Ch 1,3,4,5,6,7,8 Flashcards
What are the 3 branches of the federal government?
Legislative
Executive
Judicial
This principle provides that no one branch of government is clearly dominant over the other two; however, in the exercise of its functions, each can affect and limit the activities, functions, and powers of the others.
Separation of powers
The primary function of the ______ branch of the government on the state and federal level is to administer and enforce the law.
Executive branch
Who serves as the administrative head of the executive branch?
The president
On the state level who serves as the head of the executive branch of the government?
Governor
On the federal level legislative powers are vested in the?
Congress of the US
The function of the _______ branch is to enact laws that can amend or repel existing legislation and to create new legislation.
Legislative
The legislature branch determines the nature and extent of the need for new ______ and existing laws.
Laws
Committees of both house of ______ are responsible for preparing federal legislation
Congress
The function of the ________ branch of government is adjudication—- resolving disputes in accordance with the law.
Judicial
________ is the resolving of disputes in accordance with the law
Adjudication
What does it mean for a court to have at least one appellate court?
There is a provision for appeal with further review in all but select cases
What is the trial court of the federal system?
US district court, there are 94 of these in the 50 states and one in the district of columbia
Why are there more courts in the US than number of states?
Because some of the larger states have more than one district court
How many judges are required to sit and decide a case?
Usually one however, there are some cases that require up to 3
What is the nations highest court?
The supreme court and its the only one created directly by the constitution
How many people sit in the supreme court?
8 associate justices and one chief justice…
The supreme court has _______ original jurisdiction over the _______ federal courts and the highest state courts.
Limited, lower
If a president vetoes a bill how much of congress does it take to over ride the veto?
Two-thirds
A president can also prevent a bill from becoming law by avoiding any action while congress is in session, this is known as a?
Pocket veto
DHHS is a cabinet level department of the executive branch of the federal government, is concerned wth people and is the most involved with the nations human concerns.
Department of health and human services
What s the main source of regulations affecting the health care industry?
DHHS
CMS is formerly known as the Health Care Financing Adminstrion and was created t combine under one administration the oversight of the medicare program, federal portion of medicaid, the state children’s health insurance program, and related quality assurance activities
Centers for medicare and medicaid services
Which program is for those 65 and older and certain disabled persons?
Medicare
PHS is responsible for the protection of the nations physical and mental health
Public health service
PHS is composed of several agencies.
National institute of health
Centers for disease control and prevention
Fda
Health resources and services administration
Agency for healthcare research and quality
Agency for toxic substances and disease registry
Indian health services
________ is a system of principles and processes by which people in a society deal with disputes and problems, seeking to resolve or settle them without resorting to forces
How scholars define the law
________ are rules of conduct that is enforced by the government which imposes penalties when violated
Laws
________ law deals with relationships between individuals and governments
Public
_______ law deals with relationships among individuals
Private
_______ law, which is a segment of public law, prohibits conduct deemed injurious to public order and provides punishment of those proven to have engaged in such conduct
Criminal
Tort and contract actions are two basic types of _______ law
Private
_______ _______ one party asserts that the wrongful conduct of another has caused harm, and the injured party seeks compensation.
Tort action
______ ______ involves a claim by one party that another party has breached an agreement by failing an obligation
Contract action
________ policy is the principle of law that holds no one can lawfully do that which tends to be injurious o the public or against the public good.
Public
_________ law refers to the body of principles that evolve and expand from judicial decisions that arise during the trial of court cases.
Common
Where do many of our legal principles and rules come from today?
Origins in english common law
After the revolution which state did not adopt all or part of the english common law?
Louisiana
Louisiana has based their civil law on what?
French and spanish laws and especially on the code of napoleon
Is there a national system on common law?
No
Legal cases are tried by applying common law principles unless what?
