HOSA Medical Law and Ethics

Controlled Substances Act 1970 (CSA)

Enforced by Drug Enforcement Administration (DEA), responsible for regulating drugs with potential of abuse and addiction. 

Medical Practice Acts

Regulates requirements to practice medicine, setting guidelines for licenses.

Stark 1 & 2 Regulations

Prohibits physicians to refer patients to services of someone the physician has family or financial relations with.

Civil Monetary Penalties Act

States that physicians who falsely bill clients/patients will be held liable

Family & Medical Leave Act 1993 (FMLA)

Applies to organizations with 50+ employees: requires up to 12 weeks of job-protected unpaid leave for family and medical purposes.

Statue of Limitations

Restricts time allowed for legal actions; varies state to state, usually 1 - 6 years depending on offense; Does not apply until 18, mental capacity can have an impact.

Good Samaritan Law

Legal protection for individuals helping in emergency situations.

Health Insurance Portability and Accountability Act (HIPPA) 1996

Requires standardization of patient health, administration, and financial data; unique health identifiers; security standards to protect confidentiality and integrity of individual’s past, future, and present. Patients must grant written or oral consent to provide protected health information (PHI). 

Occupational Safety and Health Administration (OSHA)

U.S. agency under Department of Labor, its primary functions is to: ensure safe & health working conditions by setting and enforcing standards, training, and education. Requires employers to ensure a Clinical Hygiene Plan (CHP).

Drug Enforcement Administration (DEA)

Under Department of Justice, responsible for combating illicit drug and trafficking & distribution. Also refers to DEA registration numbers (National Provider Identifier (NPI): ID # for health care providers): assigned to healthcare professionals to allow them to write prescriptions.

Controlled Substance Act 1970 (CSA)

Places all substances under federal law into 5 schedules: 1: most potential for abuse and or addictions; 5: lowest potential for abuse, acceptable medicinal qualities, prescription, and have few refill regulations.

Food and Drug Administration (FDA)

Agency under Department of Health and Human Services, responsible for protecting public health by: ensuring safety, efficiency, and security of drugs, medical devices, biologics (medicine derived from living sources EX: cells & tissues), cosmetic and food supply.

American Medical Association (AMA)

Largest and only national association of physicians in U.S., advocates for physicians: interests, and health & medical education.

Center for Disease Control (CDC)

Nation’s leading public health agency for disease prevention.

National Health Insurance (NHI)

System of health insurance—provides health care coverage (insurance).

Health Maintenance Organization Act 1973 (HMO)

Type of healthcare insurance that that coordinates with primary care providers (PCP) offering lower fees but restrictions you to a network of providers for all services other than emergencies.

Department of Health & Human Services (DHHS)

Aims to protect health and provide human services.

Center for Medicare & Services

Under DHHS: provides insurance for ages 65+ and young with disabilities and administers medicare programs.

American with Disabilities Act (ADA)

Prohibits discrimination against individuals with disabilities, ensuring equal opportunities in various aspects of like. Defines disabilities as: physical/mental impairment limiting one’s life activities. 

Emergency Medical Treatment and Labor Act (EMTALA)

Federal law requiring medicare-participating hospitals to provide emergency medical care to anyone who needs it; national health insurance. Must provide: medical screening, stabilizing treatment, and transfer of facilities if needed.

Affordable Care Act 2010 (ACA)

Expanded health insurance coverage.

Health Information Technology for Economical and Clinical Health Act (HITECH ACT)

Encouraged adaption/usage of electronic health records (EHR) to improve privacy, security, and efficiency. 

Health Rights Commission Act 1991 (HRC)

Addresses discrimination in healthcare, protects patient and ensures equal treatment.

Uniform Determination of Death Act 1980 (UDDA)

Defines death as the irreversible cessation of circulatory/respiratory functions or brain functions.

Uniform Anatomical Gift Act (UAG)

Individuals 18+ and of sound-mind may donate part or all of their body for: purposes of education, research, advancement, therapy, and transplantation; can be donated to individuals, universities, organ bank or facility for those purposes.

Medical Malpractice Acts

Each state defines how medicine should be practiced.

National Childhood Injury Act (1986)

Certain vaccines and toxoids (similar to antibiotics) need documentation of: date of administration, name + address of administrator, manufacturer, LOT of vaccine, and any adverse events after administration. Required for all health care providers of childhood vaccines.

The Department of Labor, Wage, and Hour Division

Concerned with: minimum wages, child labor, length of work day, etc.

Uniform Parentage Act (UPA)

Modernize the law for determining the legal parents of children and facilitate modern methods of testing for parentage.

Medical Law

Addresses legal rights/obligations that affect patients, protect individual rights, including healthcare employees.

Ethics

Branch of morals, moral principals and judgement; “Critical reflection about morality & rational analysis of it.”

Bioethics

Study of ethics in relation to issues in healthcare

What are the four pillars of Medical Law & Ethics/Hippocratic Oath? 

Autonomy, Beneficence, Justice, and Nonmalficence

What is the Hippocratic Oath?

An ancient Greek medical pledge of ethical conduct for physicians, emphasizing 4 pillars: justice, autonomy, beneficence, and nonmaleficence

Autonomy

Right to make decisions about one’s own life

Beneficence

To protect patients from harm and promote well being; “to do good.”

