Medical Law And Ethics Flashcards
Which branch of the federal government passes laws?
The legislative
Which branch of the federal government implements laws?
The executive
Which branch of the federal government interprets laws?
The judicial
What is meant by type of law known as common law?
Common law is a law that derives authority from ancient usages and customs affirmed by court judgments and decrees.
How are common laws created?
They are created by the judicial branch through decisions in court cases
What is meant by type of law known as criminal law?
A law dealing with criminal offenses and their punishments
What is meant by type of law known as private law?
The legal rights defining the relationship between private entities
What is meant by type of law known as public law?
The legal rights defining the relationship between the government and governed
What is meant by type of law known as case law?
Law established by judicial decision in legal cases and used as legal precedent.
What is meant by type of law known as civil law?
Rules that govern private rights and remedies, as well as disputes between individuals regarding contracts, property and family law. It is separate from criminal or public law.
Who is a defendant?
The person or group accused in a court action.
Who is a plaintiff?
A person who files a lawsuit initiating a civil legal action.
Who is the plaintiff in criminal actions?
The prosecution is the plaintiff, acting on behalf of the people
Who is a litigant?
A party to a lawsuit
What is litigation?
A lawsuit or a contest in court
What is a jurisdiction?
The power, the right and the authority given to a court to hear a case and make a judgement
What is a layperson?
An individual who does not have training in a specific profession
What is a crime?
An act that violates a criminal law
What is a criminal?
A person who contributes to or aids in the commission of a crime either by a direct or indirect act.
What is an accessory?
A person who contributes to or aids in the commission of a crime either directly or indirectly.
What is a felony?
An offense punishable by death or imprisonment in a state or federal prison.
What type of crimes constitute a felony?
Crimes like:
- Rape
- Murder
- kidnapping
- assault
What is a misdemeanor?
A crime that is a less serious than a felony and consequently carries a lesser penalty.
What is a tort?
A civil wrong committed against a person or property, excluding a breach of contract.
What is the most common civil claim in medical law?
Tort
What are types of intentional torts?
- Assault
- battery
- defamation of character
- fraud
- invasion of privacy
- emotional distress
- malicious betrayal of professional secrets
- abandonment
- false imprisonment
What is an intentional tort?
An intentional tort is a wrongful act that someone plans and carries out while fully aware of their actions
What are the four d’s of negligence?
- Duty
- Dereliction
- Damage
- Direct causation
What is the duty portion of the four d’s of negligence?
A patient must show that the physician-patient relationship existed, in which the physician owed the patient a duty.
What is the dereliction portion of the four d’s of negligence?
Patients must show that the physician failed to comply with the standards of the profession (dereliction).
What is the duty portion of the four d’s of negligence?
The patient must prove that an injury(damage) was done.
What is the direct causation portion of the four d’s of negligence?
A patient must show that any damages were a direct cause of the physician’s breach of duty
What is assault?
A willful attempt or threat by a person to injure another person with the apparent ability to do so.
What is defamation?
Spoken or written words about a person that are both false and malicious and that injure that person’s reputation or means of livelihood and for which damages can be recovered.
What two forms can defamation take?
- Slander
- Libel
What is an allegation?
A statement by a party to a legal action of what the party undertakes to prove; an assertion made without proof.
What is libel?
Defamatory writing, such as published materials or pictures.
What is slander?
Defamatory spoken words
What is false imprisonment?
The intentional, unlawful restraint or confinement of a person.
What can be considered false imprisonment in a hospital setting?
Refusing to dismiss a patient from a healthcare facility upon his or her request or preventing a patient from leaving the facility may be seen as false imprisonment.
What is fraud?
Dishonest or deceitful practices undertaken in order to induce someone to part with something of value or a legal right.
What is invasion of privacy?
Intrusion into a person’s private affairs and public disclosure of private facts about a person, false publicity about a person, or use of a person’s name or likeness without permission.
In the medical setting, what counts as invasion of privacy?
Improper use of or breaching the confidentiality of medical records may be seen as invasion of privacy.
