Medical Law and Ethics

by Fremgen, Bonnie F.

• ISBN13: 9780835951388
• ISBN10: 0835951383
• Edition: 1st
• Format: Paperback
• Copyright: 2002-01-01
• Publisher: Prentice Hall

Summary

"Medical Law and Ethics 2nd Edition provides essential legal and ethical principles for anyone pursuing a healthcare career. It provides a foundation of all the essentials including the legal system, the patient/physician relationship, professional liability and medical malpractice prevention, public duties of the physician, the medical record, confidentiality, bioethical issues, and HIPAA."--BOOK JACKET.

Table of Contents

Preface	xi
Acknowledgments	xiii
About the Author	xv
Introduction to Medical Law, Ethics, and Bioethics	1	(14)
Why Study Law, Ethics, and Bioethics?	2	(2)
Medical Law	4	(1)
Ethics	5	(5)
Utilitarianism	5	(1)
Rights-Based Ethics	6	(1)
Duty-Based Ethics	6	(1)
Virtue-Based Ethics	6	(1)
Interpersonal Ethics	7	(2)
Three-Step Ethics Model	9	(1)
What Ethics Is Not	10	(1)
Bioethics	10	(5)
PART I THE LEGAL ENVIRONMENT	15	(42)
The Legal System	17	(26)
The Legal System	19	(2)
Sources of Law	21	(3)
Constitutional Law	22	(1)
Statutory and Regulatory Law	22	(1)
Common Law	23	(1)
Classification of Laws	24	(8)
Civil (Private) Law	24	(3)
Contract Law	27	(3)
Public Law: Criminal Law	30	(2)
The Court System	32	(1)
Types of Courts	32	(1)
The Trial Process	33	(10)
The Procedure	33	(2)
Subpoena	35	(2)
Expert Witness	37	(1)
Testifying in Court	38	(5)
Importance of the Legal System for the Physician	43	(14)
Medical Practice Acts	44	(1)
Licensure of the Physician	44	(2)
Examination	45	(1)
Endorsement	45	(1)
Reciprocity	45	(1)
Registration	45	(1)
Revocation and Suspension of Licensure	46	(1)
Licensure and Certification of Allied Health Professionals	46	(1)
Practicing Medicine without a License	46	(1)
Standard of Care	47	(1)
Confidentiality	48	(1)
Statute of Limitations	49	(1)
Good Samaritan Laws	49	(1)
Respondeat Superior	49	(8)
Employee's Duty to Carry Out Orders	51	(1)
Employer's Duty to Employees	51	(6)
PART II THE HEALTH CARE ENVIRONMENT	57	(114)
Medical Practice and Allied Health Professionals	59	(16)
Today's Health Care Environment	60	(1)
Types of Medical Practice	61	(3)
Solo Practice	61	(1)
Partnership	61	(1)
Associate Practice	61	(1)
Group Practice	62	(1)
Professional Corporation	63	(1)
Medical Specialty Boards	64	(3)
American College of Surgeons	66	(1)
American College of Physicians	66	(1)
Allied Health Professionals	67	(8)
Registered Nurse	67	(1)
Nurse Practitioner	67	(1)
Licensed Practical Nurse	68	(1)
Pharmacist	68	(1)
Physician's Assistant	68	(1)
Certified Medical Assistant and Registered Medical Assistant	69	(1)
Certified Medical Transcriptionist	69	(1)
Laboratory Technician	69	(1)
Laboratory Technologist	69	(6)
The Physician-Patient Relationship	75	(16)
The Physician-Patient Relationship	76	(1)
Physician Rights	76	(1)
The Physician's Responsibilities	76	(1)
Professional Practice Responsibilities	77	(1)
The Patient's Rights	77	(5)
Confidentiality	80	(1)
Patient Self-Determination Acts	80	(2)
Rights of Minors	82	(1)
The Patient's Responsibilities	82	(9)
Consent	82	(9)
Professional Liability and Medical Malpractice	91	(20)
Professional Negligence and Medical Malpractice	92	(1)
The Tort of Negligence	93	(4)
The Four Ds of Negligence	93	(4)
Defense to Malpractice Suits	97	(2)
Denial Defense	97	(1)
Assumption of Risk	97	(1)
Contributory Negligence	97	(1)
Comparative Negligence	98	(1)
Borrowed Servant	98	(1)
Ignorance of Facts and Unintentional Wrongs	98	(1)
Statute of Limitations	98	(1)
Res Judicata	99	(1)
Professional Liability	99	(3)
Civil Liability Cases	99	(1)
Physical Conditions of the Premises	100	(1)
Promise to Cure	100	(1)
Law of Agency	100	(1)
Who Is Liable?	100	(1)
