Chapter_026 udated 8edcobb.pdf

Chapter 26 Medical Law 1 Objectives (1 of 3) ˜ ˜ ˜ Differentiate among the various types of law. Outline how the standard of care is established for radiologic and imaging science technologists. Discuss the concept of tortious conduct and causes of action that may arise from the behavior of a health...

Chapter 26 Medical Law 1 Objectives (1 of 3) ˜ ˜ ˜ Differentiate among the various types of law. Outline how the standard of care is established for radiologic and imaging science technologists. Discuss the concept of tortious conduct and causes of action that may arise from the behavior of a health care practitioner. 2 Objectives (2 of 3) ˜ ˜ Argue the importance of privacy of records and the relationship between privacy of records and patient confidentiality issues. Explain negligence and the four elements necessary to meet the burden of proof in a medical negligence claim. 3 Objectives (3 of 3) ˜ ˜ ˜ ˜ Explain the legal theory of res ipsa loquitur and how an attorney may use it in a claim of medical negligence. Illustrate how a hospital may be liable under the doctrine of respondeat superior. Describe the rationale for informed consent. Outline the information a patient must have before an informed consent may be given. 4 Laws The body of rules, regulations, and guidelines that govern conduct in society to protect the health, safety, and welfare of its citizens Occasionally, laws and medicine conflict with each other. Plaintiff vs. defendant Litigation 5 Relationship between Patients and Health Care Practitioners Defined in 1914 by a precedent-setting case, Schloendorf v. Society of New York Hospital “Every human being of adult years and sound mind has a right to determine what shall be done with his own body, and a surgeon who performs an operation without his patient’s consent commits an assault, for which he is liable in damages.” 6 Doctrine of Patient–Provider Relationship ˜ ˜ ˜ ˜ ˜ ˜ Protects individual autonomy. Protects patient’s status as a human being. Avoids fraud and duress. Encourages health care practitioners to consider their decisions carefully. Fosters rational decision making by the patient. Involves the public in medicine. 7 Types of Law ˜ ˜ Constitutional Legislative Ø Ø Ø ˜ Case Law Ø Ø ˜ Administrative rules Regulations Ordinances Derived from the Common Law of England Laws determined on a case-by-case basis Contract Law 8 Causes of Legal Action ˜ ˜ ˜ ˜ ˜ Torts Assault Battery False imprisonment Defamation Slander o Involves spoken word Ø Libel o Involves written word Ø ˜ Fraud 9 Torts ˜ ˜ ˜ Patient’s claim that they have been wronged or have sustained some injury, other than a breach of contract, for which they believe cause exists for an action for damages. Comes from a violation of a duty imposed by general law on all persons involved in a transaction or situation. A breach of duty must occur to warrant tort action. 10 Assault ˜ ˜ ˜ An assault claim may arise when a patient believes he or she has been threatened in such a way that reason to fear or to expect immediate bodily harm exists. Assault does not require physical contact. Assault may only be verbal. Ø Patient perceives possible harm by comments Example: “Hold still or we’ll have to start all over!” Example: “If you don’t swallow these pills, the radiologist will not come in to do the study” 11 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 has touched them in an offensive way. When positioning patients and using palpation, get the patient’s permission and use professional palpation techniques. Ø Improper positioning methods and rough handling can warrant a charge of battery. Ø 12 False Imprisonment ˜ ˜ ˜ ˜ False imprisonment arises when a person is restrained or believes that they are being restrained against their own will. The individual must be aware of the confinement and have no reasonable means of escape. With senile, pediatric, or other incompetent patients, obtaining consent to restrain or immobilize from someone authorized to give consent is important. Understand your responsibilities regarding false imprisonment. 13 Defamation ˜ ˜ ˜ ˜ Slander Libel Be aware of social media sites and the risk of disclosure of confidential patient information, which can be viewed as harmful to patient. Maintain the strictest standards regarding the privacy of a patient’s medical information or condition. Be very careful of your use of social media technologies, regarding work, patients, and colleagues!!! 14 Fraud ˜ ˜ The willful and intentional misrepresentation of facts that may cause harm to an individual or result in loss of an individual right or property. Fraudulent cases require three sources of proof: An untrue statement, known to be untrue by the party making it, was made so as to mislead. 