Heath care law and ethics
Process for validating the background and assessing the qualifications of health care professionals to provide health care services in an organization, evaluating licensure, training, experience, competence and ability to perform the services or procedures requested
Credentialing
is the intentional commission of an act, such as giving a patient a lethal drug resulting in death. Any person who assists in the causing of death could be subject to criminal sanction for aiding and abetting suicide
Active Euthanasia
When lifesaving treatment (respirator) is withdrawn or withheld, allowing terminally ill patient to die a natural death
Passive Euthanasia
When person suffering an incurable illness makes the decision to die. Consent must be made by a legally competent adult and based on material information concerning the possible ramifications and alternatives available
Voluntary Euthanasia
When decision to terminate the life of an incurable person (incompetent or non-consenting competent) is made by someone other than the incurable patient
Involuntary Euthanasia
Allows a terminally ill Oregon resident to obtain a lethal dose of medication from his or her physician. The act legalized physician-assisted suicide but specifically prohibits euthanasia, where a physician or other person directly administers a medication to end another’s life
Oregon Death with Dignity Act
Patients have a right to formulate advance directives and to make decisions regarding their health care. Self-determination includes the right to accept or refuse medical treatment. Health care providers receiving federal funds under Medicare are required to comply with the new regulations
Patient Self Determination Act
In the form of a living will or durable power of attorney, allows the patient to state in advance the kinds of medical care that he or she considers acceptable or unacceptable
Advanced Directives
Instrument or legal document that describes treatments an individual wishes or does not wish to receive should he or she become incapacitated and unable to communicate treatment decisions
Living Will
Legal device that permits one individual, known as the principal to give another person, called the attorney in fact, the authority to act on his or her behalf
Durable Power of Attorney
Agent who acts on behalf of a patient who lacks the capacity to participate in a particular decision
Surrogate Decision Maker
The legal mechanism by which the court declares a person incompetent and appoints a guardian. Court transfers responsibility for managing financial affairs, living arrangements and medical care decisions to the guardian
Guardianship
Allows a person to appoint a health care agent to make treatment decisions in the event he or she becomes incompetent and is unable to make decisions
Health Care Proxy
Orders given by a physician indicating that in the event of a cardiac or respiratory arrest no resuscitative measures should be used to revive the patient. Made by patient or legally appointed healthcare decision maker via advanced directive or living will
DNR (Do not resuscitate)
Prohibits gender discrimination in the payment of wages for women and men performing substantially equal work in the same establishment. Under the Equal Pay Act lawsuits may be filed by the Equal Employment Opportunity Commission (EEOC) or by individuals on their own behalf
Equal Pay Act of 1963
Legal concept providing that a patient has a right to know the potential risks, benefits and alternatives of a proposed procedure
Informed Consent
When immediate treatment is required to preserve the life of a patient or to prevent an impairment of the patient’s health and it is impossible to obtain the consent of the patient or representative legally authorized, an emergency exists and consent is implied
Emergency Consent
An individual who by law is vested with the power and charged with the duty of taking care of a patient by protecting the patient’s rights and managing the patient’s estate
Guardian
Presumed when immediate action is required to prevent death or permanent impairment of a patient’s health. If it is impossible in an emergency to obtain the consent of the patient or someone legally authorized to give consent, the required procedure may be undertaken without liability for failure to procure consent
Implied Consent
Harmful treatment of elderly people and includes abandonment, emotion, financial, verbal, mental, sexual, or physical abuse, corporal punishment and involuntary restraint and seclusion
Senior Abuse
The unintentional commission or omission of an act that a reasonably prudent person would or would not do under given circumstances
Negligence
The negligence or carelessness of a professional person (nurse, pharmacist, physician, accountant, attorney)
Malpractice
A nonexistent, hypothetical person who is put forward as the community ideal of what would be considered as reasonable behavior
Reasonably Prudent Person
Requires plaintiff’s attorney show that the defendant violated a legal duty by not following an acceptable standard of care and that plaintiff suffered injury because of defendant’s breach
Burden of Proof
Knowing that a danger exists and voluntarily accepting the risk by exposing oneself to it, knowing that harm may occur, whether implicitly assumed (alcohol consumption) or expressly assumed (warnings on cigarette packaging).
Assumption of the Risk
Time constraints that limit the period of time after injury in which the plaintiff can file a complaint. Statutory period begins when injury occurs or in some cases when the injured person discovers or should have discovered the injury
Statute of Limitations
May be awarded over and above compensatory economic loss, covering physical disability, mental anguish, loss of a spouse’s services, physical suffering, injury to one’s reputation and loss of companionship
Punitive Damages
Claim for damages by parents of unexpected child based on allegation that conception resulted from negligent sterilization procedures or defective contraceptive device
Wrongful Conception
Prohibits discrimination on the basis of genetic information with respect to availability of health insurance and employment
Genetic Information Nondiscrimination Act of 2008 (HR 493)
Discrimination in the admission of patients and segregation of patients on racial ground are prohibited in any organization receiving federal financial assistance
Civil Rights Act of 1964
Every contract or conspiracy in restraint of trade or commerce is illegal. Those who attempt to monopolize, combine or conspire to monopolize any part of the trade or commerce is deemed guilty of a felony
Sherman Anti-trust Act
Forbids Medicare participating hospitals from dumping patients out of Emergency Departments
Emergency Medical Treatment and Active Labor Act (EMTALA)
Designed to improve the quality of health care, reduce it costs and broaden access to essential services
Agency for Health Care Research and Quality (AHRQ)
Ensures that patients are informed of their rights to execute advance directives and accept or refuse medical care
Patient Self Determination Act
An employer is answerable for the torts (wrongful acts) committed by their employees.
