Medical Law & Ethics Review

abuse

...any care that results in physical harm, pain, or mental anguish

advance directives

...legal documents that allow individuals to state what medical treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care

agent

...in contract law this person is working under the employer in this role

assault and battery

...threat or attempt to injure or the unlawful touching of another person without consent

civil law

A law that governs relationships between individuals and defines their legal rights.

confidentiality

information about the patient must remain private and can be shared only with other members of the patient's health care team

contract

...an agreement between two or more parties

criminal law

...deals with the wrongs against a persons property example: practicing without a license

defamation

...occurs when false statements either cause a person to be ridiculed or damage there person's reputation

designation of health care surrogate

...to appoint another person to make any decisions regarding health care if the principal should become unable to make decisions

Durable Power of Attorney

...Document that appoints another person to make any decisions regarding health care if the principal should become unable to make decisions

ethics

a set of principles relating to what is morally right or wrong

expressed contracts

...stated in distinct and clear language, either orally or in writing ex. surgical permit

false imprisonment

...restraining or restricting an individual's freedom

health care records

...privilege communications that contain information about the care provided to the patient

implied contracts

...obligations that are understood without verbally expressed terms

informed consent

permission granted voluntarily by a person who is of sound mind and aware of all factors involved

invasion of privacy

...includes unnecessarily exposing an individual or revealing personal information about and individual without that person's consent

legal

...based on law

legal disability

...a person who does not have legal capacity to form a contract

libel

...written defamation

living wills

...documents that allow individuals to state what measures should or should not be taken to prolong life when their conditions are terminal

malpractice

...professional negligence

negligence

...failure to give care that is normally expected of a person in a particular position, resulting in injury to another person

Patient self determination act

...federal law that ensures patients are informed of their rights

Patients' Bill of Rights

...List of patient rights honored by hospitals

patients' rights

...the factors of care that patients can expect to receive

privileged communications

...comprise all information given to health care personnel by a patient

Resident's Bill of Rights

...List of resident rights honored by long term care facilities

slander

...spoken defamation

tort

...wrongful act that does not involve a contract

Law

societal rules or regulations that are adviseable or obligatory to observe (mandatory, face civil or criminal liability).

Ethics

moral standards and a code for behavior that govern an individual's interactions with others and within society.

Bioethics

the ethical implications of biomedical technology and its practices; life & death issues; local, organizational, personal, worldwide implications

Morality

what is believed to be right and wrong.

Medical Ethics

"applied ethics;" the practical application of moral standards that concern benefiting the patient.

Difference between 'morality' & 'ethics'

"Morality is what people do in fact believe to be right and good, while ethics is the critical reflection about morality and the rational analysis of it."- Fletcher

What shapes the US

Law; the US is a litigous society

Conflict

Sometimes law, ethics & bioethics conflict

The ultimate goal

to understand complex health care public policy from all sides of an issue.

The Primary Duty

to protect our patients from harm

The conection between law and ethics

generally, if something is illegal, it's unethical, but if it's unethical, it may still be legal.

preventive medicine

ordering unnecessary tests & procedures, or avoiding to order risky tests & procedures in order to cover all the legal bases and avoid a lawsuit

problems with the law 1

the law allows many morally offensive actions

problems with the law 2

not all laws are are enforced

problems with the law 3

the law does not cover every situation a person may encounter

difference between 'law' and 'morality'

law= requirements are negative
morality= standards are positive
eg: morality says help the drowning man, the law does not require you to help, simple to not drown him yourself.

