law and ethics lecture + important reading Flashcards
What is the difference between morality and the law?
Morality refers to principles and rules concerning how a person ought and ought not to behave, which can come from religion or personal/cultural secular origins. The law, on the other hand, comes from officials of the government voting or decreeing them and has the enforcement power of the state behind it. Violating moral rules affords one shame, while violating legal rules affords one fines or jail.
What is legal positivism?
Legal positivism is the belief that the laws of a country are what the government says they are. They are based on reasoning and deciding but do not need any further validation than that of being sanctioned by a legitimate government.
Are all laws tied to ethics?
No, laws are not necessarily closely tied to ethics. There might be unjust, unfair, or discriminatory laws.
How do hospitals distinguish between ethical and legal issues?
Hospitals and related institutions make an implicit distinction between morality and the law by distinguishing between ethical and legal functions and personnel. There may be hospital attorneys or a risk management department that handles legal and some ethical issues, while clinical ethical questions are referred to groups of physicians, clergy, and sometimes an ethics committee consisting of participants from various parts of the organization.
What is clinical medical ethics?
Clinical medical ethics is a discipline or methodology for considering the ethical implications of medical technologies, policies, and treatments, with special attention to determining what ought to be done (or not done) in the delivery of health care. It is related to the identification, analysis, and resolution of moral problems that arise in the provision of healthcare to individual patients.
What do practitioners need to know regarding the intersection of ethics and the law?
Practitioners need to have knowledge of their legal responsibilities, the limitations of professional practice, and the implications of their personal actions. They also need to understand the “the law of ethics” behind prominent ethical debates, protect healthcare professionals, patients, co-workers and healthcare facilities, and organizations/systems through risk management, and observe ethical behavior to ensure and promote quality patient care, positive work relationships, and effective, efficient workplaces.
What is medical law?
Medical law is the body of laws concerning the rights and responsibilities of medical professionals and their patients.
What are the main areas of focus for medical law?
The main areas of focus for medical law include confidentiality, disclosures, standard of care, patient-provider relationship, professional conduct, management and disclosure of medical errors, negligence, and other torts related to medical treatment (especially medical malpractice) and criminal law.
What is the regulatory system in medical law?
The regulatory system is the law that clinicians will interact with most often during the course of their practice throughout their careers. It refers to regulations concerning medical practice rather than malpractice.
What should clinicians be well-versed at in medical law?
Clinicians must be well-versed at navigating the complex legal, regulatory/enforcement, and business realities of modern medical practice. For example, they need to understand complex reimbursement schemes and provider contracts, Medicaid and Medicare statutes, insurance company administrative authorizations for proposed care, basic principles of malpractice law, management of a clinical practice, healthcare finance, basic risk management principles, as well as managing patients from special or vulnerable populations.
What does regulation encompass in medical jurisprudence?
Regulation cuts the broadest swath in medical jurisprudence, encompassing all areas where the government interacts with and regulates the practice of medicine.
What are some examples of regulatory agencies in medical law?
Regulatory agencies from the FDA, HHS, CMS to the Department of Justice exercise great power over the practice of medicine in the United States. This also includes state licensure boards, certification agencies, and credential verification authorities.
What types of law exist in medical law?
The types of law in medical law include common law, statutory law, and tort law. Common law is the traditional civil law of an area or region based on a judge’s rulings of cases. Statutory law is enacted by legislatures and enforced by courts; statutes command or prohibit something or declare policy. Tort law is a wrongful act causing harm that requires restitution and can be intentional or unintentional.
How have some states expanded Medicaid under the ACA?
Some states, like Missouri and Oklahoma, have expanded Medicaid under the ACA through direct democracy by voting to endorse state constitutional amendments rather than legislation or executive decisions.
What is Medicaid expansion and how has it impacted health outcomes?
Medicaid expansion is a policy accomplishment of the ACA. More than 21 million people have gained insurance coverage within 10 years since the law’s passage, and more than half have received it through Medicaid expansion. Medicaid expansion has been linked to considerable improvements in health outcomes, with one life saved annually for every 239 to 316 adults gaining insurance.
