Ch 3 Legal and Ethical Issues

What is the broadest definition of "law"?

A system of rules enforced through a collection of institutions that have the authority to do so.

Who creates federal laws, and to whom do they apply?

Congress makes federal laws, and they apply to everyone in the country.

What are local government laws or regulations called?

Resolutions or ordinances.

What is common law (also known as case law or the law of precedent)?

Laws that are derived from the court system based on prior judicial decisions.

What are the two primary characteristics of Criminal Law?

1. It is exclusively statutory.

2. It deals with someone who has performed an act prohibited by law, or failed to perform an act required by law.

What is Civil Law?

A collection of rules that govern the conduct, affairs, and rights of people and entities, infractions of which are not considered crimes.

What is a "tort" and what branch of law does it belong to?

The term comes from the Latin tortum (meaning "wrong"). Tort law is a branch of common law covering civil wrongs that cause harm.

What is the difference between intentional and unintentional torts? Give examples of each.

• Unintentional: Accidental wrongs, such as negligence.

• Intentional: Deliberate wrongs, such as slander, libel, and medical malpractice.

What are the 4 elements required to prove negligence?

1. Duty of care owed by the defendant to the plaintiff.

2. Breach of duty by the defendant.

3. Harm (injury) suffered by the plaintiff.

4. Causation (the harm resulted directly from the breach of duty).

What are the 6 elements required to prove medical malpractice?

1. A current relationship between the provider and patient.

2. The relationship created a duty of the provider toward the patient.

3. The nature of that duty required a professional standard of care.

4. The provider breached that duty.

5. The patient suffered a resulting injury.

6. Causation (the patient would not have sustained the injury but for the provider’s breach).

What is the purpose of Medical Professional Liability Insurance?

It protects physicians and licensed healthcare professionals from liability associated with wrongful practices resulting in bodily injury, medical expenses, and property damage, as well as covering the cost of defending lawsuits.

What is the legal nature of the relationship between a doctor and a patient?

It is a contract, which creates an affirmative duty for the provider to care for the patient according to an expected professional standard of care.

What is the difference between an express contract and an implied contract?

• Express: The parties clearly stated their intentions (verbally or in writing).

• Implied: The parties agreed through nonverbal actions or conduct.

What is Risk Management in a medical setting?

The identification of all exposure to financial loss of a business and the selection of techniques to manage those exposures. It makes the provider, employer, and medical assistant less vulnerable to litigation.

What must a patient provide before a doctor can legally treat them?

Consent.

What is the difference between a Durable Power of Attorney and a Living Will?

• Durable Power of Attorney: Authorizes a designated person to make medical decisions (consent, refuse, or withdraw treatment) on behalf of the patient.

• Living Will: A document stating the patient's medical wishes, but does not designate another person to make decisions.

Name 6 major federal laws that govern medical offices.

1. Affordable Care Act (ACA)

   1. Key Provisions: Prohibits insurance companies from denying coverage or charging more for pre-existing conditions and bans annual or lifetime dollar limits on essential health benefits. It created health insurance marketplaces to provide premium subsidies and expanded Medicaid eligibility.

2. Health Insurance Portability and Accountability Act (HIPAA)

   1. Key Provisions: The HIPAA Privacy Rule regulates the use and disclosure of Protected Health Information (PHI), while the Security Rule specifies how electronic PHI must be safeguarded. It also improves health insurance portability for workers and their families when they change or lose their jobs.

3. Good Samaritan Act

   1. Key Provisions: They generally protect volunteer rescuers from being successfully sued for ordinary negligence if an aspect of their emergency care goes wrong, as long as the care was voluntary, uncompensated, and not grossly negligent.

4. Americans with Disabilities Act of 1990 (ADA)

   1. Key Provisions: Employers with 15 or more employees must provide "reasonable accommodations" to qualified applicants or employees, provided it does not cause "undue hardship". It also ensures physical and electronic accessibility for public services and commercial facilities.

5. Uniform Anatomical Gift Act (UAGA)

   1. Key Provisions: It ensures that an individual's decision to register as an organ donor during their lifetime is legally binding and cannot be overturned by next of kin. It strictly prohibits the sale or purchase of human organs for profit.

6. Genetic Information Nondiscrimination Act of 2008 (GINA)

   1. Key Provisions: Title I prohibits health insurers from using genetic information (including family medical history) to determine eligibility, coverage, or premium rates. Title II prevents employers from using genetic information in hiring, firing, or job assignment decisions, and restricts employers from requesting or purchasing genetic data.

What is the medical assistant's primary legal responsibility regarding their clinical duties?

To be aware that their actions have legal consequences and to always act within their scope of practice.

Differentiate between an ethical dilemma and a moral issue.

• Ethical Dilemma: Occurs when there is no clear-cut right/wrong answer, when right behavior leads to a wrong outcome, or when justice is missing from the legal system.

• Moral Issue: Stems from a personal belief system used to judge right versus wrong.

Define the three key bioethical concepts: Autonomy, Beneficence, and Distributive Justice.

• Autonomy: The patient’s right to make determinations for themselves.

• Beneficence: The requirement to do what is in the best interests of others.

• Distributive Justice: The principle of how society/healthcare allocates resources that are in scarce supply.

Name 7 common ethical issues encountered in healthcare resource allocation and bioethics.

Abortion, artificial insemination, euthanasia, life support, organ transplantation, surrogacy, and vaccination.

How should a medical assistant handle situations where their personal ethical views conflict with their professional role?

They must adapt their personal views to be in complete alignment with the ethical standards of their profession and the organization employing them.

What code of ethics are physicians expected to uphold, and what governs medical assistants?

• Providers: The AMA’s Code of Medical Ethics.

• Medical Assistants: Codes of professional conduct set by credentialing organizations like the AAMA, AMT, NHA, and AAPC.

What are Organizational Ethics?

The core values by which an organization conducts its business.