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law & ethics CH 4-6
| Question | Answer |
|---|---|
| liable | accountable under law |
| standard of care | level of performance expected from health care professional |
| duty of care | the legal obligations to treat patients and sometimes nonpatients |
| reasonable person standard | responsible for our actions or failure to act rationally |
| how can medical personal make sure to maintain patient privacy? | place records outside doors facing toward the door, don't display patient photos with any identifiable marks |
| confidentiality | holding information, not to be released to unauthorized people |
| privileged communication | information protected within a relationship such as a doctor and patient |
| when can confidentiality be waived? | for employment and that party pays the doctor's fees, records are subpoenaed, and waiver has been signed by patient |
| Malfeasance | totally wrongful act can be illegal |
| Misfeasance | legal act done badly/poorly |
| Nonfeasance | did not act when should have |
| In negligence you have to prove the 4D’s | Duty, Derelict(doing something wrong), Direct cause, and Damages |
| JCAHO | Joint Commission on Accreditation of Healthcare Organizations |
| Res Ipsa Loquitor | “the thing speaks for itself” common knowledge |
| damages | monetary awards sought by plaintiffs in lawsuits |
| wrongful death statutes | patient hurt and killed by medical personal, family members can sue |
| Summons and complaint | written notification you are being sued and list of complaints by number, pay attention to time frame if you don’t respond you automatically loose the law suit |
| Subpoena | when patient sues and they must sign waiver for release of information it will say exactly what patient wants done with records |
| Depositions | sworn testimony outside of the court usually in a lawyer’s office, trying to see how strong your case is and poke holes in it |
| interrogatory | written set of questions requiring written answers from a plaintiff or defendant under oath |
| Subpoena duces tecum | the person is required to come with the record in court |
| testimony | statements sworn to under oath |
| courtroom conduct | dress properly, answer only the questions you are asked as short as possible |
| Alternative Dispute Resolution (ADR) | techniques for resolving civil disputes without going to court, stuck with decision of mediator |
| what is the basis for most medical malpractice claims? | unintentional tort of negligence |
| when a patient sues a doctor for negligence, who has the burden of proof the plaintiff or the defendant? | plaintiff |
| types of damages | general compensatory, special compensatory, consequential, punitive, and nominal |
| general compensatory | violation of patient rights and dollar value need not be proved |
| special compensatory | losses not directly caused by the wrong and dollar loss must be proved |
| consequential | product defect and no limit on damages if personal injury |
| punitive | harsh punishment and amount of damages may be set by law |
| nominal | pateint wasnt hurt much and small token awarded |
| denial | defense that claims innocence of the charges |
| Doctrine of informed consent | risks, what if you do nothing, other options, why treatment needed |
| Defenses | denial, contributory, technical, affirmative (something else caused the issue) |
| who owns the medical records | the facility, give patient only copies |
| who owns the information in the medical records | the patient |
| how do you correct a patient record | patient must write letter, sign and state specifically what they want fixed, doctor makes sure mistake has been made,one line through bad information, put correction above, date and your initials |
| what to document | Cxx appointments (cancelled appointments), Missed appointments, Refills, and Treatment refusals |
| Statute of limitations | amount of time to bring a lawsuit to court |
| Public health statute | state laws about communicable disease patient have that you have to report to the state department |
| Doctrine of professional discretion | allows doctor to make judgment call to not release medical record to patient, usually people who are alcoholic, drug addict, mental problems |
| Emancipated minor | living away from home, self-supporting, married, or military |
| how long do you have to Retain medical records | 10 years Medicare so most places do this for everything, most pediatricians keep indefinitely |
| To get rid of record | has to be destroyed so no one can ever read it like burning or shredding |
| Abortion laws | vary state by state |
| res judicata | "the things has been decided" claim cannot be retried if it has already been resolved |
| tails-coverage | option available to doctors from former carriers to continue coverage for dates claims-made was in effect |
| prior acts insurance coverage | supplement to claims-made that can be purchased from a new carrier when doctor changes carriers |
| self-insurance coverage | subscribers contribute to trust fund to pay for potential damage awards |
| the statue of limitations is the same or varies by state | varies |
| fiduciary duty | doctor's obligation to patients based on trust and confidence |
| precautions to follow for a fax | verify the phone number of receiving location, dont fax if others in room can view the material, dont leave unattended, dont discard without shredding, use fax cover sheet that states, "confidential: to addressee only. please return if recieved in error |
| those who must have agent to give consent | minors, mentally incompetent, and those who speak limited or no english |
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