Medical Law and Ethics Lesson 2: Patient/Physician Relationship

Lesson Objectives Upon completion of this lesson, students should be able to … Discuss informed consent.

Physician Rights A physician and patient form a contract The patient must confide truthfully If the physician does not know all the facts, there could be serious consequences

Critical Thinking Questions 1. Does a physician have to treat every patient that comes into the office? 2. When might the physician choose not to treat a patient?

Physician Rights Physicians have the right to: ◦ Select the patients they wish to treat ◦ State the types of services they will provide ◦ State the hours their offices will be open ◦ Determine where their offices will be located ◦ Expect payment for the treatment given ◦ Take vacations and time off from practices

Patient Rights Patients have the right to: ◦ Approve or give consent for all treatment ◦ Expect the standard of care ◦ Expect confidentiality by the physician and employees ◦ Privacy

Informed Consent Involves informing the patient about the possible consequences of both having and not having certain procedures and treatments

Doctrine of Informed Consent Explanation of advantages and risks Alternatives Potential outcomes What might occur if there is no treatment The use of understandable language

Implied Consent When a patient is seen for a routine examination for medical treatment, there is implied consent that the physician will touch the person during the examination

Implied Consent emergency situation

Refusal of Treatment Patients have the right to refuse treatment

Rights of Minors Minor: Under 18 in most states (though this varies in some states) Minors are unable to give consent for treatment Exceptions:

Categories of Minors Who Can Give Consent Mature minors: Emancipated

Situation #1 Think About It! Situation #1 A teenager is seeking birth control. She has the right to confidentiality. The girl cannot pay for services. How does your office get payment?

Think About It! Situation #2 A teenager living with her mother needs treatment for an STI. The patient has a right to confidentiality. The parents are divorced and the father has financial responsibility for care and treatment.

Patient Self-Determination Act Documents that provide protection to both the patient and physician

Requirements of Health Care Institutions Provide patients a written summary of their rights Give written policy with respect advance directives Ask and document if patients have an advance directive Educate staff about advance directives Never discriminate based on whether patients have advance directives

Living Will Allows patients to request that life-sustaining treatments and nutritional support not be used to prolong their life Gives patients the legal right to direct the type of care they wish to receive when death is imminent Protects physicians and hospitals when they follow the patient’s wishes Copy of living will should be kept with the patient’s records

Durable Power of Attorney (DPOA) Allows an agent to act on behalf of the patient Can be for health care only or other legal things Agent may be a spouse, grown child, friend, or an attorney

Durable Power of Attorney (DPOA) Used when a patient becomes mentally incapacitated Document is in effect until the patient cancels it or until the patient is able to make their own decisions again

Uniform Anatomical Gift Act Allows a person 18 yrs or older and of sound mind to make a gift of any or all parts of their body for the purposes of organ transplantation or medical research A physician who is not involved in the transplant will determine the time of death No money is allowed to change hands for organ donations Donor carries a card signed by 2 witnesses The family can make this decision in some cases

Critical Thinking Question 1. What are the potential controversies to organ donation?

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