A statute governs
_______ is when a case sets forth a new legal principle and establishes?
A precedent
A precedent is rendered to serve as a rule for _____ _______ when deciding similar cases
Future guidance
_____ _______ means the thing is decided refers to that which has been previously acted on or decided by the courts.
Res judicata
______ ________ common law principle provides that when a decision is rendered in a lawsuit involving a particular set of facts another lawsuit involving an indentical or substantially similar situation is to be resolved in the same manner as the first law suit
Stare decisis
_____ ________ is a written law emanating from a legislative body.
Statutory law
Can statutory law be amended, repealed, or expanded by action of the legislature?
Yes
______ law is the extensive body of the public law issue by either state or federal agencies to direct the enacted laws of the federal and state governments. It is the branch of law that controls the administrative operations of the government
Administrative
Where can resolution be sought if federal and state laws conflict?
The appropriate federal court
The ____ ____ act describes the different procedures under which federal administrative agencies must operate
Administrative procedures
The _____ of _____ _____ is an agency within the executive branch of government, established in 1978 by?
Office of government ethics…… ethics in government act
What does the office of government ethics do?
Exercise leadership in executive branch to prevent conflicts of interest on the. Part of government employees, and to resolve those conflicts of interest that occur
The _____ of _____ is designated as the supervising ethics office for the House of Representatives
Committee on ethics
Which two ancient civilizations had crude hospitals?
India and egypt
Who appointed a physician for every 10 villages and built hospitals for the crippled and the poor?
Buddha
Who built places for the pregnant and diseased?
Upatiso, buddhas son
Were hindu physicians capable of surgery?
Yes
Who were the first to administer drugs to patients? What kind of drugs did they administer?
Egyptians, alum, peppermint, castor oil, and opium
The term _____ derives from hospitality, which relates to guests and their treatment
Hospital
This physician employed principles of percussion and auscultation, wrote intelligently on fractures, performed numerous surgical operations, and described conditions like epilepsy, TB, malaria, and ulcers.
Hippocrates
This persian physician was the first to use the intestines of sheep for suturing and cleansing patient wounds with alcohol.
Rhazes
Who said was is the only proper school for a surgeon?
Hippocrates
What dominated the establishment of hospitals during the middle ages?
Religion
A number of religious orders created _____ or travelers’ rests and infirmaries adjacent to monasteries that provided food and temporary shelter for weary travelers and pilgrims.
Hospitia
When did the hospital movement grow rapidly?
During the crusades, 1096.
What were lazar houses built for?
Built on the edges of towns to accommodate those with leprosy.
This group is credited with virtually stamping our leprosy.
Members of the Order of St. Lazar
What hospital was used exclusively for the mentally ill in england?
St. Mary of Bethlehem
The great ____ ____ was built in Cairo in 1276, and was a contrast to the european institutes of the middle ages. It was equipped with separate wards for the more serious diseases and outpatient clinics. These hospitals laid the ground works of hospital progress to come in later centuries.
Al-Mansur hospital
Who was known as the originator of the cross-sectional anatomy and performed dissections?
Leonardo da Vinci, Vesalius
When did the practice of surgery become more scientific?
During the renaissance
During the renaissance who performed surgeries and who performed shaving the patient and leech therapy?
Long robed surgeons performed surgery
Short robe barber surgeons shaved and applied leech therapy
How were long robe surgeons and short robe barbers regarded by other physicians?
They were looked down upon and thought of as inferior
When was the royal college of surgeons of edinburgh established?
1506
Who discovered bacteria, free living and parasitic microscopic protsits, sperm cells, good cells, and microscopic nematodes?
Antony Van Leeuwenhoek
Where was the first hospital in the new world?
Manhatten Island
Where was the first site for the incorporated hospital in america? And also the first place for the quarantine station for immigrants
Philadelphia 1743
What hospital in boston opened its door in 1832 for those women who were unable to afford in home medical care?
Boston Lying-in Hospital one of the nations first maternity hospitals
What era had more surgical procedures done due to more knowledge of anatomy?
19th century
_______, this practice in the 19th century where surgeons believed the production and discharge of pus was desirable and encouraged
Suppuration
During which war did nightingale create order and cleanliness ?
Crimean war
Who first used ether as an anesthetic to remove a small tumor from the neck of a patient?
Crawford Long, he did not publish any of this so many attribute this to WTG morgan a dentist who developed sulfuric ether
When was the AMA founded?
