INFORMED CONSENT & JURISPRUDENCE

What is informed consent?

The patient's acceptance of a line of treatment based on the information provided by a health care provider.

What must patients be informed about for informed consent?

Treatment alternatives, benefits and risks of treatment, and diagnosis.

What are the two sides to informed consent?

Being informed and giving consent.

What do patients have the right to regarding medical procedures?

Patients have a right to be informed and to make an independent decision whether to accept or reject a procedure or treatment strategy.

What are the three forms of consent in medical practice?

Implied, Expressed, and Written

Exceptions to the Rule

A patient's mental or psychological state
A legal or surrogate should be involved
This precaution prevents the undesirable scenario where a provider makes decisions that, despite the good intention, could disrupt the life of the patient

Jurisprudence

is the science or philosophy of law, which may also include the establishment, regulation, and enforcement of legislation

Statuary law is enacted by legislation; two types are:

Criminal offences against society
Civil offences against individual

What does criminal law concern?

Offenses or wrongful acts against society

What is the primary goal of criminal law?

To punish offenders

Who does criminal law apply to?

Everyone

What is required for a jury's judgment in criminal cases?

A unanimous agreement

What must prosecutors prove in criminal cases?

Guilt beyond reasonable doubt

Unlicensed Practice of Dentistry

A criminal act !!
Anyone engaged in activities assigned to dentist and not assigned to them
If dentist permits that: legal liability & loss of license
Person engaged in activity also liable
If dentist is not aware = still liable

What does civil law concern?

Offenses or wrongful acts against an individual person, property, or reputation.

What are the two main areas included in civil law?

Tort law and contract law.

What is the primary goal of civil law?

To compensate the victim.

What are nominal damages in civil court?

Cost of damage.

What are compensatory damages in civil court?

Extra cost, pain, and suffering.

What are punitive damages in civil court?

Punishment cost.

Tort law

covers rights & duties of people towards each other & wrong committed in violation of those rights & duties.

What is contract law?

An agreement between 2 or more competent parties covering a specified act for consideration.

What is an implied contract?

A contract made by certain actions on the part of the parties.

What is an expressed contract?

An oral or written agreement that is legally binding.

Breach of Contract occurs

When financial or privacy breaks occur
When services are not preformed.
Other party may sue for breach of contract

Breach of Contract Defenses

The pt. withdrawal from the contract by failing to return
The pt. not giving the dentist a reasonable opportunity to satisfy where satisfaction has been promised
The pt. contributory negligence by failure to follow instructions
The dentist has not fulfilled all requirements agreed upon

What are tort laws?

Civil wrongful acts, except one involving breach of contract, for which the injured party recovers damages in civil action.

What are the two main types of tort law?

Intentional and unintentional.

What are the two types of acts in tort law?

Acts of omission and acts of commission.

The 4 D's: elements which must be present before a tort can be considered to have been committed

Duty - legal duty owe to someone
Dereliction - breach duty by the accused
Due to - harm or damage to the accuser
Damage - harm caused proximal by breach of duty.

Dental professional/patient relationship (legal duty) does not exist in law until:

the pt. seeks services
The dentist, accepts

Ethical & Legal requirements

Dentist not legally compelled to accept or treat a new patient - even if an emergency exists
Once accepted as a patient, the dentist has DEFINITE legal duties to the patient

Duties Required of Patient

Simpler & fewer in number
The pt. Must follow instructions both during and after treatment ****
The pt. must pay a "reasonable" fee or a fee agreed upon between dentist and patient

****Contributory Negligence

Contributory Negligence

The failure on the part of the patient to follow dentist instructions.


Could bar the patient from recovery of damages from the dentist for alleged substandard treatment

Malpractice-

professional negligence that causes harm. Can't sue for malpractice if there is no breach.

Conditions necessary to prove malpractice

There was an act omission
There was failure to satisfy standard of care
There was harm or injury to patient.

Duties Required of Dentist

Once accepting a patient, dentist has many duties to the patient
Must be duly licensed
Must exercise reasonable skill, care, & judgment in diagnosis & treatment
Must use standard drugs, materials & techniques
Must complete agreed upon treatment within a reasonable time

Duties Required of Dentist 2

Must not abandon the patient
Must do only those things consented by the patient
Must give adequate instructions
Must make a reasonable charge for the services rendered
Must achieve a reasonable result
Must arrange care for patient during temporary absence
Must refer unusual cases to a specialist
Must hold inviolate the patient's privacy
"Use Reasonable Care in Treatment"

Libel

is the written or published defamation; one of 2 types of defamation, the other being slander

Slander

is verbal defamation

Technical Assault

is touching without permission but with no intention of harming

Abandon-

to end a patient provider relation terminate treatment or refrain from seeing the patient