Terminology Flashcards
Bioethics
The study of ethical implication in biological medicine
Code of Ethics
Set of standards created to govern their members
Common Sense
Practical judgment
Compassion
Empathy, Understanding to the patient’s POV
Courtesy
Good manners
Qualities of a Successful Health Care Practitioner
Courtesy Compassion Common Sense People Skills Technical Skills Critical Thinking
Ethics
Set of moral values
Ethics Committee
Committee convened to assess and advise over ethical dilemmas; they do not make decisions.
Etiquette
Good manners; particularly used in patient care
Fraud
Misrepresentation
Hippocratic Oath
Pledge made by physicians
Law
Rules meant to protect the public; rules of conduct
Liable
Responsible
Moral Values
Values of right and wrong learned from family, church, environment, etc.
Plaintiff
Person bringing charges in a lawsuit
Precedent
Previous ruling made by a court that is treated as law without legislation being enacted.
Protocol
Rules of etiquette created by employer
Summary Judgment
Motion granted by court that asserts there is no basis for trial
Autonomy
Patient’s ability to make decisions for themselves
Beneficence
Promote well-being
Non-Maleficence
To “do no harm”
Veracity
Truth telling
Justice
What is due an individual
Confidentiality
Keeping patient information private
Role Fidelity
Operating only within the limitations of your capabilities
Categorical Imperative
Emmanuel Kant. The right action is one based on a determined principle, regardless of the outcome.
Deontological (Duty) Theory
Morality is based on the intent of the act, not the end result
Teleological (Consequence-Oriented) Theory
Morality is based on the outcome of the decision
Virtue Ethics Theory
The decision made is moral because the person is moral/virtuous
Needs-Based Motivation
Human behavior is based on specific needs.
Maslow/Piaget/Kohlberg
Maslow: Needs must be met in a specific order (pyramid)
Piaget: 4 stages of moral development
Kohlberg: Expanded on Piaget’s theory by adding that stages may take more time; 6 Stages in 3 Levels
Principle of Utility
(Utilitarianism) Says the rule used must benefit the majority when applied to a generalized to a wide variety of situations
Accreditation
Approval for conforming to a standard
Certification
Voluntary credentialing process where applicants meet certain requirements
Registration
Adding your name to a list
Licensure
Involuntary credentialing process where applicants have received mandatory schooling and passed necessary exams
Associate Practice
Two or more physicians share expenses but operate independently
Corporation
Legally recognized single entity. Minimized risk and cost-sharing for expenses such as liability insurance
Group Practice
Three or more physicians that split all costs. Can operate as partnership or corporation.
Telemedicine
The interaction of doctors and patients through technology
Cybermedicine
Direct contact between patients and doctors over the internet
E-Health
Term for the internet being a source of consumer information about health and medicine
Patient Protection and Affordable Care Act (PPACA)
2010 Federal law enacted to expand health insurance coverage and regulate the health insurance agency
Health Care and Education Reconciliation Act (HCERA)
2010 Federal law that added to regulations imposed on the insurance industry by PPACA
Health Insurance Portability and Accountability Act (HIPAA) of 1996
Federal statute that helps workers keep continuous health coverage when changing jobs, protects confidential medical information from unauthorized disclosure or use, and helps to improve the efficiency and effectiveness of the health care industry.
Led to the creation of the Healthcare Integrity and Protection Data Bank (HIPDB)
Health Care Quality Improvement Act (HCQIA) of 1986
Federal statute passed to improve the quality of medical care nationwide. Established the National Practitioner Data Bank.
Healthcare Integrity and Protection Data Bank (HIPDB)
Established by HIPAA. National health care fraud and abuse data collection program. Handles reporting and disclosure of certain adverse actions taken against health care providers, suppliers, or practioners.
National Practitioner Data Bank (NPDB)
Established by the HCQIA. Contains any adverse information about health care practitioners such as medical malpractice payments, licensure actions, clinical privilege actions, and professional society membership actions
Federal False Claims Act
Law that allows individuals to bring civil actions on behalf of the US government for false claims made to the government. “Whistle blower”
Reciprocity
One state accepts a professional license from another state by prior agreement without reexamination
Endorsement
Professional license may be awarded based on an individual’s credentials and whether those credentials meet licensing requirements in the new state
Medical Practice Acts
State laws written to govern the practice of medicine
Medical Boards
Bodies (group) established for the purpose of protecting the health, safety, and welfare of health care consumers through the proper licensing and regulation of physicians and other health care practitioners
Managed Care
The delivery of health care (and all that entails) to subscribers for a prepaid fee.
Indemnity
Form of health insurance that covers the insured against the potential loss of money from medical expenses resulting from an illness or accident
Health Maintenance Organization (HMO)
A health plan that combines coverage of health care costs and the delivery of health care for a prepaid premium. All health services are delivered and paid for through one organization.
Individual Practice Association (IPA)
A type of HMO that contracts with groups of private practice physicians who receive a per-member payment from participating HMOs
Preferred Provider Organization (PPO)
A network of various health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer’s plan.
