Chapter 1:

 Medical Laws and Ethics



Introduction to medical ethic:

The laws and ethical code of conduct for the medical profession must be understood by all members of the health care team. These laws and ethics code protect all members of the medical profession, as well as the patient and the client.


Medical ethics have been important in the study of medicine as far back as 400 B.C when Hippocrates wrote the Hippocratic oath, a document that first developed the standards of medical conduct and ethic.


Today, many health care associations have adopted codes of ethics and passed them to each member of the health care team which provide guidelines for their professional behavior.


Today’s practice of medicine exists within a framework of laws.

The branch that deals with standards of behavior or beliefs is called ethic. Ethics can be defined as moral principles. "What’s right and what’s wrong".




EKG Technicians should study ethics for a number of reasons:

It is an important part of an individual’s education to develop the intellectual skills to analyze complex problems and justify the choices made in certain situations.


Learning about ethics and social issues encourages ordinary people to have input into social beliefs and expectations.


There is a need to make informed choices about what care will be provided to whom, and when, rather than simply responding to special interests.


As a member of the health care team, you are responsible for always displaying ethical behavior.


This means maintaining the highest level of ethical conduct, to accomplish such a task, you should always:


Respect the rights of all patients, opinions, lifestyles, and beliefs that are different from your own.


Remember that everything seen, heard, or read about a patient is considered confidential and does not leave the job site (HIPAA).


Follow closely the specific rules of ethical behavior established by your employer.

The American Hospital Association felt it was necessary to establish a document which identified what the person could expect from those individuals who cared for the patient.


The intent of such document is to make both members of the health care system and the patients aware of what the patient has a right to expect.


According to the AHA, the patient has the right to:


Considerate and respectful care


Obtain complete and current information concerning their diagnosis, treatment, and prognosis, in terms that they can be reasonably expected to understand.


Informed consent, which should include knowledge of the proposed procedure, along with is risk and probable duration of incapacitation,


The patient has right to information regarding medically significant alternatives.


Refuse treatment, and to be informed of the medical consequence of such action.


Expect that all communications and records pertaining to his or her care be treated in a confidential manner.

Every healthcare worker is expected to abide by a professional code of conduct. 


Traditionally, five main duties of a health care professional have been identified:


1) Do no harm: the concept of no malfeasance means, doing no harm in any treatment given.


2) Do the best possible: the concept of beneficence, "doing your best", is seen in some systems of ethics as a separate duty, whereas in others it is considered an extension of doing no harm.


3) Be truthful to reasonable expectations: in the case of medical practice, it is usually interpreted as being honest about expectations.


4) Be a patient advocate: an advocate is a person who intercede on behalf of another person. An EKG Technician functions as an advocate for patients by suggesting appropriate treatments or care.


5) Tell the truth is the concept of veracity: physicians and another health professionals must provide truthful information without having to be asked.



Protection under the Law:

In the health care field, both the patient and the health care worker must be assured protection under the law.


For the patient, this means being assured of safe care. For the health care professional, it means being protected if something goes wrong during a procedure.


The good Samaritan law is a law that addresses the problem of medical malpractice suits for a physician or any trained health care professional who comes upon an accident scene and attempts to render aid to the victim, this law encourages members of health care profession to offer treatment without fearing the possibility of malpractice suit.


In health care, under the rule of personal liability, all individuals are held responsible for their own personal conduct. You can also be held jointly responsible if you witness an illegal act and do not report it.



Every healthcare professional must report crimes that they learn about when practicing medicine, neglect, child or elder abuse, and financial abuse. 




Patient Consent:

When a Doctor makes a diagnosis and recommends a specific mode of treatment, the patient, has the right to accept or refuse such diagnosis and treatment.


In the event that a patient may have difficulty understanding or speaking the language, the explanation of treatment and options must be translated or prepared in the patient’s native language.


A patient who has not been properly informed through the informed consent process can not grant consent for a procedure.



Guidelines for the informed consent:


Always make sure that the patient fully understands the consent form and realizes what he or she has signed, patients who are mentally handicapped should be given an explanation that can be understood completely, with a few confusing terms possible.


The patient must never be forced to sign the consent form and must not be allowed to sign under any medication which might impair his decision making abilities.


Any adult over eighteen years of age may sign his or her own consent unless the patient is incompetent. 


If in an emergency situation, a physicians may authorize consent.




Emancipated Minors:

An emancipated minor, who is under the age of 18, and has been declared by a court of law to be legally responsible for his or herself, may sign his or her own consent form.



Telephone consent are valid only in emergency situations, provided that the telephone consent is witnessed by two people and is immediately followed by a written confirmation.



Patient’s Medical Records

The patient’s medical record is considered a legal document, it is extremely important that these records be as accurate, complete, up to date and as neat as possible, in order to protect members of the medical staff from any future litigation.


If you are documenting in the patients’ medical records, always remember to use only permanent ink, and never erase an entry.


Medical records are considered legal document, they can be use in a court of law, and you need to document only objective information.


If an error has been made, simply cross the error out using only one line, initial it, and rewrite the correct entry above or next to the original entry.


No documentation written in pencil is acceptable, and the record can be automatically rejected as legal evidence.

Lawsuits: in any court proceeding, there is a plaintiff (the person or entity that makes the complaint), and a defendant (the person or entity against whom a lawsuits is brought upon).


A crime: is an offense in violation of a law that prohibits or require certain behavior.


A misdemeanor: is a less serious crime, punishable by a fine or imprisonment for less than 1 year.


A felony: is a serious crime, punishable by death or imprisonment for more than 1 year.





Types of intentional and unintentional tort:




Intentional tort:


Abandonment: failure to continue to provide medical care to a patient without proper notification.


Assault: threat to touch another person without his consent.


Battery: touching a person without his consent.


Defamation: making a false claim that may harm a person’s reputation. An attack in a patients reputation.


False imprisonment: confining a person without legal authority.


Invasion of privacy: public disclosure of private information.


Misrepresentation: providing information with knowledge that is incorrect.



Unintentional tort:


Negligence: failure to give reasonable care.


Malpractice: harm to the patient

Health Insurance Portability and Accountability Act (HIPAA)


A federal law that requires Protected Health Information to be kept private and secure


The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established guidelines for the use and distribution of protected health information (PHI). 


PHI includes any information about the health status, use of health care services, and payment for health services that can be linked to an individual. 


This includes any patient identifiers, such as name, date of birth, medical record number, Social Security number, phone number, and address. 


All treatments, assessments, test results, diagnoses, medications, and payments for services are considered PHI.


Under HIPAA, limit communication of PHI to the patient and essential clinicians and staff members. Limit discussion of PHI among clinicians to the minimum amount of information necessary to accomplish the goal. Furthermore, health care staff who are not directly involved in patient care are not allowed to review patient medical records unless the patient's case is being discussed during quality assurance meetings. PHI may be used for educational purposes if all patient identifiers are removed.


Patients have the right to confidentiality. 


Open discussion of PHI in public areas is prohibited. 


Do not disclose PHI to family members or friends unless authorized by the patient. 


In some cases, PHI must be reported to regulating agencies, including cases of abuse, crime, or certain infectious diseases.


Patients also have a right to accurate medical records and can ask that any errors be corrected. 


Patients can also request to see any medical records; this information must be provided within 30 days of the request.



Remember:

HIPAA applies to all healthcare providers


all healthcare workers must follow HIPAA regulations no matter where they are or what they are doing


penalties may be imposed for not adhering to HIPAA


A patient’s protected health information (PHI) may be shared only with those staff members are working with that resident