© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-1 Introduction  Reasons to study medical law and ethics Function at the highest professional level Avoid legal problems Add clip art

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-2 Medical Law and Ethics  Knowledge of Medical Law and Ethics provides insight into The rights, responsibilities, and concerns of health-care consumers The legal and ethical issues facing society, patients, and health-care professionals as the world changes The impact of rising costs on the laws and ethics of health-care delivery

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-3 Medical Law and Ethics (cont.) Ethics is a standard of behavior. Moral values serve as the basis for ethical conduct. Family, culture, and society help form an individual’s moral values. A law is a rule of conduct or action. Governments enact laws to maintain order and public safety. Criminal and civil laws pertain to health-care practitioners.

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-4 Medical Law and Ethics (cont.)  Criminal law Crimes against the state Criminal acts are  Felonies or  Misdemeanors Examples include:  Murder  Arson  Sexual Assault  Burglary  Civil law Crimes against the person Includes a general category of laws known as torts Torts are either:  Intentional (willful)  Unintentional (accidental)

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-5 False imprisonment Assault Defamation of character Fraud Invasion of privacy Open threat of bodily harm Interference with a person’s right to be left alone Damaging a person’s reputation by making false and malicious public statements An action that causes bodily harm to another, including touching without permission Intentional, unlawful restraint or confinement of a person Intentional Torts Depriving or attempting to deprive a person of his or her rights Battery

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-6  Acts that are committed with no intent to cause harm but done with a disregard for the consequences  The term negligence is used to describe such actions when health-care practitioners fail to exercise ordinary care, resulting in patient injury  Malpractice is the negligent delivery of professional services Unintentional Torts

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-7 Types of Contracts  Expressed contracts Clearly stated in written or spoken words A payment contract is an example  Implied contracts Actions or conduct of the parties, rather than words, create the contract A patient rolling up his or her sleeve to receive an injection is an example

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-8 Patient-Physician Contract  Physicians Do not have to treat every patient Do not have to return patient to original state of health Do not have to make a correct diagnosis in every case Do not have to guarantee success of treatment or operation  Patients May choose their physician May terminate a physician’s services American Hospital Association’s Patient Bill of Rights

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-9 Patient-Physician Contract (cont.)  Physician rights Set up a practice within the boundaries of his or her license to practice medicine Select where to set up an office and establish office hours Specialize Decide which services to provide and how those services will be provided  Physician responsibilities Use due care, skill, judgment, and diligence Keep knowledge up-to-date Perform to the best of his or her ability Furnish complete information and instructions to the patient

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-10 Patient-Physician Contract (cont.)  Patient responsibilities Follow physician’s instructions and cooperate with care Provide relevant information to the physician Follow the physician’s orders for treatment Pay the fees charged for services provided

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-11 Patient-Physician Contract (cont.)  Consent Expressed – gives verbal permission Implied – actions imply permission Informed  Patient receives all information necessary to make a decision regarding treatment  Liability Legal responsibility for actions  Understand scope of practice  Understand standard of care and duty of care Health-care personnel are all held to the “reasonable person standard”

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-12 Malpractice (cont.)  Reasons patients sue Unrealistic expectations Poor rapport and poor communication Greed and our litigious society Poor quality of care

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-13  Legal obligation to maintain confidentiality of patient information  Discuss with patient privately  Share patient information only when appropriate  Do not discuss the case with anyone outside the medical office Confidentiality Issues

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-14 HIPAA  Health Insurance Portability and Accountability Act (1996) Improve efficiency and effectiveness of health-care delivery Protect and enhance the rights of patients  Access to health-care information  Control inappropriate use or disclosure Improve the quality of health care by restoring trust in the health-care system

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-15 Title I: Health Care Portability  Increases workers’ ability to get health-care coverage when starting a new job  Reduces workers’ probability of losing existing health-care coverage  Helps workers maintain continuous health-care coverage when changing jobs  Helps workers purchase health insurance on their own if they lose coverage under an employer’s group plan and have no other health-care coverage available

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-16 HIPAA (cont.)  Protected health information (PHI) Uses  Movement within an organization Disclosure  Transmitted between or among organizations Managing and storing Sharing Patient notification  Notice of privacy practices Security measures  HIPAA Security Rule Computer networks The Internet Disks, other storage media, and extranets  Chart  Reception area and clinical stations  Fax, copier, and printer

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-17 HIPAA (cont.)  Violations and penalties Civil Criminal  For knowing, wrongful misuse of health information  Administrative simplification Standardizing patient information Standardized codes

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-18 Code of Ethics  Principles of right and wrong Laws are based on ethical considerations  Medical professionals are expected to act ethically Will have a positive effect  On your reputation  Employer’s practice

© 2009 The McGraw-Hill Companies, Inc. All rights reserved 3-19 Code of Ethics (cont.)  Bioethics Pertains to issues that arise due to medical advances Principles of medical ethics have developed over time dating back to Hippocrates A document called the Patient’s Bill of Rights lists ethical principles that protect the patient