Liability Insurance	101	(1)
Malpractice Insurance	101	(1)
Arbitration	102	(1)
Liability of Other Health Professionals	102	(2)
Dental Assistant	102	(1)
Laboratory Technician	102	(1)
Nurse	103	(1)
Nursing Assistant	103	(1)
Paramedic	103	(1)
Pharmacist	103	(1)
Physical Therapist	104	(1)
Respiratory Assistant	104	(1)
Malpractice Prevention	104	(7)
General Guidelines	104	(1)
Safety	105	(1)
Communication	105	(1)
Documentation	106	(5)
Public Duties of the Physician	111	(18)
Public Health Records and Vital Statistics	112	(7)
Births	113	(1)
Deaths	113	(2)
Communicable Diseases	115	(1)
Child Abuse	116	(1)
Elder Abuse	117	(1)
Spousal Abuse	117	(1)
Signs of Abuse	118	(1)
Substance Abuse	118	(1)
Gathering Evidence in Cases of Abuse	118	(1)
Other Reportable Conditions	119	(1)
Controlled Substances Act and Regulations	119	(1)
Prescriptions of Controlled Drugs	120	(1)
Good Samaritan Laws	120	(2)
Protection of the Employee and the Environment	122	(7)
Medical Waste	122	(7)
Federal Regulations Affecting the Medical Professional	129	(24)
Equal Employment Opportunity and Employment Discrimination	130	(5)
Employment-at-Will Concept	130	(1)
Title VII of the Civil Rights Act of 1964	131	(1)
Equal Employment Opportunity Act (EEOA) of 1972	132	(1)
Pregnancy Discrimination Act of 1978	132	(1)
Civil Rights Act of 1991	133	(1)
Age Discrimination in Employment Act of 1967	133	(1)
Rehabilitation Act of 1973	134	(1)
Americans with Disabilities Act (ADA) of 1990	134	(1)
Employee Health and Safety	135	(2)
Occupational Safety and Health Act (OSHA) of 1970	135	(1)
Health Maintenance Organization (HMO) Act of 1973	136	(1)
Comprehensive Omnibus Budget Reconciliation Act (COBRA) of 1985	136	(1)
Drug-Free Workplace Act of 1988	136	(1)
Compensation and Benefits Regulations	137	(3)
Fair Labor Standards Act (FLSA) of 1938	137	(1)
Unemployment Compensation	137	(1)
Equal Pay Act of 1963	138	(1)
Federal Insurance Contribution Act (FICA) of 1935	138	(1)
Workers' Compensation Act	139	(1)
Employee Retirement Income Security Act (ERISA) of 1974	139	(1)
Family and Medical Leave Act (FMLA) of 1994	140	(1)
Consumer Protection and Collection Practices	140	(3)
Fair Credit Reporting Act of 1971	140	(1)
Equal Credit Opportunity Act of 1975	140	(1)
Truth in Lending Act (Regulation Z) of 1969	141	(1)
Fair Debt Collection Practices Act of 1978	141	(1)
Using a Collection Agency	141	(1)
Bankruptcy	141	(2)
Federal Wage Garnishment Law of 1970	143	(1)
Claims against Estates	143	(1)
The Statute of Limitations	143	(1)
Antitrust Laws	143	(1)
The Sherman Antitrust Act	144	(1)
The Clayton Act	144	(1)
The Federal Trade Commission (FTC) Act	144	(1)
Federal Labor Acts	144	(9)
The National Labor Relations Act (NLRA) of 1935	144	(1)
Labor Management Relations Act (LMRA)	145	(1)
Labor Rights	145	(1)
Elections	145	(1)
Effective Hiring Practices	145	(2)
Legal and Illegal Interview Questions	147	(6)
The Medical Record	153	(18)
The Medical Record	154	(1)
Purpose of the Medical Record	154	(1)
Contents of the Medical Record	154	(6)
Problem-Oriented Medical Record (POMR)	156	(1)
SOAP Charting	157	(2)
Corrections and Alterations	159	(1)
Timelines of Documentation	159	(1)
Completeness of Entries	159	(1)
Confidentiality	160	(1)
Ownership	161	(1)
Release of Information	161	(1)
Privacy Act of 1974	161	(1)
State Open Record Laws	161	(1)
Alcohol and Drug Abuse Patient Records	162	(1)
Retention and Storage of Medical Records	162	(2)
Storage	163	(1)
Computerized Medical Records	164	(1)
Reporting and Disclosure Requirements	164	(1)
Duty to Report AIDS, HIV, and ARC Cases	164	(1)
Use of the Medical Record in Court	165	(6)
Improper Disclosure	165	(1)
Subpoena Duces Tecum	165	(6)
PART III MEDICAL ETHICS	171	(98)
Ethic and Bioethic Issues in Medicine	173	(16)
