Professional Ethics & Jurisprudence Midterms PDF

PROFESSIONAL ETHICS & JURISPRUDENCE MIDTERMS KRISTIAN LHOYD PATUBO, RRT, MD Negligence vs Malpractice Negligence – refers to the failure to exercise reasonable care, resulting in harm to another person. It applies to any individual, not just professionals. Malpractice...

PROFESSIONAL ETHICS & JURISPRUDENCE MIDTERMS KRISTIAN LHOYD PATUBO, RRT, MD Negligence vs Malpractice Negligence – refers to the failure to exercise reasonable care, resulting in harm to another person. It applies to any individual, not just professionals. Malpractice – Malpractice is a type of negligence specifically involving a professional who fails to perform their duties according to the accepted standards of their profession. It is negligence by someone with specialized skills or knowledge. Plaintiff vs Defendant Plaintiff – Is the person(s) who has alleged that wrongdoing has been done to them. Defendant – Is the person(s) or entity that has been accused of committing a wrongful act. DOCTRINES APPLIED IN MEDICAL MALPRACTICE CASES DOCTRINE OF VICARIOUS LIABILITY Responsibility of a person who is not negligent, for the wrongful conduct or negligence of another. Also known as the doctrine of imputed negligence or doctrine of respondeat superior. holds an employer (e.g., a hospital) liable for the negligent actions of its employees (e.g., a radiologic technologist) performed within the scope of their employment. “let the master answer” DOCTRINE OF VICARIOUS LIABILITY Example: A radiology technologist at a hospital mistakenly administers the wrong type of contrast agent to a patient. The patient suffers an allergic reaction as a result. The hospital may be held liable for the technologist’s actions, even though the hospital itself did not commit the error. This is because the hospital is responsible for the actions of its employees while they are performing job-related duties. DOCTRINE OF RES IPSA LOQUITUR (COMMON KNOWLEDGE) The nature of the wrongful act is suggestive of negligence Latin term means "the thing speaks for itself." It applies when the injury would not ordinarily occur without negligence, and the defendant had control over the situation. The defendant is presumed to be negligent where the instrumentality causing another’s injury was in the defendant’s control and where the accident was one which ordinarily does not happen in the absence of someone’s negligence DOCTRINE OF RES IPSA LOQUITUR (COMMON KNOWLEDGE) Example: A patient suffers a burn from an improperly maintained X-ray machine. The injury would not typically occur unless there was negligence. The doctrine of res ipsa loquitur applies here, meaning "the thing speaks for itself." The obvious nature of the incident points to negligence by the radiology department without the need for the patient to provide detailed evidence of how the accident happened. DOCTRINE OF RES IPSA LOQUITUR (COMMON KNOWLEDGE) Elements – The event doesn't normally occur unless someone has acted negligently; – The evidence rules out the possibility that the actions of the plaintiff or a third party caused the injury; and – The type of negligence in question falls with the scope of the defendant's duty to the plaintiff. DOCTRINE OF CONTRIBUTORY NEGLIGENCE Doctrine of common fault Conduct on the part of plaintiff, contributing as a legal cause to the harm he has suffered, which falls below the standard to which he is required to conform for his own protection if a patient’s own actions contribute to their harm, they may be found partially responsible, potentially reducing or eliminating the healthcare provider’s liability. DOCTRINE OF CONTRIBUTORY NEGLIGENCE Examples: – Failure to give MD an accurate history – Failure to follow treatment recommended by MD – A patient is instructed not to consume food or water before a certain radiological procedure but ignores the instructions. This leads to complications during the procedure, making it difficult to obtain accurate images. If the patient sues for medical malpractice, the defense may invoke contributory negligence, arguing that the patient’s failure to follow pre-procedure instructions contributed to the issue. Doctrine of Comparative Negligence Similar to contributory negligence, but in comparative negligence, the patient's and healthcare provider’s actions are weighed, and the liability is