medical law 3-6-25

• Laws protect the health, safety, and welfare of citizens through rules, regulations, and guidelines.
• Law exists so an individual or group's rights are not encroached on.
• Laws should remain dynamic to reflect society.
• Laws must be applied equally without discrimination.
• Laws are based on what a reasonable and prudent person would do in similar circumstances.
• All individuals have basic rights and responsibilities.
• The precedent-setting case, Schloendorf v. Society of New York Hospital in 1914 states that every human being of adult years and sound mind has a right to determine what shall be done with their own body.
• A surgeon who performs an operation without the patient's consent commits an assault and is liable in damages.
• The principles of law entails protecting individual autonomy and patients as human beings, avoiding fraud and duress/threat, encouraging health care professionals to carefully consider decisions, fostering rational decision-making, and involving the public in medicine.

Types of Law

• Constitutional law is the supreme law of the land in the U.S.
• Constitutional law separates the three branches of government: the executive (president), legislative (senate and house), and judiciary (courts).
• Statutory law is enacted by legislative bodies or administrative agencies at the local, state, or federal levels.
• Statutory law defines and regulates many areas of health care, such as the use of ionizing radiation.
• Common law or case law is derived from the Common Law of England and they are often decided on a case-by-case basis.
• Case law dictates the fate of health care professionals in lawsuits, especially regarding negligence or violation of the standard of care.
• Two important principles of common law are res judicata (the thing is decided) and stare decisis (let the decision stand).

Causes of Legal Action

• Causes of legal action include Torts, Assault, Battery, False Imprisonment, Defamation, and Fraud.

Torts

• A patient's claim that they have been wronged or hurt in some way, other than if there’s a contract breach, which leads them to believe there is a cause for damages.
• Arises from duty violations imposed by general law on all persons.
• A breach of duty must occur to warrant tort action.

Types of Torts

• Unintentional torts:
  • Malpractice
  • Negligence
• Intentional torts:
  • Assault/battery
  • False imprisonment
• Intentional infliction of emotional distress

Tort of Outrage

• Tort of Outrage occurs when the perpetrator knew or should have known that their conduct would cause emotional distress; the conduct was extreme and outrageous; the perpetrator's actions caused the distress; and the distress was severe.

Assault

• An assault claim arises when a patient believes they have been threatened in a way that causes fear or expectation of immediate bodily harm.
• Assault does not require physical contact and may be verbal with comments that the patient perceived as harmful, such as:
  • “Hold still or we'll have to start all over!”, or
  • “If you don't swallow these pills, the radiologist will not come in to do the study".

Battery

• Battery may occur even if no injury arises from unwarranted patient contact.
• Any unlawful touching may constitute battery if the patient thinks that the radiologic and imaging science professional touched them offensively.
• Permission must be granted by the patient when positioning for palpitation techniques.
• Improper positioning methods and rough handling can warrant a charge of battery.

False Imprisonment

• False imprisonment arises when a person is restrained or believes they are being restrained against their own will.
• The individual must be aware of the confinement and have no reasonable means of escape.
• Consent to restrain or immobilize from authorized person is important with senile, pediatric, or other incompetent patients.
• Understand responsibilities regarding false imprisonment.

Defamation

• Defamation includes slander (spoken) and libel(written).
• Be cautious of social media, which can disclose patient information, potentially harming the patient.
• Standards must be upheld by ensuring medical privacy and patient condition details are held confidential

Fraud

• Fraud is the willful and intentional misrepresentation of facts that may cause harm or loss of right/property.
• Proof of fraud includes:
  • An untrue statement was made, known to be untrue by the party, to mislead.
  • The injured party relied on the statement.
  • Damages were incurred due to this reliance.

Health Information Privacy

• The Patient Care Bill of Rights defines health records as private and confidential.
• Health records are the property of the provider.
• Health information within those records are the property of the patient.
• In electronic imaging, images must be accurate, secure, and confidential.

Negligence

• Negligence is the failure to do something that a reasonable person would do, guided by considerations that ordinarily regulate human affairs, or doing something that a reasonable person would not do.
• Injurious or unprofessional treatment of a patient including neglectful Duty, Breach of duty, Injury, and Damage

Cause of Action in Diagnostic Imaging

• 10% of medical negligence claims are related to diagnostic imaging, including improper diagnosis and injuries to patient during diagnostic procedures.
• Radiographers could be called to testify.

Standard of Care

• Standard of Care represents the skills, knowledge, and care standards of medical professionals in good standing.
• Standard of Care is always changing as technology improves.
• Professionally outlined standards are judged upon “reasonable and prudent” actions.
• Components of Standard of Care outlined by the profession and used by courts are for guidance.

ASRT

• ASRT provides practice standards for medical imaging and radiation therapy.
• ASRT outlines the performance standards of the medical imaging profession.
• Imaging professionals have to be competent in the knowledge and application of these standards.

