Medical Law and Ethics

Question 1

What are some ways you can make a transgender patient feel more comfortable during the patient visit?

Answer 1

Some ideas include treating transgender individuals with respect, as you would for all patients. Politely ask the patient to state their name and pronouns. When asking for name and pronouns, ask what they “use” rather than what they “prefer.” Refer to patients by the name and pronouns they state. Make a habit of requesting this from all patients to avoid singling out only those who present as gender-nonconforming. If a patient has changed their name, use their current name. Avoid offensive language and inappropriate questions. Educate yourself and your coworkers about transgender health care and issues.

Question 2

According to the Patient’s Bill of Rights, what are two fundamental rights patients have regarding their treatment and information about their health?

Answer 2

The right to be treated fairly and respectfully, and the right to receive understandable information about their diagnosis, treatment, and prognosis.

Question 3

What rights do patients have concerning medical procedures and treatments, including refusing care?

Answer 3

The right to discuss procedures, risks, and recovery time, to ask about other care options, to make decisions about their care (before and during), and to refuse care (with the hospital informing them of medical consequences).

Question 4

What information are patients entitled to know about their healthcare providers and the cost of their care?

Answer 4

The identities of all their healthcare providers (including trainees) and information about the potential cost of care at the time of treatment and long term.

Question 5

What rights do patients have regarding advance directives and their privacy during medical care?

Answer 5

The right to have an advance directive (which the hospital should honor), and the right to privacy during medical exams, discussions, consultations, and treatments.

Question 6

What expectations should patients have regarding the confidentiality of their communication and records, and do they have the right to review their medical records?

Answer 6

The right to expect their communication and records to be treated as confidential (with legal exceptions), and the right to review their medical records and have them explained.

Question 7

What rights do patients have regarding the hospital’s response to their needs and regarding any potential business relationships that might influence their care?

Answer 7

The right to expect a reasonable response to requests for care or transfer, and the right to be informed of business relationships between the hospital and other entities that may influence their care.

Question 8

What rights do patients have concerning participation in research studies and the continuity of their care?

Answer 8

The right to consent to or decline research participation (with full explanation and without affecting their standard care), and the right to expect reasonable continuity of care and information about other options when hospital care ends.

Question 9

What final rights do patients have regarding hospital policies and resolving any issues?

Answer 9

The right to be informed of hospital policies related to their care and responsibilities, and the right to know whom to contact to resolve disputes and about service charges and payment methods.

Question 10

What is a goal of the Patient’s Bill of Rights?

Answer 10

To ensure the rights and responsibilities of both patients and health care providers and that patients play a role in their own health

Question 11

What are the main goals of the Patient Protection and Affordable Care Act (ACA)?

Answer 11

Expanding access to affordable, quality health insurance, increasing consumer protection, emphasizing prevention and wellness, and curbing rising healthcare costs.

Question 12

What fundamental rights does HIPAA provide to patients regarding their health information, and what type of information does it protect?

Answer 12

Rights over their health information, setting rules and limits on who can access protected health information (PHI), whether electronic, written, or oral.

Question 13

How does the HITECH Act expand upon HIPAA?

Answer 13

By increasing enforcement of privacy and security for electronic PHI, prohibiting its sale, making business associates liable for HIPAA compliance, and creating a penalty system for violations.

Question 14

What is the primary responsibility of employers according to the Occupational Safety and Health (OSH) Act?

Answer 14

To provide a safe and healthful workplace for employees by setting and enforcing standards and providing training, outreach, education, and assistance.

Question 15

What does the Controlled Substances Act (CSA) regulate, and how does it classify medications?

Answer 15

The manufacture and distribution of controlled substances, classifying medications into five schedules based on abuse potential and medical benefits.

Question 16

What does the Emergency Medical Treatment and Active Labor Act (EMTALA) require of hospital emergency departments that receive federal funding?

Answer 16

To provide an appropriate medical screening to any patient seeking emergency treatment and to stabilize any emergency medical condition, regardless of ability to pay.

Question 17

What is the primary objective of the Clinical Laboratory Improvement Act (CLIA)?

