Legal and Ethical Aspects

I. Patient’s Rights A. Patient Consent B. Patient Privacy C. Bill of Rights/Patient Care Partnership II. Legal Issues A. X-Ray Exam Requests B. Law/Medicolegal Issues III. ARRT Standards of Ethics

Consent Capacity

Legal and mental ability of a patient to understand and decide about medical care

Competent Adult

Person of legal age with sound mind capable of giving valid consent

Minor Patient

Individual below legal age who generally cannot provide independent consent

Emergency Doctrine

Legal principle allowing treatment without consent to preserve life or prevent serious harm

Informed Refusal

Patient’s decision to decline treatment after understanding risks and consequences

Coercion

Use of pressure or threat that invalidates voluntary consent

Disclosure Requirement

Obligation to explain procedure risks benefits and alternatives before consent

Material Risk

Risk that a reasonable person would consider significant in deciding about treatment

Surrogate Decision Maker

Person legally authorized to decide for an incapacitated patient

Durable Power of Attorney for Healthcare

Legal document appointing an agent for medical decisions

Advance Directive Activation

Occurs when patient loses decision-making capacity

Confidentiality Breach

Unauthorized access use or disclosure of protected health information

Protected Health Information PHI

Individually identifiable health data protected by privacy laws

Minimum Necessary Rule

Standard limiting access to only information required to perform duties

Need to Know Basis

Principle allowing access to patient information only for legitimate care purposes

Incidental Disclosure

Secondary exposure of patient information despite reasonable safeguards

Administrative Safeguards

Policies and training designed to protect patient data

Technical Safeguards

Electronic protections such as passwords and encryption for health records

Physical Safeguards

Environmental protections like locked files and restricted access areas

Patient Dignity

Respect for intrinsic worth and individuality of every patient

Nonmaleficence

Ethical principle to do no harm

Beneficence

Ethical obligation to promote patient welfare

Justice in Healthcare

Fair and equal treatment regardless of background or status

Veracity

Duty to tell the truth in professional practice

Fidelity

Loyalty and faithfulness to professional responsibilities

Autonomy

Right of patients to make independent healthcare decisions

Paternalism

Overriding patient autonomy for perceived benefit

Standard of Practice

Established professional guidelines defining acceptable conduct

Deviation from Standard

Failure to act according to accepted professional guidelines

Foreseeability

Ability to anticipate potential harm from an action or omission

Proximate Cause

Primary cause directly producing injury

Comparative Negligence

Legal concept reducing compensation based on patient’s contribution to harm

Contributory Negligence

Defense claiming patient’s own negligence caused injury

Assumption of Risk

Patient knowingly accepting potential danger of procedure

Malfeasance

Intentional commission of wrongful act

Misfeasance

Improper performance of a lawful act

Nonfeasance

Failure to perform a required duty

Abandonment

Improper termination of care without reasonable notice

Documentation Integrity

Accurate complete and timely recording of patient care activities

Falsification of Records

Intentional alteration or fabrication of patient documentation

Incident Report

Internal documentation of unusual event affecting patient care

Chain of Command

Hierarchical reporting structure within healthcare institution

Scope Creep

Gradual expansion of duties beyond authorized scope of practice

Credentialing

Process of verifying qualifications for professional practice

Licensure

Government authorization to practice a profession

Certification

Recognition by credentialing body of meeting professional standards

Registration

Maintenance of active professional status with certifying agency

Peer Review

Evaluation of professional performance by colleagues

Ethics Committee

Body reviewing professional conduct and violations

Professional Misconduct

Behavior violating ethical or legal standards of practice

Unprofessional Conduct

Actions inconsistent with accepted professional norms

Sexual Misconduct

Any sexual behavior toward a patient that violates professional boundaries

Boundary Violation

Crossing professional limits in patient interactions

Dual Relationship

Professional relationship combined with personal involvement creating conflict

Conflict of Interest

Situation where personal gain may influence professional judgment

Whistleblowing

Reporting unethical or illegal conduct within organization

Mandatory Reporting

Legal requirement to report certain violations or crimes

Subversion of Examination

Compromising integrity of licensure or certification testing process

Fraudulent Billing

Knowingly submitting false claims for reimbursement

Medicare Fraud

Deceptive billing practices involving government health insurance

Informed Decision Making

Process where patient evaluates information to choose treatment

Capacity Assessment

Evaluation of patient’s ability to understand and decide

Emergency Restraint

Temporary physical limitation to prevent immediate harm

Least Restrictive Alternative

Using minimal force necessary to protect patient safety

Patient Identification Protocol

Verification process using two identifiers before procedures

Time Out Procedure

Safety pause confirming correct patient site and procedure

Wrong Site Error

Performance of procedure on incorrect body part

Never Event

Serious preventable medical error such as wrong patient surgery

Radiation Protection Principle

Obligation to minimize exposure to patient and staff

ALARA Principle

As Low As Reasonably Achievable radiation safety standard

Pregnancy Declaration

Patient statement confirming possible or confirmed pregnancy

Fetal Risk Counseling

Discussion of potential radiation effects on developing fetus

Duty to Report Error

Professional obligation to disclose mistakes in patient care

Error of Commission

Wrong action taken during patient care

Error of Omission

Failure to act when action was required

Moral Character Requirement

Expectation of integrity and honesty for professional certification

Sanction

Penalty imposed for violation of professional standards

Reprimand

Formal expression of disapproval for misconduct

Suspension

Temporary removal of professional privileges

Revocation

Permanent cancellation of professional registration

Due Process

Right to fair procedure before disciplinary action

Civil Litigation

Legal process resolving disputes between individuals

Burden of Proof

Responsibility to prove allegations in court

Preponderance of Evidence

Standard of proof in civil cases meaning more likely than not

Expert Witness

Qualified professional providing opinion on standard of care

Vicarious Liability

Legal responsibility for actions of another person

Corporate Negligence

Hospital liability for failing to ensure patient safety systems

Good Samaritan Law

Protection for healthcare providers rendering emergency aid voluntarily

Statute of Limitations

Time limit within which legal action must be filed

Informed Consent Documentation

Written evidence confirming patient understanding and agreement

Professional Liability Insurance

Insurance protecting healthcare worker from malpractice claims

Ethical Decision Model

Systematic approach to resolving moral dilemmas in practice

Continuing Education Requirement

Obligation to maintain knowledge through ongoing learning

Professional Accountability

Responsibility for one’s actions decisions and ethical conduct in practice