Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc....

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Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Medical Law and Ethics

Importance of the Legal System for the Physician

Chapter 3

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Medical Practice Acts

•Establish examining boards

•Provide baseline for practice of medicine

•Determine prerequisites for licensure

•Forbid practice of medicine without a license

•Specify conditions for renewal, suspension, and revocation of licenses

•Vary from state to state

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Licensure of Physician

•Examination– National Board Medical Examination (NBME)– Federal Licensing Examination (FLEX)– U.S. Medical Licensing Examination (USMLE)

•Endorsement•Reciprocity •Registration

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

When Valid License Is Not Needed by a Physician

•When employed by federal medical facilities (but must be a licensed physician)

• In an emergency

•While establishing residency

•When engaged solely in research

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Revocation and Suspension

•Unprofessional conduct: falsifying records, gross immorality

•Commission of a crime: Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction

•Personal incapacity: physical or mental incapacity

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Licensure and Certification of Allied Health Professionals

•Licensure: graduate from accredited school and pass national exam of competency

•Certification: meet standards set by accreditation body and pass national exam of competency

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Accreditation•Voluntary request of official review by

accrediting agency•Examine policy and procedures of agency•Must demonstrate that the institution maintains

high standards•Examples: JCAHO and CAAHEP

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Standard of Care

•Ordinary skill and care that must be used by medical practitioners

•Must provide same knowledge, care, and skill that similarly trained physician would provide under same circumstances

•Perform as “reasonable and prudent” person would perform

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Prudent Person Rule

•Must provide following information to patient:– Diagnosis– Risk and consequences of treatment– Expected benefits of treatment or procedure– Alternative treatments– Prognosis if no treatment– Cost and expected pain– Follow acceptable standard of care

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Confidentiality

•Keeping private all information about patient

•No disclosure without written consent

•Medical Patient Rights Act: gives all patients right to have privacy respected and records held confidential

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Statute of Limitations

•Period of time patient has to file lawsuit

•Usually one to three years

•Discovery Rule: begins when problem discovered

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Good Samaritan Laws

•State laws help protect health care professionals and ordinary citizens from liability while giving care in emergency

•No one is required to provide aid•Only required to act within limits of acquired

skill and training •Once you start you must continue until help

arrives or you physically cannot continue

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Respondeat Superior

• “Let the master answer”

•Employer liable for acts of employee within scope of employment

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Figure 3.1An Accident Victim Receiving Emergency Care

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Figure 3.2Physician Working with the Rest of the Healthcare Team (Jose

Pelaez/Corbis/Stock Market)

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Employee’s Duty to Carry Out Orders

•Duty to interpret and carry out orders

•Duty to clarify ambiguous or erroneous orders

•Duty to decline orders that appear dangerous for patient and to notify physician

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Scope of Practice

•Must understand and work within scope of practice for discipline

•Must understand and practice within guidelines of profession

•Must understand and follow chain of command so no employee makes decision he or she is unqualified to make

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Employer’s Duty to Employees

•Responsibility to provide safe environment for employees and staff

•Most have liability insurance to cover accidents and unforeseen incidents

•May bond employees who handle money

•Some have liability insurance for auto if used for work-related business

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Risk Management

•A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer– Identify risk behaviors and practices– Develop and follow plan of action to eliminate

problem behavior– Address corrective actions in policy and procedure

books and employee handbooks