distributed proportionally. The patient may still recover damages, but the compensation may be reduced based on their degree of fault. Doctrine of Comparative Negligence Example: A radiologist delays reviewing an urgent CT scan, which leads to a delayed diagnosis of a life-threatening condition. However, the patient had also delayed seeking treatment for symptoms. Under the doctrine of comparative negligence, both parties may share responsibility, and the damages awarded to the patient may be reduced based on their share of fault. Doctrine of Statute of Limitations refers to the time limit within which a patient must file a medical malpractice lawsuit. Once the time limit expires, the patient can no longer sue, even if there was clear malpractice. Doctrine of Statute of Limitations Example: A patient believes they were harmed during an MRI procedure two years ago, but they only file a lawsuit five years later. The doctrine of the statute of limitations could apply, as it limits the amount of time a patient has to bring a legal claim. If the lawsuit is filed after the legally allowed time period, it will likely be dismissed. DOCTRINE OF ASSUMPTION OF RISK Anyone who consents to the application of a procedure involving certain risks cannot recover damages for injury resulting from inherent or ordinary risks in the procedure Example: A patient undergoing a fluoroscopy procedure is informed of the potential risks, including radiation exposure, but agrees to proceed. If complications arise, the doctrine of assumption of risk may apply because the patient voluntarily accepted the known risks of the procedure, which can limit their ability to sue for damages. DOCTRINE OF LAST CLEAR CHANCE implies thought, appreciation, mental direction and lapse of sufficient time to effectually act upon impulse to save the life or prevent injury to another. DOCTRINE OF LAST CLEAR CHANCE Example: A radiologic technologist notices that a patient is positioned incorrectly for a mammogram but proceeds with the scan anyway. The patient later suffers an injury due to the mispositioning. Under the doctrine of last clear chance, the technologist had the final opportunity to prevent the harm and failed to do so, which makes them responsible. DOCTRINE OF FORCE MAJEURE are extraordinary events that are not foreseeable nor avoidable. An “Act of God” is an extraordinary natural event, without human intervention, that cannot be reasonably avoided or prevented. RESCUE DOCTRINE provides that a person who goes to the rescue of a victim in an accident is injured, the original wrongdoer must be held liable for such injury RESCUE DOCTRINE provides that a person who goes to the rescue of a victim in an accident is injured, the original wrongdoer must be held liable for such injury the rescuer can recover damages from a defendant when the rescuer is injured rescuing someone. RESCUE DOCTRINE Example: During a fire in the radiology department, a patient trapped in the MRI machine needs to be rescued. A radiologic technologist rushes in to help and is injured in the process. Under the rescue doctrine, the technologist could potentially recover damages from the hospital if it is shown that the dangerous situation was a result of negligence. FELLOW SERVANT DOCTRINE If a servant (employee) was injured on account of the negligence of his fellow servant (employee), the employer cannot be held liable. FELLOW SERVANT DOCTRINE Example: A radiology technologist is injured due to a mistake made by a colleague, another technologist, while preparing a patient for an X-ray. Under the fellow servant doctrine, the employer may not be liable for the injury because it resulted from the actions of a co-worker at the same level, rather than from employer negligence. DAMAGES Pecuniary compensations that may be recovered for an injury sustained or from breach of some duty or the violation of some right recognized by law. damages refer to the monetary compensation awarded by a court to an individual who has suffered a loss or harm due to the wrongful conduct of another party. Damages serve the purpose of remedying the harm done. Actual or Compensatory Damages adequate compensation only for pecuniary loss suffered by a person as he has duly proved. Moral damages Includes physical suffering, mental anguish, fright, serious anxiety, besmirched reputation, wounded feelings, moral