Law And Ethics Pt 2

Question 1

What is Ethics?

Answer 1

A philosophy and systematic intellectual approach to behavior.

Question 2

What are the three ethical areas that affect each team and its members?

Answer 2

Social ethics - Principles accepted by society at large and codified into laws and regulations. * Forced ethics you might say.

Personal Ethics - Define what is right and wrong on an individual basis.

Professional Ethics - are developed by the professionals of a specific discipline that develop rules and codes of conduct for members of the profession to follow.

Question 3

Which ethical area describes principles accepted by society at large and codified into laws and regulations. Hint ** Forced ethics you might say.

Answer 3

Social Ethics.

Question 4

Which ethical area would this be categorized “Define what is right and wrong on an individual basis”?

Answer 4

Personal Ethics

Question 5

Which ethical area describes “Developed by the professionals of a specific discipline that develop rules and codes of conduct for members of the profession to follow”.

Answer 5

Professional Ethics.

Question 6

What is the purpose of a professional code of ethics?

Answer 6

To help members of a profession achieve high standards of behavior through moral consciousness, decision making and practice. *It challenges us to determine right from wrong.

Question 7

What are the four branches of Veterinary Ethics?

Answer 7

1) Descriptive Ethics
2) Official Ethics
3)Administrative Ethics
4) Normative Ethics

Question 8

What branch of Veterinary Ethics would this fall under…

Involve the creation of the official ethical standards adopted by professional organizations and imposed on it’s members.

Answer 8

Official Ethics.

Question 9

What branch of Veterinary Ethics would this fall under…

Refers to the study of ethical views of veterinarians and veterinary professionals regarding their behavior and attitudes. Essentially what is wright and wrong.

*Think of it as todays stated acceptable standard.
An example would be —> states that it is acceptable to eat animals because in our society it is acceptable.

Answer 9

Descriptive Ethics. *

Question 10

What branch of Veterinary Ethics would this fall under…

Involve actions by administrative government body that regulate veterinary practice and activities in which veterinarians engage. License revocation can result if any civil or criminal violations of these regulations occur.

Answer 10

Administrative Ethics

Question 11

What branch of Veterinary Ethics would this fall under…

Refer to the search for correct principles of good and bad, right and wrong, and justice and injustice. A search beyond society’s standards.

Example —> Is eating animals truly a good thing to do?

Answer 11

Normative Ethics.

Question 12

What is the difference in Laws and Ethics?

Answer 12

The difference in laws and ethics lies in enforcement; the government enforces laws, and the professional associations that develop the ethics enforce the ethics.

Question 13

Bernard Rollin PhD believes there are 4 types of moral problems in veterinary medicine, and they involve ethics in relation to:

Answer 13

1)Peers
2) Clients
3) Animals
4) Society

Question 14

Describe “Professional Organizational Ethics” -

Answer 14

Most professional organizations have created and agreed on a code of ethics for its members based on moral principles. These professional organizations may establish ethics, grievance, or peer review committees to address ethical issues.

Examples; AVMA, VHMA, NAVTA

**Code of ethics for VHMA is on your recommended reading list

Question 15

Describe the AVMA (The American Veterinary Medical Association) Principles of Veterinary Medical Ethics

Answer 15

Based more on professional relationships one has with colleagues than moral and ethic issues relating to animals.

Question 16

What is the Veterinary Practice Act?

Answer 16

A states or commonwealth’s law, codified into regulations, describing what licensed and non-licensed employees can and cannot do, as well as acceptable medical standards, as it relates to veterinary medicine. **This is the las of the land in your state. Those laws cannot be changed without submitting changes to the house and senate and then being signed into law by the Governor of the state.

Question 17

“Informed consent” is an example of Veterinary Practice Act (Situations in veterinary medicine that have both legal and ethical considerations. Describe informed consent…

Answer 17

It is when a practice has given information to a client regarding the proposed treatment, allowing the client to make an informed decision.

Question 18

What elements must a complete informed consent contain?

Answer 18

*Consent must be given freely
*Treatment and diagnosis must be given in understandable terms
*The risks, benefits and the prognosis of the defined procedure must be stated.
*The prognosis if no treatment is selected must be stated.
*Practice must provide alternative treatments, including risks, benefits and costs.
* The client must be given the opportunity to ask questions and have them answered

(If the consent is challenged in a court of law and these conditions were not met, the court may conclude the client did not consent.

