COMLEX Medical Law/Ethics study guide with complete solutions

What are the reportable disease in most US states? HepA HepB Syphilis Gonorrhea Mumps Measles Rubella Tuberculosis Salmonellosis Shigellosis E.Coli (think food outbreaks) AIDS (not HIV) Varicella Meningitis ***easily spread and/or dangerous diseases need to be reported True or False: Parents can refuse to have their child receive Chemotherapy False- if parents refuse consent for treatment for a non-emergent, but fatal medical condition the physical should obtain a court order 00:29 01:01 In terms of consent, if both parents (who are divorced) have custody of a child, do both need to give consent for the child to be treated? No- only one parent needs to consent for treatment What classifies one as an emancipated minor? Homeless Parent (i.e. 16yo mother) Married Military Finically independent High School Graduate What medical circumstances do minor not need parental consent? emergency care STIs substance abuse prenatal care How long does a physician have to release records when requested by a patient? 30 days What is the difference between competency and capacity? Competency= legal definition Capacity= medical definition --ability to make decisions on their own What is the Hospice Model? -focus on quality of life (not life prolongation) -symptomatic control (i.e. pain, N/V, anxiety, depression) -interdisciplinary team (medical, nursing, psychosocial, spiritual, bereavement care) -services provided at home, assisted living, or dedicated facility -requires a survival prognosis of 6mo What are the 2 components of an advance directive? 1. Living will 2. Durable power of attorney What happens if a durable power of attorney disagrees with the patients living will? (the living will must ultimately be honored) 1st Step= meet with family and discuss situation (while providing supportive care) and review living will 2nd Step=if conflicts arise- consult hospital's ethics committee. What is the most common cause of medical errors? Miscommunication between providers True or False? A physician can respond to an employers request for health information if given verbal permission by the patient? True- physicians can respond to an employers request for health information either by a verbal or written consent. Is it legal/ethical for students to practice medical procedures on recently deceased patients? Yes- the attending physician must obtain permission from the family (or patient prior to death) before a student can perform procedures. The training must be a structured training sequence and performed under close supervision. True or False? A pregnant mother who has the capacity to chose has the right to refuse treatment even if it places her unborn child at risk. True Autonomy Autonomy is the right or capacity to make one's own rational decisions, using one's own value system, and act on those decisions, without undue coercion from other people or influences. Thus autonomy requires an adequate degree of freedom of thought and action. Beneficence One should act in such a way that it produces beneficial results. Usually in health care, beneficence is interpreted as a health care professional's duty to act in a manner that in their best judgement will benefit the patient. Euthanasia Euthanasia is intentionally causing the death of a person, the motive being to benefit that person, honor his/her wishes, or protect him/her from further suffering. If the motive is other than the interests of the patient, then it does not qualify as euthanasia (i.e. cost-cutting, triage, etc.). Active Euthanasia Active is providing or doing something that directly causes the patient's death. (i.e. giving lethal medication, withdrawing a ventilator when the patient is still paralyzed from medication, delivering carbon monoxide, etc.). Passive Euthanasia Passive is when one has a treatment with a good chance of preventing or delaying a patient's death and does not use it (i.e. withdrawing or withholding a ventilator in a patient with an underlying condition that makes it difficult or impossible to breathe without assistance, withdrawing or withholding medication necessary to keep the patient's blood pressure up, not treating pneumonia in a patient with PVS, etc.). Fidelity Fidelity (loyalty and/or promise-keeping) - In some cases this term is used to describe a duty to be loyal. In other instances it is used to refer to the duty to keep one's promises. With managed care contracts and the increase in institutional affiliations, more health care professionals are finding themselves in situations where they have to choose between honoring a contractual obligation or doing what they believe is in the patient's best interests. They may also find that their obligations to different third parties conflict Nonmaleficence (Primum Non Nocere) "Above all, do no harm." 1. A health care professional has a duty to avoid harming his/her patient. 2. A health care professional has a duty to prevent any harm to the patient Paternalism Acting like a parent towards another. Paternalism is where person A decides to treat Person B in accordance with what Person A believes to be in Person B's best interests, regardless of Person B's wishes. This is done out of beneficent motives for Person B. Person A assumes that he/she knows what is best for person B. Paternalism weighs patient well-being more highly than patient autonomy. Furthermore, it does not recognize the subjectivity of well-being and individual values. Doctor Assisted Suicide Assisted Suicide - Assisted suicide involves helping a person kill him or herself. The main difference between this and euthanasia is that in assisted suicide the patient is in complete control of the process that leads to death because he/she is the person who performs the act of suicide. The other person simply helps (for example, providing the means for carrying out the action). What is the Federal Anti-Kickback statue? made with intention to prohibit the practice of paying medical professionals solely to endorse and promote the use of certain medical devices and supplies. -you must disclose any financial relationship you have with a product (i.e. getting royalties for a new device you helped invent) Vicarious liability "respondeat superior" form of strict, secondary liability that arises under the common law doctrine of agency - "respondeat superior" - the responsibility of the superior for the acts of their subordinate, or, in a broader sense, the responsibility of any third party that had the "right, ability or duty to control" the activities of a violator. Fee For Service ... Medicare "care for the elderly"- funded by social security taxes and is not need-based. Designed for 65+ year olds, people with certain disabilities, and people with end stage disease Medicaid intended for low income coverage; it is also available for personas who are aged, blind, disabled, or certain people in families with dependent children regardless of financial burden. Medical Battery Medical battery is the intentional violation of a patient's right to direct their own medical treatments. Doctors must obtain a patient's informed consent when rendering non-emergency treatment. If medical treatment is performed without the patient's consent or against their will, the patient may have a claim for medical battery, even if the doctor did not intend to cause any harm. What are the 3 types of torts? There are basically three types of torts: -intentional torts -negligence -strict liability COBRA The Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions amend the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Service Act to require group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated. EMTALA Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, What are the requirements of EMTALA? 1.Any individual who comes and requests must receive a medical screening examination to determine whether an emergency medical condition exists. Examination and treatment cannot be delayed to inquire about methods of payment or insurance coverage. Emergency departments also must post signs that notify patients and visitors of their rights to a medical screening examination and treatment. 2.If an emergency medical condition exists, treatment must be provided until the emergency medical condition is resolved or stabilized. If the hospital does not have the capability to treat the emergency medical condition, an "appropriate" transfer of the patient to another hospital must be done in accordance with the EMTALA provisions. 3.Hospitals with specialized capabilities are obligated to accept transfers from hospitals who lack the capability to treat unstable emergency medial conditions. A hospital must report