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Chapter 8
Medical law and ethics
| Question | Answer |
|---|---|
| Law | body of regulations that govern society and that people are obligated to serve |
| Sources of law | US Constitution divides the federal government into three equal branches: legislative branch (passes laws), executive branch (implements laws), judicial branch (interprets laws) |
| Common law | derives authority from ancient usages and customs affirmed by court judgments and ecrees. created by judicial branch through decisions in court cases. |
| Criminal law | dealing with criminal offenses and their punishments |
| Private law | legal rights defining relationship between private entities. |
| Public law | legal rights defining the relationship between the government and governed. |
| Case law | established by judicial decision in legal cases and used as legal precedent. |
| Defendant | person or group accused in a court action. |
| Plaintiff | person who files a lawsuit initiating a civil legal action. in criminal actions, prosecution is plaintiff, acting on behalf of people. |
| Litigant | party to a lawsuit |
| Litigation | lawsuit or a contest in court |
| Jurisdiction | power, right, and authority given to a court to hear a case and to make a judgment. |
| Layperson | individual who does not have training in a specific profession. |
| Crime | act that violates a criminal law |
| Criminal | person who has committed a crime or who has been proven guilty of a crime. |
| Accessory | person who contributes to or aids in the commission of a crime, by either a direct or an indirect act. |
| Felony | offense punishable by death or by imprisonment in a state or federal prison. serious crime, such as murder, kidnapping, assault, or rape. punishment: prison more than 1 year, death |
| Misdemeanor | crime that is less serious than a felony and consequently carries a lesser penalty. It is punishable by fine or by imprisonment in a facility other than a prison for less than 1 year. |
| Tort | civil wrong committed against a person or property, excluding a breach of contract. most common civil claim in medical law. oner personan intentionally harms another, law allows injured party to seek remedy in civil suit. |
| Intentional torts | assault, battery, defamation of character, false imprisonment, fraud, invasion of privacy, trespass, and infliction of emotional distress. Intentional torts may also be crimes. |
| Assault | willful attempt or threat by person to injure another person with apparent ability to do so. |
| Defamation | spoken or written words about a person that are both false and malicious and that injure that person's reputation or means of livelihood and for which damages can be recovered. Defamation can take the form of libel or slander. |
| Libel | defamatory writing, such as published material or pictures. |
| Slander | defamatory spoken words. |
| False imprisonment | intentional, unlawful restraint or confinement of a person. Refusing to dismiss a patient from a health-care facility upon his/her request or preventing a patient from leaving the facility may be seen as fase imprisonment. |
| Fraud | dishonest and deceitful practices undertaken in order to induce someone to part with something of value or a legal right. |
| Invasion of privacy | intrusion into a person's private affairs and public disclosure of private facts about a person, false publicity about a person, or use of a person's name or likenes without permission. |
| Infliction of emotional distress | intentionally or recklessly causing emotional or mental suffering to others. |
| Battery | unlawful use of force on a person. Also, nonconsensual or illegal touching of another person. |
| Trespass | Wrongful injury or interference with the property of another. |
| Burglary | The act of breaking and entering into a building with intent to commit a felony, especially in order to steal. |
| Misuse of legal procedure | bringing legal action with malice and without probably cause. |
| Unintentional torts | acts that are not intended to cause harm but are committed unreasonably or with a disregard for consequences. This consitutes negligence. |
| Tortfeasor | person who commits a tort either intentionally or unintentionally. |
| Court system | there are both federal and state court systems, each system has two types of court: lower and higher, or inferior and superior. |
| Supreme court | both state and federal supreme courts. State supreme court is highest state court. Federal Supremem court is final court of appeal, highest court in US. |
| Appeal | legal proceeding by which a case is transferred from a lower to a higher court for rehearing. |
| Motion | application made to a court or judge to obtain an order, ruling, or direction. |
| Arbitration | hearing and determination of a case in controversy, without litigation, by a person chosen by parties involved or appointed under statutory authority. |
