Final Flashcards
The meaning of litigious.
Increased engagement of lawsuits
Legal term for person initiating the lawsuit
Plaintiff
A court decision that becomes precedent is what type of law?
Case law
When there is no basis for trial and plaintiff wins as a matter of law it is called…
Summary judgement
Most important reason medical professionals should be familiar with law and ethics?
To help avoid legal entanglements that may threaten a successful living.
One regulation for manufacture of medical devices and pharm products.
In Drug injury cases is whether or not manufacturer made false or misleading statements to win FDA approval.
The role of moral values in society
Serving as a guide for personal ethical conduct
Term for state laws that apply to health practitioners in medical field
Medical practice acts
Conduct in workplace that draws upon influences of family, culture, and society is called…
moral values
Author of medical code of ethics in Babylonia around 2250 BC
Hammurabi
AMA member accused of unethical conduct by fellow members. What is recourse of group.
Expelling the physician from the group
Etiquette rules are determined by
Protocols
Qualities inherent to the critical thinking process
Identifying and clarifying problems
Organization that approves devices before marketed and meets all specifications
Food and Drug Administration
The purpose of the codes that govern health care professional’s practice
To increase the competence and standards of care within the profession
Meaning of D needs in Maslow’s heirarchy
Deficient
Current thought on how value development is made.
When people are born, they have no values in place.
The behavior of playing games and making up rules as you go along is what stage of normal development?
Preoperational stage
An example of subjective decision making in workplace …
Deciding how to handle a friend/co-worker’s alcohol problem
What type of framework is used when decision is based on results that will produce the greatest balance of good over evil, everyone considered.
Act-utilitarianism
Utilitarianism method - which do proponents indicate should be the solution of choice.
The solution that provides happiness over pain for those invovled.
Which of the following principles of health care ethics does informed consent protect?
Autonomy
A patient who was injured in a fall in a healthcare facility due to negligence of nurse files malpractice. What ethical principle applies in this situation?
Justice
Nurse practitioner double checks all meds prior to dispensing. Which of the seven principles of health care ethics is the nurse following?
Nonmaleficence
Principle of health care ethics used in discussion that everyone is entitled to health care regardless of ability to pay for that care.
Justice
Doctor prescribes placebo who feels patient is complaining of pain that is not there. What example of violation of principle of health care ethics?
Veracity
Medical tech speaking loudly about patient blood test outside patient’s door violates what principle of health care ethics
Confidentiality
What is the unique focus of healthcare providers that challenges them to make sound ethical decisions.
The present and future health of the patient
The nurse is planning care for a client and makes a list of all the options from which to choose. This is an example of what step of the decision making process?
Step 3
Achievement of state requirements for credentials to practice is called …
licensure
Managed health care plan accredited by NCQA - what accurate regarding participation in this certification program?
Approximately half of the nation’s HMOs are accredited
Physician moves to another state asking new state to accept old license is ….
Reciprocity
Basic difference between MDs and DOs
MDs are trained in allopathic medicine
Reason med students more likely to specialize than remain generalists
Lack of attractiveness of general practice in rural and underserved areas
Situation when phys doesn’t need valid license to practice in state
Engaged solely in research & not treating patients
License can be revoked for felony, unprofessional conduct or incapacity. What considered unprofessional conduct?
falsifying records
A primary mandate of medical practice acts in all 50 states
Define what is meant by “practice of medicine” in each state
PA employed by physician is a medical office. Which describes the role of this health care team member?
The PA can legally perform more procedures than a registered nurse.
Example of fraud
Falsifying a medical diploma
A test to determine whether an employee was acting with the scope of employment when a negligent act is committed.
The act serves the interest of the employer.
Disadvantage of a sole proprietorship practice
Physician has unlimited personal liability
Arrangement where 2 drs practice individually but share office space and employees is called
Associate practice
Advantage of 3 physicians form partnership under written agreement.
Sharing the workload and expenses
Patient in managed care insurance program pays $500 annually for plan - payment called
Deductible
Immanuel Kant defined categorical imperative as the guiding principle for all decision making. What is the meaning of this principle?
There are no exceptions from the rule.
System to keep any one branch of gov from assuming too much power
checks and balances
3 branches of gov which is a characteristic of state governements
The governor is the head of the state’s branch.
Type of law based on customs and traditions of the people
common law
Individual laws, called statutes start as …
Bills
Laws such as those pertaining to the functioning of the IRS are known as:
Administrative law
Practicing medicine without a license is what type of law violation?
