Legal Considerations ICS 120 Chapter 7

Sources of Law: Executive branch: President, Vice President, Cabinet Offficers. Legislative branch: U.S. Senate, House of Representatives, staffs of individual legislators and legislative committees. Judicial branch: courts, U.S. Supreme Court, Courts of Appeal, and District Courts.

Laws: Statutory Law: body of laws made by the state. Common Law: Judge-made laws. Criminal Law: addresses wrongs committed against the welfare and safety as a whole. Felonies (more serious) Misdemeanors Civil Law: affects relationships between individuals, corporations, government bodies, other.

Title VII of the Civil Rights Act 1964 protects employees from sexual harassment. Employer should have written policy of: Harassment not tolerated If so, bring matter to immediate attention of person designated in policy. Statement about confidentiality of incidents. Procedure to follow if this should happen

Federal Age Discrimination Act 1967 employer with 15 or more employees must not discriminate in matters of: Race, Sex, Creed, Marital status National origin, Color, Disabilities Valid reasons to decline applicants: Health issues Unavailability for work schedule Insufficient training or experience Someone else better qualified

Uniform Anatomical Gift Act 1968 act that allows persons 18 years or older and of sound mind to make a fit of all or any part of their body. Regulation Z of the Consumer Protection Act Act of 1967, referred to the Truth and Lending Act. Requires and agreement between physicians and their clients for payment of medical billing in more than four installments must be in writing and provide information on finance charges.

Occupational Safety and Health Act (OSHA) Act of 1967, division of Department of Labor Mission to ensure workplace is a safe and healthy environment. Penalties can be high for repeated and wilfull violations.

Americans with Disabilities Act (ADA) Act of 1990, prohibits discrimination of individuals who have physical or mental disabilities from accessing public services and accommodations, employment and telecommunications. Also protects persons with HIV infection or AIDS, making certain they cannot be refused treatment by healthcare professionals. Applies to businesses with at least 15 employees.

Health Insurance Portability and Accountability Act (HIPAA) Act of 1996 Requires the adoption of privacy and security standards to protect an individual’s health information. Goal: to assist in making health insurance more affordable and accessible to individuals.

Contract Law Contract: a binding agreement between two or more persons. Exists when the patient arrives for treatment and the physician accepts the patient by providing treatment. Expressed: can be written or verbal; specifically describes what each party in the contract will do. Implied: indicated by action rather than words. (most common in healthcare)

Termination of Contracts A physician is legally bound to treat a patient until: the patient discharges the physician the physician formally withdraws from patient care (patient may be noncompliant) the patient no longer needs treatment and is formally discharged by the physician

Termination of Contracts Patient discharges physician: physician should send a letter to patient to confirm and document the termination of the contract should be sent certified mail with return receipt requested keep a copy of the letter in the patient’s record

Tort Law Defined: a wrongful act resulting in injury to one person by another. Standard of Care – all health care providers have the responsibility and duty to perform within their scope of training. Negligence – defined as the failure to exercise the standard of care that a reasonable person would exercise in similar circumstances. Malpractice – professional negligence.

Types of Torts Intentional torts: are deliberate acts of violation of another’s rights (malpractice). Negligent torts: not deliberate and are the result of omission and commission of an act

4 Ds of Negligence Duty: duty of care Derelict: breach of the duty of care Direct cause: a legally recognizable injury occurs as a result of the breach of duty care Damage: wrongful activity must have caused the injury or harm that occurred.

Common Torts Battery-unprivileged touching of one person by another. Defamation of character-injury to another person's reputation, name, or character through spoken or written words. Libel – false and malicious writing about another Slander – false and malicious spoken words Invasion of privacy-unauthorized publicity of patient information, medical records being released without patient's knowledge and permission, and patients receiving unwanted publicity and exposure to public view

Common TortsCont’d Invasion of privacy-unauthorized publicity of patient information, medical records being released without patient's knowledge and permission, and patients receiving unwanted publicity and exposure to public view. Subpoena – not an invasion of privacy to disclose information required by a court order or statute but a order from the court name the specific date, time and reason to appear in court.

Types of Consent Informed: it is the responsibility of the health care provider to make certain the patient understands the procedure to be performed and the potential outcomes. Implied: When there is a life-threatening emergency, or the patient is unconscious or unable to respond (most physician-patient contracts are this). Example: the patient who rolls up a shirtsleeve for a blood pressure reading is consenting to the action to be taken. NOTE: consent for treatment is not valid if the patient is not legally incompetent to give consent.

Public Duties Physicians have a duty to the public to report diseases and injuries that jeopardize public health and welfare (transmittable or contagious diseases and injuries resulting from knife for gunshot, are examples; do not need patient consent). Local or state health departments can provide lists of diseases and injuries to report and will also provide the appropriate forms.

Public Duties Cont’d Abuse: Careful documentation critical. Report the incident to the proper authorities Confidentiality in the physician-patient relationship does not exist when children are abused. Failure to report could result in criminal or civil penalties.

Physician’s Directives Legal documents in which patients indicate their wishes in the case of a life-threatening illness or serious injury. Living Wills: necessary because advance in medicine allow medical professionals to sustain life even if the individual will not recover from a persistent vegetative state. Goes into effect when provide to a patient’s health care provider and when patient is no longer capable of making health care decisions.

Physician’s Directives Cont’d Durable Power of Attorney: name another person as the official spokesperson for the patient should the patient be unable to make health care decisions (may include the handling of finances or personal matters also). Copies of advance directives are to be provided to patient’s physicians so they can be transferred to a hospital or nursing facility. Family members should also have a copy.