| Summons | an official paper issued by clerk of court and delivered with copy of complaint to defendant, directing him or her to respond to the charges. |
| Subpoena | official paper ordering a person to appear in court under penalty for failure to do so. |
| Subpoena duces tecum | legal document requiring the recipient to bring certain records to court to be used as evidence in a lawsuit. |
| Witness | person who can testify under oath to events he/she has heard or observed, such as the signing of a will or a consent form. |
| Testimony | statements sworn to under oath by witnesses testifying in court and giving depositions. |
| Deposition | sworn pretrial testimony given by a witness in response to written or oral questions and cross-examination. Made before a public officer for use in a lawsuit, and it may also be presented at trial if witness cannot be present. |
| Perjury | voluntary violation of an oath to tell the truth; also, false statement made under oath. |
| Interrogatory | formal written questions about a case, addressed to one party by another, that are required to be answered under direction of a court. |
| Credibility | quality or power of a witness to inspire belief. |
| Disposition | final settlement of a case in criminal law |
| Verdict | finding or decision reached by a jury or judge on the matter submitted to trial. |
| Bench trial | trial in which a judge serves without a jury and rules on the law as well as the facts. |
| Assumption of risk | legal defense that holds that the defendant is not guilty of a negligent act because the plaintiff knew of and accepted beforehand any risk involved. |
| Burden of proof | task of presenting testimony to prove guilt or innocence at a trial. |
| Plaintiff | person bringing charges in a lawsuit |
| confidentiality | principle and practice of treating something as a private matter not intended for public knowledge. |
| Releasing medical records | release permitted only when authorized in writing by the patient or the patient's legal guardian, when ordered by subpoena, or when ditated by statute to protect public health or welfare. |
| Privilege | authority granted to a physician by a hospital governing board to provide patient care in the hospital |
| Privilieged communication | information held confidential within a protected relationship, such as atoorney-client and physician-patient. Physicians are prohibited from revealing info about clients in court. |
| Consent | approval and permission from a patient to allow touching, examination, treatment, or release of medical info by medically authorized personal. unnecessary in emergency situations. |
| Doctrine of informed consent | legal precept that is usually outlined in a state's medical practice acts. |
| Good samaritan act | statute that provides immunity from liability to volunteers at the scene of an accident who render emergency care. provide measure of protection to physicians who might otherwise be discouraged by possibility of a lawsuit from intervening at accident site |
| Mandatory reports | satutory reports that must be submitted by physicianson a regular basis to various governmental agencies. |
| Birth certificate | legal document that records info about birth. Used throughout a person's life to prove age, parentage, & citizenship. Tells whether a certified midwife was present at birth. |
| Minor | person who has not reached the age of majority, or legal age. |
| Standard of care | degree of care that a reasonable prudent person should exercise under the same or similar circumstances. |
| Medical practice acts | state laws that govern the practice of medicine. health professionals must practice within the scope of their training and not beyond the limits of stat'es medical practice acts. |
| Protocol | written plan specifying the procedures to be followed in giving a particular exam. rules or standards of behavior applicable to one's place of employment. |
| Medical boards | established by each stat'es medical practice act to protect the health, safety, and welfare of health-care consumers by licensing health-care practitioners. |
| Patient's Bill of Rights | statemtn by American Hospital Assoc. that guarantees patients certain rights. |
| Defensive medicine | practice of performing medical tests and procedures in order to protect against future liability and to document the health-care provider's judgment. |
| Forensic medicine | division of medicine that involves medical issues or medical proof at trials having to do with malpractice, crimes, and accidents. |
| Medical malpractice | medical professional misconduct, also called professional negligence. stems from lack of professional knowledge, experience, or skill that is expected from practitioners and results in injury or harm to the patient. |
| Negligence | Elements necessary to prove negligence: duty, dereliciton, direct cause, and damage. These elements are often called the four Ds of negligence. |
| Res ipsa loquitur | latin phrase meaning "the matter speaks for itself" also known as doctrine of common knowledge. |
