chapters 1-6

Plaintiff

Person bringing charges in lawsuit

Defendant

Person against whom charges are being brought

Liable

Legally responsible or obligated

Precedent

Decisions made by judges in various courses that become rule of law, also known as case law

Summary judgement

Decision made by a court that pleads no basis for trial

Law

Set of governing rules to protect the public

Ethics

Principles, standards, guide to conduct

Moral values

Beliefs formed through the influence of family, culture, and society to serve as a guide for personal ethical conduct

Bioethics

Discipline relating to ethics concerning biological research, especially as applied to medicine.

Etiquette

Courtsey and manners to enabled in order to get along with others

Protocol

Rules of etiquette applicable to one's place of employment

Hippocratic oath

A pledge for physicians, influences by the practices of the Greek physician Hippocrates.

Contemporary codes of ethics

Established by the appropriate professional organization and increase the level of competence and standards of care within the group.

Early codes of ethics

Code of hammurabi, hippocratic oath, Percival's medical ethics

Qualities for success in healthcare

Courtsey, compassion, common sense, people skills, technical skills, and critical thinking

Needs-based motivation

The theory that human behavior is based on specific human needs that must often be met in specific order.

Basic life, safe environment, to belong, esteem, and self-actualization

Maslow's Hierarchy of needs in order

Virtue development theories

Individuals develop personal value systems in stages as they grow. Jean Piaget and Lawrence Kohlberg.

Teleological theory

Judges the righteousness of a decision based on the outcome. Act and rule ultiliarianism.

Principle of utility

Requires the rule used to make the decision brings about positive results when generalized to a wide variety of situations.

Duty-oriented theory

Focuses on the essential righteousness wrongness of an act, not the consequences of the act. -Immanual kant

Virtue ethics

Focuses on traits, characteristics, and virtues a moral person should have.

Autonomy

Capacity to be one’s own person, make decisions on one’s own reasons, and not be manipulated or dictated to by external forces

Beneficence

Perform acts to help people stay healthy or recover from illness

Nonmaleficence

The duty to “do no harm”. The benefit to the patient must always outweigh the harm

Justice

What is due an individual

Confidentiality

Health care professionals must always protect patient privacy

Role fidelity

Health care practicioners have a specific scope of practice for which they are licensed

Veracity

Truth-telling.

Licensure

Mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills.

Reciprocity

The process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without re-examination

Endorsement

Another process by which a license may be awarded based on indiviual credentials judged to be licensing requirements in the new state of residence

Certification

A voluntary credentialing process where applicants who meet specific requirements may recieve a certificate

Registration

Historically it was a credentialing procedure whereby one’s name was listed on a register as having paid a fee and/or met certain educational criteria within a profession

Scope of practice

The duties/procedures thay a person may and may not perform under the auspices of a specific health care practicioner’s license

Accreditation

Official authorization or approval for an organization conforming to specific standards, usually voluntary

Educational program accreditation

Accreditation agencies for health care education are national association

Practice acts

Professional boards to protect health, safety and welfare of Healthcare consumers.

Business aspects of healthcare

One of the few major industries where most costs are paid by third party payers

Managed care organizations

A system in which corporations link the financing, administration, and odelivery of health care services that are combined to provide medical services to subscribers for a specific fee

Coinsurance

Patient/policy holder agrees to pay a certain amount of each claim directly

Copayment

A fixed amount you pay for a covered health care service after you’ve paid your deductible

Deductible

The specific amount of money a policyholder must pay out of policy for covered services or damages before insurance coverage begins to pay

Formularies

The list of generic and brand name prescription drugs covered by a specific health insurance plan

Utilization reviews

A process in which a patient's care plan undergoes evaluation, typically for inpatient services on a case by case basis.

Legislative branch (congress)

Senate, House of Representatives: write, debate, and pass bills

Executive branch (President)

Executive orders become law without approval of congress

Judicial branch (Supreme court)

Interprets and oversees laws

Constitutional law

Based on U.S. constitution

Case law

Set by legal precedent

Statuary

Enacted by state or federal legislatures

Administrative law

Enacted to define specific agency powers

Substantive

Definces and regulates legal rights and obligation

Procedural laws

Defines rules used to enforce substantive law

Criminal law

Law involving crimes against state

Civil laws

Involves wrongful acts against persons

Felony

An offense punishable by death or by improvement 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

Tort

A civil wrong committed against a person or property excluding breach of contract. Intentional or unintentional.

Tortfeasor

Person guilty of a tort

Negligence

Charged when a healthcare practitioner fails to exercise ordinary care and a patient is injured. Unintentional tort.

Jurisdiction

Power to hear and decide about a case

Federal courts

Jurisdiction over federal law such as antitrust, federal crimes, patients, and fraud in medicare/medicaid.

Contract

Voluntary agreement between two parties in which specific promises are made for consideration.

Expressed contract

Written or oral agreement in which all terms are explicitly stated

Implied contract

Unwritten or unspoken agreement whose terms result from the actions of the parties involved

Regulation z

Part of the consumer protection act, agreement in writing

Rights of physicians

Make reasonable limitations on physician patient relationship

Liability

All compeneny adults are liable, or legally responsible, for their actions on the job and in private life

Law of agency

Law governing relationship between principal and agent. Expressed or implied.

Standard of care

Level of performance expected of health care worket carrying out duties

Duty of care

Obligations of health care workers to patients/non-patients

Reasonable person standard

The 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

Duty, dereliction, damage, and direct cause

Four elements to prove negligence

General compensatory

To compensensate for injuries or losses due to violation of a patient’s rights

Special compensatory

To compesate for losses not directly caused by the wrong

Consequential

To compensate for losses caused indirectlty by a product defect

Punitive

To punish the offender

Nominal

To recognize that righta of patients were violated, though no actual loss was proved

Res ipsa loquitur

The thing speaks for itself

Pleading phase

Summoning is issued

Interrogatory phase

Subpoena and deposition may occur

Trial phase

Jury selected, witnessses are called to testify for both sides, jury reaches a verdict

Appeals phase

Request for the case be reviewed by a higher court

Alternative dispute resolution

Techniques for resolving civil didputes without going to court. Uses neutral mediators or arbitrators

Mediation

Method of settling disputes without going to court

Abitration

Method of settling disputes in which opposing parties agree to abide by tbe decision of an arbitrator

Minors, mentally inconpetent, limited english

Who cannot give informed consent?

Married minors, emanipated minors, and minor parents

Who can consent to HIV testing?

Caring, communication, competence, charting

Four Cs of malpractice prevention

Res Judicata

“The thing has been decided”

Release of tortfeasor

A technical defense that prohibits a lawsuit against the person who caused an injury, if the person was expressly released from further liability in the settlement of a suit

Quality improvement/assurance

Programs to uphold the quality of patient care and reduce liability risk

Professional liablity insurance

Covers costs of defending a medical malpractice lawsuit up to policy limit

Claims-made insurance

Covers the insurer only for claims made (not for injury occurring) while policy is in force

Occurance insurance

Covers the insurer for any claims made that occurred while policy is in force regardless of when a claim is made