Answer 17

To regulate all laboratory facilities for safety and handling of specimens and to ensure the accuracy and timeliness of testing.

Question 18

What does Title VII of the Civil Rights Act of 1964 prohibit for employers with 15 or more employees?

Answer 18

Discriminating on the basis of race, national origin, gender, or religion.

Question 19

What are the key protections and requirements of the Americans with Disabilities Act (ADA)?

Answer 19

Forbids discrimination against qualified individuals with disabilities in employment and requires employers to provide reasonable accommodations.

Question 20

What is the main function of the Heads of the European Radiological Protection Competent Authorities (HERCA)?

Answer 20

To identify radiation protection issues and propose possible solutions.

Question 21

What protection do Good Samaritan Acts generally provide to bystanders in emergency situations?

Answer 21

Protection from being sued if their actions inadvertently contribute to a person’s injury or death.

Question 22

What does the Genetic Information Nondiscrimination Act of 2008 (GINA) prohibit?

Answer 22

Discrimination on the basis of genetic information with respect to health insurance and employment.

Question 23

What is the purpose of the Patient Safety and Quality Improvement Act (PSQIA)?

Answer 23

To create a framework for gathering and analyzing patient safety information within the confines of protected health information laws.

Think of M & M conferences

Question 24

What does the Anti-Kick Back Statute (AKBS) prohibit?

Answer 24

Receiving benefits for referrals or business involving federal healthcare programs.

Question 25

What key protection does the No Surprise Act (NSA) offer to individuals with health insurance?

Answer 25

Protection from surprise billing for emergency services from out-of-network providers or facilities without prior authorization.

Question 26

Why is proper documentation and maintenance of medical records crucial, and what is the most significant law governing patient privacy and confidentiality?

Answer 26

Essential to maintain patient privacy; HIPAA is the most important law outlining patient privacy, confidentiality, and how patient information is managed.

Question 27

According to HIPAA, what are three fundamental rights patients have regarding their health care information?

Answer 27

The right to receive a copy of their information, ensure the medical record is correct, and know who has had access to the record.

Question 28

What are the three main categories of safeguards that medical facilities must implement under the HIPAA Security Rule to protect patient information?

Answer 28

Administrative safeguards, physical safeguards, and technical safeguards.

Question 29

When is written consent required under HIPAA for sharing a patient's health care information, and does this requirement extend to family and friends?

Answer 29

Written consent is required when sharing health care information; it is not required for family or friends unless they are legally identified as the patient’s personal representatives.

Question 30

Who owns the physical medical record, and who owns the information (data) within the record, including the patient's right to access it?

Answer 30

The healthcare provider or facility owns the physical record, but the patient owns the information (data) within it and has the right to inspect, review, and receive a copy (with few exceptions).

Question 31

What is required from a patient before their medical records can be released to another healthcare provider or entity?

Answer 31

A signed release form from the patient.

Question 32

Name three specific situations in which medical records can be released without the patient's authorization or a signed release form.

Answer 32

Criminal acts (evidence in abuse, stabbings, etc.), legally ordered (subpoena), communicable diseases (required by CDC or health departments), and mandated examinations (workers' compensation).

Question 33

How is implied consent demonstrated by a patient, and in what emergency situations is it assumed?

Answer 33

Inferred through signs, actions, or conduct (e.g., opening mouth for temperature). Assumed in emergent care for unconscious or unable to speak individuals for CPR and lifesaving treatments.

Question 34

How is expressed consent given by a patient?

Answer 34

Either by oral or written words (e.g., agreeing to an injection and stating the preferred arm).

Question 35

What is the purpose of informed consent, and what does it ensure for the patient?

Answer 35

To ensure the patient (or guardian) knows, understands, and accepts the explained treatment.

Question 36

What are the critical components of informed consent that a healthcare provider must ensure?

Answer 36

Clear and voluntary indication of preference, freely given after available options and consequences have been made clear through shared decision-making with a competent adult patient who understands the disclosed risks, benefits, alternatives, and potential prognoses.

Question 37

What legal ramifications can occur if informed consent is not obtained before a procedure (unless it's an emergency)?