| Contributing negligence | legal term defining a stuation in which both the plaitiff and defendant share in negligence that caused injury to plaintiff. |
| Quid pro quo | latin phrase meaning "something for something"-that is, giving something in return for something else. |
| Abuse | improper use of equipment, a substance (such as a drug), or a service (such as a program), either intentionally or unintentionally. |
| Respondeat superior: | latin phrase meaning "let the higher-up answer" - that is, that the physician is responsible for employee acts. |
| Scope of education and training | laws dictating what medical assistants may or may not do. |
| Res judicata | latin phrase meaning "the matter has been decided" signifies that a claim cannot be retired between the same aprties if it has already been legally resolved. |
| Child abuse | physical, sexual, or emotinal mal-treatment of a child. |
| Child abuse prevention and Treatment Act | law passed by Congress mandating the reporting of cases of child abuse. |
| Elder abuse | physical abuse, neglect, intimidation, or cruel punishment of an elderly individual as defined by the Older American Act, which created the Administration on Aging and outlined 10 objectives aimed at preserving rights and dignity of older citizens. |
| Amendments to the Older Americans Act | law passed by Congress that defines elder abuse, neglect, and exploitation but that does not deal with enforcement. |
| Rape | sexual assault involving intercourse without consent. it's a crime of violence, and victims are treated for medical and psychological trauma. are criminal acts. |
| Drug Enforcement Admin (DEA) | agency responsible for enforcing the Comprehensive Drug Abuse Prevention and Control Act of 1970. |
| Contracts | voluntary agreements between two or more parties in which specific promises are made for a consideration. Three parts to any contract: offer, acceptance, and consideration. |
| Acceptance | aggrement to terms of contract; a patient indicatesacceptance of physicin's offer of practicing medicine by scheduling appointments, submitting to physical exams, and allowing physician to prescribe or perform medical treatment. |
| Condsideration | something of value that is bargained for as part of a contract. It is what each party agrees to provide for the other. |
| Breach of contract | failure of a party to comply with terms of legally valid contract. |
| Void | without legal force or effect. |
| Implied contract | unwritten and unspoken agreement, terms of which result from actions of parties involved. |
| Termination of contract | generally takes place when all treatment has been completed and all bills have been fully paid. |
| Premature termination of contract | may occur as result of failure to pay for services, missed appointments, failure to follow physician's instructions, or obtaining the services of another physician. |
| Liable | accountable under the law |
| Bonding | insurance against embezzlement for employees who handle financial matters in the medical office. |
| Licensure | granting of permission by competent authority to an individual or organization to engage in a practice or activity that would otherwise be illegal. mandatory credential process established by law. strongest form of regulation. |
| Registration | recording of professional qualification information relevant to government licensing regulations. |
| Certification | voluntary credential process usually made by a nongovernmental agency. purpose of certification is to ensure that the standars met are those necessary for safe and ethical practice of profession. |
| Reciprocity | policy under which a professional licese obtained in one state may be accepted as valid in other states by prior aggreement |
| Telemedicine | remote consultation by patients with physicians or other health professionals via telephone, internet, or closed-circuit television. legal concerns over telemedicine involve matters such as state licenses, reimbursement, confidentiality, and informed cons |
| Business structures | legally, business structures include sole proprietorships, partnerships, and corporations |
| Sole proprietorship | type of medical practice management in which a physician practes alone and is responsible for all profits and liabilities of business. |
| Partnership | medical practice management involving the assoc. of two or more individuals practicing together under a written agreement specifying rights, obligations, and responsibilities of each partner. |
| Corporation | body formed by group of people who are authorized by law to act as single person. governed by state law. |
| professional corporation | corporation designed for professionals such as physicians, dentists, lawyers, and accountants. |
| Group practice | medical management system in which a group of three or more licensed physicians share their collective income, expenses, facilities, equipment, records, and personnel. |
| Indemnity | security against loss, hurt, or damage. Indemnity is traditional form of health insurance that covers the insured against potential loss of money from medical expenses for an illness or accident. |