Early History	174	(1)
Ethical Standards and Behavior	175	(1)
Codes of Ethics	175	(5)
American Medical Association (AMA) Principles of Medical Ethics	176	(1)
Judicial Council Opinions of the AMA	176	(1)
Code of Ethics of the American Association of Medical Assistants (AAMA)	176	(3)
Nurses' Code of Ethics	179	(1)
Bioethical Issues	180	(1)
Ethical Issues and Personal Choice	180	(1)
The Ethics of Biomedical Research	181	(2)
Ethics of the Biomedical Researcher	181	(1)
Consent	182	(1)
Conflicts of Interest	182	(1)
Ethics of Randomized Test Trials	182	(1)
Problems with the Double-Blind Test	183	(1)
Model for Examining Ethical Dilemmas	183	(1)
Medical Etiquette	184	(5)
Ethical Issues Relating to Life	189	(22)
Fetal Development	190	(1)
When Does Life Begin?	190	(1)
Assisted or Artificial Conception	191	(4)
Artificial Insemination	191	(1)
In-Vitro Fertilization	192	(1)
Surrogate Motherhood	193	(1)
Fertility Drugs	194	(1)
Contraception	195	(1)
Sterilization	195	(3)
Voluntary Sterilization	195	(3)
Abortion	198	(4)
Roe v. Wade	199	(1)
Historical Progression of Cases Affecting Abortion	200	(1)
Incompetent Persons and Abortion	201	(1)
Employee's Right to Refuse to Participate in Abortions	201	(1)
Funding for Abortion	202	(1)
Ethical Issues Surrounding Abortion	202	(1)
Conscience Clauses	202	(1)
Genetic Counseling and Testing	203	(3)
Genetic Counseling	203	(1)
Prenatal Testing	204	(1)
Genetic Testing of Newborns	205	(1)
Wrongful Life Suits	206	(5)
Wrongful Life	206	(1)
Wrongful Conception/Wrongful Pregnancy	206	(5)
Death and Dying	211	(20)
The Dying Process	212	(1)
Legal Definition of Death	212	(9)
Karen Ann Quinlan Case	212	(1)
Criteria for Death	213	(1)
Cardiac Death	213	(1)
Brain-Oriented Death	214	(1)
Uniform Determination of Death Act	215	(1)
Withdrawing versus Withholding Treatment	216	(1)
Active Euthanasia versus Passive Euthanasia	216	(2)
The Nancy Cruzan Case	218	(1)
Direct versus Indirect Killing	218	(1)
Ordinary versus Extraordinary Means	219	(1)
Right to Die Legislation or Right to Refuse Treatment	220	(1)
Stages of Dying	221	(1)
Advance Directives	221	(3)
Choices in Life and Death	224	(1)
Suicide	224	(1)
Death Certificate	225	(1)
Medical Examiner Cases	225	(1)
Ethics Committees	226	(5)
Allocation of Resources	231	(38)
The Health Care Dilemma	232	(1)
Health Care Costs and Payments	233	(2)
The Allocation of Resources	233	(1)
Medicare	234	(1)
Medicaid	234	(1)
Diagnostic Related Groups (DRGs)	235	(1)
Ethics and Managed Care	235	(3)
Ethical Considerations of Managed Care	236	(1)
The Ethics of Preferred Provider Organizations	236	(1)
The Ethics of Fee Splitting	237	(1)
Cost Containment Dilemma	237	(1)
Distribution of Health Care	238	(7)
Limited Access to Health Care	238	(1)
Macroallocation and Microallocation of Health Care	238	(1)
Principles of Justice and Health Care	239	(1)
Rescher's Theory of Social Worth	240	(1)
Childress' Lottery Method	241	(1)
The Ethics of Transplant Rationing	241	(2)
Duty to Treat Indigent Patients	243	(1)
Duty to Treat AIDS Patients	243	(2)
Quality-of-Life Issues	245	(1)
Ethical Concerns with Information Technology (Informatics)	245	(8)
Appendices
A. Codes of Ethics	253	(12)
Hippocratic Oath	253	(1)
Declaration of Geneva	254	(1)
Declaration of Helsinki	254	(3)
The Nuremberg Code	257	(2)
Code for Nurses: Ethical Concepts Applied to Nursing (International Council of Nurses)	259	(1)
Allied Health Codes of Ethics	260	(1)
Code of Ethics for the Profession of Dietetics	260	(1)
Code of Ethics of the American Health Information Management Association	261	(1)
Code of Ethics of the American Society for Medical Technology	262	(1)
Code of Ethics for Radiation Therapists	263	(2)
B. Health Care Regulatory Credentialing Agencies	265	(2)
C. Medical Web Sites	267	(2)
Index	269

