medical law and ethics, fourth edition bonnie f. fremgen copyright 2012 by pearson education, inc....

Medical Law and Ethics, Fourth EditionBonnie F. Fremgen

Copyright ©2012 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Medical Law and Ethics

Importance of the Legal System for the Physician and the Healthcare Professional

Chapter 3




Medical Practice Acts

• Establish examining boards• Provide baseline for practice of medicine• Determine prerequisites for licensure• Forbid practice of medicine without a

license• Specify conditions for renewal,

suspension, and revocation of licenses• Vary from state to state




Licensure of Physician

• Examination– National Board Medical Examination

(NBME)– Federal Licensing Examination (FLEX)– U.S. Medical Licensing Examination

(USMLE)





• Endorsement: an approval or sanction• Reciprocity: cooperation of one state in

granting license to practice medicine to a physician already licensed in another state





• Registration:• Occurs annually or biannually• Physicians must pay a fee• Physicians are required to complete

seventy five hours of CME in a three year period




When Valid License Is Not Needed by a Physician

• When employed by federal medical facilities (but must be a licensed physician to practice medicine in some state)• In an emergency• While establishing residency• When engaged solely in research




Revocation and Suspension

• Unprofessional conduct: falsifying records, gross immorality• Commission of a crime:

Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction• Personal incapacity: physical or mental

incapacity




Licensure and Certification of Allied Health Professionals

• Licensure: graduate from accredited school and pass national exam of competency• Certification: meet standards set by

accreditation body and pass national exam of competency




Accreditation

• Voluntary request of official review by accrediting agency• Examine policy and procedures of

agency• Must demonstrate that the institution

maintains high standards• Examples: JCAHO and CAAHEP




Standard of Care

• Ordinary skill and care that must be used by medical practitioners• Must provide same knowledge, care, and

skill that similarly trained physician and/or medical professional would provide under same circumstances • Perform as “reasonable and prudent”

person would perform




Physicians Are…

• Not obligated to treat everyone in case of emergency• Expected to use reasonable, ordinary

skill and care (not extraordinary)• Expected to exhaust all resources

available to them for patient care• Not to expose patients to undue risk




Prudent Person Rule(also called the “reasonable person standard”)

• Must provide following information to patient:– Diagnosis– Risk and consequences of treatment– Expected benefits of treatment or procedure– Alternative treatments– Prognosis if no treatment– Cost and expected pain– Follow acceptable standard of care




Confidentiality

• Keeping private all information about patient • No disclosure without written consent• Medical Patient Rights Act: a federal

law that gives all patients right to have privacy respected and records held confidential




Statute of Limitations

• Period of time patient has to file lawsuit• Usually one to three years• Discovery Rule: begins when problem

discovered or when the patient should have known of the injury




Good Samaritan Laws

• State laws help protect health care professionals and ordinary citizens from liability while giving care in emergency • No one is required to provide aid –

Except in Vermont




Good Samaritan Laws

• Only required to act within limits of acquired skill and training • Once you start you must continue until

help arrives or you physically cannot continue




Respondeat Superior

• “Let the master answer”• Employer liable for acts of employee

within scope of employment




Employee’s Duty to Carry Out Orders

• Duty to interpret and carry out orders• Duty to clarify ambiguous or erroneous

orders• Duty to decline orders that appear

dangerous for patient and to notify physician




Scope of Practice

• Must understand and work within scope of practice for discipline• Must understand and practice within

guidelines of profession• Must understand and follow chain of

command so no employee makes decision he or she is unqualified to make




Employer’s Duty to Employees

• Responsibility to provide safe environment for employees and staff• Most have liability insurance to cover

accidents and unforeseen incidents• May bond employees who handle money• Some have liability insurance for auto if

used for work-related business




Risk Management

• A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer– Identify risk behaviors and practices– Develop and follow plan of action to

eliminate problem behavior– Address corrective actions in policy and

procedure books and employee handbooks

medical law and ethics, fourth edition bonnie f. fremgen copyright 2012 by pearson education, inc....

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