| Managed care | system in which the financing, administration, delivery of health care are combined to provide medical services to subscribers for a prepaid fee. |
| Capitation | payment method for health-care services in which a fixed amount of money is paid per month or other period to an HMO, medical group, or individual health provider for full medical care of subscribers. |
| Liability insurance | contract coverage for potential damages incurred as a result of a negligent act. Doctors are often required to show proof of coverage up to a predetermined amt before hospitals will grant privileges or before managed care organization will enter into cont |
| Employment-at-will | concept of employment whereby either the employer or the employee can terminate employment at any time and for any reason. |
| Wrongful discharge | concept established by precedent wherby an employer risks litigation if he or she does not have just cause for firing an employee. |
| Legal protections | laws against wrongful discharge that prevent employers from firing someone for refusing to commit an illegal act, whistleblowing, performing a legal duty, or exxercising a private right. |
| Wagner Act of 1935 | statute that makes it illegal to discriminate in hiring or firing because of union membership or organizing activities. |
| Fair Labor Standards Act of 1938 | statute that prohibits child labor and firing of employees for exercising their rights under the act's wage and hour standards. provides for overtime pay and minimum wage. |
| Equal Pay Act of 1963 | statute that requires equal pay for men and women doing equal work. |
| Title VII of the Civil Rights Act of 1964 | statute that applies to businesses with 15 or more employees working at least 20 weeks of the year. prevents employers from discriminating in hiring or firing on basis of race, color, religion, sex, national origin. |
| Right-to-know laws | state laws that allow employees access to info about toxic or hazardous substances, employer duties, employee rights, and other workplace health and safety issues. |
| SOAP | approach to documentation that provides an orderly series of steps for dealing with medical case. Lists: pt's symptoms (subjective data), diagnosis (objective data, assessment, plan of action. |
| POMR or POR | system of problem-oriented medical records based on client problems-conditions or behaviors that result in physical or emotional distress or interfere with functioning. |
| Ownership of medical records | pt's medical records are considered the property of owners of facility where they were created. |
| Transferring medical records | clients who request that their medical records be transferred to another physician should do so in writing. Original record may be retained in office. |
| Children's medical records | parent or legal guardian may sign the release forms. If parents are legally separated or divorced, release forms must be signed by parent who has legal custody. |
| Health Insurance Portability and Accountability Act (HIPAA) | law passed by US Congress in August 1996 to create national guidelines for health privacy protection. |
| TITLE I, Health-Care Portability | part of HIPAA that deals with protecting health-care coverage for employees who change jobs. |
| TITLE II, Preventing Health Care ABuse, Admin. Simplification Liability Reform | Commonly known as HIPAA Privacy Rule, part of HIPAA that provides the first comprehensive federal protection for privacy of health info. |
| Individually identifiable health info | an individual's personal info that is gathered in process of providing health care. |
| Protected health info (PHI) | individually identifiable health info that is transmitted or maintained by electronic or other media, such as computer storage devices. info is protected by HIPAA Privacy Rule. |
| Use | defined by HIPAA, act of doing any of following to individually identifiable health info by employees or other members of an organization's workforce: sharing, employing, applying, utilizing, examining, analyzing |
| Disclosure | defined by HIPAA, act of doing any of following by party holding the info so that the info is outside that party: release, transfer, providing acces to, divulging in any manner |
| Treatment, payment, and operations (TPO) | uses that HIPAA authorizes for sharing patient info: to provide care, to receive payment, to conduct normal business activities, such as quality improvement. |
| Notice of Privacy Practices (NPP) | document given to patients by health care providers that informs patients of their rights as outlined by HIPAA |
| HIPAA Security Rule | technical safeguards that protect the confidentiality, integrity, and availability of health info covered by HIPAA. Security Rule specifies how patient info is protected on computer networks, internet, disks, and other storeage media. |
| Ethics | study of values or principles gove3rning personal relationships, including ideals of autonomy, justice, and conduct. |
