Instructor Provided Study Questions Flashcards
Hill v. Ohio County - How would this case (40+ years old) be decided differently today?
Today, courts would likely apply stronger patient rights standards, recognize expanded hospital duty of care, and consider modern healthcare access principles. Evolving standards of informed consent and anti-discrimination protections would influence the outcome.
Hill v. Ohio County - What is the significance of the hospital being public and receiving Hill-Burton funds?
Public hospitals receiving Hill-Burton funds have obligations to provide care to all community members regardless of ability to pay. This creates heightened responsibility and subjects them to constitutional requirements and federal regulations that private hospitals may avoid.
Stowers v. Wolodzko - Note that this case was decided in 1971 on facts presented in the early 1960s. The
case may remind you of the classic movie One Flew Over the Cuckoo’s Nest.
At the time, laws addressing involuntary psychiatric commitment were not common or were nonexistent in some jurisdictions. What are the procedural steps to follow under the commitment laws of Maryland?
Modern Maryland laws require:
(1) evaluation by licensed psychiatrists,
(2) clear evidence of danger to self/others or inability to care for basic needs,
(3) court hearings with legal representation,
(4) consideration of least restrictive alternatives, and
(5) periodic review of commitment status. 1960s laws had minimal safeguards.
Hawkins v. McGee - How did the court calculate damages?
The court used “expectancy damages” - the difference between promised outcome (perfect hand) and actual outcome (hairy, scarred hand). This represents the difference between promised value and received value, rather than comparing pre-surgery and post-surgery conditions.
Mills v. Pate - What was Dr. Pate’s defense?
Dr. Pate claimed there was no physician-patient relationship established because he never personally saw or treated the patient, only consulted with another physician about the case, believing this absolved him of direct responsibility to the patient.
White v. Harris - Why didn’t the court enforce the limited agreement between physicians?
The court prioritized patient welfare over contractual limitations between physicians. It recognized that the duty of care cannot be contractually diminished once a physician-patient relationship is established, as this would harm public interest in maintaining quality healthcare standards.
Mills v. Pate - Why did the plaintiff sue in contracts rather than negligence?
Contract claims may have offered advantages:
(1) potentially longer statute of limitations,
(2) avoiding the need for expert testimony on standard of care,
(3) possibility of different damages calculations, and
(4) focusing on breach of promise rather than negligent performance.
Helling v. Carey - Is the court correct in imposing its own risk-benefit conclusion on the ophthalmology specialty?
Debatable. The court substituted its judgment for professional standards by mandating glaucoma testing despite customary practice. While promoting patient safety, this judicial intervention in medical standards raises concerns about courts’ ability to evaluate complex medical risk-benefit analyses without specialized expertise.
Helling v. Carey - What problems exist with the court’s opinion?
Problems include:
(1) judicial overreach into medical practice standards,
(2) insufficient consideration of resource allocation implications,
(3) potential for defensive medicine,
(4) failure to analyze financial/practical reasons behind existing standards, and
(5) setting precedent for courts to override professional judgment in other specialties.
Wickline v. State - How does the fiduciary role of physicians square with resource limitations?
Physicians must navigate dual obligations: primary fiduciary duty to patients while acknowledging system resource constraints. They must advocate for necessary care when third-party payers deny it, document disagreements, pursue appeals processes, and cannot use payer limitations to justify substandard care or avoid professional responsibility.
Ostrowski v. Azzara - Should contributory/comparative negligence apply to patient behavior like smoking?
Complex issue.
Arguments for: patients bear responsibility for health outcomes; failure to follow medical advice affects results.
Arguments against: addiction is disease not choice; punishes vulnerable populations; creates slippery slope of judging “deserving” patients; and challenges patient autonomy.
Marsh v. Arnot Ogden Medical Center - What negligent acts did nurse Doe commit?
Nurse Doe
(1) administered incorrect medication dosage,
(2) failed to properly verify the order,
(3) did not follow hospital protocols for medication administration,
(4) neglected to document the error properly, and
(5) failed to adequately monitor the patient for adverse reactions following the error.
Darling v. Charleston Community Memorial Hospital - Why should hospitals have direct duties to patients for quality of care?
Hospitals should have direct duties because:
(1) they are in position to supervise all care providers,
(2) patients reasonably rely on institutional quality assurance,
(3) hospitals control credentialing and privileging processes,
(4) they establish protocols and systems affecting patient safety, and
(5) corporate responsibility creates incentives for quality improvement.
Thompson v. Nason Hospital - What does Thompson add to Darling’s discussion of corporate negligence?
Thompson expanded corporate negligence by establishing four distinct hospital duties:
(1) maintaining safe facilities/equipment,
(2) selecting/retaining competent physicians,
(3) overseeing all persons practicing medicine within its walls, and
(4) formulating/enforcing rules for quality care. This created broader institutional accountability beyond Darling.
Canterbury v. Spence - Why did the court reject the professional standard of disclosure?
The court rejected the professional standard because:
(1) it subordinated patient autonomy to physician judgment,
(2) disclosure is not exclusively a medical decision but concerns patient rights,
(3) professional standards often protected physicians rather than informing patients, and
(4) patient self-determination requires material information regardless of customary practice.
In re Baby K - Do you agree with requiring hospitals to treat anencephalic infants with ventilators under EMTALA?
The EMTALA ruling creates tension between several principles:
(1) parental rights vs. medical futility,
(2) value judgments about quality of life,
(3) resource allocation concerns, and
(4) literal statutory interpretation vs. intended purpose.
Litowitz v. Litowitz - Do procreative rights exist with Assisted Reproductive Technology (ART)?
Procreative rights do exist with ART but differ from natural conception:
(1) they involve competing rights between multiple parties (genetic contributors, gestational carriers, intended parents),
(2) may include time limitations due to storage contracts,
(3) require balancing negative rights (avoiding parenthood) against positive rights (achieving parenthood), and
(4) involve property/contract elements not present in natural conception.
Vacco v. Quill/Washington v. Glucksberg - Should judges recuse themselves from bioethics cases where they have personal beliefs?
Recusal should depend on demonstrated inability to apply law objectively, not merely holding personal views. All judges have moral frameworks.
Key considerations:
(1) whether judge has publicly advocated specific position,
(2) organizational leadership vs. membership,
(3) capacity to separate legal analysis from personal views, and
(4) appearance of impartiality to maintain public confidence.
