Midterm Review: Chapters 1-4 (Ethics, Law, and Health Care)

Vocabulary flashcards covering essential terms from ethics, law, and health care topics discussed in Chapters 1-4.

Plaintiff

The person who brings a lawsuit.

Defendant

The person or party against whom charges are brought in a lawsuit.

Liable

Legally responsible or obligated.

Summary judgment

A court decision without a trial in response to a motion that there is no basis for a trial.

Litigious

Prone to engage in lawsuits.

Law

Rule of conduct recognized and enforced by a controlling authority.

Moral values

One’s personal concept of right and wrong shaped by family, culture, and society.

Ethics

Standards of behavior developed as a result of one’s concept of right and wrong, beyond what is legal.

Bioethics

Ethical implications of biological research and medicine.

Code of Ethics

A list of principles intended to govern behavior in a profession, especially healthcare.

Ethical guidelines

Publications detailing a wide variety of ethical situations and how to handle them.

Hippocratic oath

A traditional ethical guide for physicians emphasizing patient welfare.

AOTA Code of Ethics and Standards

Ethics and standards governing occupational therapy practice.

Etiquette

Standards of good manners within a profession.

Protocol

Code describing correct behavior in specific situations, such as a medical office.

Courtesy

Polite behavior and consideration for others.

Compassion

Empathy and understanding of another’s situation.

Empathy

Identification with and understanding of another’s feelings.

Common sense

Sound practical judgment.

People skills

Interpersonal abilities that help you relate well to others and patients.

Technical skills

Specialized abilities acquired through study and practice.

Critical thinking

Identify and clarify the problem, gather information, evaluate evidence, consider alternatives and implications.

Identify problem

First step in critical thinking: identify and clarify the problem.

Maslow deficiency needs

Need for basic life, safety, belonging, and shelter.

Maslow being needs

Need for esteem and self actualization.

Kohlberg theory

Moral development theory with levels and stages; Level 1 pre conventional, Level 2 conventional, Level 3 post conventional with stage examples.

Piaget theory

Moral development theory with four stages: sensorimotor, preoperational, concrete operational, formal operational.

Deontological

Duty oriented ethics focusing on rightness of actions rather than outcomes.

Categorical imperative

Kantian principle that there are universal rules with no exceptions guiding decision making.

Teleological

Outcome oriented ethics focusing on consequences; includes utilitarian approaches.

Autonomy

Capacity to be one’s own person, make decisions, and resist manipulation; includes informed consent and competence.

Competence

Legal ability to act and make decisions.

Informed consent

Patient awareness and voluntary agreement to treatment after being told risks and alternatives.

Paternalism

Interfering with another’s autonomy by making decisions without their consent.

Beneficence

Acting to promote the patient’s health and well being.

Nonmaleficence

Do no harm; avoid causing harm when possible.

Confidentiality

Privacy of patient information protected by law.

HIPAA

Health Insurance Portability and Accountability Act; protects privacy and security of health information.

Justice

Fair distribution of health resources and opportunities; what is due to each person.

Fidelity

Loyalty to professional duties and staying within a licensed role.

Veracity

Truth telling in patient care; honesty in information sharing.

AMA

Against medical advice; patient leaves AMA or refuses treatment against advice.

Formularies

Plans list of medications that are approved for reimbursement.

Co-insurance

Share of costs the insured must pay after deductible is met.

Co-payment

Flat fee paid by the insured per service.

Deductible

Amount the insured must pay out of pocket before benefits begin.

Utilization review

Process to measure the amount and appropriateness of health services used.

HMOs

Health maintenance organizations; prepaid plans that combine coverage with care delivery.

PPOs

Preferred provider organizations; providers contract with insurers for services.

PHOs

Physician-hospital organizations; physicians join hospitals and contract with insurers.

EPO

Exclusive provider organization; plans restrict to network providers.

HRA

Health reimbursement arrangement; employer funded plan to reimburse medical expenses.

HSA

Health savings account; tax advantaged account to pay medical costs.

HDHP

High deductible health plan; high deductible with lower premiums.

IPA

Independent practice associations; networks of physicians contracting with insurers.

POS

Point of service plans; allow non-network care with higher cost; PCP referrals often required.

Open access plans

Plans allowing members to see any in-network provider without referral.

ACA

Affordable Care Act; major health reform law expanding coverage.

HCQIA

Health Care Quality Improvement Act; provides peer review protections to improve care.

Criminal law

Crimes against the state; enforcement by government.

Civil law

Wrongful acts against persons; lawsuits for damages.

Felony

A serious crime punishable by more than one year in prison.

Misdemeanor

Less serious crime punishable by fines or up to one year in jail.

Tort

Civil wrong not arising from a contract; can be intentional or unintentional.

Intentional tort

Torts like assault, battery, defamation, false imprisonment, fraud, invasion of privacy.

Unintentional tort

Negligence; failure to exercise reasonable care.

Negligence

Failure to exercise ordinary care resulting in injury.

Malpractice

Professional negligence by a healthcare provider.

Expressed contract

Contract stated explicitly in writing or spoken words.

Implied contract

Contract terms inferred from actions, not words.

Licensure

Mandatory credentialing required by law to practice.

Certification

Voluntary credentialing often national; requires exam.

Accreditation

Official approval to meet standards for education programs or facilities.

Registration

Official listing of people who meet requirements in a field.

Reciprocity

Recognition of a license in another state by agreement without reexamination.

OT Licensure Compact

Interstate agreement allowing practice in member states without separate licenses.

Tort law vs contract law

Tort covers civil wrongs; contract covers promises enforceable by law.