Transcript Legal and Ethical Issues in Medical Practice, Including HIPAA

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Introduction

Reasons to study medical
law and ethics
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Function at the highest
professional level
Add clip art
Avoid legal problems
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Medical Law and Ethics

Knowledge of Medical Law and Ethics provides
insight into
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The rights, responsibilities, and concerns of health-care
consumers
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The legal and ethical issues facing society, patients, and
health-care professionals as the world changes
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The impact of rising costs on the laws and ethics of
health-care delivery
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Medical Law and Ethics (cont.)
A law is a rule of conduct
or action.
Ethics is a standard of
behavior.
Governments enact laws to
maintain order and public
safety.
Moral values serve as the
basis for ethical conduct.
Criminal and civil laws
pertain to health-care
practitioners.
Family, culture, and society
help form an individual’s
moral values.
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Medical Law and Ethics (cont.)

Criminal law
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Crimes against the state
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Criminal acts are
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Felonies or
Misdemeanors
Examples include:
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Murder
Arson
Sexual Assault
Burglary
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Civil law
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Crimes against the
person
Includes a general
category of laws known
as torts
Torts are either:
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Intentional (willful)
Unintentional
(accidental)
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Intentional Torts
Assault
Open threat of bodily
harm
Battery
Invasion of privacy
Interference with a person’s
right to be left alone
Defamation of character
Damaging a person’s reputation
by making false and malicious
public statements
Fraud
An action that causes
bodily harm to another,
including touching
without permission
Depriving or attempting to
deprive a person of his or
her rights
False imprisonment
Intentional, unlawful restraint or
confinement of a person
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Unintentional Torts
 Acts
that are committed with no intent to cause harm
but done with a disregard for the consequences
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The term negligence is used to describe such actions
when health-care practitioners fail to exercise ordinary
care, resulting in patient injury
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Malpractice is the negligent delivery of professional
services
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Types of Contracts
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Expressed contracts
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Clearly stated in written or spoken words
A payment contract is an example
Implied contracts
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Actions or conduct of the parties, rather than words, create
the contract
A patient rolling up his or her sleeve to receive an
injection is an example
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Patient-Physician Contract

Physicians
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Do not have to treat every
patient
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Patients
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May choose their
physician
Do not have to return
patient to original state of
health
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May terminate a
physician’s services
Do not have to make a
correct diagnosis in every
case

American Hospital
Association’s Patient
Bill of Rights
Do not have to guarantee
success of treatment or
operation
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Patient-Physician Contract (cont.)
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Physician rights
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Physician responsibilities
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Set up a practice within the
boundaries of his or her
license to practice medicine
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Use due care, skill,
judgment, and diligence
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Select where to set up an
office and establish office
hours
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Keep knowledge up-to-date
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Perform to the best of his or
her ability
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Furnish complete
information and instructions
to the patient
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Specialize
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Decide which services to
provide and how those
services will be provided
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Patient-Physician Contract (cont.)
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Patient responsibilities
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Follow physician’s instructions and cooperate with care
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Provide relevant information to the physician
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Follow the physician’s orders for treatment
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Pay the fees charged for services provided
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Patient-Physician Contract (cont.)
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Liability
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Legal responsibility for
actions
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Understand scope of
practice
Understand standard of
care and duty of care
Health-care personnel
are all held to the
“reasonable person
standard”
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Consent
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Expressed – gives
verbal permission
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Implied – actions imply
permission
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Informed
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Patient receives all
information necessary
to make a decision
regarding treatment
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Malpractice (cont.)

Reasons patients sue
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Unrealistic expectations
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Poor rapport and poor
communication
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Greed and our litigious
society
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Poor quality of care
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Confidentiality Issues
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Legal obligation to maintain confidentiality of
patient information
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Discuss with patient privately
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Share patient information only when appropriate
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Do not discuss the case with anyone outside the
medical office
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HIPAA
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Health Insurance Portability and Accountability Act
(1996)
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Improve efficiency and effectiveness of health-care
delivery
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Protect and enhance the rights of patients
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Access to health-care information
Control inappropriate use or disclosure
Improve the quality of health care by restoring trust in the
health-care system
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Title I: Health Care Portability
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Increases workers’ ability to get health-care coverage when
starting a new job
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Reduces workers’ probability of losing existing health-care
coverage
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Helps workers maintain continuous health-care coverage
when changing jobs
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Helps workers purchase health insurance on their own if they
lose coverage under an employer’s group plan and have no
other health-care coverage available
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HIPAA (cont.)
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Protected health information (PHI)
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Uses
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Security measures
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Transmitted between or
among organizations
Managing and storing
Sharing
Patient notification
HIPAA Security Rule
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Disclosure
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Movement within an
organization
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Computer networks
The Internet
Disks, other storage
media, and extranets
Chart
Reception area and
clinical stations
Fax, copier, and printer
Notice of privacy practices
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HIPAA (cont.)
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Violations and penalties
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Civil
Criminal
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For knowing, wrongful misuse of health information
Administrative simplification
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Standardizing patient information
Standardized codes
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Code of Ethics
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Principles of right and wrong
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Laws are based on ethical considerations
Medical professionals are expected to act
ethically
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Will have a positive effect
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On your reputation
Employer’s practice
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Code of Ethics
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(cont.)
Bioethics
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Pertains to issues that arise due to medical advances
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Principles of medical ethics have developed over
time dating back to Hippocrates
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A document called the Patient’s Bill of Rights lists
ethical principles that protect the patient
© 2009 The McGraw-Hill Companies, Inc. All rights reserved