Under what legal circumstances is the release of patient medical information allowed?
The release of medical information requires prior written consent from the patient
What is abandonment?
A situation wherein a patient is provided with insufficient care, or no care at all.
What is inflicting of emotional distress?
Intentionally or recklessly causing emotional or mental suffering to others.
What is battery?
The unlawful use of force on a person. Also non consensual or illegal touching of a person.
What can be considered battery in the hospital setting?
Any health care provider who fails to receive a formal expression of consent to touch a patient could be charged with battery by a patient.
What is burglary?
The act of breaking and entering into a building with intent to commit a felony, especially in order to steal.
Why are most burglaries attempts made in the hospital setting?
They are made to steal narcotics
What is misuse of legal procedure?
Bringing legal action with malice and without probable cause
What are unintentional torts?
a type of unintended accident that leads to injury, property damage, or financial loss
What are the mists comments torts within the healthcare delivery system?
Unintentional torts
When is negligence charged in a health care setting?
When a provider fails to exercise ordinary care and a patient is injured as a result of that.
What is a tortfeasor?
a person who commits a tort whether intentionally or unintentionally.
When it comes to maintaining patient privacy, what is the recommended mode of sending confidential materials?
It is recommended not to send confidential materials by:
- personal email
- text message
- open access printers
Question:
What are three essential precautions to take when printing confidential patient information to maintain privacy and security in a hospital or medical office setting?
• C – Check the copier and remove all confidential papers.
• P – Print only when you can monitor the printer; never leave it unattended.
• S – Secure patient information by using a private or restricted-access printer.
What is the recommended method of disposing of copies of confidential material in the hospital setting?
Shredding is recommended over discarding in shared trash containers
What are some important considerations to take when sending sensitive materials by fax?
- Use of a fax cover sheet with a cautionary statement
- Verifying phone number before sending the fax
- Faxing must take place in a secure location where no one else can see the sensitive information
what is an important safety consideration for accessing patient files on a computer?
The computer monitor must not be left unattended with sensitive information displayed on it.
What is durable power of attorney?
A written document in which one person appoints another to act as his or her agent giving authority to the agent to act or function on behalf of the person making the request.
What are hospital privileges?
Authority given to a physician by a hospital governing body to provide patient care in the hospital.
What is privileged communication?
Information held confidential within a protected relationship, such as attorney-client and physician-patient.
What does privileged information mean for the patient in a physician-patient relationship?
It means that the physician is prohibited from revealing information about clients in court
What is consent in the medical setting?
Consent is approval and permission from a patient to allow touching, examination, treatment, or release of medical information by medically authorized personnel.
When is consent unnecessary in the medical setting?
It is unnecessary in an emergency situation
What are the three types of consent?
- Informed consent
- Implied consent
- Expressed consent
What is an important caveat that patients must remember with regards to consent?
It can be withdrawn at any time
What is informed consent?
Approval and permission by a mentally competent individual to receive medical services, based on the understanding of all essential information about what will be done, and possible outcomes.
What is implied consent?
The granting of permission for receiving medical services without a formal agreement between the patient and the provider, such as making an appointment to be treated which implies consent to be treated.
What is expressed consent?
The granting of permission for receiving medical services via an individual’s direct communication with a healthcare professional.
What is a doctrine of informed consent?
The doctrine of informed consent is a legal and ethical principle.
What is a purpose of a doctrine of consent?
The purpose of a doctrine of consent is to inform patients about the risks, benefits, and alternatives of a treatment before asking a patient for their voluntary agreement in the form of a consent form.
What should a medical assistant do after a patient signs a consent form?
They must document the fact that in the patient’s chart and note that the patient’s questions were answered and that risks and alternatives were communicated.
What is the meaning of patient incompetence?
Patient incompetence means an individual cannot properly exercise certain individual rights and options due to mental incapacity.
What is a mature minor?
An individual younger than 18 years of age who has an understanding of the nature and consequences of proposed medical treatment.
What is a contract?
