informed consent may include what 7 items that would help a patient make an informed decision?

Answer 8

1. Nature of condition
2. Risks
3. Benefits
4. Inability to predict risks/benefits
5. Irreversibility of procedure
6. Likely result of no treatment
7. Available alternatives, including risks/benefits

Question 9

T/F A plaintiff was not successful in a claim because the court determined “[r]egardless of the severity of the potential injury, if the probability that the injury will occur is so small as to be practically non-existent, then the possibility of that injury occurring cannot be considered a material factor.”

Answer 9

True

Question 10

Mental capacity/incapacity.

Answer 10

Competence/Incompetence

Question 11

A health care provider has the duty to disclose all significant information that he/she possesses or reasonably should possess that is material to an intelligent decision by the patient. This applies to what legal principle?

Answer 11

Doctrine of Informed Consent

Question 12

All ethical dilemmas may not have legal standards, if courts have not heard cases based on those ethical dilemmas. In the absence of court decisions, professionals are guided by _____.

Answer 12

Ethics/personal moral standards

Question 13

When there is an ethical vs legal conflict, courts will evaluate whether a rational basis exists for a decision and generally consider the _____ when deciding an issue.

Answer 13

Public good

Question 14

T/F “Extraordinary” measures has expanded in the past few decades to include not just ventilation, but possibly IV or feeding tubes.

Answer 14

True. The definition has expanded and may include IV in a patient unable to understand/tolerate pain. Courts have reviewed some ethical issues and guidelines exist, but they are not comprehensive and may not answer your specific situations.

Question 15

Can be activated/inactivated to act on behalf of patient as needed.

Answer 15

Proxy

Question 16

Identify whether issue is legal/ethical/both and ensure it is fact specific. Withdrawing treatment from an individual who wants it could be a/an _____ issue. Who is able to make that decision would be a/an _____ issue.

Answer 16

Ethical

Legal

Question 17

Makes recommendations for patient in court.

Answer 17

Guardian ad Litem

Question 18

Is this legal or ethical?

Competency issues.

Answer 18

Both

Question 19

Obligation to give adequate information does not require disclosure of information the health care provider reasonably believes patient has.

Answer 19

Explicit/Implicit Understanding

Question 20

Makes decisions patient would make.

Answer 20

Guardian

Question 21

Is this legal or ethical?

Failure to properly document.

Answer 21

Legal

Question 22

What practice tips can help prevent legal issues (8)?

Answer 22

1. Know red flag conditions/complaints.
2. Treat worst thing first.
3. Know risk factors that call for screening exams/tests.
4. Follow up on diagnostic tests and referrals.
5. Revisit unsolved problems until resolved.
6. Have systems in place for follow up.
7. Audit charts for errors/mistakes/omissions.
8. Treat every medical opinion as though to a patient in the office (differs from consultations with colleagues).

Question 23

Is this legal or ethical?

Failure to show concern and consideration.

Answer 23

Both. Ethically, patient has a right to self-determination. Provider must show concern and consideration to allow that. Legally, there are potential omissions if the provider fails to communicate.

Question 24

Is this legal or ethical?

Failure to follow/understand institutional policies/procedures.

Answer 24

Legal

Question 25

Is this legal or ethical?

Failure to communicate/poor communication with the treatment team.

Answer 25

Legal

Question 26

T/F Courts acknowledge that the patient’s right to know must be balanced with the recognition that an undue burden must not be placed on health care providers.

Answer 26

True

Question 27

Is this legal or ethical?

Failure to understand/master use of equipment.

Answer 27

Legal

Question 28

This is an example of what? Many don’t state the risk of infection, but being in an institutional setting increases that risk.

Answer 28

Explicit/Implicit Understanding

Question 29

Is this legal or ethical?

Failure to keep up with current treatment (deviation from standard).

Answer 29

Legal

Question 30

What “trouble spots” open you up to legal claims (5)?

Answer 30

1. Failure to treat according to standards.
2. Failure to refer/obtain consultation.
3. Improper management/care.
4. Delay of treatment/care.
5. Medication errors.