MDA 136MEDICAL LAW AND ETHICS

Chapter 2 Lecture

COURSE OBJECTIVES

1. Differentiate between legal and ethical issues2. Describe the legal and ethical importance of

maintaining patient privacy and confidentiality.3. Define and properly use medicolegal terminology 4. Identify duties within the scope of practice for a

Medical Assistant5. Discuss litigation situations and defenses6. Explain methods of protecting patient

confidentiality

MEDICAL ETHICS Ethics – standards of conduct and moral guidelines generally

expected by the professional community. Codes of ethics – each professional organization creates it’s

own rules and guidelines for it’s members to follow. (Hippocratic oath, *AMA principles of ethics, and *AHIMA codes of ethics)

*American Health Information Management Association *American Medical Association

MEDICAL ETHICS

As a professional, you must possess both personal and professional ethics!

Personal ethics- guidelines for behavior based on a person’s moral and/or personal values.

Professional ethics- standards of conduct set by professional organizations. This is something that is learned while studying for the profession or while on the job.

MEDICAL ETHICS vs. MEDICAL LAW

Medical ethics - refers to a moral obligation to follow the

rules. Medical ethics deals primarily with morals, values and integrity (principles of right and wrong).

Medical law - refers to a legal obligation to follow the rules.

(Not following medical law can get you arrested and/or put in jail.)

There are some acts that are legal but unethical.

example: not volunteering/helping in an emergency situation (car accident)

There are acts that are ethical but illegal.

example: euthanasia “mercy killing”

Ethical dilemma- there may be times when you are faced with an “ethical dilemma” which is often a conflict between what you think is “right” and what is legal.

Although it may be a tough decision, always choose what is legal, regardless of how compelled you feel to do the opposite.

MEDICAL ETIQUETTE

Medical etiquette - customs, common courtesy and manners of the medical profession. (Consideration for others)

MEDICAL ETIQUETTE VS. MEDICAL ETHICS

Medical etiquette has more to do with self conduct, behavior and common courtesy for those working with and around you.

Poor medical ethics could get you fired; poor medical etiquette could make people in your office upset.

1. Liability- an obligation that legally binds an individual or organization to settle a debt or wrongful act.

2. Torts- wrongful acts committed against a person or

property. Torts often result in emotional, mental and physical harm or death.

3. Tortfeasor- a person who commits the tort or

wrongful act.

MEDICOLEGAL TERMS

4. Breach of contract- the failure to fulfill an obligation or agreement as outlined in a contract.

5. Intentional torts- committed by a person with the intent to do

something wrong.

6. Nonintentional torts/unintentional torts- (accidental) acts committed by a person who does not intend to do so. Most medical malpractice lawsuits fall under this category.

7. Assault- to threaten or act in a way that causes the person to fear harm. (Non-physical)

8. Battery- battery is unlawful touching, with or without physical harm.

9. Slander- verbally spreading lies or rumors about another person which causes harm to their reputation or employment.

10. Libel- writing lies or rumors about another person which causes harm to their reputation or employment. This includes all types of writing (texting, e-mailing, typing, faxing, etc.)

11. Invasion of privacy- to seek or give out information about another person’s private, personal matters or activities.

12. Medical abandonment- occurs when the physician stops all forms of care and treatment with a patient who is still in need of care.

In this situation, the physician fails to give the patient sufficient or proper notice.

13. Fraud- a deceitful act with the intention to conceal the truth.

14. False imprisonment- keeping a person against their will. (Example- telling a patient they can’t leave until they pay their co-pay or office visit fee.)

15. Negligence- failing to take reasonable precautions to prevent harm to a patient. It can occur in one of two ways:

A. Doing something that a reasonable person would not do.B. Not doing something that a reasonable person would do

16.Malpractice- When a professional is negligent in their duties.

17. Malfeasance- the performance of a wrong and unlawful act (example - giving medical treatment without the knowledge or presence of a doctor).

18. Misfeasance- the performance of a lawful act in an improper way (example- failing to use a sterile bandage when dressing a wound, resulting in an infection).