Criminal
Punishment for a felony
Death or imprisonment in a state or federal prison for more than one year
A nurse who steals narcotic drugs from a medication cart is committing what type of crime?
Criminal
Civil law includes a general category of law known as torts. What is not a tort?
Breach of contract
Example of an unintentional tort
Negligence
What element of a contract is fulfilled when an acute-care facility makes an offer and the patient accepts it?
Agreement
An agreement with a mentally incompetent person may be set aside or validated at a later date because it is ….
voidable
An implied contract results from …
The actions of the parties involved
When is the patient/physician contract usually terminated?
When the treatment ends and the bill is paid.
Which of the following legislation governs the extension of consumer credit if the credit is offered to consumers on a regular basis, is subject to a finance charge and is for personal, family, or household purposes?
Regulation Z
The term for employers legal responsibility for employees.
Liable
What responsibility for employees does not fall under what employers must do?
Employee safety to and from work place
Concept of a certain standard of care expected of health care practitioners.
An expected level of performance
A health care worker is responsible for his or her actions or failure to act. Which of the following best describes this responsibility to prevent negligence from occurring?
Reasonable person standard
What is true regarding the standard of care expected of an obstetrics physician
Held to the same standard as other obstetricians.
Which of the following is an example of privileged communication?
A patient tells his physician that he is addicted to pain killers.
In which of the following situation may patient confidentiality be waived?
When a third party requests a medical examination of a person for employment.
The basis for professional malpractice claims and the most common liability in medicine?
Negligence
A nurse dispensing a painkiller to a patient without the physician’s order for the medication is an example of which tort?
Malfeasance
An example of misfeasance.
A nurse is changing a patient’s IV line, but does not wash her hands prior to procedure.
Not one of the 4 Ds of negligence.
Defense
The english meaning for res ipsa loquitur
The thing speaks for itself
A judge award plaintiff $1 is known as what type of award.
Nominal
A set of written questions requiring written answers are given to a plaintiff while under oath.
Interrogatory
A neutral 3rd party listening to both sides of the argument and helping resolve the dispute is called.
Mediation
4 cs of med malpractice prevention - The C with the benefits of improved medical condition and decreased likelihood that they will sue
Caring
The 4 c that states if it isn’t in writing it wasn’t done.
Charting
The highest rated action that might prevent litigation.
An explanation and apology
Defense for med malpractice claiming patient didn’t follow treatment regimen prescribed and contributed to own injury.
Contributory negligence
Defense to professional liability suits is informed consent one of the most important elements
Assumption of risk
Physician comes to aid in earthquake and sued for malpractice would not be held liable under common law if defense established which of the following
The appropriate standard of care was met, given the emergency situation.
What does res judicata mean
The thing has been decided
The statute of limitations generally specifies how many years.
1-6 years
Most common dates for marking the beginning of the statutory period is …
The day the alleged act was committed.
Term for determining and eliminating problems that may lead to a malpractice lawsuit.
Risk Management
employer’s plan in place to ensure all gov regs are enforced in office
Compliance
Liability insurance to work in a partnership with other physicians. What does insurance cover?
Potential damages incurred as a result of a negligent act
Upon what is the cost of liability premium based
Physician specialty and dollar amount covered by the policy.
The coverage a claims-made liability policy provides for the designated period.
The determining factor is when the claim is made, not when the injury occurs.
Policy that covers incidents that occurred before the beginning of a new insurance relationship but have not yet been brought to the insured’s attention as a claim.
Prior acts insurance coverage
What does a subpoena deces tecum provide as evidence?
Medical records
What should not be a part of a patient’s medical record?
personal judgements
How do you correct errors to medical record.
Draw a line through the error so that it is still legible and write above or below the line.
Who owns the medical records generated by a physician’s office?
The physician
Who owns the information contained in medical records?
The patient
What is the usual timeframe for keeping records against litigation?
2 - 7 years
How does patient transfer to another physician?
Patient signs an authorization to release his or her records to the new physician.
Confidentiality of Alcohol and Drug Abuse, Patient Records is designed to protect what info
patient treatment
legal term for patient giving permission to examine or treat
consent
Example of implied consent
patient makes an appointment for an examination
Example of patient who usually cannot give informed consent
adult who is mentally incompetent
Good Samaritan Acts protects physicians from being charged with …
negligence
What action by a physician helping at a car accident would negate immunity under the Good Samaritan Acts?
Billing for services
legislation that mandates procedures and standards for electronic transmission and storage of health care info
HIPAA
Patient making effort to read info on providers computer screen concerning other patient - what should be done?
Fix the computer so no information is on the screen.
