Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright 2012 by Pearson Education, Inc....
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Transcript of Medical Law and Ethics, Fourth Edition Bonnie F. Fremgen Copyright 2012 by Pearson Education, Inc....
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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 and the Healthcare Professional
Chapter 3
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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)
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Licensure of Physician
• Endorsement: an approval or sanction• Reciprocity: cooperation of one state in
granting license to practice medicine to a physician already licensed in another state
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Licensure of Physician
• Registration:• Occurs annually or biannually• Physicians must pay a fee• Physicians are required to complete
seventy five hours of CME in a three year period
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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 to practice medicine in some state)• In an emergency• While establishing residency• When engaged solely in research
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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 and/or medical professional would provide under same circumstances • Perform as “reasonable and prudent”
person would perform
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Physicians Are…
• Not obligated to treat everyone in case of emergency• Expected to use reasonable, ordinary
skill and care (not extraordinary)• Expected to exhaust all resources
available to them for patient care• Not to expose patients to undue risk
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Prudent Person Rule(also called the “reasonable person standard”)
• 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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: a federal
law that gives all patients right to have privacy respected and records held confidential
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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 or when the patient should have known of the injury
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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 –
Except in Vermont
Medical Law and Ethics, Fourth EditionBonnie F. Fremgen
Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Good Samaritan Laws
• 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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, Fourth EditionBonnie F. Fremgen
Copyright ©2012 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