Question 19

True or False…

Veterinarians have an ethical responsibility to provide essential service to animals to save a life or relieve suffering, even in the absence of identity of the owner?

Answer 19

True. Even tho this could lead to care without payment due to the lack of consent.

**The law of Unjust Enrichment was created to avoid unjust enrichment of one party at the expense of another (owner receives emergency veterinary care at the veterinarian’s expense.

Question 20

In regards to Unjust Enrichment what are some elements that the legal team will look for before considering apply the law to a situation?

Answer 20

*The more valuable that the animal is, the greater the chances for financial recovery.

*The more emergent the animal’s needs are the more leeway exists to provide the emergency medical care.

*The veterinarian attempted to reach the owner prior to medical care.

*The extent of the emergency care required to stabilize the patient was reasonable.

The extent of detailed documentation of 2,3, and 4 by the veterinarian and practice above will have a significant bearing on the outcome of any court case.

Question 21

Author Jim Wilson states that before making a decision involving moral issues, we must first determine all of the relevant moral issues, not just the most obvious or striking ones. Simply put, what is he saying?

Answer 21

He states that it is the situation, not the act that should be analyzed for ethical considerations, because what may be unethical in on scenario, may be acceptable in a different scenario.

Question 22

When does moral distress / ethical exhaustion occur?

Answer 22

You know the ethically appropriate action to take, but you are unable to act on it.

You act in a manner contrary to your personal and professional values, which undermines your integrity and authenticity.

Question 23

What are the 4 A’s to rise above moral distress ?

(Helps with self guidance to help one climb out of moral exhaustion - This is a system that critical care nurses use)

Answer 23

Ask - Reflect on your present feelings and ask yourself questions to determine whether Moral Distress is present.

Affirm - This is when you make a commitment to address the moral distress.
*Affirm your distress and your commitment to take care of yourself.
* Validate your feelings and perceptions with others.
*Affirm your professional responsibility to act.

Assess - This is when you contemplate your readiness to act, considering the risks and benefits.
*Identify sources of your distress
* under what circumstances do signs and symptoms occur?
* Do others suffer related to these resources?

Act - This is when you implement strategies to initiate changes and manage any resulting setbacks. It is also the step where you preserve your integrity and authenticity.

Question 24

If struggling with the 4 A’s to rise above moral distress, consider the 4 R’s…
What are they?

Answer 24

Relevance - What impact could your action have (Improve patient care, improve relationships?)
Risk - What is the risk of not acting?
Rewards - Imagine how you will feel after acting
Roadblocks - Make a written list of roadblocks to help identify strategies to avoid such a resistance to change, criticism, retaliation, and alienation.

Question 25

__________________ known as Fatigue, Emotional Distress, and the lack of will to continue to act in a way that is consistent with what you believe is the right thing to do.

Answer 25

Ethics Exhaustion Ethics Exhaustion isn’t a lack of compassion, but it is being prevented from acting on what you believe is the compassionate, caring thing to do. **Prevention is key to minimizing Moral Distress which can lead to Ethics Exhaustion.

Question 26

Name some of the most common complaints to the board of veterinary medicine.

Answer 26

Unsatisfied experience Lack of communication Unexpected death Conduct, Record Keeping, Premises, and Pharmaceutical Issues **The most common premise complaint is that the surgery room is not a separate room from all other rooms. **Most common pharmaceutical complaints include veterinarians not honoring a clients request to dispense or provide a written prescription for a drug that had been determined by the veterinarian to be appropriate for the patient.

Question 27

What are some ways we can do our best to avoid complaints to the board?

Answer 27

Creating Standard Operating Procedures for Ethics/Laws in an effort to mitigate risks. Can do so by… **Develop a hospital policy regarding the shredding of confidential documents. **Develop liability release forms for volunteers, interns and students. **Follow AVMA for current updates regarding the Fairness To Pet Owners Act and compounding regulations. **Develop medical records standards, including SOAP format, abbreviations, Data entry, and required password protection. **Develop standard protocols to handle client communication, conflict, and complaints. **Ensure practice protocols meet state requirements daily, not just when inspected. Make sure the things that you do every day, are the things that you do every day. Not just on the day the inspector is there. ***Best way to avoid any issues.