Patient Bill of Rights

• The American Hospital Association (AHA)'s Patient's Bill of Rights includes a set of 15 guarantees for anyone who seeks medical care in a U.S. hospital
• Patient Bill of Rights promotes respect for patients/providers, and open dialogue about diagnosis, treatment, fees, and the delivery of effective care.

Legal Doctrines

• Respondeat superior: "The master speaks for the servant."
• Res ipsa loquitur: "The thing speaks for itself," which will shift burden of proof shifts to health care practitioner

Legal Doctrine of Informed Consent

• Requires health care professionals to provide sufficient facts about procedure risks, and benefits.
• Requires patient agreement prior to proceeding.
• In radiology, ensure patients understand imaging purposes, including risks, benefits, and possible radiation exposure.

Legal Doctrine of Negligence

• Occurs when health care professional does not follow care standards.
• This can cause patient harm and is the most common legal basis for malpractice claims.
• In radiology, examples include improper positioning, low quality imaging, and missing abnormalities

Legal Doctrine of Malpractice

• Professional misconduct or lack of skill leads to patient harm.
• Radiologists and technologists are liable for malpractice if they cause patient harm by not meeting standards.

Legal Doctrine of Vicarious Liability

• Similar to respondeat superior and employer is responsible and accountable for errors made by employees while at work

Legal Doctrine of Implied Consent

• In emergencies, or patients who are unconscious in trauma situations.
• Radiologic technologists can proceed with imaging in emergency situations (e.g., trauma Patients have the right to refuse imaging procedures like X rays, CT scans and MRIs.

Legal Doctrine of Patient Autonomy

• Patients can refuse the right to treatment

Legal Doctrine of Confidentiality

• Requires healthcare to keep patient information private, including imaging results
• Patient information and imaging results must be only shared with authorized individuals.

Legal Doctrine of Mandatory Reporting

• Requires health care professionals to report certain situations like suspected abuse or communicable diseases.
• Radiologists and Technologists have the obligation to report if they are suspicious of abuse or injuries

Legal Doctrine of Direct Causation

• Requires a direct link between a healthcare provider and the harm patient that has suffered

Why Use Consents?

• Premised on trust and required for interventions that provider’s action acting on their patients interest

Types of Consent

• Implied consent entails implied action not expressly given.
• Informed consent follows a full information disclosure, knowledge of a procedure

When Informed Consent is needed:

• Invasive procedures, procedures with significant risks, procedure purposes need to be known

Requirements for Informed Consent:

• Shared decision-making with the patient and physician is necessary, patients should be of mental compentency and of legal age. Patient Autonomy should be respected

What an Informed Consent Form Should Contain:

• Authorization to allow physicians, health care providers to perform examination
• Disclosure clause to explain the explanation, clause, risks and benefit
• Signature signature, and all information contains can be viewed as confidential.

Types of Consent

• Expressed: Non-verbal ex: Noddings
• Oral/Verbal actions can be a sign of silence

Emergency Situations

• In an emergency the consent is implied and a authorization form signatures of 2 licenses from MDs must representing 2 different disciplines and any documentation to conduct to contact family must be included for consent .

Advanced Directives

• Legal documents that allow individuals to specify their healthcare preferences in case they are unable to communicate their decisions.

Common Types of Advanced Directives

• Living Will: Specifies treatment preferences.
• Takes effect if the person is terminally ill or permanently unconscious.
• Durable Power of Attorney for Healthcare (Healthcare Proxy)

Do Not Resuscitate (DNR)

• Medical order instructing health providers not to perform CPR.

Key Features of DNR

• Only applicable to patient with terminal illness, where patient doesn’t wish to proceed
• Can be written by a doctor in consultation, but doesn’t prevent other medical treatments

Do Not Intubate (DNI)

• Order not to preform intubation ( breathing tube)

Healthcare Proxy

• Document appointment healthcare positions, where patients can be acting for healthcare purposes
• The patient must be able to act best for the person, but make decisions about treatment/surgeries

Importance of Advanced Directives:

• Can make sure that personal and future wishes are respected if there’s communication loss.
• Relieves family members from difficult decisions
• Prevent unnecessary wants to be conducted

Aspects of Giving Consent

• Mentally and physically able for given consent

Those who give consent:

• Competent adult must be capable
• Legally Guardians, not the person in need of care, but the one giving consent.
• Emancipated Minors.

What the Language Translator entails

Translators entails translating legally or qualified medical translators.

Contacting the proper representatives

• Appointing a guardian for the court
• Appointing the order
• Parents (Adult and Over)

Precautions needed to be looked out for are

• All actions must be verbally in written
• Action can always be in power
• Conscious is in control
• Must be in control/valid of those being involved

The Autonomy of principles

• Actions must uphold
• Actions must entail a free, with respect
• Actions can entail the autonomy, patient must follow the right.

Conclusion

• Radiologic Sciences all the health must be respected and all actions must be in good for the profession.