Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

Medical Law and Ethics, Third EditionBonnie F. Fremgen

Copyright ©2009 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.

Medical Law and Ethics

Importance of the Legal System for the Physician

Chapter 3




Medical Practice Acts

•Establish examining boards

•Provide baseline for practice of medicine

•Determine prerequisites for licensure

•Forbid practice of medicine without a license

•Specify conditions for renewal, suspension, and revocation of licenses

•Vary from state to state




Licensure of Physician

•Examination– National Board Medical Examination (NBME)– Federal Licensing Examination (FLEX)– U.S. Medical Licensing Examination (USMLE)

•Endorsement•Reciprocity •Registration




When Valid License Is Not Needed by a Physician

•When employed by federal medical facilities (but must be a licensed physician)

• In an emergency

•While establishing residency

•When engaged solely in research




Revocation and Suspension

•Unprofessional conduct: falsifying records, gross immorality

•Commission of a crime: Medicare/Medicaid fraud, rape, murder, larceny, narcotics conviction

•Personal incapacity: physical or mental incapacity




Licensure and Certification of Allied Health Professionals

•Licensure: graduate from accredited school and pass national exam of competency

•Certification: meet standards set by accreditation body and pass national exam of competency




Accreditation•Voluntary request of official review by

accrediting agency•Examine policy and procedures of agency•Must demonstrate that the institution maintains

high standards•Examples: JCAHO and CAAHEP




Standard of Care

•Ordinary skill and care that must be used by medical practitioners

•Must provide same knowledge, care, and skill that similarly trained physician would provide under same circumstances

•Perform as “reasonable and prudent” person would perform




Prudent Person Rule

•Must provide following information to patient:– Diagnosis– Risk and consequences of treatment– Expected benefits of treatment or procedure– Alternative treatments– Prognosis if no treatment– Cost and expected pain– Follow acceptable standard of care




Confidentiality

•Keeping private all information about patient

•No disclosure without written consent

•Medical Patient Rights Act: gives all patients right to have privacy respected and records held confidential




Statute of Limitations

•Period of time patient has to file lawsuit

•Usually one to three years

•Discovery Rule: begins when problem discovered




Good Samaritan Laws

•State laws help protect health care professionals and ordinary citizens from liability while giving care in emergency

•No one is required to provide aid•Only required to act within limits of acquired

skill and training •Once you start you must continue until help

arrives or you physically cannot continue




Respondeat Superior

• “Let the master answer”

•Employer liable for acts of employee within scope of employment




Figure 3.1An Accident Victim Receiving Emergency Care




Figure 3.2Physician Working with the Rest of the Healthcare Team (Jose

Pelaez/Corbis/Stock Market)




Employee’s Duty to Carry Out Orders

•Duty to interpret and carry out orders

•Duty to clarify ambiguous or erroneous orders

•Duty to decline orders that appear dangerous for patient and to notify physician




Scope of Practice

•Must understand and work within scope of practice for discipline

•Must understand and practice within guidelines of profession

•Must understand and follow chain of command so no employee makes decision he or she is unqualified to make




Employer’s Duty to Employees

•Responsibility to provide safe environment for employees and staff

•Most have liability insurance to cover accidents and unforeseen incidents

•May bond employees who handle money

•Some have liability insurance for auto if used for work-related business




Risk Management

•A practice used to control or minimize incidence of problem behavior that might result in injury to patients and employees and liability for physician/employer– Identify risk behaviors and practices– Develop and follow plan of action to eliminate

problem behavior– Address corrective actions in policy and procedure

books and employee handbooks

Medical Law and Ethics, Third Edition Bonnie F. Fremgen Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

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