Question 28

The AVMA Principles of Veterinary Medical Ethics is an example of what branch of ethics? A) Descriptive B) Official C) Administrative D) Normative

Answer 28

C - Official branch of ethics. **Involve the creation of the official ethical standards adopted by professional organizations and imposed on its members.

Question 29

What is the process for making changes to Veterinary Practice Laws? A) Only a Unanimous vote of The State’s Veterinary medical associations board members. B) Proposed changes must be submitted to the House and Senate and ultimate signed into law by a Governor C) Through a lengthy process that includes introduction of the proposed changes, membership time for rebuttal, and eventually voting opportunities for all members.

Answer 29

The process for making changes to Veterinary Practice Laws start with the proposed changes must be submitted to the House and Senate and ultimately signed into law by a Governor.

Question 30

Multiple choice. In regards to Unjust Enrichment - The legal system will look for which of the following elements before considering applying the law to a situation: A) The more emergent the animal’s needs are the more leeway exists to provide the emergency medical care. B) The Veterinarian attempted to reach the owner prior to medical care C) The extent of the emergency care required to stabilize the patient was reasonable.

Answer 30

ALL OF THE ABOVE. A) The more emergent the animal’s needs are the more leeway exists to provide the emergency medical care. B) The Veterinarian attempted to reach the owner prior to medical care C) The extent of the emergency care required to stabilize the patient was reasonable.

Question 31

What is the first A - in the 4 A’s to Rise Above Moral Distress? A) Analyze B) Assess C) Ask D)Appraise

Answer 31

C) Ask Ask—> Affirm —> Assess —>Act

Question 32

_____________ Deals with duties established by individuals as a result of contractual agreement. Simply stated, it is an agreement that creates an obligation.

Answer 32

Contract Law. Law ________I_______ I I Civil Law Criminal Law _______I__________ I I Tort Law Contract Law

Question 33

What are the four elements needed to create a contract?

Answer 33

The offer - A promise or commitment made in reasonably certain terms. Acceptance - acceptance has occurred when the part to whom the offer was made makes the return requested in the offer, typically money. Consideration - people do or promise to do something they were not legally obligated to do, or refrain or promise to refrain from something that they had a legal right to do. Intent to contract -

Question 34

_____________ acceptance is a clear statement of agreement to the terms offered that establishes an Express Contract.

Answer 34

Express Acceptance

Question 35

______________ Acceptance is no direct statement of agreement, but is demonstrated by actions indicating acceptance of the offer leading to an implied contract. Example would be… hand shake/ eye contact (Do not speak)

Answer 35

Implied acceptance.

Question 36

Describe Promissory Estoppel —

Answer 36

Although there may have been no formal agreement, justice requires the enforcement of one’s promise when another party has justifiably relied on that promise, change its position, and incurred substantial detriment.

Question 37

What are the three situations where the capacity to make a valid contract would be questioned (this is known as Capacity to Contract)

Answer 37

Minority - Minors can enter into contracts and uphold them, but the law does grant people the right to avoid or disaffirm any contracts made while they were minors. Mental disability - Lacking the required mental capacity. Intoxicants/substance abuse - The courts do not look favorable on intoxication as an incapacity, but they do look closely at whether the sober party should have been aware of the intoxication, or if the tool advantage of it.

Question 38

What is the Law of Agency —

Answer 38

Involves a person who has been authorized to act on behalf of another.

Question 39

Describe Agency and Consent for Care —

Answer 39

When a pet owner gave authority to another person to request goods or service for the owner. *The recommended best practice for this situation is to contact the owner for confirmation of the authorization prior to the provision of care, unless emergency care is required, then provide stabilizing care and call for verification of the agency relationship immediately there after.

Question 40

Describe Agency and Consent for Euthanasia —

Answer 40

In general the person who’s name and animal registered on the patient medical record is considered the owner. When an animal is presented for euthanasia by someone other than the owner on file, the recommended best practice is to have the owner on file come into the practice in person to sign the euthanasia consent form.

Question 41

_________________Requires the production of a written memorandum before the courts will enforce certain types of contracts (as opposed to an oral contract).

Answer 41

Statue of Frauds.

Question 42

What are some of the most common contracts that must be in writing?