Limited PHI data set is one
- in which the direct identifiers have been removed
- used for research
- used for public health purposes
How many patient rights does HIPAA rules set
six
Standard 2, the Privacy Rule, states that
policies and procedures must be in place to protect unauthorized viewers from accessing PHI
Right to privacy is found in what amendment of constitution
None
A Notice of Privacy Practices NPP is a document that every …
patient is asked to read and sign
HIPAA now requires that
code sets must be uniform throughout the country
Under HIPAA patients may not receive these directly
- Psych notes
- Records compiled for legal action
- Lab results direct from lab
Persons performing disaster relief notification activities
may receive PHI from providers unless the patient objects
FDA is entitled to PHI when
- Saafety issues are apparent
- Adverse events related to drugs are apparent
- Product recalls
Law enforcement officials are entitled to PHI
in certain specific circumstances, such as a gun shot wound or child abuse
Protected psych notes include
NOT - prescriptions, results of clinical tests, counseling start and stop times
TPO disclosures within healthcare facility or in consultation with another practitioner
may require separate authorization from patient depending on the situation
Example of incidental disclosure of PHI …
- limited message on answering machine
- patient sign in sheet
- chart outside exam room w/ reasonable precautions to avoid patient identification
handles problem of computer hacker accessing patient info
security officer
Business associate under HIPAA is
person, group or organization outside med practice that has HIPAA approved reason to see protected health info
unintentional exposures of content on your computer by …
- shopping internet at work
- downloading games or music from internet
- sending receiving unsecured emails to from friends
What do if patient complains privacy breached
speak to security office to try to handle complaint in office
Privacy officer’s responsibilites
- research privacy rules
- develop privacy practices
- train staff on privacy policies and procedures
Not covered by HIPAA’s Security Rule
The contents of all documents pertaining to patient privacy.
Not considered marketing under HIPAA provisions
A reminder to female patients when their mammograms should be scheduled.
violation of HIPAA’s privacy rule
- Call across a crowed waiting room to tell patient he has forgotten prescription for dilantin
- telling friend that mutual friend is pregnant after seeing your employer
- caller says from ins wanting PHI, don’t know caller, but you comply
T/F Patients must submit complaints to the Secretary of Heath and Human Services through the office of Civil Rights
True
HIPAA’s Privacy Rule protects PHI only in ..
ALL forms (electronic, written, spoken)
T/F HIPAA requires that healthcare practitioners must change a med record if a patient complains
False
Firewalls and encryption are software to
help ensure privacy of records
Fed/state privacy laws based on these considerations
When info collected, person have opportunity to check the info for accuracy
Act forbids fed agencies from allowing info to be released other than for what it was collected for.
privacy act
Act guarantees workers change jobs can obtain ins and improves security and privacy of patient info
HIPAA
Who has enforcement authority for HIPAA standards
Centers for Medicare and Medicaid Services (CMS)
Per HIPAA who is covered entity?
Health care providers
Physician gives info to managed care plan following what HIPAA process
Covered transactions
what not a designated record set in hospital med records
personnel records
What is name of HIPAA for patients sign
Notice of Privacy Practices
What info is removed when patient record is de-identified?
All PHI is removed from patient record
Hospital accounting dept hires outside accounting firm for billing they are what?
business associate
Provider can disclose patient info but must identify reason for each use. Term for this reason
permission
When forbidden to disclose PHI about a person
when person is subject of investigaation
this PHI may be disclosed w/out consulting privacy officer
Coroners
Definition of a limited data set
Protected health information with removal of certain patient identifiers.
Initial patient action if feels practitioner has violated the HIPAA privacy rule.
Patient must file a written complaint w/ the secretary of HHS.
Describes encryption
Info is scrambled or encoded before sending electronically
T/F Employer cannot access an employee’s health record without patient permission.
True
T/F One physician cannot send a patient’s records to another physician w/out patient consent.
False
T/F HIPAA requires that healthcare practitioners must change a medical record if a patient complains
False
T/F Provider disclosing info to a patient’s husband w/out patient consent after the patient identifies him as entitled to receive info is not a violation of HIPAA.
True
Concern about …. has led to enactment of many fed/state laws governing collection, storage, transmission, and disclosure of personal data.
Privacy
If state’s privacy laws stricter than HIPAA which takes precedence?
