Chapter 8—Physicians’ Public Duties and Responsibilities PowerPoint to accompany Law & Ethics For Medical Careers Fourth Edition Judson · Harrison · Hicks Chapter 8—Physicians’ Public Duties and Responsibilities Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display 8-1

Physicians’ Public Duties and Responsibilities Objectives List at least four vital events for which statistics are collected by the government Discuss the procedures for filing birth and death certificates Explain the purpose of public health statutes Tell when a medical examiner or coroner is required to sign a death certificate

Physicians’ Public Duties and Responsibilities Objectives continued Cite examples of reportable diseases, and explain how they are reported Identify three types of reportable injuries Discuss federal drug regulations State the purpose of the Controlled Substances Act

Vital Statistics Collected by State and Federal governments Used to assess population trends and needs Examples include -live births -marriages -deaths -divorces -fetal deaths -induced terminations -changes in civil status of pregnancy

Vital Statistics - Births Live births are reported to the state registrar Hospitals file birth certificate for babies born in the hospital with attending physicians’ verification Non-hospital births are filed by the person in attendance at the birth

Vital Statistics - Deaths The attending physician completes the medical portion of the death certificate which includes cause of death date and time place presence or absence of pregnancy (if female) if an autopsy was performed

Public Health Statutes All states have public health statutes, and the laws vary from state to state All states provide for guarding against unsanitary conditions in public facilities inspecting establishments where food and drink are processed and sold

Public Health Statutes continued All states have statutes that provide for exterminating pests and vermin that can spread disease checking water quality setting up measures of control for certain diseases requiring physicians, school nurses, and other health care workers to file certain reports for protecting the public

Communicable Diseases Regulations for reporting communicable and other diseases vary by state Examples of reportable diseases are -tuberculosis -smallpox -anthrax -HIV/AIDS -infectious hepatitis -tetanus -influenza -certain STD’s -meningococcal meningitis

National Childhood Vaccine Injury Act The Act established a national educational program about advantages and risks of vaccines Established guidelines for administration and documentation Requires informed consent and specific documentation -date -vaccine manufacturer -vaccine lot # -provider who administered

Reportable Injuries Injuries resulting from an act of violence should be reported for authorities to investigate They must be reported in the case of child or elder abuse according to federal law Reporting of spousal abuse differs in each state

Reportable Injuries – Child Abuse The Federal Child Abuse Prevention and Treatment Act mandates reporting of cases of child abuse and States have passed similar acts The individual reporting the abuse is granted civil and criminal immunity Check with your individual State’s Department of Health for regulations and reporting process

Reportable Injuries – Elder Abuse Amendments to the federal Older Americans Act defines elder abuse, neglect and exploitation All states have legislation for reporting elder abuse Check with your individual State’s Department of Health for regulations and reporting process

Reportable Injuries – Spousal Abuse State laws protect victims of domestic abuse In many states, patient must give permission before a report is made to the authorities unless it is a rape, gunshot, or stabbing Check with your individual State’s Department of Health for regulations and reporting process

Unborn Victims of Violence Act Federal Act provides for prosecution of anyone who causes injury to or the death of a fetus in utero while also injuring or killing a pregnant woman Passed in April, 2004

Identifying Abuse – Physical Signs unexplained fractures repeated injuries or bite marks burns with unusual shapes or friction burns malnutrition, dehydration torn or bloody underwear pain or bruising in the genital area unexplained venereal or other genital infection

Identifying Abuse – Behavioral Signs illogical or unreasonable explanations for injuries frequently changing physicians, missed appointments attempts to hide injuries with makeup, sunglasses frequent anxiety, depression, or loss of emotional control changes in appetite problems at school or on the job

Drug Regulations The Federal government has jurisdiction over the manufacture and distribution of drugs in the U.S. Food and Drug Administration (FDA) Tests and approves drugs before releasing them for public use Drug Enforcement Agency (DEA) Regulates the sale and use of drugs

Drug Enforcement Administration Physicians who purchase, prescribe, dispense, or administer controlled drugs must comply with the regulations of the Comprehensive Drug Abuse Prevention and Control Act, also known as the Controlled Substances Act See Table 8-1 for Drugs under the Act

Table 8-1

Physician Responsibilities Under DEA Register with the DEA register for each office location DEA registration number must appear on all prescriptions Keep records concerning administering or dispensing drugs for two years

Physician Responsibilities Under DEA continued Note in patient’s chart when controlled substance administered or dispensed Prepare a written inventory of drug supplies every two years and retain for another two years Keep drugs in a locked cabinet or safe

Ethics Guide Discussion As an office manager who has responsibility for risk management, you routinely audit the narcotics log in your office. Several of the employees in the office are also patients of the physician. You discover in a routine audit that an employee of the practice has received several injections of a pain medication. These injections are not noted in the medical record of the patient/employee. What are the various legal and ethical issues in this case?