Answer 42

Contracts for the sale of real-estate Leases for longer than one year Contracts not to be performed within one year. Contracts to answer for the debt of another. Contracts for the sale of goods over a specified price.

Question 43

When two parties have made and signed a written contract and included in the agreements a clause stating that the writing represents the entirety of the contract, oral testimony aimed at altering or contradicting the terms of the writing will not be permitted. What is this known as?

Answer 43

This is know as Parole Evidence. **KNOW THIS!!

Question 44

______________ is an agreement between to professionals limiting the ability to practice medicine within a specified area, for a specified time, if one should leave a practice.

Answer 44

Covenants not to compete. **State laws vary regarding covenants, and they must be reasonable. **The scope of activity is generally restricted and includes a time limitation and geographic restraint. ** If a covenant restricts a professionals ability to earn a living or restricts the public from having the benefit of the competition, the courts may not enforce the covenant. (Contracts, Benefits, and Practice Management for the Veterinary Professional covers covenants not to compete in great detail in chapter 9)

Question 45

What is a Guardian Ad Litem -

Answer 45

Is a person appointed to protect the interest of a minor or legally incompetent person in a lawsuit, or in this case, of an animal.

Question 46

A clear statement of agreement to the terms offered is called what.

Answer 46

Express Acceptance - This is when you state out loud or in writing that you accept the term. **Implied Acceptance is when you give a handshake and don’t say a word.

Question 47

In a covenant not to compete the scope of activity is generally restricted and includes a time limitation and geographic restraint. True or False.

Answer 47

True -

Question 48

What laws involve a person who has been authorized to act on behalf of another? A) Law of authority B) Law of Agency C) Law of Power of Attorney

Answer 48

B) Law of Agency -

Question 49

What is the sneaky fourth element of a contract ? A) Contract final agreement B) Intent to contract C) Agreement to complete

Answer 49

B) Intent to contract Offer —> Acceptance —> Consideration —-> Intent to Contract

Question 50

____________________Ethics ——refers to the study of ethical views of veterinarians and veterinary professionals regarding their behavior and attitudes. Essentially what is right and wrong.

Answer 50

Descriptive Ethics.

Question 51

______________Ethics —- involve the creation of the official ethical standards adopted by professional organizations and imposed on its members

Answer 51

Official Ethics.

Question 52

_____________ Ethics — involve actions by administrative government body that regulate veterinary practice and activities in which veterinarians engage . License revocation can result if any civil or criminal violations of these regulations occur.

Answer 52

Administrative Ethics.

Question 53

______________ Ethics - Refer to the search for correct principles of good and bad, right and wrong, and justice and injustice.

Answer 53

Normative Ethics.

Question 54

What type of Ethics refers to the study of ethical views of veterinarians and veterinary professionals regarding their behavior and attitudes. Essentially what is right and wrong.

Answer 54

Descriptive Ethics

Question 55

What type of Ethics involve the creation of the official ethical standards adopted by professional organizations and imposed on its members

Answer 55

Official Ethics

Question 56

What type of Ethics involve actions by administrative government body that regulate veterinary practice and activities in which veterinarians engage . License revocation can result if any civil or criminal violations of these regulations occur.

Answer 56

Administrative Ethics

Question 57

What type of Ethics refers to the search for correct principles of good and bad, right and wrong, and justice and injustice.

Answer 57

Normative Ethics

Question 58

What are the four types of Ethics?

Answer 58

Descriptive Ethics Official Ethics Administrative Ethics Normative Ethics

Question 59

What is the Veterinary Practice Act?

Answer 59

A State’s or commonwealths law, codified into regulations, describing what licensed and non-licensed employee’s can and cannot do, as well as acceptable medical standards, as it relates to veterinary medicine.

Question 60

What is the name for A State’s or commonwealths law, codified into regulations, describing what licensed and non-licensed employee’s can and cannot do, as well as acceptable medical standards, as it relates to veterinary medicine.

Answer 60

The Veterinary Practice Act.

Question 61

What is involved in making changes to the Veterinary Practice Act?

Answer 61

Proposed changes must be submitted to the House and Senate and ultimate signed into law by the Governor.

Question 62

What six elements do the courts want satisfied to consider the existence informed consent in a situation?