19. Nonfeasance- the failure to perform a necessary act(example- not doing CPR on a patient who has stopped breathing).

20. Res ipsa loquitur- (res- ip- suh low- key- tor) a Latin term which means “the thing speaks for itself.” An obvious mistake made by the healthcare professional. (Example- A surgeon is to remove a patient’s left leg during surgery and instead removes the right leg by accident).

21. Respondeat superior/Vicarious liability- (ray-spon-deet) a Latin term which means “let the master answer.” This law makes physicians responsible for MOST of their employees actions while working under them.

22. Subpoena- orders issued by the court to obtain evidence. A subpoena can be for a person or an item.

23.Plaintiff- the accuser in a lawsuit

24.Defamation of character- malicious, false statements about a person’s character or reputation.

25. Res judica/Res judicata- “the thing that has been decided” is a legal doctrine that a claim can’t be retried once a lawsuit has been decided or settled.

Once a final judgment has been made on a case, the parties of the lawsuit are forever barred from bringing another lawsuit under the same claim or demand. One reason for this is to prevent the plaintiff from recovering damages from the defendant twice for the same injury. (fraud)

(Example- if a physician is found innocent of a wrongdoing in a lawsuit, the patient can’t bring the same suit with a different attorney based on the same evidence.)

26. Subpoena duces tecum- “ bring with you under penalty of punishment” : a command by the court ordering the party(s) to appear and produce records and /or tangible evidence (documents) for use at a hearing or trial.

27. Subpoena ad testificandum- “ under penalty to give testimony”: a command by the court ordering the appearance of a witness in order to give an oral testimony.

28. Remittitur- a ruling by a judge to lower the amount of damages (money) granted by the jury.

29. Additur- a ruling by a judge to increase the amount of damages (money) granted by the jury. This ruling is very rare.

30. Bioethics- Is concerned with moral issues that deal with human life. The study of the ethical and moral practices primarily in the area of medical research and technology.

31.Self-Determination Act- A federal law that allows patients to appoint a healthcare surrogate and make decisions about his or her health before they become unable to do so.

32. Direct cause- any action that causes a secondary action or event to happen.

33.Duty- a moral and/or legal commitment to someone or something.

34.Dereliction of duty- The failure to obey a direct order or regulation, which includes the avoidance of any duty which may be properly expected.

In addition to duty and direct cause, the plaintiff must be able to prove “dereliction of duty”

in a negligence lawsuit.

35. Standard of care- requires physicians to perform acts that a reasonable and prudent physician in a similar situation would perform.

36. Tort of outrage- intentionally causing severe emotional and/or mental distress to another person.

37. The Hippocratic Oath- traditionally taken by doctors; swearing to ethically practice medicine.

HIPPOCRATIC OATH:

I SWEAR by Apollo the physician and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation -- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.

I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.

37. Uniform Anatomical Gift Act- an act which governs organ/tissue donations, transplants and medical research cadavers.

38. Living will- also known as “advanced directive" allows an individual to legally document their wishes and treatment/care options in the event of their death.

Included in a living will:

•DNR or resuscitation orders • Organ or tissue donation• Medical power of attorney

ARIZONA BOARD OF MEDICAL EXAMINERS

Each state governs or regulates it’s Medical doctors and providers. In our state, this board is known as, “The Arizona Board of Medical Examiners,” “Arizona Medical Board” or “BoMex.” This board has the power to suspend and revoke medical licenses. The Medical Board not only holds physicians accountable for their actions, it makes this information known to the public. The Arizona Medical Board is comprised of 12 members – eight physicians and four public members. The Arizona Board of Medical Examiners also regulates Medical Assistants as well. An outline of our scope of practice and legal definition can also be found at this website.

Patient’s who wish to file a complaint or malpractice claim can start here.

www.azmd.gov

THE GOOD SAMARITAN LAW

The Good Samaritan law- a law designed to protect health care professions from being sued for injuries or negligence when helping or volunteering in emergency situations.

A “Good Samaritan” is someone who unselfishly helps others.

Although you are not legally required to help an injured person when you are not on the job, (unless you live in the state of Vermont), as a medical professional, you have an ethical duty to help.

Exceptions to the Good Samaritan law:

1. Standard of care- a medical professional is held at a higher standard of care than a person with no medical training.

2. Duty of care- once a person decides to help a victim, they are obligated to continue to help that person until someone more qualified arrives.