What is the outcome of the November 2022 Election in South Dakota regarding Medicaid?
South Dakota voters voted to broaden Medicaid to roughly 42,500 low-income residents starting in mid-2023. The measure passed 56% to 44%.
What was the outcome of the Kentucky Constitutional Amendment 2 regarding women’s reproductive rights protections?
The amendment, which would state there is no right to abortion or any requirement to fund abortion in the state constitution, was not approved.
What was the outcome of Vermont Proposal 5 regarding women’s reproductive rights protections?
The proposal was approved, creating a constitutional right to personal reproductive autonomy.
What was the outcome of Michigan Proposal 3 regarding women’s reproductive rights protections?
The proposal was approved, creating a state constitutional right to reproductive freedom, including decisions “about all matters relating to pregnancy,” such as abortion and contraception.
What was the outcome of California Proposition 1 regarding women’s reproductive rights protections?
The State Constitution would be amended to protect a person’s reproductive freedom “in their most intimate decisions,” including the right to abortion and contraceptives.
What was the outcome of Montana Legislative Referendum 131 regarding born-alive infants regulation?
The measure was not approved. It would have enacted a law making any infant “born alive” at any gestational age a legal person and criminalized health care providers who do not make every effort to save the life of an infant “born during an attempted abortion” or after labor or C section.
What is the Kansas Legislature considering in April 2023 regarding transgender rights?
The Kansas Legislature is considering a sweeping transgender bill that is among several hundred measures aimed at rolling back LGBTQ rights across the United States. The measure deals with bathrooms, locker rooms, and other facilities and defines “sex” as “either male or female, at birth,” which LGBTQ rights advocates say would legally erase transgender people and deny recognition to nonbinary, gender fluid, and gender nonconforming people.
What are examples of crimes against the state under criminal law?
Examples of crimes against the state under criminal law include treason and sedition.
What are examples of criminal acts under criminal law?
Criminal acts under criminal law are felonies or misdemeanors. Examples of felonies include murder, arson, sexual assault, and burglary.
What are crimes against the person under civil law?
Crimes against the person under civil law include a general category of laws known as torts.
What are the two types of torts under civil law?
The two types of torts under civil law are intentional (willful) and unintentional (accidental).
What is criminal law?
Criminal law deals with wrongs against a person, property, or society, and involves the prosecution of individuals who commit crimes. Examples of criminal law in healthcare include practicing without a license, use of narcotics, theft, extortion, and murder.
What is civil law?
Civil law involves legal relationships between people and the protection of a person’s rights, including torts, which are wrongful acts that do not involve contracts. In healthcare delivery, civil law mainly affects contractual and torts relationships.
What is a contract?
A contract is an agreement between two or more parties that outlines the obligations and responsibilities of each party. In healthcare, contracts typically involve an offer, acceptance, and consideration, which is the payment made by the patient for services rendered. Contracts can be either implied or expressed, and can be either verbal or written.
Who is considered legally disabled in terms of forming a contract?
Those lacking the legal capacity to form a contract include minors, mentally incompetent individuals, semi or unconscious individuals, and people under the influence of drugs.
What is the relationship between an agent and a principal?
An agent is a person working under an employer (the principal), and the principal is responsible for the actions of the agent. If an agent causes injury to others, the principal can be required to pay or compensate those who have been injured by the agent.
When is a patient-provider relationship established?
As a general rule, physicians are under no obligation to treat a patient unless they choose to, except in emergency situations or when refusal to treat is based on discrimination. However, a patient-physician relationship is generally formed when a physician affirmatively acts in a patient’s case by examining, diagnosing, treating, or agreeing to do so. Once the physician consensually enters into a relationship with a patient in any of these ways, a legal contract is formed in which the physician owes a duty to that patient to continue to treat or properly terminate the relationship. It is recommended that physicians consult with their local medical boards to determine the law for their particular state.
