Medical Law And Ethics Flashcards
Legislative
Congress
-passes law
Executive
Administers law
Judicial
Interprets and enforces law
Criminal
Crime committed against society, individual or property
- government prosecutes the defendant
- if defendant found guilty
- results in imprisonments or fine
Civil
- tort or contract
- concern dispute or alleged wrong committed against individual or property by individual or organizations
- individual or group prosecutes
- if defendant is guilty
- result in monetary compensation
Tort
Accidental or intentional wrongful act by someone against another or property
Negligence
- Failure to perform professional duties prudently
- according to accepted standard of care
- most common tort
Nonfeasance
Form of negligence
- failure to act when duty is indicated
- result in injury of another
Misfeasance
Form of negligence
- improper performance of an act
- result in injury of another
Malfeasance
Form of negligence
- committing an improper (illegal) act
- result in injury of another
Malpractice
Form of negligence
-professional misconduct, lack of skill, wrongful practice
Res ipsa loquitur
- the thing speaks for itself
- negligence is obvious
- the event could not have occurred without negligence
Respondeat superior
- let the master answer
- the provider may not be directly responsible but is responsible for negligence of employee
Duty
First D of malpractice
-the provider and patient relationship was established
Dereliction
Second D of malpractice
-provider neglected a professional obligation to act or acted improperly
Direct cause
Third D of malpractice
-negative outcome is direct result from provider action or failure to act
Damage
Forth D of malpractice
- a negative act resulted in the patient sustaining harm
Contract
Voluntary agreement between 2 parties that create enforceable obligations and rights
Express contract
Agreement between 2 parties that details responsibility of both parties
- written or oral
- if written: both parties must sign
Implied contract
Most common between provider and patient
- not written
- provider treats within the scope of practice
Quid pro quo
Something for something
-service render for payment
Consent
Agreement between legally capable parties
- legal intent is made
- offer made and accepted
- transaction is made
Consenter
- Can be a competent adult
- emancipated minor
- minor of armed forces
- minor parent with custody
- minor seeking sexually related treatment
Informed consent
-patient right to know before agreeing to treatment, procedures and care
-disclose risk, benefits of receiving or not receiving treatment
- as well as alternative
AMA suggest obtaining beginning age 15
Uninformed consent
Patient gives permission without full understanding
Advance directive
- Document state patient wishes, in case they become incapable of making competent decisions
- signed and witnessed
Living will
Documents of patient wish not to have certain life sustaining measure taken when prognosis is immenant death
Durable power of attorney (healthcare)
Document allowing a designated person to act on behalf of patient to determine use of heroic or extraordinary measure
Do not resuscitate
Order originating from pastas a directive to the healthcare provider to withhold cardiopulmonary resuscitation if they experience cardiac or respiratory arrest
Occupational safety and health administration
Division of us department of labor
-jurisdiction over and administer federal law regulating safety in workplace
In medical field, blood borne pathogen, needle stick safety precautions
Bloodborne pathogen standards
Protocol to protect from hepatitis B/C and HIV
Effective 1991
Needle stick safety and prevention act
Promote use of safer needles
- identifies / documents device to ensure safety
- new equipment monitoring
- effective 2003
Hazard communication standards
- Site must have hazard plans for accidental exposure
- manufacturers / chemical importers must provide material safety data sheet information and container labels
Centers for Medicare and Medicaid services
Division U.S. Department of Health and Human services
-regulated agency for Clinical Laboratory Improvement Amendments
—HHS develop federal regulations 1988 set standard for quality assurance performed in labs and accuracy in United States
Office of clinical standards and quality
Responsible of implementing and monitoring lab compliance with CLIA regulations
Food and Drug Administration
Responsible of determining CLIA categories of lab test
Waived lab test
Simple, easy to perform procedure with low risk of unreliable test results
-physician office laboratory hold a certificate of waiver must adhere to good laboratory practice
—include quality control, specimen handling, performance and test results
Moderate-complexity lab test
Most performed by outside labs
-microscopic exam of urine sediment, blood and urine cultures, some blood chemistry studies
High-complexity lab test
Procedure related to cytology, histopathology, cytogenetic or histocompatibility
Internal revenue services
Regulates payroll taxes
Drug enforcement administration
Regulates provider registration and all handling of control substance in office
Abandonment
- Ceasing to care for or attend to patient, when needs care
- if physician withdraws from contract relationship while patient needs treatment
Accreditation
Formal recognition that facility meets predetermined standards
- for policy, practice, performance and procedures
- outside agency grants after on-site evaluation and survey, self study survey by facility
Affidavit
Verbal or written voluntary statement sworn to be true under oath
Appellant
Party appealing decision of lower court to jurisdiction to of higher court
Arbitration
Dispute between parties, settled by judgement of uninvolved third party, mutually selected by disputing party
Assalt
Threat made with capability of doing physical harm
Battery
Non consensual touching of person, without legally justifiable reason
Considered harmful / offensive
Intentional tort
Common law
Traditional law based on earlier case
- decision made by judges (court)
- take into account case specific information
Confidentiality
Expectation of when entrusting an individual with private information
- it will remain private between 2 involved parties
- information gain as result of patient-physician relationship
Defamation
False, malicious communication to third party, to damage person reputation
- libel, slander
Defendant
Party against whom action being brought
Emancipated minor
Person less than 18 years is responsible for their own debt
Guardian
Individual assigned by courts to protect and make decisions on behalf of individual not capable of making competent decision
In loco parentis
Status of person assigned by court system represent parents in legal right, responsibilities and duties toward child
Liability