Excerpts

The allied health professional has always been an important member of the medical team. This team awareness is even more critical in today's health care environment since the physician no longer practices medicine alone. Medical Law and Ethics is written in straightforward language that is aimed at the non-lawyer health professional who must be able to cope with multiple legal and ethical issues. This text is appropriate for those persons studying in a college or university who are working toward careers in the allied health field in a variety of settings such as the medical office, hospitals, clinics, and skilled nursing facilities. A wide range of pertinent topics are discussed, such as the legal system, the physician-patient relationship, professional liability and medical malpractice, public duties of the physician, the medical record, and ethical and bioethical issues. The intent is to help the health care professional to better understand our ethical obligation to ourselves, our patients, and our employer. Many legal cases are sprinkled throughout the text to demonstrate the history of the law as it pertains to subjects such as patient confidentiality, managed care, federal regulations affecting the employee, death and dying, and abortion. In some examples, the cases may seem old, but since our legal system is based on case law, they are still pertinent today. A special feature called Med Tips provides quick information about the law and ethics. These brief scenarios and hints help to maintain interest in this vital subject. All chapters include glossary terms highlighted in bold on first reference, extensive end-of-the-chapter exercises, and one actual practice case. The appendix includes a thorough compilation of codes of ethics that form a basis for current practice and a listing of health care regulatory agencies. This text is meant to provide an overview of medical law and ethics. Practicing health care professionals should know the legal requirements in their own jurisdictions. Chapter Structure LEARNING OBJECTIVES.These are an overview of the basic knowledge discussed within the chapter and can be used as a chapter review. GLOSSARY.Important vocabulary terms are listed alphabetically at the beginning of each chapter and printed inboldthe first time they are defined in the text. INTRODUCTION.Each chapter begins with an introductory statement that reflects the topic of the chapter. END OF CHAPTER EXERCISES.A selection of matching and multiple-choice questions are included to test the student's knowledge of the chapter material. SUMMARY.Using a bulleted format, the summary provides a recap of material presented in the chapter. CASE STUDY.The case studies are based on real-life occurrences and offer practical application of information discussed within the chapter. These are included to stimulate and draw upon the student's critical-thinking skills and problem-solving ability. REFERENCES.These useful resources provide further information on the topics included within the chapter. Special Features MED TIP.Brief scenarios are placed at strategic points within the narrative to provide helpful hints and useful information relating to the discussion within the text. LEGAL CASE CITATIONS.Discipline-specific cases are used throughout the text to illustrate the topic under discussion. The cases reflect the many medical disciplines, including that of the physician, that come together in the care of the patient. POINTS TO PONDER.Thought-provoking questions give students an opportunity to evaluate how they might answer some of the tough medically related ethical dilemmas in today's society. These questions can also be used for critical debate among students during a class activity. DISCUSSION QUESTIONS.The