Legal Issues facing

Healthcare Employees

Medical Therapeutics

Gibson County High School

Learning Objectives for Standard 2

Compare and contrast the specific laws and ethical issues that impact relationships among patients and the healthcare professional

Explain characteristics of advanced directives, living wills, durable power of attorney, and other legal directives governing medical treatment. Explain, using domain-specific language and accurate definitions of legal concepts, how the content of these legal documents impacts patients’ rights for all aspects of care.

At the conclusion of class today I CAN:

Identify malpractice issues in healthcare and how they affect the every day operations of healthcare

Define key terms that are used within medical law

compare and contrast advanced directives, living wills, durable power of attorney and give examples of how they are used in healthcare

Medical Malpractice Act

Statute or law regulating the practice of medicine

Safeguards patient’s safety and privacy

Responsibility of all personnel in health care

Licensure

Regulation to ensure competence

May vary from state to state

Renew and pay every 2 years

Continued education

Revoking a License

Conviction of crime such as a felony or fraud

Unprofessional conduct,

such as, addiction, breach

of confidentiality, false

advertising, unethical

behavior, inability to

perform duties, or fee

splitting

Respondent Superior

“Let the master answer”

Physicians are legally responsible for their employees

Hospitals carry malpractice insurance for it’s employees

Employees should have their own malpractice insurance

Certification ensures competence

Scope of Practice

The range of services a professional can

offer based on education, training, ability, and

licensure

For example, medical assistants are trained

to assist with minor surgery…medical

assistants cannot perform surgery!

Standard of Care

The minimum safe professional conduct under specific

conditions as determined by professional peer

organizations

Failure to perform is negligence

Omission: failure to use good judgment that results in

harm to the patient

Commission: performance of improper act that results in

harm to patient

Unintentional tort: negligence resulting in harm to a patient

Consent

Implied consent— patient

consents to treatment

through actions What would be an example of

implied consent?

Informed consent—

written form, signed by

patient explaining

procedure or treatment,

who will perform, risks,

and expected results When would informed consent

be necessary?

Interpreters may be necessary if a patient is hearing impaired or speaks a different language

Good Samaritan law protects emergency personnel when a patient may not be able to speak or give consent

When might the Good Samaritan law be used?

Barriers to Informed Consent

Malpractice

Medical form of negligence proven by four criteria, the 4 “D’s”

Duty: must prove relationship existed (how?)

Dereliction of duty: Must prove standard of care was not met (Use of expert witness)

Direct cause: Damages suffered were a direct result of action in question

Damage: must prove injury occured

This patient received an overdose of an antibiotic, which

was ultimately the fault of the pharmacy – the pharmacist

and the pharmacy tech. She developed Stevens Johnson

syndrome, which, to describe it in layman’s terms, burns you

from the inside out.

This is the patient now…

The Lawsuit Process

Subpoena—legal document requiring appearance

in court or for a deposition

Deposition—formal gathering of information

Trial—information is gathered, date is set by court,

expert witnesses, jury, verdict, and settlement

Malpractice insurance—mandatory in most states

A patient who brings a lawsuit against the

physician is the plaintiff, the person who seeks

monetary damages for the tort allegedly

committed against him or her . The plaintiff will

hire a lawyer to represent him or her in court.

The accused physician is the defendant, the

person who must defend or explain his or her

actions before the court.

Employees need to have their own insurance

and not just “be covered” under the facility’s

plan.

Intentional Torts: gross negligence, a form of negligence that involved an intentional act or failure to act that causes harm;

MALPRACTICE INSURANCE DOES NOT COVER INTENTIONAL TORTS

Assault—threat or

perceived threat of

bodily harm to

another person

Battery—touching

inappropriately

without permission

Defamation—slander

False imprisonment—holding a patient against his or her will

Fraud—intentional misrepresentation of facts for financial gain

Invasion of privacy—release of private information

Criminal Law

Protects the safety and welfare of the public

Determines what is legal and illegal

The crime is considered to be against

society or the state

Civil Law

Private law

Protects the rights of individuals

Most commonly exercised type of law in ambulatory care

Patient Noncompliance

Physician and patient enter into contract

Physician responsible for diagnosing and treating patient,

being available for patient care and communication, and

arranging for different physician if absent

Patient responsible for truthfully relating medical history,

following treatment recommendations, and keeping

appointments

Patients who fail to comply with treatment

recommendations cannot expect the treating physician to

be responsible for the outcome of their care

Either party may end the physician–

patient contract

Physician must send certified letter to

patient

If physician does not follow proper

procedure, abandonment may be

charged

Patient Noncompliance

Statute of Limitations

Determined by each state

Determines length of time during

which a lawsuit may be filed

Medical records

Accurate documentation

Risk Management

Medical staff and physician can best defend against

medical malpractice lawsuits by preventing lawsuits

from occurring

Accurate, complete documentation provides the

best back up

Proper documentation, presenting reasonable

expectations, and being kind and empathetic

toward patients all decrease the risk of a

malpractice lawsuit.

Confidentiality

Patient’s medical and personal

information used for treatment,

payment, and administrative operations

“Need to know”

Authorized release of information

HIPAA – confidentiality and access

Exceptions to Disclosure Rules

Court order such as

workers’ compensation

Impact on public safety

such as reporting

communicable diseases

and abuse

Harm to patient or

another individual may

result

Organ donor

Vital statistics such as

births and deaths

Reporting Abuse

Healthcare professionals are required by law

to report all suspected abuse

Procedures and forms vary from state to state

Follow office policy and procedure manual

Child Abuse Neglect—child

unattended, needs are not

being met

Emotional abuse—

caregiver yells at child, fails

to provide affection and

attention

Physical abuse—bruises,

cigarette burns, and bites

Sexual abuse—painful

urination and unusual

sexual knowledge for

child’s age

Elder Abuse

Neglect—unclean or

unsafe living conditions,

poor hygiene, and weight

loss

Physical abuse—frequent

injuries, bruises, and

patient’s fear of the

caregiver

Durable Power of Attorney

Legal document that is effective when a patient is

unable to speak for himself or herself or make

medical decisions

Patient names another to make decisions

States have standard forms

What happens when someone has not appointed

a durable power of attorney?

Living Will

Document outlining type of care a patient requests in the event of severe injury

Life support, feeding tubes, medications, kidney dialysis, ventilators, organ donation, etc.

https://www.youtube.com/watch?v=1rmlGJxdpMk

Can you…?

Explain Medical Malpractice Act and discuss what this means for

physicians

Identify who should have durable power of attorney and living wills

in place

Discuss what you would do if you suspect abuse when you are

interviewing a patient

What type of court are most medical malpractice lawsuits tried in?

Why?

What are the the 4 D’s? Why are they important?