A voluntary agreement between two or more parties in which specific promises are made for a consideration.
What is the Good Samaritan Act?
A statute that provides immunity from liability to volunteers at the scene of an accident who render emergency care.
What are mandatory reports?
Mandatory reports refer to legally required reports that healthcare workers must submit to authorities when they become aware of specific situations that pose a risk to individuals or the public.
What is the purpose of mandatory reports?
These reports are intended to protect vulnerable populations and ensure appropriate intervention
What type of reports are considered mandatory reports?
- birth reports
- death reports
- cases of food poisoning
- communicable diseases
- abuse of any kind
- drug abuse
- criminal acts
What type of information can be released by a physician without written consent from a patient?
Communicable disease information
What diseases count as communicable diseases?
- AIDS
- hepatitis
- neonatal herpes
- Lyme disease
- rabies
-sexually transmitted diseases
What kind of abuses are included in mandatory reports?
- child
- elderly
- adult
- battered spouse
What type of criminal acts are included in mandatory reports?
Acts that are indicated by injuries resulting from violence such as:
- gunshots
- stab wounds
What is a birth certificate?
It is a legal document that records information about a birth.
It is used throughout a person’s life to prove age, parentage, and citizenship.
What other information is given on a birth certificate?
It tells whether a mid wife was present
What is a minor?
A minor is a person who has not reached the age of majority or legal age.
What is the age of majority in most states?
The age of majority in most states is 18 years old in most jurisdictions. 21 in some.
What are laws regarding medical consent for minors?
Minors cannot legally consent to medical treatment unless in special circumstances.
What are the exceptions that allow minors to seek medical treatment despite not being the age of majority?
- emancipatied minors
- married minors
- other way self-sufficient minors
Based on state laws, what medical services can minors receive without parental consent?
- pregnancy
- birth control
- sexually transmitted diseases
What is standard of care?
Standard of care is the level of skill, care, and diligence that a reasonably competent healthcare professional in the same specialty would provide under similar circumstances.
What are medical practice acts?
State laws that govern the practice of medicine
Can nonlicensed personnel perform clinical procedures while employed by licensed physicians?
Yes
What is the purpose of medical practice acts (mandates) ?
They are designed to monitor and discipline doctors.
Who enforces mandates?
State medical boards
What are medical boards?
Boards established by each state’s mandates to protect, the health, safety and welfare of healthcare consumers by licensing health-care practitioners.
What is protocol?
- A written plan specifying the procedures to be followed in giving a particular examination.
- Rules or standards of behavior applicable to one’s place of employment
What is the patient’s bill of rights?
A statement by the American Hospital Association that guarantees patients certain rights.
What is Defensive medicine?
The practice of performing medical tests and procedures in order to protect against future liability and to document the health-care provider’s judgment.
What is Forensic medicine ?
A division of medicine that involves medical issues or medical proof at trials having to do with malpractice, crimes, and accidents.
What is Equal Employment Opportunity Commission?
A body appointed by the president of the United States to administer the Civil Rights Act of 1964, primarily to investigate complaints of discrimination in employment among businesses engaged in interstate commerce.
What are public health statutes?
Regulations set forth by individual states to promote the health and wellbeing of a specific population.
What is the purpose of complying with public health statutes?
By following these state regulations, there are proven reductions in:
- communicable diseases
- abuse
- neglect
- exploitation
- injuries caused by violence
What is locum tenens?
A Latin term meaning “to hold a place for”. Locums physicians fill in for other physicians on a temporary basis, typically for a few days to six months.
What are the patient’ bill of rights?
A patient has a right to:
1. I - Informed consent
2. P - Privacy and Confidentiality
3. R - Records access
4. E - Emergency care
5. F - Fair and respectful treatment
6. E - End treatment or refuse
7. R - Report complaints
8. C - Choice of providers and plans
What is medical malpractice?
Medical professional misconduct also called professional negligence.
What are the causes of medical malpractice?
- Lack of professional knowledge
- Lack of experience
- Lack of skill that is expected from practitioners and results in injury or harm to the patient.