shock, social humiliation and similar injury The 2 most common methods utilized to determine how much damage must be assessed for pain and suffering are: – Per diem method: estimated value of pain and suffering per day times the number of days the victim will suffer – Golden rule method: To call on the judge to determine how much the damage he wishes to receive whenever he is the plaintiff in the law suit. Nominal damages Trifling sum awarded to the plaintiff in an action where there is no substantial loss or injury to be compensated but where the law recognizes a technical invasion of the right of the plaintiff or a breach of the defendant’s duty. awarded when a legal wrong has occurred, but the plaintiff has not suffered any significant loss or harm. It serves as a symbolic acknowledgment that a violation took place, even though no substantial damages were caused. Liquidated damages These are damages agreed upon by the parties in a contract to be paid in the event of a breach. They are specified ahead of time and aim to avoid prolonged litigation. refer to a predetermined amount of compensation agreed upon by parties in a contract, to be paid if one party breaches the agreement. Torts a civil wrong that causes harm or loss to another person, resulting in legal liability for the person who commits the wrongful act. Torts are part of civil law, and they focus on compensating the injured party rather than punishing the wrongdoer (as in criminal law). In healthcare, tort law plays a significant role in regulating the professional conduct of healthcare providers and ensuring patients’ rights. The failure to comply a duty Failure to perform a duty that leads to harm of another person Key Elements of a Tort For a tort claim to succeed, certain elements must be proven: 1. Duty of Care: The defendant had a legal obligation to act in a certain way toward the plaintiff (e.g., a healthcare provider owes a duty of care to a patient). 2. Breach of Duty: The defendant failed to meet that obligation. 3. Causation: The defendant’s breach directly caused harm to the plaintiff. 4. Damages: The plaintiff suffered actual harm (physical, emotional, or financial) as a result of the breach. Torts 1. Intentional tort occurs when a person deliberately engages in actions that cause harm to another person. The key element here is intent. The wrongdoer (the defendant) acts with the knowledge or purpose of causing harm or offensive contact. 2. Unintentional tort (Negligence) occurs when a person fails to exercise a reasonable standard of care, resulting in harm to another. The focus here is not on the intent, but rather on the failure to act with the care that a reasonable person would exercise in the same situation.  Intentional tort Assault: threatening or attempting to make physical contact in a harmful or offensive way; intimidation of the patient/threatening the patient Battery: Intentional and wrongful physical contact with a person without their consent. False Imprisonment: Wrongfully restricting someone’s freedom of movement. Intentional tort Invasion of privacy: right to be left alone; right to privacy; right to be unwarranted and exposure to public view Defamation: Damaging someone’s reputation through false statements (libel for written and slander for spoken words); character assassination Unintentional tort Medical Malpractice: When a healthcare professional fails to provide the standard of care that a reasonably competent provider would offer, leading to patient injury. Any professional misconduct Unreasonable lack of professional skill Unintentional tort Professional negligence: Commission/omission of an act, pursuant to duty that a reasonably prudent in the same or similar circumstance would or would not do & acting on the non-acting of which is proximate cause of injury to another person or his property When a healthcare provider misses a diagnosis or delays it, causing harm to the patient. Ex: mistaken identity; defects in equipment such as stretchers and wheelchairs may lead to falls thus injuring the patient Unintentional tort Incompetence Lack of ability Ground for revocation/suspension of the COR Professional Negligence ELEMENTS OF PROFESSIONAL NEGLIGENCE 1.) Existence of a duty on the part of the person 2.) Failure to meet the standard of due case 3.) The foreseeability of harm resulting from failure