1847
Who discovered that puerperal fever was being spread by the med students after they came from autopsies and implemented the order to wash hands in lye prior to touching live patients?
Semmelweis
Who proved bacteria were produced by reproduction and not spontaneous generation?
Louis Pasteur
Who demonstrated that wound healing could be hastened by using antiseptics to destroy disease bearing organisms and by preventing contaminated air from coming into contact with these organisms?
Lister
Who introduced the steam sterilization?
Bergmann in 1886
Who introduced rubber gloves?
William Stewart Halstead 1890
What is the estimated number of deaths from HAI’s?
99,000
What are the two most significant influences in the development of surgical procedures and the modern hospital in the 19th century?
The discovery of anesthesia and the principle of antiseptics
What did anesthesia do?
Improved pain control, hygiene practices, which helped reduce the number of surgical site infections
Who and when wa the x-ray discovered?
Wilhelm Konrad Roentgen 1895
What else was discovered in the 19th century?
Thermometer, laryngoscopes, ophthalmoscope
Who discovered the electrocardiograph?
Willem Einthoven 1903
______ ______ a veritable constitution for hospitals, setting forth requirements for the proper care of the sick
Minimum standard developed by the american college of surgeons
The ______ ______ movement focused on the efforts of the patient with the goal of providing the patient with the best professional, scientific, and humanitarian care possible.
Hospital standardization
_______ _______. A plan of care whereby a patient pays an annual retainer fee in exchange for immediate access to a physician for health care.
Boutique medicine
What are the basic objectives of tort law?
Preservation of peace between individuals
Determining fault
Deterrence by discouraging the wrong doer from committing future tortious acts
Compensation for the ones injured
________ is a tort, it is the unintentional commission or omission of an act that a reasonably prudent person would or would not do under the same circumstance.
Negligence
________ is a form of conduct caused by heedlessly or carelessness that constitutes a departure from the standard of care generally imposed on reasonable members of society
Negligence
Give a few examples of commission of an act:
Administering the wrong med Adm the wrong dose Adm to the wrong patient Surgery without patient consent Surgery on the wrong patient Wrong surgical procedure
Give a few examples of omissions of an act:
Fail to conduct a thorough h&p exam Fail to assess and reassess nutritional needs Fail to adm meds as prescribed Fail to order diagnostic test Fail to follow up critical lab tests
Negligence or carelessness of a professional person is generally described as?
Malpractice
How many deaths per year are allegedly due to medical errors?
100,000
There are three basic forms of negligence:
Malfeasance
Misfeasance
Nonfeasance
_______ performance of an unlawful or improper act
Malfeasance
_________ improper procedure or performance of an act that leads to an injury of another
Misfeasance
__________ failure to act, when there is a duty to act as a reasonably prudent person would under similar situations
Nonfeasance
3 degrees of negligence
- Slight: minor deviation of what is expected under the circumstance
- Ordinary: failure to do what a reasonably prudent person would or would not do in similar circumstances
- Gross negligence: intentional or wanton omission of required care or performance of an improper act
4 elements of negligence that must be present for a plaintiff to recover damages caused by negligence:
- Duty to care: must be an obligation to conform to recognized standard of care
- Breach of duty: must be a deviation from the recognized standard of care… must be failure to adhere to an obligation
- Injury: actual damage estab, no injuries no damages are due (no harm no foul)
- Causation: departure from standard of care must be the cause of plaintiff injury…. injury must be foreseeable
When the four elements of negligence have been proven, the plaintiff is said to have presented a ___ ___ case of negligence, enabling the p laintiff to prevail in a lawsuit
Prima facie cause of negligence
The ____ of ____ in a negligence case is not as great as the beyond a reasonable doubt standard in a prosecutor criminal case
Burden of proof
______ _____ seek to restore the injured party’s financial situation to match the party’s financial situation before suffering harm
Compensatory damages
_______ _____ can also be awarded to plaintiffs for pain and suffering caused by the conduct that would be considered egregious
Punitive damages
Any unproven element of negligence will _____ a lawsuit based on negligence
Defeat
_______ of ______ describes what conduct is expected of an individual in a given situation
Standard of care
When is expert testimony deemed necessary?