State
W/in HIPAA, …. means that a health care provider can provide care.
treatment
HIPAA’s Security Rule pertains just to PHI in … from, while the law’s Privacy Rule protects PHI in … forms
Electronic
All
Using and disclosing PHI must fall w/in eleven HIPAA-defined ….
permissions
Purpose of collecting fed vital stats of birth, death, marriage, divorces, and changes in civil status.
to assess population trends and needs
… responsible for collecting much of vital stats
health care practitioners
Who completes med portion of death cert?
attending physician
the role of coroner or med examiner in event of death.
Med examiner who is frequently a pathologist may order and perform an autopsy.
Main reason health care practitioners required to report sexually transmitted infections to state.
to treat others who may be infected.
Person with what STI required to tell sexual partners.
person w/ HIV
National Childhood Vaccine Injury Act of 1986 created National Vaccine Injury Compensation Program to protect who.
Vaccine manufacturers
What info regarding vaccine does not need to be in patient’s permanent med record?
Location of the vaccine manufacturer
What not a mandated reportable injury?
suspected spousal abuse however patient does not admit it occurred.
Example of vulnerable adult who many states have passed laws to protect.
Mentally challenged adult.
Laci and Conner’s law passed to protect …
fetuses
As of Feb. 2011 35 states recognize death of unborn child in some circumstances as what …
homicide
Which of the following agencies tests and approves drugs before releasing them for public use?
FDA
T/F Physician must keep records concerning administering or dispensing of controlled drug on file for two years.
True
Which schedule of drugs are used strictly for research?
Schedule I
Employment-at-will
Employer or employee can end the employment anytime for any reason
Just cause in wrongful discharge lawsuit
employee is sexually harassing another employee
Example of quid pro quo
resident offered opportunity to scrub in on a procedure if dates surgeon
Programs to give preferential treatment to minority persons who did not have opportunities given to them in the past
affirmative action
A provision of the Civil Rights Act of 1991
Employees may collect punitive damages fro discrimination
Provides for overtime pay and minimum wage
1938 Fair Labor Standards Act
OSHA’s major concern
Safety in the workplace
Best source for OSHA standards
the Federal Register
Initial action for OSHA violation
Ask the employer to voluntarily remedy the situation
employee right-to-know laws protect from
unsafe work environments
Guideline for handling hazardous materials at work
employer must provide Material Safety Data Sheet for each hazardous chemical.
Act that mandates employers maintain a sharps injury log and involved non managerial employees in selecting safer med devices
Occupational Exposure to Bloodborn Pathogen Standard
Initial action if injured on the job
Report injury to a supervisor
Info potential employer CAN ask about
education
What does bondable mean
employee can be insured in case he or she embezzles funds
Science that explains blue eyes in children of parents with blue eyes
genetics
of chromosomes
46
Contain characteristics for eye, skin, and hair color in chromosomes.
genes
Human Genome Project’s purpose
to locate and map the location of all 46 genes
how to test if harmful genes are present in baby during pregnancy
amniotic fluid
permanent change in DNA and usual cause of genetic diseases
mutation
Term for manipulating DNA w/in cells
genetic engineering
Describes cloning
clone is genetically identical to the parent
Bringing couple’s eggs and sperm together in test tube then transplanting embryo
In vitro fertilization
Difference b/ween traditional and gestational surrogate mother
traditional - related to fetus
gestational - not related to fetus
Legal doctrine allows state to act in best interest of child
Parens Patriae
parent leaves infant at nurse’s station and protected from full legal prosecution
safe haven law
Legal rights for newborns in US
same as any other Amer of any age
17 yr old meets require for informed consent and lives with parent is considered
mature minor
A right guaranteed to emancipated minors
Right to Privacy
Criteria for death under Uniform Determination of Death Act
Entire brain ceases to function
PVS by irreversible cessation of higher functions of brain most often caused by damage to what
cerebral cortex
can be said death results from lack of which
oxygen
what may happen to determine cause of death if under suspicious conditions
autopsy
lung cancer patient w/ death imminent under what type of care
palliative
educational programs for health have placed more emphasis on what type of care
curative
Courses in thanatology focuses on.
Death and psychological methods of coping with it
Right to die matter in courts in 1976 w/ death of whom
Karen Ann Quinlan
1989 Uniform Rights of Terminally Ill Act serves as guideline for state legislatures in constructing laws addresses …
advance directives
State legislation first to permit physician-assisted suicide in certain circumstances
Oregon’s Death with Dignity Act
Physician agrees to withhold med treatment is an example of what type of euthanasia.
passive
Not considered an advance directive
voluntary suicide
legal term for advance directive specifying individual’s end of life wishes for med treatment w/o appointing a designee to make legal decisions
living will
National Organ Transplant Act addresses what
shortage of organs
best description for grief
grief is human reaction to loss
