Transcript Civil Law

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Contrast laws, morals, and ethics.
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Explain the purpose of professional codes of
ethics.
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Define the term standard of care.
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Describe informed consent.
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Discuss the importance of confidentiality and
HIPAA for healthcare professionals.
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Explain what is an advance directive.
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Compare a living will, a durable power of
attorney, and a healthcare proxy.
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Describe clients’ rights and responsibilities.
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Name the qualities of a successful healthcare
worker.
Law – a body of rules,
regulations, and legal opinions
of conduct and action that are
made by controlling authority
and are legally binding.
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Area of the law related to
violations of statutes that pertain
to public offenses or acts
committed against the public.
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A
Commission, if there is a law forbidding a certain act.
Omission, in violation of a law requiring a certain act.
healthcare provider can be
prosecuted for criminal acts such as
assault and battery, fraud, and
abuse.
Area of the law related to
violations of private rights and
remedies.
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 Examples:
Contract violation
 Slander or libel
 Product liability
 Family matters
 Automobile accidents
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Torts – a civil wrong committed
against a person or property. May
have caused physical injury,
resulted in damage to someone’s
property, or deprived someone of
his or her liberty and freedom.
 Intentional (Willful) - caused by
negligence
 Unintentional (Accidental) - acts that
were not intended to cause harm. However,
they are committed without regard for
consequences.
Unintentional Tort – acts that
are not intended to cause harm.
However they are committed
“unreasonably”, or without
regard for the consequences.
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 Negligence – an unintentional tort
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Medical Malpractice – an action taken by a
healthcare professional that injures a
patient, and fails to meet reasonable
standards of professional care.
Negligence – is charged when a
healthcare practitioner fails to
exercise ordinary or expected
care and a client is injured or
sustains damages of some sort as
a result.
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“Didn’t intend to do it”
 “ Should have known better”
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Medical practice acts are state
statutes that govern medical
practices. They do the
following:
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 Cover
requirements and methods for
licensing healthcare providers
 Establish medical licensing boards
 List ground for revoking licenses
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Common Errors in Medical
Malpractice
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Medication errors (causes injury or death in 1.5
million persons per year)
Anesthesia errors
Birth injury, including Cerebral Palsy, Erb's Palsy, and
Brain Damage
Delayed diagnosis or failed diagnosis of a medical
condition (including cancer)
Misdiagnosis (for example, heart attack misdiagnosed
as indigestion)
Improper or inadequate treatment of an illness or
disease
Surgical error
Plantiff – the person bringing
the lawsuit
Defendant – the person facing
the charges (defending the
lawsuit)
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The 3 D’s must be present for
negligence to occur:
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Duty of Care – the extent to which a healthcare
provider must reasonably ensure that no harm
comes to a patient under the provider's care
Dereliction of Duty – willful neglect; the act of
abandoning; abandonment or neglect
Damages - Harm or injury to property or a
person, resulting in loss of value or the
impairment of usefulness
Assault – intentionally
attempting or threatening to
touch a person’s body without
the person’s consent
 Battery – touching a person’s
body without his or her consent
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Invasion of Privacy – violating a
person’s right not to have his or
her name, photo, or private
affairs exposed or made public
without giving consent
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False Imprisonment – unlawful
restraint or restriction of a
person’s freedom of movement
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Abuse – the intentional
mistreatment or harm of
another person
 Defamation – injuring a person’s
name and reputation by making
false statements to a third
person/party
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Noncomplicance
 Noncompliant
healthcare workers may
face fines or prison sentences and can
lose their licenses to practice their
profession.
 Unethical conduct may result in
expulsion or censure from your
professional organization, but only the
state can revoke a license.
Privileged Communication –
refers to information that is held
private within a protected
relationship, such as that
between a physician and patient
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 Health
Care Records
 HIPAA – Privacy Act
 Authorization to release health
information
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Privileged Communication
It is illegal and unethical for a healthcare
worker not to observe confidentiality.
Privileged communication refers to information
held confidential within a protected
relationship.
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Privileged Communication
Keeping client medical information confidential
means:
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Not informing any unauthorized person about the
information contained in a patient’s medical records.
Not showing written information to an unauthorized
third party.
Taking proper precautions when communicating such
information over a computer, telephone, or fax
machine.
Written consent must be obtained before
releasing information to a third party.
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Privileged Communication
Guidelines to follow if you have access to a
patient’s information:
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Do not decide if information is confidential based on
your approval or agreement.