When a jury is not qualified to determine what the reasonably prudent professionals standard of care would be under similar situations
What can be used to establish an institutions standards of care?
Joint commission, policies and procedures of the organization, regulatory requirements
Some duties can be created by _____, which occurs when a ____ specifies a particular standard that must be met.
Statute, statute
To establish liability based on a defendants failure to follow the standard of care outlined by statute, the following elements must be present:
- Defendant must have been within the specified class of persons outlined in the statute
- plaintiff must have been injured in a way that the statue was designed to prevent
- The plaintiff must show that the injury would not have occurred if the statute had not been violated
Duties can also be created by an organizations internal _____, ____, ______, and _______.
Policies, procedures, rules, and regulations
______ of ____ is the failure to conform to or the departure from a required duty of care owed to a person
Breach of conduct
_______ is any harm or damage suffered by a person as a result of the defendants/ breach of duty
Injury
________ requires that there be a reasonable, close, and casual connection or relationship between the defendants negligent conduct and the resulting damages
Causation
________ ______ is a term that refers to the relationship between a breach of duty and the resulting injury.
Proximate cause
_____-_____ _____ to determine if the injury is directly the result of a defendants act or omission of an act.
But-for rule
If an injury would have occurred regardless of a defendants negligent act, _______ cannot be assigned to the defendant
Liability
_________ is the reasonable anticipation that harm or injury is likely to result from an act or failure to act.
Foreseeability
There are two main difference between intentional torts and negligence:
- Intent, which is an element of an intentional tort but not in negligence
- Intentional wrong
An _______ ______ always involves a willful act that violates another’s interests
Intentional wrong
Examples of intentional wrongs:
Assault and battery False imprisonment Defamation of character Fraud Invasion of privacy Infliction of emotional distress
_______ is defined as the deliberate threat, coupled with the apparent present ability to do physical harm to another
Assault
_______ is the intentional touching of another’s person in a socially impermissible manner without that persons consent
Battery
______ _______ is the unlawful restraint of an individual’s personal liberty of the unlawful restraint or confinement of an individual
False imprisonment
What provides guidelines for caring for contagious disease patients?
State health codes
Regulations governing the use of restraints under the _____ ____ ___ ___ of 1987, make it clear that restraints are to be applied as a last resort rather than as a first option in the control of a residents behavior.
Omnibus Budget Reconciliation Act
______ of _____ is a communication to someone about another person that tends to hold that persons reputation up to scorn and ridicule.
Defamation of character
To be an actionable wrong, _____ must be communicated to a third person
Defamation
_____ is the written form of defamation and can be presented in such forms as signs, photographs, letters, and cartoons
Libel
________ is the verbal form of defamation and tends to form prejudices against a person in the eyes of the third person
Slander
Words or accusations that require no proof of actual harm to one’s reputation are:
- Accusing someone of a crime
- Accusing someone of having a loathsome disease
- Using words that affect a person’s profession or business
- Calling a woman unchaste
2 defenses to a defamation action:
Truth and privilege
_____ is defined as willful and intentional misrepresentation that could cause harm or loss to a person or property
Fraud
To prove fraud the following facts must be shown:
- an untrue statement known to be untrue by the party making it and that it was made with the intent to deceive
- justifiable reliance by the victim on the truth of the statement
- damages as a result of that reliance
______ _______ is the accountability of a manufacturer, seller, or supplier of chattels to a buyer or other third party for injuries sustained because of a defect in the product
Product liability
An injured party may proceed with a lawsuit against a seller, manufacturer, or supplier on three legal theories:
- Negligence
- Breach of warranty (express or implied)
- Strict liability
3 types of product defects that incur liability are:
- Design defects
- Manufacturing defects
- Defects in marketing
_______ ________ is a legal doctrine that makes some persons or entities responsible for damages their actions or products cause, regardless of fault on their part
Strict liability
A ________ is a type of guarantee concerning goods or services provided by a seller to a buyer
Warranty
An ____ ____ includes specific promises or affirmations made by the seller to the buyer