Gatekeeper Physician
The primary care physician who directs the medical care of managed care health plan members
Primary Care Physician (PCP)
The physician responsible for directing all of a patient’s medical care and determining whether the patient should be referred for specialty care
Point-of-Service Plan (POS)
Plan that allows members to go out of network, but pays the highest benefits for care given by PCP or referral of PCP
Open Access Plan
Feature of managed care where subscribers can see any in-network provider without referral
Executive Order
Rule or regulation issued by the president that becomes law without the prior approval of Congress
Checks and Balances
Keeps any one branch of government from assuming too much power over the other branches
Constitutional Law
Law that derives from federal and state constitutions
Case Law
Law established through common law and legal precedent
Common Law
Laws derived from English laws that were not written down; were based on the customs and traditions of the people
Statutory Law
Law passed by Congress or state legislatures
Administrative Law
Those statutes enacted to define specific powers and procedures when agencies are created
Substantive Law
Statutory or written law that defines and regulates legal rights and obligations; defines legal relationships between parties
Procedural Law
Law that defines the rules used to enforce substantive law
Criminal Law
Law that involves crimes against the state
Felony
Offense punishable by death or by imprisonment in a state or federal prison for more than one year
Misdemeanor
A crime punishable by fine or by imprisonment in a facility other than a prison for less than one year
Civil Law
Law that involves wrongful acts against persons
Tort
A civil wrong committed against a person or property; excluding breach of contract
Tortfeasor
Person guilty of committing a tort
Negligence
Unintentional tort alleged when one performed or failed to perform an act that a reasonable person would or would not have done in similar circumstances
Jurisdiction
The power of a court to hear and decide a case before it
Plaintiff
The person bringing charges in a civil lawsuit
Prosecution
The government as a plaintiff in a criminal case
Defendant
Person/party against whom charges are brought in a criminal or civil lawsuit
Contract
Voluntary agreement between two parties in which specific promises are made for a consideration
Void
Without legal force or effect
Breach of contract
Failure of either party to comply with the terms of a legally valid contract
Mentally Incompetent
Unable to fully understand all the terms and conditions of a transaction, and therefore unable to enter into a legal contract
Voidable
Able to be set aside or to be re-validated at a later date
Expressed Contract
A written/oral agreement in which all terms are explicitly stated
Implied Contract
An unwritten/unspoken agreement whose terms result from the actions of the parties involved
Statute of Frauds
State legislation governing written contracts
Third-Party Payer Contract
A written agreement signed by a party other than the patient who promises to pay the patient’s bill
Fair Debt Collection Practices Act (FDCPA)
Federal Statute prohibiting certain unfair and illegal practices by debt collectors and creditors
Law of Agency
Employers are liable for the actions of their employees when employees perform said actions as part of their work under the supervision of the employer
Agent
One who acts for or represents another (employee)
Respondeat Superior
Employer is legally liable for the acts of his or her employees, if such acts were performed within the scope of the employees’ duties
Liable
Legally responsible or obligated
Standard of Care
Level of performance expected of a health care practitioner in carrying out his/her professional duties
Duty of Care
Legal obligation of health care worker to patients and nonpatients
Reasonable Person Standard
That standard of behavior that judges a person’s actions in a situation according to what a reasonable person would or would not do under similar circumstances
Confidentiality
The act of holding information in confidence, not to be released to unauthorized individuals
Privileged Communication
Information held confidential within a protected relationship
Malfeasance
The performance of a totally wrongful and unlawful act
Misfeasance
The performance of a lawful act in an illegal or improper manner
Nonfeasance
The failure to act when one should
Res Ipsa Loquitur
“The thing speaks for itself”, also known as the doctrine of common knowledge. A situation that is so obviously negligent that no expert witnesses need be called.
Damages
Monetary awards sought by plaintiffs in lawsuits
Wrongful Death Statutes
State statutes that allow a person’s beneficiaries to collect for loss to the estate of the deceased for future earnings when a death is judged to have been due to negligence
Summons
A written notification issued by the clerk of the court and delivered with a copy of the complaint to the defendant in a lawsuit, directing him or her to respond to the charges brought in a court of law
Subpoena
A legal document requiring the recipient to appear as a witness in court or to give a deposition
Deposition
Sworn testimony given and recorded outside the courtroom during the pretrial phase of a case
Interrogatory
A written set of questions requiring answers from a plaintiff or defendant under oath
Subpoena Duces Tecum
A legal document requiring the recipient to bring certain written records to court to be used as evidence in a lawsuit
Testimony
Statements sworn to under oath by witnesses testifying in court and giving depositions
Alternative Dispute Resolution
Settlement of civil disputes between parties using neutral mediators or arbitrators without going to court
Denial
A defense that claims innocence of the charges or that one or more of the four Ds of negligence are lacking
Affirmative Defenses
Defenses by defendants in medical professional liability suits that allow them to present factual evidence that the patient’s condition was caused by some factor other than the defendant’s negligence
Contributory Negligence
An affirmative defense that alleges that the plaintiff, through a lack of care, caused or contributed to his or her own injury