1. 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
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2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. Table 8-1

21. 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

22. 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

23. 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?