What are conscience clauses?
Conscience clauses are legal clauses attached to Federal laws & state statutes that permit healthcare providers not to provide certain medical services for reasons of religion or conscience.
What are the reasons that can give rise to conscientious objection in healthcare?
Conscientious objection in healthcare can arise from religious beliefs, ethical views, or moral principles.
What kind of medical services are most frequently associated with conscience protections?
Conscience protections are most frequently associated with issues relating to reproduction rights, such as abortion, sterilization, contraception, and stem cell-based treatments, but may include any phase of patient care.
Who do conscience protections apply to?
Conscience protections apply to healthcare providers who refuse to perform, accommodate, or assist with certain health care services on religious or moral grounds.
How are health care provider conscience rights protected by federal law?
Federal statutes protect health care provider conscience rights and prohibit recipients of certain federal funds from discriminating against health care providers who refuse to participate in these services based on moral objections or religious beliefs.
What is the Medical Ethics and Diversity Act in Arkansas?
The Medical Ethics and Diversity Act in Arkansas is legislation that allows doctors to refuse to treat someone because of religious or moral objections, even when a procedure is medically necessary, except in emergency situations.
What is the physician’s duty in a patient-physician relationship?
In a patient-physician relationship, the physician has an ethical and legal duty to continue care and not to abandon the patient.
When does abandonment occur in a patient-physician relationship?
Abandonment occurs when the relationship between physician and patient is terminated either at an unreasonable time or without affording the patient time to find a qualified replacement.
What is the legal definition of tort?
A tort is a legal wrong committed upon the person or property independent of contract.
What are the different types of intentional torts?
The different types of intentional torts include assault, battery, false imprisonment, invasion of privacy, and defamation of character.
What are the different forms of abuse?
The different forms of abuse are physical, verbal, emotional/psychological, and sexual.
What is required by laws in all states when abuse is reported?
Laws in all states require reporting of any form of abuse to proper authorities. There may be civil and/or criminal penalties.
What are unintentional torts?
Unintentional torts are acts that are committed with no intent to cause harm but done with a disregard for the consequences.
What term is used to describe the actions of healthcare practitioners who fail to exercise ordinary care, resulting in patient injury?
The term negligence is used to describe such actions.
What is malpractice?
Malpractice is the negligent delivery of professional services.
What is the most common contributing cause of medical errors?
The most common contributing cause of medical errors is human error.
What are some factors that can contribute to medical errors?
lack of training, fatigue, or inattention can all contribute to medical errors. When medical professionals do not work carefully, or when they do not have the appropriate training, or work outside of or beyond their scope of practice, a medical error can occur.
What is iatrogenesis?
Iatrogenesis refers to harm experienced by patients resulting from medical care.
Is all iatrogenic injury due to negligence?
No, all harm resulting from negligence is iatrogenic, but not all iatrogenic injury is negligent.
What is the oldest and most famous rule of medical ethics?
The oldest and most famous rule of medical ethics is primum non nocere, or above all, do no harm.
What is the “To Err Is Human” report, and what did it conclude about medical errors in the United States?
The “To Err Is Human” report was a 2000 report by the Institute of Medicine that focused on medical errors in the United States. It took two studies and extrapolated their results to all hospital admissions in the United States, concluding that between 44,000 and 98,000 Americans must be dying each year as a result of medical errors.
What is the current thinking about solutions to medical errors, and why?
The current thinking is that solutions to medical errors are more likely to be found at the organizational level rather than expecting individual clinicians to be aware of all relevant facts at all relevant times and take all the right actions. The systems approach holds that the “system” controlling these interconnecting parts needs to be redesigned to make it harder for things to go wrong.
What is the most common error that involves healthcare professionals when working with a patient?
The most common error that involves healthcare professionals when working with a patient is a medication prescribing error, accounting for 46.5% of medical errors. Administration errors account for another 29% of medical errors.