3. The Samaritan- victim relationship- a payment, “tip” or reward is never allowed to be accepted by a good Samaritan. Accepting a payment creates an “implied contract” between the good Samaritan and the victim. In this case, if something goes wrong, the good Samaritan would not be free from liability.

4. Scope of practice- the person performing CPR/emergency aid must stay within their scope of practice. They can only perform actions for which they have been trained and/or certified to perform.

5. Gross negligence- extremely careless actions taken by the good Samaritan. (Example- treating the injured victims scraped knee instead of controlling the profuse bleeding from his head.)

6. Office/hospital emergencies- good Samaritan laws don’t apply to medical offices or hospitals. In medical facilities, medical professionals are required by law to help the victim.

7. Consent- even in an emergency, you must get the victims consent for treatment. The only exception is if they are unconscious or incompetent. If the patient refuses help, you must obey their wishes.

Exceptions? . . .Yes! If and when the patient becomes unconscious and/orstops breathing- you then can begin to help them, even if they refused helpwhen they were conscious. (It then becomes a life threatening condition.)

Good Samaritan Laws:

• Designed to protect health care professionals against liability for negligence in certain circumstances

• Deal with treatment of accident victims

• Encourage health care professionals to render emergency first aid

TYPES OF CONSENT

TYPES OF CONSENT1. Implied consent- consent that is indicated by a person’s actions (body

language or gestures)

2. Informed consent- a type of consent form given to the patient which explains facts, options and risk factors associated with a particular surgery or procedure. An “informed consent“ must be given to a patient and signed before all invasive surgeries.

3. Substituted consent- consent given by a person other than the patient. This consent is given on behalf of a person who is legally incompetent. (Minors, mentally handicapped, elderly etc.)

4. Express consent- consent that is indicated and presented verbally and in writing. This is the most important type of consent. Because it is signed by the physician and the patient, it is written “proof” that consent was given and the patient was informed of the risks.

THE PHYSICIAN - PATIENT

RELATIONSHIP

• Perform to the best of his or her ability

• Always use their best professional judgment.

• Use established customary treatments

• Abstain from experiments

• Provide proper care instructions

• Prevent the spread of contagious diseases

• Advise patient’s against needless operations or procedures.

The physician is obligated to . . .

• Restore the patient to the same condition as they were before treatment

• Effect the recovery

• Make a correct diagnosis

• Be free from mistakes of judgment

• Guarantee a successful result

• Treat beyond their capacity or knowledge

• Know a patients allergies which have not been disclosed or discovered.

The physician is NOT obligated to . . .

• Have an open, honest relationship with their physician

• Provide any or all information that might be relevant to their condition, diagnosis, and treatment.

• Follow the physician’s instructions and/or advice

• Take all prescriptions and treatments as directed

• Pay all fees, copays and out-of-pocket costs in a timely manner or as agreed via a payment plan.

The patient is obligated to . . .

Once the physician- patient relationship is damaged in some way, it is best for the physician to discontinue care with the patient.

This is done by sending the patient a “letter of intent to terminate care” or a letter of “disengagement”. This letter must be certified and is, in essence, the doctor “firing” the patient.

Sample letter terminating the physician-patient contract

1. Why contract is being terminated2. Date termination is effective3. What patient should do to get a copy

of their medical records4. Strong recommendation to seek

further treatment elsewhere

THE PHYSICIAN- PATIENT RELATIONSHIP

Physician’s letter of termination must state:

Physicians may terminate the contract when:

1. Patients do not keep appointments2. Patients refuse to follow orders3. The physician has personal reasons

which prevent him or her frombeing able to carry out their duties.

THE PHYSICIAN- PATIENT RELATIONSHIP

THE PHYSICIAN- PATIENT RELATIONSHIPMinor: a person under the age of consent. Usually the age is 18, but in some states the age of consent is 16 or 21. A minor is not legally allowed to give consent for their own treatment, but there are exceptions to the law.