2. The injured party relied on the statement. 3. Damages were incurred as a result of this reliance. 1. 15 Health Information Privacy ˜ ˜ ˜ ˜ Patient Care Bill of Rights clearly defines that health records are to be held private and confidential. Health records are the property of the provider. Health information in those records is the property of the patient. In the new world of electronic imaging, it is critical that images are kept accurate, secure, and confidential. 16 HIPAA Health Insurance Portability and Accountability Act 1996 ˜ ˜ ˜ Standardization of all electronic data interchange. Protection of confidentiality. Security of patient information. 17 Negligence ˜ ˜ Negligence is a failure to use such care as a reasonably prudent, comparable person would use under similar circumstances. Basis for comparison is premised on the standard of a “reasonable, prudent person under like circumstance.” 18 Negligence Proofs Injurious or unprofessional treatment of a patient including neglectful actions Duty Breach of duty Deviation from duty Causation Damage As a result of the breach Compensable injury 19 Standard of Care ˜ ˜ ˜ ˜ The degree of skill (proficiency), knowledge, and care ordinarily possessed and employed by members in good standing within the medical profession. Ever-changing as technology improves. Judged against “reasonable and prudent” actions under similar circumstances. Components of Standard of Care outlined by the profession and used by courts for guidance. 20 American Society of Radiologic Technologists ˜ Practice standards for medical imaging and radiation therapy. Ø ˜ ˜ Found in Appendix A in text. Outline the performance standards of the medical imaging profession, at a minimum. It is imperative that imaging professionals become competent in the knowledge and application of these standards. As a professional in the radiologic and medical imaging sciences, we ALL have the responsibility to understand and comply with the established Practice Standards. 21 Legal Doctrines ˜ Respondeat superior. Ø ˜ Corporate liability. Ø Ø Ø ˜ “The master speaks for the servant.” Duty of reasonable care in the selection and retention of employees and medical staff Duty of reasonable care in the maintenance and use of equipment Availability of equipment and services Res ipsa loquitur. Ø Ø “The thing speaks for itself.” Burden of proof shifts to healthcare practitioner 22 Informed Consent (1 of 2) ˜ ˜ ˜ ˜ ˜ Premised on the basis of TRUST. Required for any interventional procedure. Assumes the provider is acting in the best interest of the patient and in a manner that is consistent with Standards of Care. Patients have the right to make informed decisions regarding their care. Not typically required for simple, routine, noninvasive, medical imaging studies: Ø Implied consent generally used for simple procedures 23 Informed Consent (2 of 2) ˜ ˜ ˜ ˜ ˜ Information provided in lay language. Provided in patient’s primary language. Patient autonomy must always be respected. Consent form signed and witnessed by disinterested third party. Not to be confused with Implied Consent. 24 Informed Consent Form (1 of 2) ˜ ˜ ˜ Authorization clause to permit the physician or other health care professional to perform the examination. Disclosure clause to explain the procedure, its risks and benefits, and possible alternatives to the procedure. Anesthesia clause if required. 25 Informed Consent Form (2 of 2) ˜ ˜ No-guarantee clause for therapeutic procedures. Tissue-disposal clause: Ø ˜ Patient understanding clause: Ø ˜ If the removal of tissue may be necessary. States that all the information contained in the consent form has been carefully explained to the patient Signature clause: Ø Calls for the signature of the patient and witness 26 The Principle of Autonomy ˜ ˜ ˜ ˜ Right to information and self-determination. Free and informed consent. Free will and accord—intentional participation in treatment. Respect and dignity maintained. The patient’s autonomy should always be considered when performing diagnostic or therapeutic procedures. 27 Conclusion (1 of 2) ˜ ˜ Radiologic and medical imaging science professionals are legally liable for their actions in the daily performance of diagnostic procedures and patient management. Professionals have a responsibility to understand and practice the Standard of Care of the profession. 28 Conclusion (2 of 2) ˜ ˜ ˜ Professionals must respect patient autonomy at all times. A patient’s health information must be kept confidential. Professionally appropriate behavior is premised on trust of the patient and a willingness to “do no harm, and always do good.” 29