Answer 37

May lead to a case of medical negligence and malpractice.

Question 38

In what two specific situations can minors (under 18) provide medical consent without parental permission?

Answer 38

When seeking birth control, pregnancy care, STD treatment, or substance abuse treatment; and if the minor has been declared emancipated by the courts.

Question 39

What are some ways a minor can be declared emancipated by the courts?

Answer 39

Being enlisted in the military, being financially independent, living independently, or being married.

Question 40

What is the primary purpose of an advance directive?

Answer 40

To provide written requests for healthcare in case a patient becomes incapacitated and unable to speak for themselves, expressing their values and desires related to end-of-life care.

Question 41

What are the two main legal documents that comprise an advance directive?

Answer 41

A living will and a durable power of attorney for health care.

Question 42

What is the function of a living will, and what are some examples of medical treatments it might address?

Answer 42

A legal document stating what medical procedures a patient would want, which they would not want, and under what conditions these decisions apply (e.g., analgesia, CPR, ventilators, dialysis, DNR).

Question 43

What is the role of a durable power of attorney (DPOA) for health care?

Answer 43

A legal document naming a healthcare agent (proxy) to make medical decisions for the patient when they are unable to do so due to incapacitation or inability to communicate.

Question 44

If a patient lacks an advance directive and cannot make healthcare decisions, what is a typical order of individuals who might be appointed by state law to make decisions on their behalf?

Answer 44

Court-appointed guardian/conservator, spouse/domestic partner, adult child, adult sibling, close friend, nearest living relative.

Question 45

When do advance directives become legally valid, and how often should they be reviewed?

Answer 45

Legally valid upon the patient's signature with required witnesses (nationwide). They should be reviewed often and revised if necessary.

Question 46

What is a DNR order, and what specific type of medical intervention does it address?

Answer 46

A legal order (in hospital or on a specific form) communicating a patient's wish not to undergo CPR or advanced cardiac life support if their heart stops or they stop breathing.

Question 47

What is a POLST form, and for what type of patient is it typically reserved?

Answer 47

Physician Orders for Life-Sustaining Treatment; typically for patients who may be near the end of life. It's a physician-filled form detailing end-of-life care based on shared decision-making and is portable across healthcare settings.

Question 48

What are the two primary categories of law that healthcare professionals should be aware of?

Answer 48

Criminal law and civil law.

Question 49

What are misdemeanors?

Answer 49

Misdemeanors are lesser crimes with fines or imprisonment of 1 year or less

Question 50

What are felonies?

Answer 50

Felonies are more serious with larger fines and/or imprisonment for more than 1 year, potentially including the death penalty and license revocation for healthcare professionals.

Question 51

What are some examples of criminal acts a healthcare professional might be prosecuted for?

Answer 51

Practicing without a license, falsifying information to obtain a license, failing to provide life support, and potentially battery (a felony) for failing to obtain informed consent resulting in unconsented physical contact.

Question 52

What does civil law protect, and what is the typical consequence of violating civil law?

Answer 52

Protects the private rights of a person or their property; violation may lead to a civil lawsuit by the victim to hold the responsible party accountable for a wrongdoing (a tort).

Question 53

Define what a tort is in the context of civil law.

Answer 53

An action that wrongly causes harm to an individual but is not a crime.

Question 54

Define an intentional tort and provide three examples relevant to healthcare.

Answer 54

A deliberate act that violates the rights of another. Examples include assault, battery (including administering an injection without consent), and invasion of privacy.

Question 55

How does negligence (unintentional tort) differ from an intentional tort in a healthcare setting?

Answer 55

Negligence is not a deliberate action or intended to harm but results from failing to act reasonably where a duty was owed.

Question 56

What are the four basic elements, known as the "four Ds," that must be proven to establish negligence?

Answer 56

Duty of Care, Dereliction of Duty (Breach), Direct Cause, and Damages.

Question 57

How is malpractice defined in relation to negligence, and what are some potential examples in healthcare?

Answer 57

An act of negligence --> requires proof of a breach of standard care and must cause damage/harm

Question 58

What is the critical question for medical malpractice?