Examples:

1. Emancipated minors 2. Reproductive health, including birth control3. Abortion/adoption services4. Testing and treatment for STDs5. Substance abuse treatment and care6. Mental health care and treatment7. Pregnancy testing and obstetrical care

CONFIDENTIAL COMMUNICATIONSPhysicians and all other health care professionals have a legal and ethical responsibility to safeguard the patient’s privacy by keeping their medical information confidential.

HIPAA requires you to keep this information safe and confidential! It’s the law!

. . .Remember, you as the healthcare professional , are entrusted with access to personal, private patient information and you are legally and morally obligated to keep it confidential.

THE PATIENT BILL OF RIGHTS

THE PATIENT BILL OF RIGHTS1. Information disclosure2. Choice of providers and plans3. Access to emergency services4. Participation in treatment decisions5. Respect and nondiscrimination6. Confidentiality of health information7. Complaints and appeals

INFORMATION DISCLOSUREPatients have the right to clear and accurate information about their care plan, health care professionals, and health care facilities

examples - If the patient speaks another language, a translator should be provided. If the patient has a physical or mental disability, the patient has a right to assistance.

CHOICE OF PROVIDERS AND PLANS

Patients have the right to choose their health care provider and health insurance plan.

ACCESS TO EMERGENCY SERVICES

If a patient’s health is in serious jeopardy, he or she has a right to emergency services, without prior authorization or financial penalty.

PARTICIPATION IN TREATMENT DECISIONSPatients have the right to know treatment options they have and to participate in decisions about their care and treatment. If necessary, the patient has the right to appoint someone else to make decisions for them. Patients have the right to refuse treatment.

RESPECT AND NONDISCRIMINATION

Patients have a right to considerate, respectful, and nondiscriminatory care.

Physicians can’t refuse to treat a patient because of a personal bias.

CONFIDENTIALITY OF HEALTH INFORMATION

Patients have the right to speakcandidly with their health care providers, and to be assured the information they share will be protected and kept strictly confidential.

COMPLAINTS AND APPEALS

Patients have the right to a fair, fast, and objective review of any complaint they have, including:

Waiting timesOffice hoursFees and chargesConduct of office staff or providersAdequacy of health care facilities

Always remember that patients are “customers” and we must practice good customer service. Patients pay your salary- and could have an impact on your employment.

MALPRACTICE

• Medical reasons• Usually related to treatment• Personal reasons• Treatment by staff and physician• Unrealistic expectations• Poor outcomes/procedural complications

WHY DO PATIENTS SUE THEIR PROVIDERS?

MALPRACTICE PREVENTION

1. Have open and honest communication with the patient

2. Show the patient kindness, patience and compassion

3. Document everything accurately , clearly, and legibly

4. Do not violate their right to confidentiality

5. Avoid guaranteeing a cure

Steps in the litigation process1. Complaint2. Discovery3. Pretrial conference4. Trial5. Sentencing (if applicable)

LAWSUIT

If a defendant in a criminal case is found guilty, the defendant is sentenced.

Statute of limitations- a specific time limit the plaintiff has to bring charges.

Depends on 3 factors:1. The state2. Civil or criminal case3. Type of wrongdoing

STATUTE OF LIMITATIONS

Liability and malpractice insurance protects medical providers.

Pays damages to patient if the provider loses the case

May pay the provider’s attorney fees

Malpractice insurance does NOT cover mistakes committed if a Medical Assistant was working out of his/her scope of practice.

MALPRACTICE INSURANCE

MEDICAL RECORDS AND THE LAW

The number one defense method that any health care provider can use in a lawsuit is . . .

The medical record.

THE MEDICAL RECORD

RELEASING INFORMATION1. Never disclose information without the

patient’s consent

2. The patient must sign a release form in order to release their records

3. Their consent may be withdrawn at any time

4. Don’t talk to the patient’s family and friends without their consent

5. Don’t talk about patients with your own friends or family.

6. Always be cautious of others overhearing and eavesdropping - you never know who’s listening!

“ear hustling”

Is it EVER permissible to release confidential records without the consent of the patient?

Yes – but in very limited situations:

1. Public health and safety laws2. Official military requests3. Government/FBI investigations4. Law enforcement (with a warrant)5. Suspected child abuse/CPS6. Medical emergency

RELEASING RECORDS

Medical assistants may need to provide medical record(s) in the event of a subpoena duces tecum.