Refers to damage results from negligent act which someone is directly responsible
Libel
Deliberately defamatory written communcation
Medical record
Document containing administrative and clinical information of patient seen within medical practice
-hard copy or digital
Moral
Concerned with ideas about Right and wrong
Plaintiff
Party bringing the suit or claim to court
Protected health information
Patient identifiable health information may be transmitted or maintained by electronic or other media
Privacy rule
Protect PHI transferred, held or transited by covered entity
Public law
Law regulating public at large
Rights and responsibilities of government to citizens and vice versa
Res judicata
Principal meaning once a case is resolved on merits, cannot be tried again on basis of same evidence
Slander
Defamatory verbal communication
Standard of care
Care given by sound and rational person in same situation
Measure against which defendant conduct is compared
Stare decisis
Let the decision stand
Adherence to precedents made in cases have already been decided
Statue of limitations
Time limit starting legal action after wrongful act, injury, breech of contract occurs
- varies state by state
- date contracted cease to exist
- date of wrongful act
- date of physician terminated treatment
- date injury discovered
- date of discovery of injury should have been made
Subpoena duces tectum
Commands individual to appear in court with patient medical record or other pertinent documents
Liscensed
Are granted by individual states on meeting requirements practice legally within scope of practice
-must pass the licensing exam and pay a fee
Licensed medical practitioners
- medical doctors
- doctor of osteopathy
- registered nurse
- license practical nurse
- licensed vocational nurse
Reciprocity
License to practice granted when one state recognizes and accepts another states licensing prodedure
License revocation or suspension
- convicted of crime
- guilty or unprofessional conduct
- incapable professionally or personally
Certified
Granted by professional organizations on meeting its requirements
- must pass credential exam
- pay certification fee
Credentialed professions
- CMA: by AAMA
- RMA: AMT
- NCMA: NCCT
- CMAS: AMT
- NCMOA: NCCT
- medical laboratory technician:
- medical technologist
- certified medical transcriptionist
- certified coding associates
- certified coding specialist
Licensed / certified
Some states regulations require a license, certification or both
- nurse practitioner
- physicians assistant
Registration
- individual registered with field professional organization
- to remain registered, the credentialed individual must earn continuing education unit, pay a fee to accrediting agency each year
Solo practice
One medical practitioner owns practice
-makes all decisions, retain all profits, cost and liabilities
Partnership
Two medical practitioner owns practice through written agreement
-share cost, liabilities, profits, decision making
Group practice
3 or more practitioner share cost, profits, decision
Professional service corporation
Organization comprises various professionals
-benefits include profit sharing and pensions, individual liability , state law regulation
Americans with disabilities act
Prohibit discrimination (15 more employees) in employment practices, hiring, fringe benefits, leaves and termination
Child abuse prevention and treatment act
State mandates all professionally trained personnel working with children to report suspected child abuse or neglect
Civil rights act
Governs all form of discrimination among employees, supervisor and employers
CLIA
Quality and complexity level regulations for hospital, private, and physician office lab
Controlled substance act
Controls prescribing, dispensing, and administration of narcotic, stimulant, and other dangerous drug can be abused
-managed by DEA
Employee retirement income security act
Protect and regulates employee pension
Equal credit opportunity act
Ensures all patient offer extended credit
-denial must be based on inability to pay rationale
Equal employment opportunity act
Prohibit inquiry on job applications of race, color, sex, religion, national origin, medical records, arrest records and past substance abuse
Fair credit billing act
Establish time limit in billing complaints
- 60 days to complain
- medical facility 90 days to respond
Fair debt collection practice act
- Regulates debt collection process
- eliminates unfair practice
Fair labor standards act
Regulates employees wages, pay records, overtime pay and child labor
Family and medical leave act
Allow leave without position loss up to 12 weeks in sites and employs more than 50 people
- birth, adoption,ill family member, own illness
- applies if employed for 1 year
Wage garnishment law
Require an employer to withhold earnings of individual for court order payment of debt
-law sets dollar limit can be attached to person wage or property
Freedom of information act
Law allowing full or partial disclosure of previous unreleased information
-document controlled by US government
—defines agency records subject to disclosure
—outlines mandatory disclosures
—grant 9 exemption to statue
Good Samaritan law
Protect individual stopping to give aid in emergency situations outside of employment
-protect care provider from civil lawsuit
Health insurance portability and accountability act
Provide national guidelines for health care privacy protection
-employee must be trained in HIPAA law in policies and procedures
Title I: health care protability
Protects insurance coverage for employees changing jobs, have same plan and coverage, limits use of exclusion for preexisting condition
Title II: administrative simplification
Address fraud and abuse prevention, medical liability reform, privacy of health information
Medical practice act
States statue governs the practice of medicine
Occupational safety and health act
Regulates employee safety from known hazards causing death or injury
Patients bill of rights
American hospital association statement guaranteeing patient certain rights
Patient self determination act
Requires written information regarding rights, medical decision making and execution of advance directives
Truth in lending act
Regulation Z
- signed agreement for full debt payment in more than 4 payments
- stipulates applied or non applied finance charge
Uniform anatomical gift act
Living individual do sound mind, more than 18 years old, may donate all or part of body after death
- physicians who determine time of death, cannot remove or transplant, or use body parts for research
- physicians cannot be sued for accepting body parts, if done in good faith and proper documentation
Medical ethics
Moral conduct of people in medical profession
- everyone has code of ethics
- contribute to well being of community
- responsibility to society, medical professional must remain current in knowledge and skills