What is misfeasance?
The performance of a lawful act in a way that is illegal or improper, resulting in harm.
What is malfeasance?
Malfeasance is the performance of a totally wrongful, unlawful act, for example, when a person prescribes medications but is not allowed to.
What is nonfeasance?
The failure to act when one is required to do so; for example, not scanning a barcode on a package when it is a job duty to do so.
What is res ipsa loquitur?
It’s a Latin phrase meaning “the matter speaks for itself”.
What is the use of res ipsa loquitur?
It is a doctrine that applies if an injury or harm is so obviously a result of negligence that no further proof is needed to establish liability.
What is contributing negligence?
A legal term defining a situation in which both the plaintiff and the defendant share in the negligence that caused injury to the plaintiff.
What is non compos mentis?
Not of sound mind
What type of law is broken when a person makes a mistake that breaks the law in healthcare?
Civil law
What are the two types of civil law crimes?
- Torts
- Breaches of contract
What is a contributory defense?
A contributory defense is a defense in which the plaintiff is found to be at least partially responsible for injury and so the health care provider is not held liable for negligence.
What is a comparative defense?
A comparative defense is a defense in which, damages are awarded based on a percentage of negligence for both plaintiff and defendant.
What is intervening cause?
Intervening cause is when an independent factor affects the outcome of a treatment for the patient.
What is assumption of risk?
Assumption of risk means that the patient voluntarily accepted the risks.
What is a technical defense?
A technical defense is a defense decided by a judge as a point of law.
What is criminal negligence?
Criminal negligence is outrageous carelessness or disregard for patient safety.
What is the meaning of respondent superior in the medical setting?
It means “Let the higher up answer” in Latin. In a medical setting, the physician is responsible for the acts of their employees.
What is scope of education and training?
Scope of education and training is the laws dictating what medical assistants may or may not do.
What is child abuse?
The physical, sexual, or emotional maltreatment of children.
What is the Child Abuse Prevention and Treatment Act?
A law passed by congress mandating the reporting of cases of child abuse.
What is elder abuse?
The physical abuse, neglect, intimidation, or cruel punishment of elderly people as defined by the Older Americans Act.
What is the Amendments to the Older Americans Act?
A law passed by Congress that defines elder abuse, neglect, and exploitation but that does not deal with enforcement.
In how many states is it mandatory for physicians to report elder abuse?
42 states
In how many states is it voluntary (not mandatory) for physicians to report elder abuse?
In 8 states:
1. New Jersey 2. New York 3. North Dakota 4. South Dakota 5. Wisconsin 6. Colorado 7. Nebraska 8. Pennsylvania
What is rape?
A sexual assault involving intercourse without consent.
What is the Drug Enforcement Administration (DEA)?
It is the agency responsible for enforcing the Comprehensive Drug Abuse Prevention and Control Act of 1970.
Under what conditions can a physician terminate the provider-patient relationship without it being seen as abandonment?
A physician can terminate the provider-patient relationship if there is just cause.
What are some examples of just cause for termination of the provider-patient relationship?
- Noncompliance with treatment recommendations
- Repeatedly missing appointments
- Refusal to pay for services
How must a patient be notified if their services are terminated?
A patient must be notified by certified mail, with a return receipt requested.
What are the four purposes to a medical record?
- It is a legal record
- It is a record of health treatment
- It is a communication tool between members of the health care team.
- It is a research tool.
What is employment-at-will?
Employment-at-will is a concept of employment where either the employer or the employee can terminate employment at any time and for any reason.
What is wrongful discharge?
A concept established by precedent whereby an employer risks litigation if he or she does not have just cause for firing an employee.
What are legal protections?
Laws against wrongful discharge that prevent employers from firing someone for refusing to commit an illegal act, whistle-blowing, performing a legal duty, or exercising a private right.
What is the Wagner Act of 1935?
A statute that makes it illegal to discriminate in hiring or firing employees because of union membership or organizing activities.
What is the Fair Labor Standards Act of 1938?