Answer 62

*Consent must be given freely * Treatment and diagnosis must be given in understandable terms. * The risks, benefits and the prognosis of the defined procedure must be stated. * The prognosis if no treatment is selected must be stated. * Practice must provide alternative treatments, including risks, benefits and costs. * The client must be given an opportunity to ask questions and have them answered.

Question 63

The law of ______________ was created to avoid benefit of one party at the expense of another (owner receives veterinary care at the veterinarians expense.)

Answer 63

Unjust Enrichment

Question 64

In relation to the Acceptance stage of a contract; what is the difference between Express Acceptance and Implied Acceptance?

Answer 64

Express Acceptance is a clear statement of agreement to the terms offered that establishes and Express Contract. Implied Acceptance has no direct statement of agreement, but is demonstrated by actions indicating acceptance of the offer, leading to an Implied Contract.

Question 65

In regards to the acceptance stage of a contract…. Which is a clear statement of agreement to the terms offered.

Answer 65

Express Acceptance.

Question 66

In regards to the acceptance stage of a contract… which Acceptance has no direct statement of agreement, but is demonstrated by actions indicating acceptance of the offer.

Answer 66

Implied Acceptance.

Question 67

Although there may have been no formal agreement, justice requires the enforcement of one’s promise when another party has justifiably relied on that promise, changed it’s position, and incurred substantial detriment. This situation is called _________________ __________________.

Answer 67

Promissory Estoppel.

Question 68

When is comes to the Law of Agency; what two scenarios are considered likely to be common in veterinary medicine?

Answer 68

*Agency and Consents for Care * Agency and Consents for Euthanasia.

Question 69

Describe the Law of Agency…

Answer 69

The law of agency is defined as the ability to act through another. In most cases, this applies to commercial relationships or contractual agreements. The most common example of this is the employer-employee relationship. The employer is authorizing the employee to complete work on their behalf.

Question 70

Ethics exhaustion is a state where an individuals compassion has died out, even if just temporarily. True or False….

Answer 70

False …. Ethics exhaustion isn’t a lack of compassion, but it is being prevented from acting on what you believe is the compassionate, caring thing to do.

Question 71

What statute requires the production of a written memorandum before the courts will enforce certain types of contracts ( as opposed to an oral contract)?

Answer 71

The Statue of Frauds.

Question 72

Describe what the Statue of Frauds is in regards to….

Answer 72

The Statue of Frauds was an Act of the Parliament of England. It required that certain types of contracts, wills, and grants, and assignment or surrender of leases or interest in real property must be in writing and signed to avoid fraud on the court by perjury and subornation of perjury.

Question 73

The Law of Negligence requires proof of four essential elements, what are they?

Answer 73

1) Establishing that the defendant had a duty to prevent an injury from occurring to the plaintiff or the plaintiffs property. 2) Establishing that the defendant violated that duty by failing to act in accordance with the Standard of care expected of other DVMs under the same or similar circumstances. 3)Showing that a reasonable close casual connection existed between the defendant’s DVMs conduct or lack of conduct and the resulting injury (Doctrine or proximate cause) 4) Providing that the actual damage or harm occurred to the interests of another person.

Question 74

Define Negligence…

Answer 74

Negligence is defined as the doing of some act that a person of ordinary prudence would not have done under the same or similar circumstances.

Question 75

Of all the types of legal actions in tort law (legal law) veterinarians are most likely to insure some degree of professional liability from the law of negligence. The law of malpractice is an extension of the law of negligence, therefore understand the malpractice laws, a thorough knowledge of negligent law is necessary. The law of negligence requires proof of four essential elements, what are they?

Answer 75

1) Establishing that the defendant had a duty to prevent an injury from occurring to the plaintiff or the plaintiffs property. 2) Establishing that the defendant violated that duty by failing to act in accordance with the standard of care expected of other DVMs under the same or similar circumstances. 3) Showing that a reasonable close casual connection existed between the defendants DVMs conduct or lack of conduct and the resulting injury (doctrine or proximate cause). 4) Providing that the actual damage or harm occurred to the interests of another person. Law and Ethics page 133-134

Question 76

All federal and state Anti-trust legislation preserves the underlying principle that our nation shall function under a competitive business economy. The basic unifying principle of these statues is to ensure economic freedom for competitors and consumers. The _________________ Antitrust Act was enacted in 1890 and the goal of the Act is to guarantee the freedom to compete.

