Medical Law and Ethics Lesson 3: Documentation and Regulations.
Medical Law and Ethics
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Transcript of Medical Law and Ethics
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
Public Duties of the Physician
Chapter 7
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Public Health Recordsand Vital Statistics
•Vital events in person’s life
•Used by government to determine population trends and needs
•Public duty of physicians to report vital events
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Births
•Physician must sign certificate of live birth
•Certificate is filed at county clerk’s office in state birth took place
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 7.1Sample of a Birth Certificate
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Figure 7.1Sample of a Birth Certificate (continued)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 7.1Sample of a Birth Certificate (continued)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 7.1Sample of a Birth Certificate (continued)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
•Date and time of death
•Cause of death
•How long deceased was treated before dying
•Presence or absence of pregnancy
•Whether autopsy took place
Deaths
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Deaths (continued)•Coroner: public health officer holds inquest if
death from unknown or violent cause
•Medical examiner: physician who investigates unexplained deaths and can perform autopsy
•Autopsy: examination after death to determine cause of death
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Examiner Cases
• Legal investigation by medical examiner or coroner in case of suspicious death
• Investigation is required if death is:– Violent in nature (homicide, suicide, accident)– Caused by criminal abortion– Related to contagious or virulent disease– Of a person confined to jail or correctional institution– Result of unexplained or unexpected cause– Caused by electrical, radiation, or chemical injury
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Examiner Cases (continued)
• Legal investigation by medical examiner or coroner in case of suspicious death.
• Investigation is required if death is:– Of a person who had no physician in attendance
within 36 hours of death– Of a person whose body is not claimed by friend or
relative– Of a child under age of two if death is from unknown
cause– Of a person of unknown identity
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Communicable Diseases
•Diseases transmitted from one person to another—considered threat to public
•Reportable diseases
•National Childhood Vaccine Injury Act
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Duty to Report AIDS, HIV,and ARC Cases
•All states require reports of these cases to local or state department of health
•Who shall report the case varies from state to state (attending physician, laboratory, etc.)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Child Abuse
•All abuse must be reported by teachers, health professionals, law enforcement and day care personnel, and social service workers
•Physicians have been held liable for not reporting cases
•Person reporting is protected by law from being sued by parents and others
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 7.2A Young Child Explains Her Injury to a Physician
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Elder Abuse
•Older American Act (1987)
• Includes physical abuse, neglect, exploitation, abandonment, and financial abuse of adults 60 and older
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Spousal Abuse
• Laws governing the reporting vary by state
• Local police may have to become involved when spousal abuse is suspected
•Court may issue restraining or protective order prohibiting abuser from contact with victim
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Signs of Abuse•Signs of inadequate
nutrition•Venereal disease
and genital abrasions•Makeup to hide
bruises•Sunglasses worn
inside to hide blackened eyes
•Repeated injuries•Bruises and
unexplained swelling•Unexplained
fractures•Bite marks•Unusual marks•Bruising or swelling
in genital area
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Substance Abuse
•Abuse of prescription drugs is reportable immediately according to law
•Violation of controlled substances laws is a criminal offense
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Gathering Evidence in Cases of Abuse
•Precise documentation of all injuries, bruises, and suspicious genital fluid deposits in children is critical
•Court may subpoena records at later date
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Gathering Evidence in Cases of Abuse (continued)
•Evidence includes– Photos– Urine specimen– Clothing – Body fluids– Various samples such as blood, semen, vaginal or
rectal smears– Foreign objects
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Other Reportable Conditions
•Physicians required to report certain medical conditions to maintain accurate public health statistics, including– Cancer– Epilepsy– Congenital disorders– Certain infectious diseases, such as tuberculosis
(TB)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Controlled Substances Act and Regulations
•Food and Drug Administration (FDA)
•Drug Enforcement Administration (DEA)
•Controlled Substances Act of 1970
•Bureau of Narcotics and Dangerous Drugs (BNDD)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Prescription of Controlled Drugs
•Only those with a DEA number may issue prescriptions for narcotics
•Number must appear on all prescriptions for controlled substances
•Schedule II drugs require triplicate form
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Prescription of Controlled Drugs (continued)
•Schedule II drug prescription cannot be refilled•Must take written inventory of drug supply
every two years•Narcotics dispensing records must be kept for
two years (state regulations may vary)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
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Protection of Employee and the Environment
•Employee Assistance Program (EAP)– Confidential counseling and referral service– Helps employees and their families assess a
problem– Develops plan to resolve problem– Determines appropriate resource to assist in
process
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Waste
•Solid
•Chemical
•Radioactive
• Infectious