Medical Malpractice Acts

in all 50 states; define how medicine is practiced in a particular state.

items of unprofessional conduct 1

practicing without a liscense

items of unprofessional conduct 2

impaired ability to practice due to addiction or mental illness

items of unprofessional conduct 3

conviction of a felony

items of unprofessional conduct 4

insufficient record keeping

items of unprofessional conduct 5

allowing an unlicensed person to practice medicine

items of unprofessional conduct 6

physical abuse of patients

items of unprofessional conduct 7

prescribing drugs in excessive amounts

Medical ethics 2

mandates that the welfare and confidentiality of the individual patients must be the chief concern

Philosophies of ethics

Utilitariansim
Rights-Based Ethics
Duty-Based Ethics
Virtue-Based Ethics

Theories of ethics

teleological theory
deontological theory

utilitarianism definition

'the good of the many...;' cost/benefit analysis

utilitarianism advantages

encourages efficiency and productivity by looking at the impact on all involved; get the most value for the least cost

Legal Responsibilities

Responsibilities that are authorized or based on law

Types of laws affecting health care

Criminal, civil law

Tort

A wrongful act that doesn't involve a contract

Malpractice

Bad practice, professional negligence

Malpractice

The failure if a professional to use the degree of skill and learning commonly expected in that individuals profession

Result of Malpractice

Injury, loss or damage to the person receiving care

Negligence

Failure to give care that is normally expected of a person in a particular position

Result of negligence

Injury to another person

Assault

A threat or attempt to injury

Battery

Unlawful touching of another person without consent

Informed consent

Permission granted voluntarily by a person who is of sound mine after the procedure and all risks involved have been explained

Invasion of privacy

Unnecessarily exposing or revealing personal information without the persons consent

False imprisonment

Restraining an individual or restricting an individuals freedom

Abuse

Results in physical harm, pain, or mental anguish

Examples of abuse

Physical, verbal, psychological, sexual

Defamation

False statements either cause a person to be ridiculed or damage the persons reputation

Slander

When defamation occurs and the information is spoken

Libel

When defamation occurs and the information is written

Contract

An agreement between two or more parties

Part of contracts

Offer, acceptance, consideration

Implied contracts

Obligations that are understood without verbally expressed terms

Expressed contracts

Stated in distinct and clear language either orally or in writing

Legal disability

When someone doesn't have the legal capacity to form a contract.

Agent

When a person works under the direction or control of another person the person working under the employer is called:

Principal

When a person works under the direction or control of another person the employer is called:

Privileged communications

All information given to health care personnel by a patient

Patients rights

The factors of care that patients can expect to retrieve

Patients bill of rights

Recognized by many health care facilities

Advance directives

Legal documents that allow individuals to state what medical treatment they want to or do not want in the even they become incapacitated and are unable to express their wishes regarding medical care

Living wills

Documents that allow individuals to state what measures should or should not be taken to prolong life when death is expected

POA

Designation if health care surrogate / durable power of attorney

Designation of health care surrogate / durable power of attorney

A document that permits an insignias to appoint another person to make any decisions regarding health care if the principal is unable to

PSDA

Patient self-determination act

Patient self-determination act

Mandates all health care facilities receiving any type of federal aid comply with requirements.

Health Service Delivery

Transplantation and Anatomy Act 1979
Health Rights Commission Act 1991
Anti-Discrimination Act 1991
Workplace Health and Safety Act 1995
Information Privacy Act 2009
Child Protection Act 1999
Civil Liability Act 2003
Powers of Attorney Act 1998
Guardianship and Administration Act 2000

CRIMINAL LAW

Legal action between State and a citizen
Citizen alleged to have committed an offence
Action usually brought by Police in first instance Standard of proof is "beyond reasonable doubt" Outcome = punishment

CIVIL LAW

Legal action between citizens
Plaintiff vs. Defendant
Involves many divisions of substantive law, Standard of proof is "the balance of probability"
Outcome varies depending on relief sought

Civil Law Remedies

Financial compensation (damages)
Injunction (order to stop doing something)
Specific performance (order to do something).

Active Euthanasia

Positive act to bring about death, eg. administration of lethal dose of drug.

Passive Euthanasia

-Withdrawal of life-sustaining treatment allowing patient to die from natural causes.
-Withdrawal of treatment allowing patient to die of natural causes (PASSIVE)
-In response to a medical decision made in the best interests of the patient and in accordance with good medical practice (NON-VOLUNTARY)