It is a statute that prohibits child labor and the firing of employees for exercising their rights under the act’s wage and hour standards. It also provides for overtime pay and a minimum wage.
What is the Equal Pay Act of 1963?
A statute that requires equal pay for men and women doing equal work.
What is Title VII of the Civil Rights Act of 1964?
Employees are not allowed to discriminate on the basis of race, color, religion, sex or national origin.
To which businesses does Title VII of the Civil Rights Act of 1964 apply?
A statute that applies to business with 15 or more employees working at least 20 weeks a year.
What are Right-to-Know laws?
They are state laws that allow employees access to information about toxic or hazardous substances, employer duties employee rights, and other workplace health and safety issues.
What is the Americans with Disability Act of 1990?
An act designed to eliminate discrimination against individuals with disabilities.
In what areas does the Americans with Disabilities Act of 1990 apply?
- telecommunications
- housing
- public transportation
- air carrier access
- voting accessibility
- education
- rehabilitation
How does the Americans with Disabilities Act of 1990 apply to healthcare facilities?
Healthcare facilities are public accommodations and as such must comply with specific requirements for architectural standards and modifications suited to disabled individuals.
What is the Patient Quality Improvement Act of 2005 Statute and Rule?
It is a U.S. federal law designed to enhance patient safety and healthcare quality by encouraging the confidential reporting and analysis of medical errors and adverse events.
What is the Health Information Technology Economic and Clinical Health Act (HITECH) of 2009?
A law designed to promote the adoption of and meaningful use of health information technology.
What is POMR?
POMR (Problem-Oriented Medical Record) is a method of medical documentation that organizes patient information based on specific health problems rather than by traditional chronological notes. It helps healthcare providers track a patient’s conditions systematically.
What are the components of POMR?
- Database
- Problem List
- Initial Plans
- Progress Notes(SOAP)
What is the database portion of POMR?
The database portion of POMR includes the patient’s:
- history
- physical exam
- lab results
- diagnostic tests
What does the problem list portion of POMR?
It is a numbered list of all the patient’s health issues
What is the initial plans portion of POMR?
A structured plan for diagnosis,
treatment, and patient education for each problem.
What is the progress notes (SOAP format) portion of POMR?
It is the documentation portion of each problem that the patient has.
What does acronym SOAP mean?
- S - Subjective(patient’s symptoms and complaints)
- O - Objective(measurable data like vitals, test results )
- A - Assessment(provider’s interpretation/diagnosis)
- P - Plan(treatment or follow-up strategy )
What is SOMR?
It is a traditional method of organizing medical records where patient information is grouped by the sources provided the data.
How is SOMR different from POMR?
POMR focuses on identifying the patients problems, SOMR focuses on documenting records in order of who wrote them.
What is the structure of SOMR records?
- History & Physical(H&P) - patient history and exam findings
- Progress Notes - Doctor’s or Nurse’s notes over time
- Laboratory Reports - Blood tests, imaging results
- Consultations - Notes from specialists
- Medications and Treatments- Pharmacy records, prescribed medications
How are progress notes handled in SOMR?
The most recent report or progress note is placed at the top.
What is an EMR?
An Electronic Medical Record (EMR) is a digital version of a patient’s paper chart used by a single healthcare organization (such as a hospital, clinic, or private practice).
What does an EMR contain?
It contains medical and treatment histories of patients within that facility and is primarily used by healthcare providers for diagnosis, treatment, and ongoing care.
Who owns a patient’s medical records?
A patient’s medical records are considered the legal property of the facility where they were created.
Under what conditions can a medical facility/office authorize the release of patient records?
- The patient or their legal guardian has signed release forms
- A court has subpoenaed the records
- An act or law mandates that the records be released to protect public welfare and safety
- The physician determines that the release is necessary to protect the patient or a third party
When signing release forms for children, in the case of parents who are divorced, which parent signs the release forms?
The released forms are signed by the parent with legal custody
What is an Advance Medical Directive?
