© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 1 Introduction to Law Jahangir Moini, MD, MPH, CPhT

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Role of Law Law includes statutes, rules, and regulations that govern: –People –Behaviors –Relationships –Interactions with society and state and federal governments

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Role of Law Provides order for resolution of conflicts without violence Protects individual citizens Evolves to meet changes and challenges of society

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sources of Law U.S. Constitution and Bill of Rights –Constitutional law –Most important source –No form of law may contradict Constitution Legislative branch – Statutory law

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sources of Law Executive branch – Administrative law Judicial branch – Common or case law (derived from England)

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Constitutional Law Constitution grants certain powers to federal government Protects health, safety, and welfare of each state’s citizens Bill of Rights guarantees fundamental rights to privacy, freedom of speech, religion, and equal protection

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statutory or Legislative Law Rules (laws) enacted by federal and state legislative bodies Developed and interpreted by judicial branch (system) Earlier decisions considered precedent and are binding on all lower courts

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statutory or Legislative Law Statutes are laws enacted by legislatures Start as bills (at federal or state levels) May be passed or repealed (revoked), revised (modified), amended (changed), or superseded (replaced) by legislatures Municipal ordinances are laws passed by city governments

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Administrative Law Proposed or vetoed by executive branch Congress, President, or individual state legislatures may create administrative agencies Agencies can enact rules and regulations that become administrative law

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Law Common law (case law) was developed by judges in Europe over many centuries Each state’s courts have decided various common law cases Law based on legal precedent Can only be changed by court that first decided the case or higher court

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Divisions of Law Criminal law Civil law Administrative law

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Criminal Law Enforced by representatives of the state against persons or corporations Violations against society based upon criminal statues and codes State and federal governments impose penalties

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Criminal Law Misdemeanors –Lesser crimes usually punishable by fines and/or imprisonment of less than 1 year –Examples: traffic violations, thefts under a specified dollar amount, attempted burglary

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Criminal Law Felonies –Punishable by much larger fines and imprisonment of more than 1 year or death –Examples: rape, murder, domestic violence, child abuse

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Criminal Law Certain felony convictions are grounds in many states for revoking licenses to practice in health care field Practicing without a license, falsifying information, failing to provide life support for terminally ill, and patient abuse may result in criminal prosecutions

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Civil Law Civil wrongs are often called torts Injury to a person by another person Plaintiff (injured party) may bring suit against alleged defendant (wrongdoer) Penalties usually in the form of fines

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Civil Law Intentional torts –Committed willfully –Examples: assault, battery, false imprisonment, fraud, libel, slander, trespassing, invasion of privacy

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Civil Law Unintentional torts –Are committed accidentally –Examples: failure to verify accurate information, providing patient with medication that is less effective than intended

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Civil Law Most civil law cases against health care workers are for malpractice or negligence –Negligence (failure to exercise reasonable care) –Malpractice (professional misconduct or negligence)

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Contract Law Pertains to agreements between two or more parties Concerned parties agree to do, or not do, certain things Legally binding exchanges of promises

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The U.S. Court System Local courts –Civil and criminal cases that do not exceed certain punitive sums Courts with general jurisdiction, including major trial courts –Cases of negligence, malpractice, elder abuse, and other major crimes

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The U.S. Court System State supreme court –Top court of the state U.S. Supreme Court –Decisions binding on all state and federal courts

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The U.S. Court System A court must have jurisdiction over any case it tries, whether in personam (over the person) or in rem (over the thing or property) Major trial courts’ jurisdiction based on county lines or similar divisions and people within those divisions

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The U.S. Court System When a trial is completed or a case is final in a court of general jurisdiction or one of the specific courts, it may be appealed to a higher court (usually called appeals court) Appeals may only raise issues of law and facts for review in consideration for overturning the previous ruling

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Neither federal nor state courts completely independent of each other Many of their laws interact Differences between Federal and State Law

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Differences between Federal and State Law Federal courts handle crimes under statutes enacted by Congress Both types handle crimes punishable under federal or state law, class action cases, and environmental regulation cases

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statute of Limitations Period of time established by state law during which lawsuit or criminal proceeding may be filed Varies by state Apply to: collections, retention of medical records, damages for child sexual abuse, wrongful death claims, medical malpractice

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statute of Limitations In professional negligence suits, statute of limitations is generally from 1 to 6 years, (2 years most common) Patients cannot file negligence lawsuits against physicians if designated length of time has expired

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statute of Limitations Most common occurrences for marking beginning of statutory period are: –On the day the negligence was allegedly committed

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Statute of Limitations –When the injury was actually discovered, or should have been discovered by a reasonably alert patient –The day the patient/physician relationship ended, or the day of last medical treatment in a series

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Negligence Negligence is the term used when an individual performs an act that a reasonable and prudent health-care professional would not perform, or when they fail to perform an act that a reasonable and prudent health- care professional would perform Most common liability in medicine

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Any deviation from accepted medical standard of care that causes patient injury Classifications of negligence: –Malfeasance – performance of a totally wrongful and unlawful act –Misfeasance – performance of a lawful act in an illegal or improper manner –Nonfeasance – failure to act when one should act Negligence

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Four elements must be proven to be convicted of negligence: –Duty – health care professional owed a duty of care to accuser –Derelict – health care professional breached duty of care to patient Negligence

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. –Direct cause – breach of care was a direct cause of patient’s injury –Damages – legally recognizable patient injury, with burden of proof on plaintiff Negligence

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Malpractice When a patient is treated in an improper or negligent manner, pharmacist or pharmacy technician may be sued Whether behavior results in injury, damage, loss, or death, malpractice is used to describe actions

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Malpractice Malpractice lawsuits have increased dramatically Have resulted in skyrocketing malpractice insurance prices Malpractice insurance covers: doctors, nurses, pharmacists, pharmacy technicians, other health care providers

© 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Malpractice Professional liability insurance protects against malpractice lawsuits Amounts of coverage vary, but plans are available that pay $1 million per claim up to 3 claims per year Can cover property loss or damage, personal injury, death, and even legal costs