1. Chapter 7
Legal Considerations

2. Sources of Law Constitutional law Statutory law Common law
Constitution and 27 amendments
Statutory law
Laws made by states
Common law
“Judge-made” law

3. Sources of Law Criminal law Malfeasance Felony Misdemeanor
Illegal conduct by an official
Felony
Serious crimes and serious punishments
Misdemeanor
Lesser crimes and lesser punishments

4. Sources of Law Civil law Misfeasance Nonfeasance
Lawful act improperly or unlawfully executed
Nonfeasance
Failure to perform an act, official duty, legal requirement
In a civil case, a plaintiff brings charges against a defendant
Common forms of civil law are administrative, contract, and tort law

5. Administrative Law IRS Medicare/Medicaid
Title VII of the Civil Rights Act of 1964
Protects employees from discrimination
Harassment
Equal Pay Act (EPA) of 1963
Federal Age Discrimination in Employment Act of 1967

6. Administrative Law Americans with Disabilities Act (ADA) of 1990
Title I prohibits discrimination in employment
Titles II–IV mandate access to public services by individuals with disabilities
Family and Medical Leave Act (FMLA) of 1993

7. Administrative Law
Health Insurance Portability and Accountability Act (HIPAA) of 1996
Requires national standards for electronic health care transactions
Assists in making health insurance more affordable and accessible when people change or lose their jobs
Set standards to protect the privacy of patient health information
Identified in Titles I–VII

8. Administrative Law
Please refer to the instructor video “HIPAA” through the instructor companion site.

9. Administrative Law Occupational Safety and Health Act (OSHA) of 1967
Controlled Substances Act of 1970
Five schedules (I, II, III, IV, V) according to potential for abuse and dependence

10. Administrative Law
Please refer to the instructor video “DEA and Controlled Substances” through the instructor companion site.

11. Administrative Law Uniform Anatomical Gift Act of 1968
Regulation Z of the Consumer Protection Act of 1967 (Truth in Lending Act)
Medical Practice Acts

12. Contract Law Expressed contracts Implied contracts
Written or verbal
Implied contracts
Indicated by actions
Majority of provider–patient contracts
Contract to be valid and binding, parties who enter into it must be competent
MAs considered agents of their employers

13. Contract Law Termination of contracts Patient discharges provider
Provider formally withdraws from patient care
Treatment no longer needed by patient
(See Figure 7-1)

14. Tort Law
Wrongful act other than a breach of contract resulting in injury by one person to another
Negligence occurs when someone sustains injury because of another’s failure to live up to a required duty of care

15. Tort Law The 4 D’s of Negligence Duty of care
Derelict: breach of duty of care
Direct cause: legally recognizable injury occurs as a result of the breach of duty of care
Damage: proof that wrongful activity caused injury or harm that occured

16. Tort Law Standard of Care and Scope of Practice
Medical Assistant’s role in negligence
Practice within scope of one’s instruction and education
Each state is likely different
Torts are intentional or negligent
Intentional torts: deliberate acts violating another’s rights
Negligent torts: not deliberate; result of omission or commission of an act
Res ipsa loquitur: “the thing speaks for itself”
Obvious negligence
Respondeat superior: “let the master answer”
Providers are responsible for their employees

17. Tort Law Common torts Battery Defamation of character
unprivileged touching of one person by another
Defamation of character
Libel and slander
Invasion of privacy
Unauthorized publicity of patient information

18. Informed Consent
For any procedure, the patient is to be told in easily understood language the following:
Nature of any procedure and how it is performed
Possible risks as well as expected outcomes of any procedure
Any other methods of treatment and those risks
Risks if no treatment is rendered

19. Informed Consent
The provider and no one else is expected to give informed consent
Implied consent
Occurs with life-threatening emergency or when patient is unable to respond
Occurs more subtly with simple procedures such as x-rays or vital signs
Consent and legal incompetence
Emancipated minors
Mature minors

20. Risk Management
Practicing good risk management makes MA and provider less vulnerable to litigation
Avoid incidents that may lead to litigation

21. Risk Management Professional liability coverage
Cover costs of litigation that may occur
Health care employees need their own professional liability coverage
MAs can purchase from American Association of Medical Assistants (AAMA)

22. Civil Litigation Process
Subpoenas
Court order naming date, time, reason to appear
Portion or entire medical record may be subpoenaed
Health care provider (subpoena duces tecum) may be subpoenaed to testify
For courts to have access to some records, a court order required in many states
HIPAA law requires clinics to identify what information they will release regarding patients

23. Civil Litigation Process
Discovery
Interrogatory
Deposition
Expert witness
Pretrial conference
Alternative dispute resolution (ADR)
Mediation
Arbitration

24. Civil Litigation Process
Trial
Held before a judge
Held before judge and a jury
If plaintiff’s case successful, judge or jury may award specific amount of money or damages
If defendant’s case successful, case is dismissed
(See Figure 7-5)

25. Statutes of Limitations
Begin at time negligent act was committed
When act discovered
When care of patient and provider–patient relationship ended
Time limit for individuals to initiate legal action

26. Public Duties Reportable diseases/injuries
“Nationally Notifiable Infectious Diseases” listed on CDC’s Web site (
Electronic or telephone reporting
Local or state health departments provide lists of diseases and injuries
Examples of incidents that must be reported
Communicable diseases
Child abuse
Gunshot and knife wounds

27. Public Duties Abuse Good Samaritan laws Child abuse Elder abuse
Intimate partner violence (IPV)
Good Samaritan laws
Encourage health care professionals to provide medical care within scope of training without fear of being sued for negligence

28. Advance Directives
Physician Orders for Life-Sustaining Treatment (POLST)
Living wills, advance directives, health care proxy
Samples available at U.S. Legal Forms Web site (
Durable power of attorney for health care

29. Advanced Directives See http://www.compassionandchoices.org/
Patient Self-Determination Act (PSDA) of 1991
Advanced directives provided to patients’ providers, family members, any agent identified