Answer 58

Would a similarly skilled healthcare professional have provided me with the same treatment under the same or similar circumstance?

Question 59

How is the "standard of care" typically defined in a medical malpractice case?

Answer 59

The type and level of care an ordinary, prudent healthcare professional with similar training and experience would provide under similar circumstances.

Question 60

What is the primary type of penalty in civil law cases, such as those involving negligence or intentional torts?

Answer 60

Almost exclusively monetary compensation (damages) awarded to the plaintiff for injuries, medical expenses, lost wages, and pain and suffering.

Question 61

What is the primary purpose of mandatory reporting duties for healthcare providers and professionals, and what are some common categories of incidents that typically require reporting?

Answer 61

To protect the safety and welfare of the public and specific vulnerable populations

Question 62

What are the common categories include in mandatory reporting?

Answer 62

Common categories include births, deaths, certain communicable diseases (including STIs), assaults/criminal acts, and abuse/neglect/exploitation (child, elder, intimate partner)

Question 63

According to the CDC, who is typically required to report these diseases to local health departments?

Answer 63

Typically required reporters include physicians, veterinarians, podiatrists, nurse practitioners/nurses/midwives, physician assistants, medical examiners/coroners, dentists, and administrators of healthcare facilities.

Question 64

According to the CDC, why is the reporting of national notifiable diseases legally and ethically mandated?

Answer 64

If a disease can be quickly transmitted to many individuals and endanger the general population and may create an epidemic - must be reported

Question 65

What types of abuse are typically mandated for reporting by healthcare professionals across most states?

Answer 65

Child abuse and elder abuse are mandated in every state, and many states also require reporting of domestic violence.

Question 66

Name the five different categories or forms that abuse can take.

Answer 66

Physical, verbal/emotional, psychological, sexual, and economic.

Question 67

Provide three potential physical or behavioral signs that might indicate child or elder abuse.

Answer 67

(Any three from the list) Previously filed reports of abuse, documented abuse of others, inconsistent stories about injuries, suspicious injuries, injuries blamed on others, repeated ED visits, bruising in specific areas, dislocations, developmental delays, erratic school attendance, poor hygiene, malnutrition, dental neglect, neglected well-baby procedures.

Question 68

List three professions or roles that are commonly mandated reporters of suspected abuse and neglect.

Answer 68

(Any three from the list) Social workers, teachers/school personnel, physicians/nurses/healthcare professionals, counselors/therapists, childcare providers, medical examiners/coroners, law enforcement officers.

Question 69

What legal protection is generally provided to individuals who report suspected abuse in good faith?

Answer 69

Anyone who reports their suspicions of abuse in good faith is typically protected from lawsuits.

Question 70

In the context of negligence, what is "Duty of Care"?

Answer 70

"Duty of Care" is OBLIGATION to act responsibly. In healthcare, this often refers to the obligation a healthcare professional has to provide a certain standard of care to their patients.

Question 71

In the context of negligence, what is "Dereliction of Duty?"?

Answer 71

"Dereliction of Duty" is FAILING to meet OBLIGATION to act responsibly

Question 72

What is the goal of the Patient's Bill of Rights?

Answer 72

To ensure the rights and responsibilities of both patients and health care providers and that patient's play a role in their own health

Question 73

According to the patient's bill of rights, which is a guarantee?

Answer 73

Patient has the right to refuse care, patient has the right to privacy while in the hospital, and patients can request to transfer to another hospital

Question 74

Why are employers not considered covered entities of HIPPA?

Answer 74

Because employee health records maintained by an employer are nor used for HIPPA-covered transactions

Question 75

Who owns the physical medical record, and why is this the case?

Answer 75

The healthcare provider or facility owns the physical medical record because it is a legal document generated by them.

Question 76

According to HIPAA, what rights do patients have regarding the information contained within their medical records, and who is authorized to access those records?

Answer 76

Patients have the right to inspect, review, and receive a copy of their medical and billing records (with few exceptions). Access is granted to the patient and any authorized representatives, such as a family member with the patient's consent.