Do not reveal financial information about a patient.
Do not use the patient’s name or other information if
others in the room might overhear.
Use caution in giving the results of medical tests to
patients over the telephone.
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Privileged Communication
Guidelines to follow if you have access to a
patient’s information:
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Do not leave medical charts or insurance reports
where patients or others can see them.
If the patient has not given written permission to
release information, do not release it.
Do not discuss patients in public places where others
may overhear, such as the cafeteria or elevator.
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Privileged Communication
Confidentiality for patient medical records may
be waived under the following circumstances:
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When a third party requests a medical examination,
such as a pre-employment examination, and that third
party pays the patient’s bill.
When a patient sues a physician or other healthcare
practitioner for malpractice.
When the patient signs a waiver allowing the release
of information.
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Privileged Communication
Clients have the following rights under HIPAA
law:
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The right to notice of privacy practices.
The right to limit or request restriction on their PHI
and its use and disclosure.
The right to confidential communications.
The right to inspect and obtain a copy of their PHI.
The right to request an amendment to their PHI.
The right to know if their PHI has been disclosed and
why.
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Contract – an agreement
consisting of one or more legally
enforceable promises among two
or more parties such as people,
corporations, and partnerships; in
healthcare, contracts are used to
govern relationships, between
employees and employers,
insurers and the insured, or
healthcare providers and patients
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Components of a Contract
 Offer
 Acceptance
 Consideration
Implied
 Expressed
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Breach of Contract - failing to
perform any term of a contract,
written or oral, without a legitimate
legal excuse
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Morals – formed from your
personal values and reflect your
concept of right and wrong
(developed through the influence of
family, culture, and society) – acting
morally toward others involves
treating them the way you would
like to be treated
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Ethics – set of principles dealing
with right and wrong; knowledge of
what is right and wrong conduct
 Provide
a standard of conduct or
code of behavior
 Helps healthcare workers analyze
information and make decisions
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Medical Ethics – a system of
principles governing medical
conduct (ie: euthanasia, DNR, living
wills, etc.)
Frequently created by modern
medicine
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 Euthanasia
 Confidentiality
of AIDS diagnosis
 Aborted fetuses and research
 Continued life support
 Expensive treatments and
payment
 Transplant decisions
Frequently created by modern
medicine
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 Legal
issues and marijuana
 Animals and research
 Genetic research
 Cloning
 Stem cell research
Save lives and promote health
 Patient comfort
 Respect of patient’s right to die
peacefully and with dignity
 Treat all patients equally
 Provide the best care possible
 Maintain competent skills and
knowledge
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Respect rules of confidentiality
 Refrain from immoral,
unethical, and illegal practices
 Show loyalty to patients, coworkers, and employers
 Be sincere, honest, and caring
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Licensure – required for certain
professions within a state; the
granting of permission – official,
legal, or both – to perform
professional actions in various
fields such as medicine, nursing,
etc. that may not be legally
done by persons who do not
have such permission
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Registration – means a person’s
name has been listed in an
official registry or record as
having satisfied the standards
for a certain healthcare
occupation; the recording of
those who are registered or
licensed to practice within a
state
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Certification – usually voluntary
and national in scope; most
often achieved by taking an
examination – passing the exam
shows that an applicant has
attained a certain level of
knowledge and skill
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Reciprocity – a state licensing
authority will accept a person’s
valid license from another state
without requiring reexamination
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Standard of Care – the level of
performance (consistent with
minimum safe professional
conduct under specific
conditions) expected of a
healthcare professional in
carrying out his or her duties
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Scope of Practice – based upon
the job description, level of
training, and qualifications
(what a healthcare professional
can do or cannot do)
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 Perform
only those procedures for
which you have been trained and
are permitted to do
 Perform correctly
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Scope of Practice
Working outside your scope of practice can make
you liable.
Working within your scope of practice ensures
that you:
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Do not injure patients or put them at risk by
performing procedures that are beyond your ability.
Will not be held liable for a standard of care that is
beyond your training, experience, and job description
if a legal situation arises.