Answer 76

The Sherman Antitrust Act.

Question 77

Who is responsible for the interpretation and application of the competitive objectives of the antitrust laws?

Answer 77

The courts, the Department of Justice, and the Federal Trade Commission. Pg 177 Law and Ethics

Question 78

There are two rules that the courts will use when making a ruling regarding anti trust laws, what are they?

Answer 78

The Per Se Rule - A type of antitrust analysis used to determine the legality of agreements (written or oral) between COMPETITORS. **This category are agreements between competitors who’s only purpose is to…. 1) Fix prices (Increase, decrease or stay the same) 2) Allocate territory or divide markets 3) Limit production 4) Boycot third parties And the rule of reason - A type of antitrust analysis used to determine legality of agreements (written or oral) that MAY RESTRICT COMPETITION. Under the rule of reason, courts examine both the positive and negative effects of an agreement before determining whether it violates anti-trust laws.

Question 79

To be in violation of the Sherman Antitrust Act there must be proof of a contract, combination, or conspiracy that restrains interstate trade or commerce. If two local veterinary practices conspired to set fees, would they be free from the Sherman Antitrust Act requirements because they did not restrain interstate trade due to being in the same state and the same town? Why or Why not?

Answer 79

No - those practices could still be found guilty of restraining interstate trade or commerce, even if the activity is purely local but the activity affects interstate commerce. See Oklahomas case page 181 Law and Ethics.

Question 80

Define Civil Law.

Answer 80

Civil law is the division of law that covers tort and contract law, and relates to the duties between government and people.

Question 81

Define contract law.

Answer 81

Contract law works with duties established by individuals as a result of contractual agreements.

Question 82

Define negligence.

Answer 82

Negligence is the performance of an act that another person under the same circumstances would not perform.

Question 83

Define malpractice .

Answer 83

Malpractice refers to any misconduct, illegal or immoral, that result in damage or injury to a person or animal.

Question 84

Why are ethics important to the veterinary profession?

Answer 84

Ethics are important to hold each member of an organization to a higher standard and determine right from wrong.

Question 85

Why is a informed consent imperative?

Answer 85

An informed consent ensures the client has a complete understanding of the procedures involved, including risks, benefits, and alternative procedures.

Question 86

Why would a consent form be upheld in court?

Answer 86

A consent form may not be held up in court if an individual under the age of 16 years signed the form, was under the influence of drugs or alcohol, or is mentally unstable.

Question 87

What branch of the law does animal abuse fall under?

Answer 87

Animal abuse falls under criminal law and is prosecuted by the attorney general or district attorneys office.

Question 88

What is PLIT? Whom does it cover?

Answer 88

PLIT is a Professional Liability Insurance Trust that covers veterinarians (and the staff members) involved in the veterinary practice.

Question 89

Why is medical record legibility important?

Answer 89

Medical records must be legible if the record is ever taken to court. The judge must be able to read and understand the record, or the court may come to the conclusion that the event did not happen (as it can be extrapolated from the record).

Question 90

Which association created the Principles of Veterinary Medical Ethics? A) AVMA (American Veterinary Medical Association) B) NAVTA (National Association of Veterinary Technicians in America) C) VHMA (Veterinary Hospital Managers Association) D) PLIT ( Professional Liability Insurance Trust)

Answer 90

A) AVMA (American Veterinary Medical Association).

Question 91

What does the acronym VCPR stand for? A) Veterinary - client public records B) Veterinary - client - patient - relationship C) Veterinary cardiac pulmonary resuscitation D) Veterinary conduct and professional responsibilities

Answer 91

B) Veterinary - client - patient relationship.

Question 92

Which of the following is considered a branch of veterinary ethics? A) Normative B) Descriptive C) Administrative D) Official E) All of the above

Answer 92

E) All of the above.

Question 93

What are two categories of law? A) Civil and Federal B) Criminal and Common C) Criminal and Civil D) Federal and Criminal

Answer 93

C) Criminal and Civil

Question 94

What is the correct definition of an intentional tort? A) An intentional action that has taken place in which harm has occurred to another member of society. B) Crimes committed against the public as a whole C) A civil offense to an opposing party in which harm has occurred. D) An injury occurring to a member of society as a result of negligence.

Answer 94

A) An intentional action that has taken place in which harm has occurred to another member of society.