Module 7: Medical Law and Ethics Flashcards
Ethics
The rules, standards, and moral principles that govern a person’s behavior and on which the person bases decisions.
Ethics are concerned with questions of how individuals in a society should act by defining right and wrong and appropriate conduct to serve the greater good.
Ethics encompasses several different facets. One aspect of morals describes how “good or bad” or how “right or wrong” an action is.
Values
An individual’s ethics, refer to one person’s moral principles or what an individual believes is right or wrong.
Values govern a person’s decisions, with a goal of maintaining one’s integrity or conscience.
An individual’s values may be influenced by concepts of honesty, fidelity, equality, compassion, responsibility, humility, and respect for life.
Personal ethics
Determines what an individual believes about morality and right and wrong.
It includes one’s personal values and moral qualities and is influenced by family, friends, culture, religion, education, and many other factors.
Personal ethics has an impact on areas of life such as family, finances, and relationships and may change during one’s life.
- Ex: to believe in the death penalty but support a woman’s right to an abortion.
Common ethics
also called group ethics, is a system of principles and rules of conduct accepted by a group based on ethnicity, political affiliation, or cultural identity.
- Ex: a person who is religious to believe all abortion and the death penalty are bad and all life should be preserved.
Professional ethics
A type of ethics that aims to define, clarify, and criticize professional work and its typical values.
Professional ethics sets the standards for practicing one’s profession and can be learned only through education or training or on the job. It involves attributes such as commitment, competence, confidence, and contract.
Professional ethics is often used to impose rules and standards on employees in an organization or members of a profession.
- Ex: employee handbooks, codes of ethics, and the Hippocratic Oath taken by physicians.
Medical law
Laws that explain the rights and responsibilities of medical providers and patients.
Patient’s Bill of Rights
The American Hospital Association (AHA) created the original Patient’s Bill of Rights in 1973, which provides guidelines and guarantees by federal law to ensure the protection and safety of patients.
The primary purposes of the Patient’s Bill of Rights are to help patients feel more confident in the health care system, to strengthen the relationship between patients and their health care provider by defining their rights and responsibilities and those of their health care provider, and to emphasize the role patients play in their health.
The Patient’s Bill of Rights outlines 15 guarantees for all patients seeking medical care in a health care organization and basic rights and responsibilities for effective patient care.
Patient’s Bill of Rights 15 guarantees
- The patient has the right to be treated fairly and respectfully.
- The patient has the right to get information they can understand about their diagnosis, treatment, and prognosis from their health care provider.
- The patient has the right to discuss and ask for information about specific procedures and treatments, their risks, and the time they will spend recovering. They also have the right to discuss other care options.
- The patient has the right to know the identities of all their health care providers, including students, residents, and other trainees.
- The patient has the right to know how much care may cost at the time of treatment and long term.
- The patient has the right to make decisions about their care before and during treatment and the right to refuse care. The hospital must inform the patient of the medical consequences of refusing treatment. The patient has the right to other treatments provided by the hospital and the right to transfer to another hospital.
- The patient has the right to have an advance directive, such as a living will or a power of attorney for health care. A hospital has the right to ask for their advance directive, put it in their file, and honor its intent.
- The patient has the right to privacy in medical exams, case discussions, consultations, and treatments.
- The patient has the right to expect that their communication and records are treated as confidential by the hospital, except as the law permits and requires in cases of suspected abuse or public health hazards. If the hospital releases their information to another medical facility, they have the right to expect the hospital to ask the medical facility to keep their records confidential.
- The patient has the right to review their medical records and to have them explained or interpreted, except when restricted by law.
- The patient has the right to expect that a hospital will respond reasonably to their requests for care and services or transfer them to another facility that has accepted a transfer request. They should also expect information and explanation about the risks, benefits, and alternatives to a transfer.
- The patient has the right to ask and to be informed of any business relationships between the hospital and educational institutions, other health care providers, or payers that may influence their care and treatment.
- The patient has the right to consent to or decline to participate in research studies and to have the studies fully explained before they give their consent. If they decide not to participate in research, they are still entitled to the most effective care that the hospital can provide.
- The patient has the right to expect reasonable continuity of care and to be informed of other care options when hospital care is no longer appropriate.
- The patient has the right to be informed of hospital policies and practices related to patient care, treatment, and responsibilities.
- The patient has the right to know whom they can contact to resolve disputes, grievances, and conflicts. And they have the right to know what the hospital will charge for services and their payment methods.
Patient Protection and Affordable Care Act
Commonly called the Affordable Care Act (ACA) or “Obamacare,” named after former president Barack Obama, who signed it into law in 2010, this federal statute was a major step in health care reform by expanding access to more affordable, quality health insurance, increasing consumer insurance protection, emphasizing prevention and wellness, and curbing rising health care costs.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.
HIPAA gives patients rights over their health information and sets rules and limits on who can look at and receive patients’ private information. HIPAA applies to protected health information (PHI), whether electronic, written, or oral.
