1. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Public Duties of the Physician Chapter 7

2. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Public Health Records and Vital Statistics Vital events in person’s life Used by government to determine population trends and needs Public duty of physicians to report vital events

3. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Births Physician must sign certificate of live birth Certificate is filed at county clerk’s office in state birth took place

4. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Deaths Date and time of death Cause of death How long deceased was treated before dying Presence or absence of pregnancy Whether autopsy took place

5. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Deaths Coroner: public health officer holds inquest if death from unknown or violent cause Medical examiner: physician who investigates unexplained deaths and can perform autopsy Autopsy: examination after death to determine cause of death

6. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Communicable Diseases Diseases transmitted from one person to another—considered threat to public Reportable diseases National Childhood Vaccine Injury Act

7. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Child Abuse All abuse must be reported by teachers, health professionals, law enforcement and day care personnel, and social service workers Physicians have been held liable for not reporting cases Person reporting is protected by law from being sued by parents and others

8. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 A young child explaining her injury to physician Figure 7-1

9. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Elder Abuse Older American Act (1987) Includes physical abuse, neglect, exploitation, abandonment, and financial abuse of adults 60 and older

10. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Spousal Abuse Laws governing the reporting vary by state Local police may have to become involved when spousal abuse is suspected Court may order restraining or protective order prohibiting abuser from contact with victim

11. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Signs of Abuse Signs of inadequate nutrition Venereal disease and genital abrasions Makeup to hide bruises Sunglasses worn inside to hide blackened eyes Repeated injuries Bruises and unexplained swelling Unexplained fractures Bite marks Unusual marks Bruising or swelling in genital area

12. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Substance Abuse Abuse of prescription drugs is reportable immediately according to law Violation of controlled substances laws is a criminal offense

13. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Gathering Evidence in Cases of Abuse Precise documentation of all injuries, bruises, and suspicious genital fluid deposits in children is critical Court may subpoena records at later date Evidence includes – Photos – Urine specimen – Clothing – Body fluids – Various samples – Foreign objects

14. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Other Reportable Conditions Physicians required to report certain medical conditions to maintain accurate public health statistics, including – Cancer – Epilepsy – Congenital disorders

15. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Controlled Substances Act and Regulations Food and Drug Administration (FDA) Drug Enforcement Administration (DEA) Controlled Substances Act of 1970 Bureau of Narcotics and Dangerous Drugs (BNDD)

16. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Prescription of Controlled Drugs Only those with DEA number may issue prescription for narcotics Number must appear on all prescriptions for controlled substances Schedule II drugs require triplicate form Schedule II drug prescription cannot be refilled Must take written inventory of drug supply every two years Narcotics dispensing records must be kept for two years

17. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Protection of Employee and the Environment Employee assistance program (EAP) – Confidential counseling and referral service – Helps employees and their families assess a problem – Develops plan to resolve problem – Determines appropriate resource to assist in process

18. Medical Law and Ethics, Second Edition Bonnie F. Fremgen ©2006 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Medical Waste Solid Chemical Radioactive Infectious