Express warranty
An _____ ______ is a guarantee of a product’s quality that is not expressed in a purchase contract
Implied warranty
______ ______ refers to responsibility without fault and makes possible an award of damages without any proof of manufactures negligence
Strict liability
4 elements that must be present for a plaintiff to proceed with a case on the basis of strict liability
- Product must be manufactured by the defendant
- Product must have been defective at time of purchase
- Plaintiff must have been injured by the specific product
- Defective product must have been the proximate cause of injury to the plaintiff
_____ _____ _____: when liability can be based on this concept, the thing speaks for itself
Res ipsa loquitur
To prove liability by res ipsa loquitur the plaintiff must establish the following evidence:
- Product did not perform the way it was intended
2. Product was not tampered with by the buyer or third party
A ____ is a legal order requiring the appearance of a person and or the presentation of documents to a court or administrative body
Subpoena
A ____ ___ ____ orders the appearance of a person at a trial or other investigative proceeding to give testimony
Subpoena ad testificandum
A subpoena for records is known as a ___ ___ ____, is a written command to bring records, documents, or other evidence described in the subpoena to a trial or other investigative proceedings
Subpoena duces tecum
Disobedience in answering a subpoena ____ ____ is considered contempt of court and carries a penalty of a fine or imprisionment or both
Duces tecum
The ____ of ____ in a civil case is the obligation of the plaintiff to persuade the jury regarding the truth of his or her case
Burden of proof
______ evidence is evidence that in the light of reason and common sense, is worthy of believe
Credible
Is claiming ignorance of the law a defense?
No
____ of a ____ is knowing that a danger exists and voluntarily accepting the risk by exposing oneself to it aware that harm might occur
Assumption of a risk
2 elements must be established for a defendant to be successful in an assumption of a risk defense:
- Plaintiff must know and understand the risk that is being incurred
- The choice to incur the risk must be free and voluntary
______ ____ occurs when a person does not exercise reasonable care for his or her own safety
Contributory negligence
_______ _____ provides that the degree of negligence or carelessness of each party to a lawsuit must establish the finders of fact and that each party then is responsible for his or her proportional share of any damages awarded
Comparative negligence
The ____ ____ ____ is a special application of the doctrine of respondent superior and applies when an employer lend to an employee to another for a particular employment. Although the employee remains the servant of the employer under this doctrine, the employer is not liable for injury negligently caused by the servant while in the special service of another
Borrowed servant doctrine
_____ of the _____ doctrine refers to the context in the operating room that the surgeon is viewed as the one in command in the OR
Captain of the ship
The ____ of ____ refers to the legislatively imposed time constraints that restrict the period of time after the occurrence of an injury during which legal action must be commenced
Statute of limitations
Statute of limitations will not be recognized in what situation?
If there is fraud in the case, with deliberate concealment from a patient of the facts that might present a cause of action for damages
_____ ____ refers to the common law doctrine by which federal and state governments historica’ally have been immune from liability for harm suffered from the tortious conduct of employees
Sovereign immunity
_____ ____ arises when the act of a third party, independent of the defendent’s original negligent conduct, is the proximate cause of an injury
Intervening cause
____ ____ are awarded as a mere token in the recognition that wrong has been committed when the actual amount of compensation is insignificant
Nominal damages
_____ ____ are estimated reparation in money for detriment or injury sustained
Compensatory damages
____ _____ are those damages awarded to compensate an individual for the loss of enjoyment of life
Hedonic damages
____ ____ are additional money awards authorized when an injury is caused by gross carelessness or disregard for the safety of others
Punitive damages
The doctrine of ____ and ___ ____ permits the plaintiff to bring suit against all persons (joint tort-reasons) who share responsibility for the plaintiffs injury
Joint and several liability
____ ____ each party to a lawsuit is liable only to the degree he or she has been determined to have contributed to the injury
Several liability
Any social harm defined and made punishable by law
Crime
This is punishable by less than one year in jail and or a fine
Misdemeanor
This is a more serious crime and is punishable by imprisonment in a state or federal penitentiary for more than one year
Felony
What are the objectives of criminal law?