| Bioethics | discipline dealing with the ethical and moral implications of biological research and applications, especially as they relate to life and death. |
| Moral | conforming to a standard of right behavior or a rule of conduct based on standards of right and wrong. usually formed through the influence of family, culture, and society, and they serve as guide for personal ethical conduct. |
| Philosophy | basic veiwpoint or system of values, general beliefs, concepts, and attitudes. |
| Etiquette | standards of behavior considered appropriate within a profession. describes a body of courtesies and manners to be observed in social situations. |
| Beneficence | active goodness or kindness |
| Nonmaleficence | abstinence from committing any harm. as human beings, we have an obligation not to harm others. |
| Duty to improve oneself | should always continue your education, learn new competencies and skills, learn fromyour own mistakes, learn from others you work with, and strive to be a good role model. |
| Genetic | pertaining to reproduction, birth, or origin or to being produced by genes or attributable to them. |
| Genetic diseases | diseases linked to genetic defects. There are as many as 4,000 human genetic diseases. |
| Genetic screening | test for genetic problems that requires a DNA samply from solid tissues, saliva, or blood. |
| Genetic engineering | gene splitting, recombinant DNA research, chemical synthesis of DNA, and other technology. involves numerous ethical issues and requires following stringent ethical guidelines. |
| Gene therapy | insertion of normally functioning gene into cells in which an abnormal or absent element of gene has caused disease. loal is to alleviate suffering and disease, not to enhance desirable characteristics or to diminish undesirable characteristics not relate |
| Cloning | procedure for producing multiple copies of genetically identical organisms or individual genes. |
| Eugenics | study of hereditary improvement achieved by controlling the characteristics of genes. |
| Artificial insemination | mechanical injection of viable semen into vagina. |
| In vitro fertilization (IVF) | fertilization that takes place outside a woman's body, usually in a test tube. ethnical concerns: fertilized human eggs should not be subjected to lab research. |
| Gestation | length of time after conception during which developing offspring are carried in uterus. |
| Amniocentesis | obstetric procedure in which a small amt of amniotic fluid is aspirated for purpose of analyzing whether a fetus is developing normally |
| Amniotomy | artificial rupture of fetal membranes. performed to stimulate or accelerate the onset of labor. procedure is painless |
| Stillbirth | death of a fetus before or during delivery. known as fetal death if weight of fetus is more than 1000g. may require neither birth nor death certificates. |
| Spontaneous abortion | aka miscarriage , usually before 20th week of pregnancy. |
| Abortion | voluntary termination of pregnancy before gestation is complete and, and before fetus is viable. |
| Stem cell | early embryonic cells that have potential to become any type of body cell. debate on therapeutic use remains intense because they have shown promise for treating patients with a wide variety of medical problems. |
| Uniform Anatomical Gift Act | law adopted by all state. |
| Transplant | transfer of an organ or tissue from one person to another or from one part of body to another. Divided into four categories, depending on source of tissue used: autograft, heterograft, homograft, isograft. |
| Autograft | surgical transplantation of person's own tissue from one part of body to another location. used in several kinds of plastice surgery, most commonly to replace skin lost in severe burns. term can be applied to transplants between identical twins. |
| Heterograft | transplant of animal tissue into human. aka xenograft. |
| Homograft | nonpermanent transplant of tissue from one body to another (in same species), such as tissue transplant between two humans who are not identical twins. aka allograft. |
| Isograft | surgical transplantation from genetically identical individuals, such as identical twins. |
| Patient self-determination Act | federal law that requires health-care providers to provide written info to patients about their rights under state law to make medical decisons |
| Advance directives | documents that make wishes known in the event that individuals are unable to speak for themselves. ex: living wills, durable powers of attorney, and health-care proxies. |
| Living will | document in which an individual expresses his/her wishes regarding medical treatment. |
| Durable power of attorney | document that gives designated person the authority to make legal decisions on behalf of grantor, usually including health-care decisions. |
| Health care proxy | durable power of attorney issued for purposes of making health-care decisions only. |