Nonmaleficence

“To do no harm,” to do good in the process but no harm

Justice

All must be treated equally

Informed consent

Patient is provided will all information about procedure/treatment: benefits, risks, etc;

Expressed consent

Written or oral, all facts must be understand and written down

Implied consent

Most common form of consent in healthcare; occurs everything physician and patient discuss treatment and agreement is reached

Advance directives

Legal documents that may be used for patients to record future wishes in the event they are unable to speak/incompetent 

Living will

Document that describes what patient wants in event of unconsciousness

Doctrine of informed consent

Patient’s rights to know treatment & care before agreeing to any; physicians must use terms and language understood by patient

Durable Power of Attorney (Healthcare Proxy)

Appoints “agent” to make decisions for patient in the vent they are unable to

Criminal liability

Results with individuals commit an act considered to be against society as a whole

Civil liability 

Results with conflicts between individuals, corporations, and organizations

Physicians abandoning clients can be held liable unless:

• They formally withdraw or discharge patient

• If patient fails to follow instructions

• Provide patient time to find another physician

4Ds of Negligence

• Duty: Exists when patient-physician relation is established

• Derelict: Client must prove physician failed to comply by professional standards

• Direct: Physician’s breach of duty was the direct cause of damages

• Damage: Injuries were sustained; compensation for injuries sustained by patient

Whats the first D of negligence

Duty: There exists a duty of cate

Whats the second D of negligence

Derelict: Healthcare professional failed to properly perform duty, didn’t comply to professional standards

Whats the third D of negligence

Direct: Patient’s harm was of direct cause by physician’s actions

Whats the fourth D of negligence

Damages: injuries were sustained; compensation was paid

“res ipsa loquitur”

Legal doctrine meaning: “the thing speaks for itself,” used for negligence charges.

Exemplary/Punitive damages

Punishes defendant, compensates plaintiff for pain, suffering, and mental anguish

Intentional torts

Intentional acts violating another person’s rights and property.

Unintentional torts

Causes harm through carelessness, recklessness, and failure to act with reasonable care

Tort

Wrongful act/civil wrong that causes harm or injury to another person

Civil law encompasses:

• Tort law

• Contract law

• Property law

• Inheritance law

• Family law

• Corporate law

Examples of intentional torts are:

• False imprisonment

• Invasion of privacy

• Fraud

• Assault

• Battery

• Defamation of character

Libel

Defamation of character; written, published, or pictures

Slander

Defamation of character; spoken

False imprisonment

Intentional and unlawful restriction of a person's freedom of movement without consent or legal justification

Fraud

Attempts to deceive another; EX: false promises, false billing, etc

Assault

The threat to inflict injury

Battery

Unlawful touching, beating, or withholding of clothing without consent

Invasion of privacy

Unauthorized publicity of patient information without patient consent or knowledge

Doctrine of Respondent Superior

“Let the master answer;” holds employer liable for the negligent/wrongful acts of employees; vicarious liability: holds another liable for another’s acts

Alternative Dispute Resolution (ADR)

Alternative to litigation; both parties agrees to allow neutral person to arbitrate case, elimatining traditional court system; more effective ad cost effective

Malpractice

Professional negligence; failure to meet professional standards of care

Negligence

Failure to exercise care resulting in harm

Federal Courts

3 jurisdictions: federal crimes, constitutional issues, and civil actions. Belongs to Supreme Court (highest in federal system).

State Court

Lower court, hears about: small claims, civil matters, some misdemeanors, housing and traffic issues. Rulings can be changed by Court of Appeals.

Court of Appeals

Has the power to review, mend, reverse, modify, and affirm decisions of State Court.

Probate Court

Probate law over sees distribution of estate after someone’s death. In Probate Court, provider must file a claim on deceased patients bill if other options are unsuccessful. 

Probate Law

Involves distribution of estate/wealth after death. 

Small Claims Court

Small claims court is a simplified, less expensive, and quicker way to resolve civil disputes that involve smaller amounts of money, typically under a specific state limit, where attorneys are not required. Parties usually represent themselves, and the process is informal, allowing for easy presentation of evidence.

What are the 4 types of law?

• Constitutional Law

• Statutory and Regulatory Laws

• Common Law

• Tort Law

Constitutional Law

U.S.’s highest judicial authority, defines government’s power to act & sets limits and well as divide and oversee power in branches. Takes precedence over all state laws and constitutions.

Statutory and Regulatory Law

Laws passed by congress and state legislatures are called statutory law/statues. Consists of ever-changing rules & regulations by congress, state, local, and gov. Legislatures can authorize agencies (EX: Food & Drug Administration) to pass rules called regulations.

Common Law

Made by judges when previous court decisions are considered/applied; how law is interpreted. Constantly updated and kept it check with new laws. Also known as “Case Law.”

Tort Law

Civil injury resulting in harm and is compensated with $; to sue, plaintiff must have suffered mental or physical injury that was caused by defendant.

“Stare decisis”

“Let the decision stand,” legal principle stating courts should follow precedent past decisions in similar cases; refers to common law.

“Subpoena” and “subpoena duces tecum”

Legal order to appear & testify in court; “you shall bring with you,” to appear & testify in court with requested documents. 

Public Law

Concerns relationship between people & gov. entities can be divided into:

• Criminal law

• Administrative (implementation of gov. policies)

• Constitutional (interpretation of laws)

• International (relation between nations; treaties and agreements)

Private Law

Relation between people & private entities; (think civil law, contract, property, tort, family, and business law).

Professional liability/malpractice insurance

Many cooperations don’t guarantee professional liability insurance or malpractice insurance so many physicians carry one themselves. $ covered can vary on practice and economy.

What are the 3 branches of government and its functions?

Legislative: Makes law

Executive: Administers laws

Judicial: Enforces laws