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Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Law and Ethics
Importance of the Legal System for the Physician
Chapter 3
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Practice Acts
•Establish examining boards
•Provide baseline for practice of medicine
•Determine prerequisites for licensure
•Forbid practice of medicine without a license
•Specify conditions for renewal, suspension, and revocation of licenses
•Vary from state to state
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Licensure of Physician
•Examination– National Board Medical Examination (NBME)– Federal Licensing Examination (FLEX)– U.S. Medical Licensing Examination (USMLE)
•Endorsement•Reciprocity •Registration
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
When Valid License Is Not Needed by a Physician
•When employed by federal medical facilities (but must be a licensed physician)
• In an emergency
•While establishing residency
•When engaged solely in research
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Revocation and Suspension
•Unprofessional conduct: falsifying records, gross immorality
•Commission of a crime: Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction
•Personal incapacity: physical or mental incapacity
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Licensure and Certification of Allied Health Professionals
•Licensure: graduate from accredited school and pass national exam of competency
•Certification: meet standards set by accreditation body and pass national exam of competency
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Accreditation•Voluntary request of official review by
accrediting agency•Examine policy and procedures of agency•Must demonstrate that the institution maintains
high standards•Examples: JCAHO and CAAHEP
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Standard of Care
•Ordinary skill and care that must be used by medical practitioners
•Must provide same knowledge, care, and skill that similarly trained physician would provide under same circumstances
•Perform as “reasonable and prudent” person would perform
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Prudent Person Rule
•Must provide following information to patient:– Diagnosis– Risk and consequences of treatment– Expected benefits of treatment or procedure– Alternative treatments– Prognosis if no treatment– Cost and expected pain– Follow acceptable standard of care
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Confidentiality
•Keeping private all information about patient
•No disclosure without written consent
•Medical Patient Rights Act: gives all patients right to have privacy respected and records held confidential
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Statute of Limitations
•Period of time patient has to file lawsuit
•Usually one to three years
•Discovery Rule: begins when problem discovered
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Good Samaritan Laws
•State laws help protect health care professionals and ordinary citizens from liability while giving care in emergency
•No one is required to provide aid•Only required to act within limits of acquired
skill and training •Once you start you must continue until help
arrives or you physically cannot continue
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Respondeat Superior
• “Let the master answer”
•Employer liable for acts of employee within scope of employment
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.1An Accident Victim Receiving Emergency Care
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 3.2Physician Working with the Rest of the Healthcare Team (Jose
Pelaez/Corbis/Stock Market)
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Employee’s Duty to Carry Out Orders
•Duty to interpret and carry out orders
•Duty to clarify ambiguous or erroneous orders
•Duty to decline orders that appear dangerous for patient and to notify physician
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Scope of Practice
•Must understand and work within scope of practice for discipline
•Must understand and practice within guidelines of profession
•Must understand and follow chain of command so no employee makes decision he or she is unqualified to make
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Employer’s Duty to Employees
•Responsibility to provide safe environment for employees and staff
•Most have liability insurance to cover accidents and unforeseen incidents
•May bond employees who handle money
•Some have liability insurance for auto if used for work-related business
Medical Law and Ethics, Third EditionBonnie F. Fremgen
Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458
All rights reserved.
Risk Management
•A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer– Identify risk behaviors and practices– Develop and follow plan of action to eliminate
problem behavior– Address corrective actions in policy and procedure
books and employee handbooks