RELEASING RECORDS

• Never attempt to modify or “fix” a medical record that has been subpoenaed by the court. •Don’t provide records that have not been subpoenaed - provide only the exact record requested • You may be required to provide the original record, so be sure to make a photocopy of the original to keep in the office.

• Subpoenaed records should be stored apart from other records - in a locked cabinet with limited access to prevent tampering.

• Advise your employer of the subpoena before releasing any records to the court.

The threat of litigation can tempt the physician and staff to alter the record by adding false information to strengthen provider’s case, or by changing information to weaken the plaintiff’s case.

Altering records is illegal, punishable by jail time and/or license suspension or revocation

DON’T DO IT!!

MEDICAL ASSISTANTS AND THE LAW

For medical assistants, what we can do is not always clearly defined.Our scope of practice . . .• Varies from state to state• Depends on the facility, specialty

and/or physician• Varies depending on the experience and training of

the individual medical assistant.

SCOPE OF PRACTICE

Medical Assistants can . . .

MEDICAL ASSISTANT SCOPE OF PRACTICE

• Remove sutures from superficial wounds

• Administer ultrasound therapy, if properly trained and supervised by physician or PA

• Find and record a pregnant patient’s fetal heart tones

• Assist in office procedures and minor surgeries

Medical Assistants are NOT allowed to . . .

Start I.V’s in any state Give out medication samples without permission or instruction to

do so Insert sutures Perform any invasive procedures without a physician being on-

site. Give out any medical advice without being instructed to do so

Exceeding your scope of practice is both unethical and illegal.

You and your physician employer are responsible for knowing what medical assistants can and can’t do

The Physician must not assign tasks beyond your scope of practice or beyond what is permitted by state law

The Medical Assistant is responsible for practicing within his or her own scope.

• Question any task or procedure you don’t feel comfortable performing

• Inform physician if you are uncomfortable performing • a task or procedure

Want more info regarding the scope of Practice for a Medical Assistant?

http://www.azsos.gov/public_services/title_04/4-16.htm#ARTICLE_4

R4-16-401. Medical Assistant Training RequirementsA supervising physician or physician assistant shall ensure that a medical assistant satisfies one of the following training requirements before employing the medical assistant:1. Completion of an approved medical assistant training program; or2. Completion of an unapproved medical assistant training program and passage

of the medical assistant examination administered by either the American Association of Medical Assistants or the American Medical Technologists.

B. This Section does not apply to any person who:Before February 2, 2000:3. Completed an unapproved medical assistant training program and was

employed as a medical assistant after program completion; or4. Was directly supervised by the same physician, physician group, or physician

assistant for a minimum of 2000 hours; or5. Completes a United States Armed Forces medical services training program.

R4-16-402. Authorized Procedures for Medical Assistants

A. A medical assistant may perform, under the direct supervision of a physician or a physician assistant, the medical procedures listed in the 2003 revised edition, Commission on Accreditation of Allied Health Education Program's, "Standards and Guidelines for an Accredited Educational Program for the Medical Assistant, Section (III)(C)(3)(a) through (III)(C)(3)(c)."

B. In addition to the medical procedures in subsection (A), a medical assistant may administer the following under the direct supervision of a physician or physician assistant:

1. Whirlpool treatments,2. Diathermy treatments,3. Electronic galvation stimulation treatments,4. Ultrasound therapy,5. Massage therapy,6. Traction treatments,7. Transcutaneous Nerve Stimulation unit treatments,8. Hot and cold pack treatments, and9. Small volume nebulizer treatments.

Credentialing:The two major organizations offering nationally recognized medical assisting examinations are the American Association of Medical Assistants (AAMA) and the American Medical Technologists (AMT), both of which are respected associations.

The question content of both exams is similar and both use a multiple choice format. The medical assisting certifications issued by the AAMA or AMT are equally accepted by employers. The eligibility criteria differ for each exam.