to meet the standard FOUR ELEMENTS OF NEGLIGENCE (4 D’s) 1.) DUTY To use due case Case which should be given under circumstances 2.) DERELICTION Failure to use due case Not giving the case which should be given under the circumstances Failure to ask like allergy FOUR ELEMENTS OF NEGLIGENCE (4 D’s) 3.) DIRECT CAUSATION Failure to use due case causes injury Failure to ask like allergy Previous experience, the drugs and reaction 4.) DAMAGE OF INJURY Actual harm results LIABILITIES OF HOSPITAL Hospital – institution maintained for reception, care and treatment of those in need of medical and surgical attention – Service institution that concerns to serve the patient, doctors and public – Includes certain clinics, dispensaries and outpatient departments not maintained by regularly established hospitals Classification of Hospitals Classification of Hospitals Classification of Hospitals Classification of Hospitals IV. Classification based on size or bed capacity (old classification) – Primary – Secondary – Tertiary hospital V. Classification of hospital whether it’s training or not – Training hospital or teaching hospital is a hospital or medical center that provides medical education and training to future and current health professionals LIABILITIES OF HOSPITAL Corporate liabilities – Arises from failure to furnish accommodations and facilities necessary to carry out its purpose – Example: the patient slipped from the puddle of water created by the leaking hospital ceiling. He suffered hematoma and hip fracture. Hospital is liable. – If a patient was being transported to another area using a defective wheelchair hence sustained injury. Vicarious liabilities – For the acts of hospital employees – Example: The Radtech left the unconscious patient alone in the Xray room, resulting patient to fall form the bucky table. If the family of the patient sues the radtech, the hospital should also be charged. Hospital Admission A hospital must have an admitting section which is its nerve center A person has no absolute right to be admitted in a hospital or to avail of hospital services. The discretion to admit is vested on the management or the governing board A government hospital has no absolute privilege of choice of patients in as much as it is established and maintained by public fund. A private Hospital is given more power to choose the Physician and patients it wants to serve. Justifiable grounds to refuse admission of patients All accommodations are filled (no beds available) The patient is chronically ill The patient needs only convalescent care (non-urgent) There is no available accommodation for the clinical service that the patient is suffering The patient’s condition is contagious and a risk to other patients MEDICAL RECORDS Compilation of pertinent facts of the patient’s life history, his illness and treatment Contents; past and present medical history, day-today condition and treatment given, impression or diagnosis, observation of the attending doctor, report of nurse care, radiology department and OR. The records must always be considered confidential and no disclosure of information must be made without the expressed consent of the patient or by anyone who can act on his behalf.  Purpose of maintaining Record: – To document the patient’s history, condition and treatment – To aid in the continuity of care – To provide a record of billing The HOSPITAL is the guardian and owner of the record; likewise, physicians are considered owners of the medical records generated and maintain by them in their private office RA 7431 radiologic technology code of ethics & radiologic technology act of 1992 Purpose & importance How RT evaluates: Professional conduct ~px, employers, health care professionals Maintains: high level of ethical conduct ~ providing: protection, safely, & comfort (px) Creates: culture of integrity, supportive & positive atmosphere ~ builds morale, internal & external loyalty, & improves reputation Key ethical principles Respect for human dignity & rights Confidentiality Competency & continuing education Integrity – professional practice Code of ethics Article I "relation with the state & society” Section l Should be aware: of supreme authority ~ & should adhere to con. RA 7431 Section 2 "Consider welfare & well-being of the public” Section 3 Involve in civic affairs & organizations ~ promote