Psychiatry & Legal Medicine Flashcards
A patient presents to the ED complaining of nausea, but only speaks Turkish. The patient’s child advises they will serve as an interpreter so you can provide care. How should the physician respond?
A third-party interpreter should be obtained. In cases when the patient is coherent, you should communicate directly with them. Never use a family member.
What are the two rules of HIPPA?
Privacy & Security Rules
Seclusion is generally utilized to prevent what type of harm?
Harm to others by a patient
This rule applies to all forms of health information (electronic and paper), requiring appropriate safeguards to protect health information and providing patients with the right to view and obtain their medical records.
Privacy Rule of HIPPA
What criteria must be proven to win a malpractice suit?
Duty (doctor-patient relationship), deviation from standard of care, damages (injury or harm), direct causation
According to this practice, the physician is in the highest place of the hierarchy and is legally responsible for all those under their supervision (PA, Nurse, MA, etc.).
Respondent superior
You are seeing a patient who is HIV positive. The patient shared they have been having unprotected sex with numerous partners and did not share their status with them. What is the most appropriate action for the physician to take to protect the patient’s confidentiality and the partners’ safety?
The physician should notify the CDC/Health Department and share the information. The appropriate health agency will follow up with the patient and partners.
While physicians are ethically permitted to break confidentiality and notify partners, they are not legally permitted to break confidentiality.
True/False. The duty to notify and protect an individual from patient harm supersedes the patient’s right to the provision of the least restrictive care.
False. Even in these instances, the least restrictive care plan should always be used.
How does capacity differ from competence?
Capacity is determined by a physician and assesses whether a patient can make a specific decision at a specific point in time.
Competence is determined by a judge and refers to the minimum ability to perform a specific act.
Restraints and seclusion are only to be used to protect the safety of patients and staff. What practices are in place to prevent abuse of this policy?
A written order must be obtained by a physician and is time limited so that the patient’s condition is regularly reviewed and documented
What exceptions override a patient’s ability to refuse a medication?
Court petition and personal safety emergencies
What is the Tarasoff Doctrine?
A law that gives physicians with a duty to warn and protect intended victims of harm, when that information is shared by a patient with a physician
True/False. HIPPA is a federal law passed in 1996. Under the law, individual states may pass more restrictive laws to protect health information.
True - many have
HIPPA requires prior authorization to release an individual’s health information. What are the exceptions to this?
Healthcare operations and treatment billing (billing of care to insurance companies)
True/False. HIPPA’s security rule protects both electronic and paper medical records.
False. The security rule protects only electronic health records.
