Medical Law and Ethics The Physician-Patient Relationship By: Noha Alaggad

Physician–Patient Relationship Both must agree to form relationship for there to be contract for services (implied contract) Under contract for services, patient can expect doctor to provide medical service for as long as necessary Patient must confide truthfully to physician

Physician’s Rights Right to select patients he or she will see Right to refuse service to patients Right to determine type of service he or she will provide Right to be paid for services rendered Right to withdraw from relationship Right to vacation and time off

Physician’s Responsibilities Human dignity كرامة Honesty Responsibility to society Confidentiality السرية Continued study

Physician’s Responsibilities Freedom of choice Responsibility to improve community Must support access to medical care for all people

Professional Practice Responsibilities Duties during a Medical emergency Cannot ethically or legally turn away patient in an emergency situation If unable to treat patient, then must call for emergency assistance Patients cannot be turned away if indigent معتاز or uninsured غير مؤمن عليه

Duty to Treat Indigent Patients Physician has right to select which patients to treat Physician does not have right to drop or abandon يهجر patients once he or she agrees to treat them

Duty Not to Abandon a Patient Once physician agrees to take care of patient, contract may not be terminated improperly غير صحيح Physician may be charged with abandonment if formal notice of withdrawal is not given Physician must allow patient time to seek service of another physician

Duty to Treat Patients with AIDS Unethical to refuse to treat, work with, or provide housing for person who is HIV-positive or has AIDS Physician, by law, must make full report to state about any patient who is HIV-positive or has AIDS

Ethical Considerations when Treating AIDS Patients Persuade إقناع patient to inform his or her partner(s) Notify authorities if concerned that patient will not inform others As last resort, notify patient’s partner(s)

Duty to Properly Identify Patients Identify patient both by stating his or her name and examining any other identification Arm band Driver’s license Have patient state name

Duty to Tell the Truth Many believe principles of justice apply when dealing with truth-telling Try to determine the “just” action for patient Just action may be at variance with obligation of confidentiality Confidentiality may be overridden when life or safety of patient is endangered

Patient’s Rights Right to give informed consent موافقه Right to privacy Right to be informed of advantages and potential risks of treatment Right to refuse treatment Right to confidentiality Privileged حظ communication

Confidentiality All information and records about treatment will be kept confidential by physician and staff unless consent to release is obtained Medical Patients Rights Act: all patients are entitled to have privacy respected and medical records handled confidentially

Patient Self-Determination Acts Advanced directive Living will (including a “Do Not Resuscitate” order) Durable power of attorney التوكيل Uniform Anatomical Gift Act - Patient may revoke these documents - Family may consent on the deceased patient’s behalf

The Patient’s Responsibilities Follow physician’s instructions Make follow-up appointments and monitor treatment and medication use if requested by physician Be honest Pay for medical services Provide informed consent

Consent Voluntary agreement by patient to allow medically trained person to touch, examine, and perform treatment Two types - Informed (expressed) consent التصريح بالموافقة -Implied consent الموافقة الضمنية

Informed or Expressed Consent Patient agrees to course of treatment after being told consequences of having or not having certain procedures and treatments Signature indicates patient understands limits or risks involved as explained by physician

Doctrine of Informed Consent Requires physician to explain in understandable language -Advantages and risks of treatment -Alternative treatments available to patient -Potential outcomes of treatment -What might occur—risk and benefits—if treatment is refused

Implied Consent Patient indicates by behavior that he or she accepts procedure (i.e., offers arm to have blood sample drawn) Consent is assumed in medical emergencies when patient cannot respond to give consent

Refusal to Grant Consent Adult patients conscious and mentally capable have right to refuse any medical or surgical treatment Refusal must be honored no matter what patient’s reasoning Failure to respect right of refusal could result in liability for assault and battery

Role of Health Care Consumer Do not self-medicate Be honest with physician Assist physician in prevention of medical errors

Thank you