Vicarious Responsibility
A branch of philosophy that seeks to understand the nature, purposes, justification and founding principles of moral rules and the systems they comprise
Ethics
Recognizing the right of a person to make one’s own decisions about what is best for him or her
Autonomy
Principle of doing good, demonstrating kindness, showing compassion and helping others
Beneficence
The obligation to be fair in the distribution of benefits and risks, persons in similar circumstances must be treated similarly
Justice
Latin for “let the decision stand” providing that when a decision is rendered in a suit involving a particular set of facts, another lawsuit involving an identical or substantially similar situation is to be resolved in the same manner as the first suit
Stare Decisis
Responsible for developing and implementing administrative regulations for carrying out national health and human services policy
Department of Health and Human Services
What conduct is expected of an individual in a given situation
Standard of Care
The failure to conform to or the departure from a required obligation owed to a person
Breach of Duty
Refers to the relationship between the breached duty and the injury, i.e. but for the breached duty the plaintiff would not have suffered injury
Proximate Cause
Reasonable anticipation that harm or injury is likely to result from an act or an omission of an act
Foreseeability
Committed deliberately, proof of intent based on the premise that defendant intended the harmful consequences of his or her behavior
Intentional Tort
The 1976 Supreme Court case in which the court, relying on Roe v Wade announced that the constitutional right to privacy protects a patient’s right to self-determination. Court applied a test balancing the state’s interest in preserving and maintaining human life against the patient’s privacy interest. In light of diagnosis, state’s interest did not justify interference with her right to refuse treatment and appointed her father legal guardian and respirator was shut off
In re Quinlan
Form of surrogate decision-making where the surrogate attempts to establish what decision the patient would have made if the patient was competent to do so
Substituted judgment
A physician will not be liable for medical malpractice if he or she follows a course of treatment supported by reputable, respected and reasonable medical experts, even if another body of expert medical opinion would favor a different course of treatment
Two schools of thought doctrine
Enacted to safeguard individual privacy from the misuse of federal records, to give individuals access to records concerning themselves and to establish a Privacy Protection Safety Commission
Privacy Act of 1974
Providing persons giving information to professional review bodies and those assisting in review activities limited immunity from damages that may arise as a result of adverse decisions that affect a physician’s medical staff privileges
Healthcare Quality Improvement Act of 1986
This act was signed by President Bush on July 30, 2002 in response to the Enron debacle and high profile cases of corporate financial mismanagement. The Act requires top executives of public corporations to vouch for the financial reports of their corporations
Sarbanes-Oxley Act
Authority to carry out corporate powers delegated by statute and set forth in the articles of incorporation
Express corporate authority
Authority arising where there is a need for corporate powers not specifically granted in the articles of incorporation
Implied corporate authority
The following elements must exist in order for liability to be imputed to an employer
(A) A master servant relationship between the employer and employee and
(B) The wrongful act of the employee must have occurred within the scope of the employee’s employment
Doctrine under which the hospital is liable if it fails to uphold the proper standard of care owed the patient, which is to ensure the patient’s safety and well-being while at the hospital. It is a non-delegable duty that the hospital owes directly to a patient
Corporate negligence
US Supreme Court case (1992) in which the court rejected the trimester approach to Roe v Wade. Instead the court will evaluate the permissibility of state abortion rules based on whether they unduly burden a woman’s ability to obtain an abortion
Planned Parenthood v Casey
Committee established by each organization conducting medical research designated by the institution to provide initial approval and periodic monitoring for biomedical research studies
Institutional Review Board
Involuntary sterilization without the need for consent
Eugenic sterilization
Case law, derived from judicial decisions
Common law
Law emanating from federal and state legislation (statutes)
Statutory law
Law prescribed by administrative agencies, both state and federal
Administrative law
One party claims that harm was caused by the wrongful conduct of another with the injured party seeking compensation (damages) for the harm caused
Tort action
Claim of one party that another party breached an agreement by failing to fulfill a contractual obligation. Monetary remuneration or specific performance of the obligation is sought as remedy
Contract action
Willful, reckless disregard for the safety of another (willful indifference to an injury that could follow an act)
Criminal negligence
Execution of an unlawful or improper act, e.g. performing an abortion in the third trimester when prohibited by state law
Malfeasance
Improper performance of an act, resulting injury to another, e.g. wrong site surgery
Misfeasance
Failure to act, when there is a duty to act as a reasonably prudent person would be similar circumstances, e.g. failing to order diagnostic tests or prescribe medications that should have been ordered or prescribed under the circumstances
Nonfeasance
Unlawful restraint on an individual’s personal liberty or the unlawful restraining or confining of an individual
False imprisonment
Requires that there be a reasonable, close and causal connection or relationship between the defendant’s negligent conduct and the resulting damages suffered by plaintiff
Causation
Latin for “the thing is decided” refers to questions of law that have already been decided by the courts
Res Judicata