LCR4802 - Past Exam Papers Verified Q AND A (2014 – 2009)

LCR4802 - Past Exam PapersLCR4802 Medical Law Q & A (2014 – 2009) VERIFIED. SUCCESS. @yash0505 Medical Law Q & A (2014 – 2009) Part 1 -- Questions posted by lecturer on myUnisa (semester 1 2015) The usual fee for a particular type of operation by a specialist surgeon is R5000. Mrs Client needs such an operation, and consults Dr Mula, a surgeon, for this purpose. Dr Mula does not inform Mrs Client of the fee he intends to charge for the operation. After the operation, Dr Mula furnishes Mrs Client with an account in which he charges a fee of R13 000. Mrs Client feels that the amount charged is exorbitant. (1) Discuss whether Mrs Client can take any steps to have the fee reduced. (2) Is the claim by Dr Mula recoverable pending the steps taken by Mrs Client? (3) Is there any statutory provision that places a duty on a medical practitioner to inform a patient of the fee he or she intends to charge before rendering any professional services? (1) The Health Professions Act 56 of 1974 requires practitioners who claim payment from patients for professional services rendered, to furnish the patient with a detailed acount within a reasonable period. In terms of the Health Professions Act, a patient may, within three months after receiving an account, apply in writing to a professional board to determine what a reasonable fee would be. Before the professional board determines the amount, the practitioner must be given an opportunity to submit to the professional board in writing his/her case in support of the amount charged. (2) The Health Professions Act provides that a claim referred to the professional board is not recoverable until a determination has been made of what would be a reasonable fee. Once such a determination has been made, the claim is recoverable only to the extent of the determination. (3) The Health Professions Act provides that unless the circumstances render it impossible for him or her to do so, a medical practitioner must inform the patient or any person responsible for the patient’s maintenance, of the fee which he or she intends to charge before rendering any professional services. However, this must only be done where: The doctor is so requested by the person, or The fee exceeds that usually charged for such a service, in which case the practitioner must also inform the person of the usual fee. LCR 4802 @yash0505 Dolores, an eighteen year old matric girl, is admitted to a psychiatric hospital with severe depression. She has made several attempts to commit suicide. It transpires that she was raped by her stepfather. During her stay in the psychiatric hospital the psychiatrist finds out that Dolores is pregnant and that her stepfather has AIDS. Her psychiatrist knows that, in terms of the National Health Act 61 of 2003, he has to inform her of her “health status”. However, he is concerned that disclosure of the fact that she is pregnant and that she might be HIV positive would, at this particular time, be devastating to Dolores’ mental health. Advise the psychiatrist on whether he may (temporarily) withhold such information. This is an instance where therapeutic privilege may apply. Therapeutic privilege entails withholding information, which would normally have had to be revealed in order to comply with the doctrine of informed consent, in circumstances where disclosure would not be in the patient’s best interests. An example that has been mentioned in the literature is where a cancer patient would probably become so discouraged when fully informed about her situation that the efficacy of her treatment may be prejudiced. Another example is where a doctor has to give very bad news to a severely depressed patient with suicidal tendencies. Therapeutic privilege enjoys some measure of recognition under both common law and statutory law. Common law Therapeutic privilege is one of the four instances where our common law curtails the duty to inform. Under common law, no disclosure is necessary if the damage caused by the disclosure would be greater than the damage caused by withholding the information. This defence has been criticised in Castell v De Greef, where the judge referred to criticism by several authors against therapeutic privilege, in particular the fact that it infringes on patient autonomy. Statutory law 1) The Mental Health Care Act 17 of 2002 provides that a mental health care provider may temporarily deny a mental health care user access to information contained in his or her health records if disclosure of that information is likely to seriously prejudice the user, or cause the user to conduct himself or herself in a manner that may seriously prejudice him or her or the health of other people. 2) The National Health Act 61 of 2003 provides that a healthcare provider has to inform a user of his or her “health status”. Coetzee and Pienaar submit that Verified Q AND A (2014 – 2009)