Health Information Technology for Economic and Clinical Health (HITECH) Act
The HITECH Act expands on HIPAA and includes provisions that allow for increased enforcement of the privacy and security of electronic transmission of patient information, such as prohibiting the sale of PHI, making business associates and vendors liable for compliance with HIPAA, and creating a penalty and violation system.
Occupational Safety and Health (OSH) Act
The OSH Act is overseen by the Occupational Safety and Health Administration (OSHA) and states that employers are accountable for providing a safe and healthful workplace for employees by setting and enforcing standards and by providing training, outreach, education, and assistance.
This includes employers providing proper equipment and training on disposing of needles and precautions on needlestick injuries.
Controlled Substances Act (CSA)
CSA is a federal policy that regulates the manufacture and distribution of controlled substances. Controlled substances can include narcotics, depressants, and stimulants.
The CSA classifies medications into five schedules, or classifications, based on the likelihood for abuse and if there are any medical benefits provided from the substance.
The Emergency Medical Treatment and Active Labor Act (EMTALA)
The EMTALA of 1986 requires any hospital emergency department that receives payments from federal health care programs, such as Medicare and Medicaid, to provide an appropriate medical screening to any patient seeking treatment.
This was enacted to eliminate “patient dumping,” where a facility would transfer a patient based on a potentially high-cost diagnosis or refuse to treat a patient based on their ability to pay.
This legislation requires the emergency department to determine whether a condition is emergent or not and to provide stabilizing treatment in the case of an emergency medical condition.
It does not require that treatment be given for nonemergency conditions. Furthermore, outpatient clinics are not medically equipped to handle emergencies and therefore are not bound by the EMTALA.
The Clinical Laboratory Improvement Act (CLIA)
The CLIA of 1988 is a group of laws that regulate all laboratory facilities for safety, handling, and testing of specimens in the United States.
The objective of CLIA is to regulate accuracy and timeliness of testing regardless of where the test is performed. The Food and Drug Administration (FDA) is the federal agency that authorizes and implements the CLIA laws and determines the test complexity categories.
Title VII of Civil Rights Act of 1964
The Civil Rights Act prohibits an employer with 15 or more employees from discriminating on the basis of race, national origin, gender, or religion.
Sexual harassment is a form of sex discrimination that also violates the Civil Rights Act.
The Civil Rights Act has also been amended several times to protect other groups.
- For example, the Pregnancy Discrimination Act of 1978 amended the Civil Rights Act and prohibited discrimination based on pregnancy and other related medical conditions.
Americans with Disabilities Act of 1990 (ADA)
ADA forbids discrimination against any applicant or employee who could perform a job regardless of a disability.
ADA also requires an employer to provide “reasonable accommodations” that are necessary to help the employee perform a job successfully unless these accommodations are unduly burdensome.
Heads of the European Radiological Protection Competent Authorities (HERCA)
An association which identifies radiation protection issues and proposes possible solutions.
Good Samaritan Acts
Law that allows bystanders to get involved in emergency situations without fear that they will be sued if their actions inadvertently contribute to a person’s injury or death.
Genetic Information Nondiscrimination Act of 2008 (GINA)
Law that prohibits discrimination on the basis of genetic information with respect to health insurance and employment.
Patient Safety and Quality Improvement Act (PSQIA)
Framework for gathering and analyzing information regarding patient safety within the confines of protected health information laws.
Anti-Kick Back Statute (AKBS)
Criminal law that prohibits receiving benefits for referral or business involving federal health care programs.
No Surprise Act (NSA)
Law that protects individuals from surprise billing if they have a group health plan or individual health insurance coverage.
This includes banning surprise bills for emergency services from an out-of-network provider or facility without prior authorization.
HIPAA Security Rule
Requires implementing reasonable and suitable safeguards to protect protected health information and to prevent breaches of confidentiality.
There are 3 safeguards set in place that medical facilities use to keep patient information private:
- Administrative safeguards
- Physical safeguards
- Technical safeguards
Administrative safeguards
Used to refer to the policies and procedures documented in writing that show how covered entities comply with HIPAA.
Ex:
- Performing internal audits
- Appointing a security officer
Physical safeguards
Refer to the physical monitoring and access to PHI.
Ex:
- Implementing a “double lock system” (using a locked room and a locked file cabinet)
- Keeping workstations with patient information out of high-traffic areas
Technical safeguards
Refer to the responsibility of the health care provider to monitor and safeguard patient information through all technology-related items.
Ex:
- data encryption system for patient information
- installing firewalls in the facility’s computer system connected to the internet
Patient data ownership
The medical provider or the facility owns the actual medical record, but the patient owns the information, or data, found within the record.
Medical records are legal documents generated by the health care provider or facility. Because medical records are legal documents, patients’ medical records must remain with the health care facility, and the health care provider is the owner of the medical records.
However, the information that is in the medical record belongs to patients, allowing them the right to inspect, review, and receive a copy of their medical records and billing records that are held by health plans and health care providers.