| Do-not-resuscitate (DNR) order | document written at request of patients or their authorized representatives stating that cardiopulmonary resuscitation should not be used to sustain life in medical crisis. |
| Geriatrics | branch of medicine pertaining to elderly individuals and treatment of diseases affecting them. |
| Termination phase | period of life of persons who are expected to die within 6 months. last stage of therapy for patients. |
| Curative Care | treatment to cure a patients disease |
| Palliative care | treatment of symptoms to make a dying person more comfortable. aka comfort care. |
| Euthanasia | administration of a lethal agent by another person to a patient with an incurable disease or condition |
| Physician-assisted suicide | Euthanasia by physician at the request of a person who wishes to die. |
| Brain death | irreversible cessation of all function in entire brain, including the brainstem, while the heart continues to beat. declared when electrical activity is absent on two electroencephalograms performed 12-24 hours apart. |
| Signs of death | six signs for pronouncing a comatose patient dead: no breathing w/o assistance, no coughing/gagging relfex, no blinking when cornea touched, no pupil response to light, no response to pain, no grimace reflex when head totated or ears flushed with ice wate |
| Thanatology | study of death, dying, psychological methods of coping with death and dying. |
| Autopsy | postmortem exam of body performed by specially trained medical person to confirm or determine cause of death. |
| Grief | normal reaction to loss, such as loss of job, loss of close friend or family member, death, diagnosis of terminal illness. |
| Stages of grief | pattern of emotional and physical responses to separation and losss. |
| Elisabeth Kubler-Ross defines 5 stages or responses of dying patients | 1) denial and isolation 2) anger, asking "why me?" 3) bargaining and guilt 4) depression 5) acceptance |
| Liable means | accountable under law |
| A partnership is | an association in which two or more individuals practice together and each assumes liability |
| The power and authority given to a court to hear a case and to make a judgment is called | jurisdiction |
| A physician is required to report | births, deaths, abuse, communicable diseases |
| A crime punishable by a fine or imprisonment for less than one year is known as | Misdemeanor |
| Professional negligence is also called | malpractice |
| All of the following are the Ds of negligence | dereliction, damages, duty, direct cause |
| where can a minor's medical records be released? | a parent with legal custody has signed the release forms |
| In order to protect the confidentiality and privacy of patients, medical assistants should not | discuss confidential matters such as test results and finances over telephone, leave messages with someone other than patient about results/finances, release medical records without the signed consent of patient or legal guardian (all above) |
| A contract | voluntary agreement, made for consideration, involves a specific promise made, involves two or more parties |
| Consent in unnecessary | in emergency situation |
| Transplant of animal tissue into human is known as | heterograft |
| all stages of grief identified by Kubler-Ross | depression, isolation, bargaining, anger |
| The age of majority in most jurisdictions is | 18 years |
| It is permissible to release private and confidential info about a patient when? | the patient has signed a release form |
| Good samaritan laws | encourage physicians to render emergency first aid, exist in all 50 states, protect physicians against liability for negligence in certain circumstances, dela w/treatment of accident victims. |
| Res ipsa loquitur is a Latin phrase that refers to | something that is common knowledge or that speaks for itself |
| All of the following are part of the Patient's Bill of Rights | privacy, confidentiality, refusing treatment, expecting continuity of care |
| Meaning of "let the higher-up answer"? | Respondeat superior |
| What is the most important for medical assistants to keep in mind during their dialy work routine in medical offices? | confidentiality |
| When is it permissible to release info from a patient's record? | When a court requests it by means of subpoena |
| Under which of the following circumstances is it permissible to release info from a patient's record? | When a patient signs a release |
| The fact that an individual is a patient of the practice is | confidential info |
| In cases of malpractice involving res ipsa loquitur | the physician has the nurden of proving his/her innocence |
| The Uniform Anatomical Gift Act includes the provision that | physicians who accept organs and tissue in good faith, relying on apparently valid documents, are protected from lawsuits, time of death must be determined by a physician, any person over 18 yrs may give all/any part of his/her body up after death for res |
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walton33