1. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Law and Ethics Public Duties of the Physician Chapter 7

2. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Public Health Records and Vital Statistics Vital events in person’s life Used by government to determine population trends and needs Public duty of physicians to report vital events

3. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Births Physician must sign certificate of live birth Certificate is filed at county clerk’s office in state birth took place

4. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 7.1 Sample of a Birth Certificate

5. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 7.1 Sample of a Birth Certificate (continued)

6. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 7.1 Sample of a Birth Certificate (continued)

7. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 7.1 Sample of a Birth Certificate (continued)

8. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Date and time of death Cause of death How long deceased was treated before dying Presence or absence of pregnancy Whether autopsy took place Deaths

9. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Deaths (continued) Coroner: public health officer holds inquest if death from unknown or violent cause Medical examiner: physician who investigates unexplained deaths and can perform autopsy Autopsy: examination after death to determine cause of death

10. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Examiner Cases Legal investigation by medical examiner or coroner in case of suspicious death Investigation is required if death is: – Violent in nature (homicide, suicide, accident) – Caused by criminal abortion – Related to contagious or virulent disease – Of a person confined to jail or correctional institution – Result of unexplained or unexpected cause – Caused by electrical, radiation, or chemical injury

11. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Examiner Cases (continued) Legal investigation by medical examiner or coroner in case of suspicious death. Investigation is required if death is: – Of a person who had no physician in attendance within 36 hours of death – Of a person whose body is not claimed by friend or relative – Of a child under age of two if death is from unknown cause – Of a person of unknown identity

12. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Communicable Diseases Diseases transmitted from one person to another—considered threat to public Reportable diseases National Childhood Vaccine Injury Act

13. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Duty to Report AIDS, HIV, and ARC Cases All states require reports of these cases to local or state department of health Who shall report the case varies from state to state (attending physician, laboratory, etc.)

14. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Child Abuse All abuse must be reported by teachers, health professionals, law enforcement and day care personnel, and social service workers Physicians have been held liable for not reporting cases Person reporting is protected by law from being sued by parents and others

15. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 7.2 A Young Child Explains Her Injury to a Physician

16. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Elder Abuse Older American Act (1987) Includes physical abuse, neglect, exploitation, abandonment, and financial abuse of adults 60 and older

17. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Spousal Abuse Laws governing the reporting vary by state Local police may have to become involved when spousal abuse is suspected Court may issue restraining or protective order prohibiting abuser from contact with victim

18. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Signs of Abuse Signs of inadequate nutrition Venereal disease and genital abrasions Makeup to hide bruises Sunglasses worn inside to hide blackened eyes Repeated injuries Bruises and unexplained swelling Unexplained fractures Bite marks Unusual marks Bruising or swelling in genital area

19. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Substance Abuse Abuse of prescription drugs is reportable immediately according to law Violation of controlled substances laws is a criminal offense

20. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gathering Evidence in Cases of Abuse Precise documentation of all injuries, bruises, and suspicious genital fluid deposits in children is critical Court may subpoena records at later date

21. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Gathering Evidence in Cases of Abuse (continued) Evidence includes – Photos – Urine specimen – Clothing – Body fluids – Various samples such as blood, semen, vaginal or rectal smears – Foreign objects

22. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Other Reportable Conditions Physicians required to report certain medical conditions to maintain accurate public health statistics, including – Cancer – Epilepsy – Congenital disorders – Certain infectious diseases, such as tuberculosis (TB)

23. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Controlled Substances Act and Regulations Food and Drug Administration (FDA) Drug Enforcement Administration (DEA) Controlled Substances Act of 1970 Bureau of Narcotics and Dangerous Drugs (BNDD)

24. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Prescription of Controlled Drugs Only those with a DEA number may issue prescriptions for narcotics Number must appear on all prescriptions for controlled substances Schedule II drugs require triplicate form

25. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Prescription of Controlled Drugs (continued) Schedule II drug prescription cannot be refilled Must take written inventory of drug supply every two years Narcotics dispensing records must be kept for two years (state regulations may vary)

26. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Protection of Employee and the Environment Employee Assistance Program (EAP) – Confidential counseling and referral service – Helps employees and their families assess a problem – Develops plan to resolve problem – Determines appropriate resource to assist in process

27. Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Waste Solid Chemical Radioactive Infectious