A legal document addressed to a patient’s family and health care providers stating what type of treatment is desired when becoming:
- terminally ill
- unconscious
- permanently comatose.
What does DNR(Do Not Resuscitate) mean?
A DNR order is a legal document that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a person’s heart stops or they stop breathing.
What does DNI (Do Not Intubate)?
A DNI order directs healthcare providers not to use intubation (inserting a tube into the airway) to assist with breathing if the patient’s condition deteriorates.
What is a MOLST(Medical Orders for Life-Sustaining Treatment)?
A MOLST is a medical order that provides clear instructions on a person’s preferences for life-sustaining treatments, such as ventilation or feeding tubes, often for patients with serious or terminal conditions. It is signed by a healthcare provider and is more specific than an advance directive.
What is HIPAA?
The Health Insurance Portability and Accountability Act. It is a US Law designed to protect the privacy and security of individuals health information.
What is Title I of HIPAA about?
It is the health care portability part of HIPAA. It deals with protecting health-care coverage for employees who change jobs.
What protections does Title I of HIPAA provide employees and their families when they are starting a new job?
-It increases their ability to get health coverage when starting a new job
What protections does Title I of HIPAA provide employees and their families when they are working at a job and are at risk of losing their healthcare coverage?
It reduces the probability of losing existing healthcare coverage
What protections does Title I of HIPAA provide employees and their families when they are changing their job?
It helps workers maintain continuous health-care coverage when changing jobs
What protections does Title I of HIPAA provide employees and their families when they lose coverage under their employer’s plan?
It helps workers purchase health insurance on their own if they lose coverage under an employer’s group plan and have no other health coverage available.
What does Title II of HIPAA?
It is the part of HIPAA that prevents healthcare fraud, abuse, administrative simplification and medical liability reform.
What is a common name for Title II of HIPAA?
It is commonly known as the HIPAA Privacy Rule
What protections does Title II of HIPAA provide patients?
It gives patients more control over their health information
What protections does Title II of HIPAA provide on the use and release of healthcare records?
It sets boundaries on the use and release of healthcare records
What protections does Title II of HIPAA have for safeguarding the privacy of healthcare information?
It establishes appropriate safeguards that healthcare providers and others must achieve to protect the privacy of health information
What protections does Title II of HIPAA provide for people whose healthcare records have been violated?
It holds violators accountable, with civil and criminal penalties that can be imposed if they violate patients’ privacy rights.
What protections does Title II of HIPAA for when public responsibility supports disclosing patient records?
It strikes a balance between when public responsibility supports disclosure of some forms of data (e.g. to protect public health)
What is individually identifiable health information?
An individual’s personal information that is gathered in the process of providing healthcare.
What is protected health information?
Individually identifiable health information that is transmitted or maintained by electronic or other media, such as computer storage devices.
Is protected health information protected by the HIPAA privacy rule?
Yes it is
What does Part II of HIPAA say about the use of protected health information?
Healthcare workers are allowed to:
- share
- employ
- apply
- utilize
- examine
- analyze
What does Part II of HIPAA say about the disclosure of protected health information?
Health care workers are allowed to:
- release
- transfer
- provide access to
- divulge in any manner
What does Part II of HIPAA say about the treatment, payment and operations (TPO) of protected health information?
- Treatment - Providers are allowed to share information in order to provide care to patients
- Payment - Providers are allowed to share information in order to receive payment for the treatment provided
- Operations - Providers are allowed to share information to conduct normal business activities such as quality improvement
What is a Notice of Privacy Practices (NPP)?
A document given to patients by healthcare providers that inform patients of their rights as outlined by HIPAA.
What is the HIPAA Security Rule?
The technical safeguards that protect the confidentiality, integrity, and availability of health information covered by HIPAA.
What does the HIPAA Security Rule do?
It specifies how patient information is protected on computer networks, the internet, disks, and other storage media.
What does HIPAA do?
It sets standards for the electronic exchange, privacy, and security of health data, ensuring that personal health information is kept confidential and only shared with authorized individuals or entities.
