Medical Law and Ethics Midterm

Laws

Rules prescribed by an authority that have legal binding force

Ethics

A branch of psychology based around morality, ethical standards, and moral judgments

Morality

The quality of being virtuous

Applied ethics

The practical application of moral standards meant to benefit a patient

Deontological

Some actions are naturally good or bad, and we must perform or not perform them, not matter the consequences

Teleological

An action is right if it produces good consequences

Virtue-based

Seeking the “good life” through good character; Aristotle

Rights-based

Protects individual rights; can lead to selfishness

Justice-based

Fair, democratic approach, protects the weak and poor, everyone is equal; John Rawls

Autonomy

A patient’s right to make their own decisions

Beneficence

Doing good and acting in a patient’s best interest

Nonmaleficence

Avoiding harm

Justice

Fairness in care and distributing resources

Lo three-step clinical model

Gather info, clarify ethical dilemma, resolve issue

Cost/benefit analysis

Justifies a treatments cost based on its benefit

Ethics committees

Advise patients, families, and staff

QA committees

Review issues like medication errors and failed blood draws

Confidentiality

Safeguarding someone’s information, disclose info to a party only with patient consent

Fidelity

Faithfulness or commitment to others

Due process

The right of an individual to certain procedures when their rights are in jeopardy

Comparable worth

Equal pay for equal work

Sexual harassment

Sexual conduct made a condition of employment, used as a basis for employment decisions, or creating a hostile work environment

Informed consent

Patient understands the treatment, risks, chance of success, and alternatives before agreeing

Congress

The legislative branch

US constitution

Sets up government, defines its powers, limits them

Statutes

Laws passed by congress or state legislature, begin as bills

Common law

Rests on precedent

Precedent

Ruling in an earlier case applied to a later case with same facts

Civil law

Between private parties, needs a preponderance of evidence, usually money damages, often settles outside of court

Preponderance of evidence

More likely than not true

Criminal law

Offenses against society, needs beyond a reasonable doubt, ends with fines, imprisonment, loss of license

Misdemeanor

Fine or jail up to a year

Felony

More serious crime with longer sentence

Tort

A civil wrong against a person or property causing harm

Negligence

Failing to use the care a “reasonable person” would use for professional duties

Expressed contract

Stated orally or in writing

Implied contract

Shown by actions or silence

Competent

Of sound mind and not inebriated

Assault

Threat or attempt of harm

Battery

Unauthorized touching

Slander

False or malicious spoken words that injure a reputation. Accusing someone of a crime, having a communicable disease, or calling a woman unchaste need no proof of harm.

Libel

False or malicious statements in print, pictures, or signs

Fraud

A dishonest act that deprives another person of his or her rights, deliberately concealing facts from patients

Invasion of privacy

Can occur at any time

Federal courts lowest to highest

District court - Court of appeals - US supreme court

Appeal

Right of a losing party to appeal if a case was handled unfairly and inappropriately

Estate court

Handles states of the deceased

Subpoena

An order to appear in court

Subpoena duces tecum

An order to appear and bring specified documents

Expert witness

Has knowledge of the case’s subject beyond that of the jury

State legislature

established medical practice acts to protect general public

Examination

Passing the states licensing exam

Reciprocity

One state grants a license to a physician already licensed in another state

Endorsement

License granted based on passing the national board of medical examiners (NBME) exam

Mutual recognition model

Allows nurses to practice in other states

Telemedicine

Over the phone treatment where a physician needs a license in the state theyre in and the state the patient is in

Veterans administration

Providers may hold a license from any state

Accreditation

A voluntary review of an institutions competence

The joint commission

accredits hospitals, long-term car facilities, and labs

Standard of care

ordinary skill and care practitioners must use

Prudent person rule

Give the info a reasonable person would want before making a decision

Scope of practice

Professional practice guidelines for each role

Chain of command

ensures no employee makes a decision they arent qualified to make

Same liability

Nursing students in clinicals are just as liable as real nurses

Respondeat superior

“let the master answer” The employer is responsible for their employees actions within scope of employment

Guardian ad litem

an adult appointed to represent a child in court in a lawsuit

Risk management

Practices that reduce behavior likely to injure patients or employees

Statute of limitations

The time a patient has to file a lawsuit, generally begins to run when the injury is discovered (rule of discovery)

Discovery rule

The time limit from when a problem was discovered or should have been discovered to file a lawsuit

Medicare

Insurance program for the elderly, disabled, and end-stage renal disease patients, managed by CMS

Diagnosis-related groups (DRGs)

Medicare’s hospital payment method, classifies patients by illness

Meaningful use

An incentive program for submitting clinical quality measures for monitoring

Medicaid

Insurance for the poor

Fee splitting (LAW)

One physician paying another for referrals

Health maintenance organization (HMO)

managed care plan where a range of services are offered for a predetermined fee, by a limited group of professionals

Preferred provider organization (PPO)

Managed care plan where patient uses a provider under contract with insurer for an agreed fee to receive a copay from the insured, a fee-for-service program, patients are not restricted to certain providers

Exclusive provider organization (EPO)

New managed care plan that has both HMO and PPO concepts where there is a limited group of providers paid on a modified fee-for-service basis

Capitation

Fixed monthly fee paid to providers per patient

The conscience clause

Protects employees who refuse on moral grounds to take part in procedures, like abortions or sterilization; penalizing them is a violation

Solo Practice

One physician, ends with owners death

Sole proprietorship

One physician owns everything and hires other physicians as employees

Partnership

Two or more physicians share everything

Associate practice

Physicians share facility and staff but not liability or profit

Group practice

Three or more physicians in the same specialty share expenses and income

Corporation

Offers profit sharing, pension plans, and protection of members income, has a decisions board

RMA credential

Offered by AMT for medical assistants

Delegation

Transfers responsibility for a patients care from one caregiver to another, following the four As

Abandonment

Leaving a patient with no formal notice of withdrawal

Dumping

Refusing to treat an uninsured, indigent patient and transferring them elsewhere; a federal offense

Veracity

Truthfulness, stressed in ANA code of ethics

HIPAA

Protects the privacy and security of health info

The doctrine of informed consent

Requires a disclosure of all relevant info before treatment

Canterbury v. Spence (1972)

Established the right to know risks, benefits, and alternatives

Unconscious patient in an emergency

Cannot give informed consent, only time it is assumed

Privileged communication

Confidential info a patient tells a physician

Advanced directive

A written statement of ones healthcare wishes incase of degradation of condition

Living will

States whether to use life-sustaining treatment and artificial nutrition (DNR)

Durable power of attorney

Names an agent whose authority continues if patient becomes incapacitated

The patient self-determination act (PSDA)

Requires institutions to tell adult patients about advanced directives