Maintain public order and safety
Protect the individual
Use punishment as a deterrent to a crime
Rehabilitate the criminal for return to society
The official charging instrument accusing the defendant of criminal conduct
Indictment
3 comments of a crime
The act itself
Requisite mental state/intent (mens rea)
Attendant circumstances
A formal reading of the accusatory instrument and includes setting the bail
Arraignment
In a criminal trial the jury verdict must be ____ and the standard of proof must be _____ a ____ ______
Unanimous, beyond a reasonable doubt ( no doubt at all)
This statute provides for criminal penalties for certain acts impacting medicare and state healthcare reimbursable services
Anti-kickback statute 1987
This act prohibits physicians who have ownership interest or compensation arrangements with a clinical laboratory from referring medicare patients to that laboratory
Ethics’s in patient referral act 1989
When was HIPPA initiated
1996
This act bars the referral of medicare patients to labs by physicians who have or have family members with financial interest in those labs
Omnibus budget reconciliation act 1989
The mistreatment or neglect of individuals who are under the care of a healthcare organization
Patient abuse
The reckless disregard for the safety of others. It is the willful indifference to an injury that could follow an act
Criminal negligence
This is a special kind of voluntary agreement, either written or oral that involves legally binding obligations between two or more parties
Contract
This type of contract is one in which the parties have an oral or written agreement
Express
This contract is one that is inferred by law, based on the conduct of the parties such as a handshake or similar conduct
Implied contract
This kind of contract is one in which one party but not the other, has the right to escape from its legal obligations under the contract
Voidable contract
There are three elements of a contract
Offer
Consideration
Acceptance
This is a promise by one party to do or not do something if the other party agrees to do or not do something
Offer
This requires that each party to a contract give up something of value in exchange for something of value
Consideration
This is the one who has the power to contract for and bind another person who is known as the principle
Agent
One who a third person believes is acting on behalf o the principal
Apparent or ostensible agent
This is an individual who agrees to undertake work without being under the direct control or direction of another
Independent contractor
This precedent is an act or event that must happen or be performed by one party before the other party has any responsibility to perform under the contract
Condition
The act of doing what is required by a contract
Performance
An incorrect judgement of the legal consequences of known facts
Mistake of law
The use of unlawful threats or pressure to force an individual to act against his or her will
Duress
The other name for compensatory damages
Monetary damages
Damages that are those than can be expected to arise from a breach of contract
General damages
These damages occur because of some unexpected, unusual, or strange development involved in the particular contract in dispute
Consequential damages
This is a written document that sets forth the terms and conditions under which a patient can be transferred to a facility that more appropriately provides the kind of care required by the patient
Transfer agreement
Basic elements of a transfer agreement:
Identification of each party to the agreement
Purpose of the agreement
Policies and procedures for transfer of the patient
Organizational responsibilities for arranging and making a transfer
Exchange of info
Retention of autonomy
Procedures for settling disputes
Procedure for modification or termination of agreement
Sharing of services
Publicity
Exclusive vs non-exclusive agreement
This is the power specifically delegated by statute
Express corporate authority
This is the right ti perform any and all acts necessary to exercise a corporations expressly conferred authority and to accomplish the purposes for which it was created
Implied corporate authority
A latin term meaning beyond the powers, those acts conducted by an organization that lie beyond the scope of authority of a corporation to perform
Ultra Vires
This is a working group of the governing body that has delegated authority to act on behalf of the full board when it is not in session
Executive committee
This type of ethics describes the ethics of an organization and how it responds to internal or external circumstances affecting their mission and values
Organizational
This act was enacted as a response to the misconducts committed by executives in companies such as enron, woldcom and tyco resulting in investors losses exceeding half a trillion dollars
Sarbanes oxley act of 2002 aka SOX or SARBOX
___ ____ (let the master respond) is a legal doctrine holding employers liable in certain cases for the wrongful acts of their agents also known as vicarious liability where an employer is liable for the torts committed by employees
Respondent superior
