MT-LAWS: Intro to Bioethics Part 2

Fell short of the standard of care/improper performance expected of other similarly trained medical professionals acting under the same circumstances

BREACH

• A direct result of the doctor’s breach

• Testimony of an expert witness

INJURY

Allows the mere existence of an injury to justify a presumption of negligence on the part of the person who controls the instrument causing the injury

RES IPSA LOQUITUR

‘the cause which produces the injury and without which the result would not have occurred’

PROXIMATE CAUSE

“The operating surgeon is the person in complete charge of the surgery room and all personnel connected with the operation”

CAPTAIN OF THE SHIP DOCTRINE

An act of voluntary agreement between two parties

CONSENT

“the patient's right of self-decision can only be effectively exercised if the patient possesses adequate information to enable him in making an intelligent choice”

THE DOCTRINE OF INFORMED CONSENT

2 Types of CONSENT

• IMPLIED CONSENT

• EXPRESSED CONSENT

The agreement given by a person's action (even just a gesture) or inaction, or can be inferred from certain circumstances by any reasonable person.

IMPLIED CONSENT

Is a clear statement of permission given by an individual to allow a specific action to be taken, can be through oral or written means.

EXPRESSED CONSENT

3 COMPONENTS OF INFORMED CONSENT

Disclosure

Capacity

Voluntariness

refers to the communication of relevant information by the clinician and its comprehension by the patient.

Disclosure

refers to the patient’s ability to understand the information and to appreciate those consequences of his or her decision that might reasonably be foreseen.

Capacity

refers to the patient’s right to come to a decision freely, without force, coercion, or manipulation.

Voluntariness

IN CASE THE PATIENT IS INCAPABLE OF l GIVING CONSENT… who can give consent?

• Spouse

• Son or daughter of legal age

• Either parent

• Brother or sister of legal age

• Guardian

Autonomy vs. beneficence

A prudent and reasonable physician will not leave the patient at the mercy of a layman’s decision

HOME AGAINST MEDICAL ADVICE (HAMA)

Detained or convicted prisoner; with a very contagious disease; mentally-ill

PATIENT DETENTION

if the patient cannot pay the hospital or physicians bill, the law provides a remedy for them to pursue, that is, by

filing the necessary suit in court for the recovery of such fee or bill’

if the patient is prevented from leaving the hospital for his inability to pay the bill, any person who can act on his behalf can

apply in court for the issuance of the writ of habeas corpus

What RA:

prohibits patient detention on the grounds of non-payment of hospital bills.

Requires execution of a promissory note covering the unpaid obligation.

RA 9439

In RA 9439, patients in private rooms are NOT covered by this act (Y/N).

Yes, patients in private rooms are NOT covered.

The patient has the right to privacy and protection from unwarranted publicity

PATIENT CONFIDENTIALITY

2 Types of PATIENT CONFIDENTIALITY

Direct disclosure

Indirect disclosure

Express complaints and grievances without fear of discrimination

RIGHT TO EXPRESS GRIEVANCES

Right to refuse medical treatment or procedures which may be contrary to religious beliefs

RIGHT TO RELIGIOUS BELIEF

What Right is for:

•No discrimination

•Good quality of service

RIGHT TO QUALITY CARE AND HUMANE TREATMENT

a legal document signed by the patient (or nearest kin) and the healthcare provider that allows no lifesaving measures in the event of cardiac arrest

DO NOT RESUSCITATE (DNR)

This means No CPR, fibrillation, IV medications, breathing support

DO NOT RESUSCITATE (DNR)

no placement of an endotracheal tube that can be attached to a ventilator

DO NOT INTUBATE (DNI)