AAMA (CMA) AMT (RMA)

CMA (AAMA)

CERTIFIED MEDICAL ASSISTANT

1. Graduating students, or recent graduates, including an externship, of a medical assisting program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP)

2. Students who have not recently graduated but who can verify graduation from a medical assisting program accredited by CAAHEP

3. Graduating students or graduates of a medical assistant program accredited by the Accrediting Bureau of Health Education Programs (ABHES) – (PMI students)

The registration deadline for the AAMA is several months in advance. Information on the application, testing locations, dates, and fees can be found at www.aama-ntl.org or by calling 1-800-228-2262

CMA (AAMA) Who is eligible to sit for the certification exam?

• I believe in the principles and purposes of the profession of Medical Assisting

• I endeavor to be more effective• I aspire to render greater service• I protect the confidence entrusted to me• I am dedicated to the care and well-being of all people• I am loyal to my employer• I am true to the ethics of my profession• I am strengthened by compassion, courage, and faith

MEDICAL ASSITANT CREED

AAMA CODE OF ETHICSThe medical assistant must always strive to: Render services with respect for human dignity Respect patient confidentiality except when providing

information is required by the law Uphold the honor and high principles set forth by the AAMA Continually improve knowledge and skills for the benefit of the

patient and the health care team Participate in community services that promote good health and

welfare to the general public

In 1999 the AAMA established policies which included sanctions against a CMA who violates disciplinary standards.

What is the cost to take the CMA exam?recent graduates (one year or less) pay $125. All others pay $250.

When and where is the exam offered?Throughout the year – see website to find local testing sites

How often do I need to recertify and how much does it cost?Every FIVE years – the cost is $125 for members $250 for non-members

What happens if I fail the exam the first time?You may take the exam again after 3 months with a new application fee of $125

How much does it cost to be a CMA member?$22.50 for students and $87 per year for non-students

RMA

REGISTERED MEDICAL ASSISTANT

RMA (AMT)Passing the AMT exam results in the credential of Registered Medical Assistant (RMA). The exam is offered throughout the year at computer testing sites every day except Sundays and holidays. In some instances AMT will provide medical assisting programs with paper-and-pencil exams that are administered by an AMT proctor. Applicants for the AMT exam must fall into one of the following categories:

1. Graduates of (or students scheduled to graduate from) a medical assistant program accreditation by ABHES or CAAHEP

2. Graduates of (or students scheduled to graduate from) a medical assisting program approved by the U.S. Department of Education. The program must include a minimum of 720 clock-hours (or equivalent) of training in medical assisting (including a clinical externship)

3. Graduates of (or students scheduled to graduate from) a formal medical services training program of the U.S. Armed Forces

4. Medical assistants employed in the profession for a minimum of 5 years.

Generally, you may take the examination as soon as your application is approved and the testing site has an opening, which may be as soon as the following day. Information on the application, testing locations, dates, and fees can be found at www.amt1.com or by calling 1-847-823-5169

What is the cost to take the RMA exam?Application /membership fee is $95

When and where is the exam offered?Throughout the year – see website to find local testing sites

Is there a yearly fee?Yes. An annual fee of $50 is required to maintain certification

What happens if I fail the exam the first time?You may take the exam no sooner than 3 months and no later than 2 years. There is a $70 retesting fee

While engaged in the Arts and Sciences, which constitute the practice of

their profession, AMT professionals shall be dedicated to the provision of competent service.

The AMT professional shall place the welfare of the patient above all else.

The AMT professional understands the importance of thoroughness in the performance of duty, compassion with patients, and the importance of the tasks which may be performed.

The AMT professional shall always seek to respect the rights of patients and of health care providers, and shall safeguard patient confidences.

The AMT professional will strive to increase his/her technical knowledge, shall continue to study, and apply scientific advances in his/her specialty.

AMT STANDARDS OF PRACTICE

The AMT professional shall respect the law and will pledge to avoid dishonest,

unethical or illegal practices.

The AMT professional understands that he/she is not to make or offer a diagnosis or interpretation unless he/she is a duly licensed physician/dentist or unless asked by the attending physician/dentist.

The AMT professional shall protect and value the judgment of the attending physician or dentist, providing this does not conflict with the behavior necessary to carry out Standard Number 2 above.

The AMT professional recognizes that any personal wrongdoing is his/her responsibility. It is also the professional health care provider's obligation to report to the proper authorities any knowledge of professional abuse.