growth & welfare of community Article II “relation with client / patient” Section l Act with dignity & sincerity ~ express genuine concern in discharge / output of their work Section 2 Confidentiality ~ disclosed by radiologists only Section 3 No discrimination Section 4 Quality service; patient care, radiation safety, ALARA, STD Article III "relation with other allied profession” Section I Profession: is a public trust ~ maintain & uphold integrity of profession & protect from misinterpretation Section 2 Do not assist in unauthorized practices of profession Section 3 Share information & experiences ~ fellow paramedical professionals Active member of accredited association of radiologic technology (ARTS) Encouraged to conduct research ~ enhance growth & advancement Section 4 Observe punctuality Respect scheduled appointments Section 5 Avoid PERSONAL / FINANCIAL interests Section 6 Perform with: honor, dignity, & fairness to all Section 7 Maintain reputation ~ work with etiquette Section 8 Strive to enhance professional growth ~ continuing education Section 9 Uphold integrity Not degrade reputation, competence, & capability Section 10 Support advancement ~ professional development of their colleagues Section 11 Equal treatment to colleagues Section 12 Align: personal philosophies & attitudes ~ workplace Section 13 Safe environment to patients & co-workers ~ express themselves freely  Section 14 Open to new ideas, knowledge, and innovations ~ development & growth in profession Article IV "relation to agency” Section 1 Improving functions to governmental agencies Section 2 Vigilant: protecting equipments & materials Section 3 Perform assigned tasks Section 4 Promote, support, assist & establish camaraderie ~ pees Article V "relationship with oneself” Section I RT’s: honest, dependable, level-headed, & morally upright Section 2 Engage in: professional growth Section 3 Entitled to just & fair compensation Section 4 Not use their names for advertisement RA 7431 radiologic technology act of 1992 Adherence to high standards of practice Promotes: responsible and professional conduct ~ RT April 22, 1992 Ensures: qualified and licensed RT can practice Helps: raise quality of healthcare RT: skilled & responsible Board of radiologic technology ~ PRC (Professional Regulation Commission) Section 15 NO Valid certificate from board ≠ Practice Section 16 Exemptions: o First members of board of RT o PASSER: civil service, private sector, chest/proficiency exam ~ X-ray tech., medical radiation tech. – before act’s approval Section 17 Exemptions: o First members of board o Visiting radiologists o Qualified medical radiation technologists o Experienced x-ray technicians *Must register w/ Board ~ meeting registration requirements Section 18 Pass: annual exam ~ Board through commission Ensures: compliance w/ rules & regulations Section 19 Filipino citizen Good moral ~ not convicted of any crime Degree: baccalaureate / associate Section 20 Scope: x-ray technology o Radiation physics 10% o Radiology & radiation protection 10% o Equipment maintenance 10% o Radiographic positioning 10% o Radiographic technique 10% o Special procedures 10% o Anatomy, physiology & med terms. 15% o Photochemistry & darkroom procedures 10% o Film analysis 5% o Nursing & departmental procedures in radiology 5% o Professional ethics 5% Section 21 Scope: radiologic technology o Radiation physics & equipment maintenance 10% o Radbiology & Radiation protection 10% o Radiographic positioning 10% o Radiographic technique 10% o Special procedures 10% o Anatomy, physiology & med terms. 15% o Photochemistry & film analysis 10% o Nursing & department procedures (radiology) & prof. ethics 5% o Ultrasound 5% o Radiation therapy 5% o Nuclear medicine 5% o Radiologic pathology 5% o CT & MRI 5% Section 22 Rating: ≥ 75% ~ no score below 60% (per subject) If: 60% (subject) retake only the subject failed Section 23 Must take professional oath Section 24 COR o Full name o Serial number o Signature of commissioner o Date of issuance o Official seal of board Section 25 Fees o Exam application 350php o Registration (after passing exam) 250php o Registration (w/o exam) 250php o Replacement: lost / destroyed certificate 100php o Reissuance (revoked certificate) 10ophp Section 26 Penal provisions o Practice (w/o COR) o Someone's COR / Revoked/ Expired COR o False info to get COR