Identify the patient
 Obtain patient’s consent
 Observe safety precautions
 Keep all information
confidential
 Think before you speak and
watch everything you say
 Treat all patients equally
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Accept no tips or bribes for the
care you provide
 If an error occurs, report it
immediately to your supervisor
 Behave professionally in dress,
language, manners, and actions
 Always carry liability insurance
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Liable – legally responsible for
your actions
 Libel – making false statements
in print, writing, or through
pictures or drawings
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Law of Agency – an employer is
legally liable for acts performed
by employees
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 Example:
the physicians affiliated
with the medical office that hired
the medical assistant could also
be held liable in the case of a law
suit
Informed Consent – a voluntary
agreement made by a welladvised and mentally competent
patient to be treated or
randomized into a research
study (risks, benefits,
alternative, consequences, etc.)
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Informed Consent
 in
order for a client to make an
informed decision regarding
treatment, the client needs to be
told the following:
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The proposed methods of treatment.
Why the treatment is necessary.
The risks involved in the proposed treatment.
All available alternative types of treatment.
The risks of any alternative methods of treatment.
The risks involved if treatment is refused.
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Informed Consent
People who cannot give informed consent
include:
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Minors – individuals under 18 years of age (21 in some
states). Exceptions include those deemed mature
minors by the court.
Mentally incompetent individuals – persons judged by
the court to be insane, senile, mentally retarded, or
under the influence of drugs or alcohol.
Persons who do not speak English.
Agencies must have written
policies for “Patients’ Rights”
 All personnel must respect and
honor these rights
 Long-term care facilities post
“Residents’ Bill of Rights”
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The American Hospital Association’s Patient’s
Bill of Rights is followed in most states. It
guarantees the client’s right to:
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Receive considerate and respectful care.
Receive complete and current information concerning
his or her diagnosis, treatment, and prognosis.
Know the identity of physicians, nurses, and others
involved with his or her care, as well as when those
involved are students, residents, or trainees.
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Know the immediate and long-term costs of treatment
choices.
Receive information necessary to give informed
consent prior to the start of any procedure or
treatment.
Have an advance directive concerning treatment or be
able to choose a representative to make decisions.
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Refuse treatment to the extent permitted by law.
Receive every consideration of his or her privacy.
Be assured of confidentiality.
Obtain reasonable responses to requests for services.
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Obtain information about his or her healthcare and be
allowed to review his or her medical record and to
have any information explained or interpreted.
Know whether treatment is experimental and be able
to consent or decline to participate in proposed
research studies or human experimentation.
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Expect reasonable continuity of care.
Ask about and be informed of the existence of business
relationships between the hospital and others that
may influence the client’s treatment and care.
Know which hospital policies and practices relate to
client care, treatment, and responsibilities.
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Be informed of available resources for resolving
disputes, grievances, and conflicts, such as ethics
committees or patient representatives.
Examine his or her bill and have it explained and be
informed of available payment methods.
 Clients’ Responsibilities – clients are
responsible for:
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Providing information about past illnesses,
hospitalizations, medications, and other matters
related to their health status.
Participating in decision making by asking for
additional information about their health status
or treatment.
Providing healthcare agencies with a copy of
their written advance directive if they have one.
Informing physicians and other caregivers if they
anticipate problems in following a prescribed
treatment.
 Clients’
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Responsibilities (cont.)
Following a physician’s orders for treatment. The
client has the right to refuse treatment to the
extent permitted by law.
Providing healthcare agencies with necessary
information for insurance claims and working
with the healthcare facility to make
arrangements to pay fees when necessary.
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Advanced Directives – a written
document in the form of a living will or
durable power of attorney prepared by a
competent person that specifies what, if
any, extraordinary procedures, surgeries,
medications, or treatments the patient
desires in the future, when he or she can
no longer make such decisions about
medical treatment
 Healthcare
workers must be aware of
the Act (Patient Self-Determination
Act – PSDA) and honor it
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Living Will – (an advance
directive) provides instructions
directly to physicians, hospitals,
and other healthcare providers
involved in a client’s medical
treatment regarding their end-oflife care (ie: intubation, feeding
tubes, etc.)
Durable Power of Attorney
(POA) – it gives one person
the authority to make a
variety of legal decisions on
behalf of another person
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$4,000,000 Medical Malpractice – Death
 $1,700,000 Medical Malpractice – Death
 $1,000,000 Medical Malpractice – left
residual tumor (did not get clear margins)
 $900,000 Birth Injury – Fetal Death
 $900,000 Medical Malpractice – Wrongful
Death (failed to dx and respond to pt’s
complaints)
 $825,000 Medical Malpractice (surgery
error – performed surgery incorrectly)
 $825,000 OB/GYN Malpractice (did not
recognize early fetal distress)
 $775,000 Failure to Diagnose
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