o False claim ~ RRT o Violating provision / Act RA 1092 CPD (continuing professional development) ACT— 2016 Mandatory requirement Enacted: July 21, 2016 Took effect: August 16, 2016 Implementation: March 15, 2017 ~ resolution No. 1032 Impact to profession Law states~ techs are responsible for: positioning px to obtain optimal diagnostic imaging RA 7431 "Radiologic technology act ~ 1992” Regulate practice of RT Ensure protection: Public health & safety in field Safety standards - equipments Proper maintenance & calibration Ensures radiology services are provided safely & responsibly  JURISPRUDENCE CLUSTER 4 RADIOLOGIC TECHNOLOGY LAW PRESIDENTIAL DECREE 223 (PD 223) June 22, 1973 PRC RA 7431 “RADIOLOGIC TECHNOLOGY ACT OF 1992” Approved on April 22, 1992 Speaker of the House: Ramon V. Mitra Jr. Senate President: Neptali A. Gonzales President of the Philippines: Corazon C. Aquino Secretary General of House of Representative: Catailo L. Sabio Secretary of the Senate: Anacleto D. Badoy Jr Hermogenes Pobre- Commissioner; Chairman when RA 7431 was signed into law Norberto Palomo- father of Radtech Education in the Philippines Gilberto Palomique- First President of PART BORT is composed of 5 persons: 1 Chairman and 4 members The FIRST Board was composed of the following: appointed in 1993 Dr. Fortunato Gabon Jr. – Chairman (001) First chairman; Radiologic Technologist Dr. Jose T. Gaffud Mr. Dexter R. Rodelas (002) Radiologic Technologist Ms. Editha C. Mora (003) Radiologic Technologist Ms. Eulinia M. Valdesco Physicist SEPTEMBER 20, 1993 The rules and regulations governing the examination, registration, licensure and practice of radiologic and x-ray technology was promulgated. DECEMBER 27, 1993 The Board conducted its First fully computerized licensure examinations, the results of which were released on April 9, 1994. May 28, 1993 Promulgation of the Code of Professional Ethics for XT and RT R.A. No. 7431 “RADIOLOGIC TECHNOLOGY ACT OF 1992” Chairman (BORT) 3 G's Gabon Gopez Gana  JURISPRUDENCE CLUSTER 4 The next member of the boards are: Mr. Nicomedes M. Gopez - Chairman Mr. Mario O. Chavez Mr. Lorenzo A. Reveldez Jr. Dr. Orestes P. Monzon Ms. Eulinia M. Valdesco January 2014 are: Ms. Wilhelmina M. Gana- Chairman Dr. Orestes P. Monzon Mr. Bayani C. San Juan Mr. Zaldy M. Ambon Ms. Cecilia S. Mananghaya June 2024: Mr. Reynaldo Apolonio S. Tisado- Chairman Orestes P. Monzon Ma. Jesette B. Canales Bayani C. San Juan Roland P. Conanan TIMELINE OF PHILIPPINE ASSOCIATION OF RADIOLOGIC TECHNOLOGISTS, INC. 1954– the Association of X-ray Technicians in the Philippines was conceived MSGT Gilberto Palomique from the V. Luna General Hospital, Armed Forces of the Philippines (now the AFP Medical Center) was then the President of the First Association. He became the officer in charge of the 2nd school of Radiologic Technology in the country- The Marian College which is known as the Emilio Aguinaldo College. In 1966-1967, Mr. Jose Querido was elected as the new president. In 1967, SSGT Norberto A. Palomo was elected as the president. Mr. Palomo is known as the Father of Radiologic Technology in the Philippines. He became the principal of the 1st Radtech School in the Philippines- the Family Clinic and Hospital School of Radiologic Technology (FCHSRT). In 1973, three different society of Radiologic Technologists emerged and they were: 1. PHISMERT (the Philippine Society of Medical Radiologic Technologists) with Mr. Norberto A. Palomo as President. 2. PSRT (the Philippine Society of Radiologic Technologists) with Mr. Gilberto Palomique as president and 3. PIRT (the Philippine Institute of Radiologic Technologists) with Mr. Almario Lutap as the President Later, the three conflicting societies of Radiologic Technology were fused into one and became the PART (Philippine Association of Radiologic Technologists, Inc.) where Mr. Gilbert Palomique acted as President. THE PHILIPPINE ASSOCIATION OF RADIOLOGIC TECHNOLOGISTS (PART) ⮚The PART is the only accredited Professional Organization of Radiologic and X ray Technologists in the Philippines as of 2014.  JURISPRUDENCE CLUSTER 4 In 1969, the PART became the 36th regular chapter member of the International Society of Radiographers and Radiologic Technologists (ISRRT). Accredited by the PRC in September 1992. The association is an affiliate of the Philippine College of Radiography (PCR)