Chapter 4 - Medical Law & Ethics

3 branches of government/Sources of Law

legislative
executive
judicial

Legislative

-those responsibilities not governed by the federal government are duties of the state
-write, debate and pass bills

Executive

-Governor is the head of the state
-executive orders become law without approval of Congress

primary duty of Congress:

-write, debate and pass bills, which are then passed on to the president for approval
-making laws controlling trade between states and between the United States and other countries
-making laws about taxes and borrowing money
-approving the printing of m

Functions of House of Representatives include:

-introduce legislation that compels people to pay taxes
-decide if a government official should be put on trial before the Senate if he or she commits a crime against the country

Functions of the Senate include:

-approve and disapprove any treaties the president makes
-approve of disapprove any people the president recommends for jobs, such as cabinet officers, Supreme Court justices and ambassadors
-hold an impeachment trial for a government official who commits

executive orders

a rule or regulation issued by the president of the United States that becomes law without the prior approval of Congress

checks and balances

the system established by the U.S. constitution that keeps any one branch of government from assuming too much power over the other branches

4 types of state law

1) Constitutional Law - law that derives from federal and state constitutions
2) Case Law - law established through common law and legal precedent
3) Statutory Law - law passed by the U.S. Congress or state legislatures
4) Administrative Law - Enabling st

Judicial

-interprets and oversees laws

National Government

-print money
-regulate interstate (between states) and international trade
-makes treaties and conduct foreign policy
-declare war
-provide an army and navy
-establish post offices
-make laws necessary and proper to carry out the above powers

State Governments

-issue licenses
-regulate intrastate (within the state) businesses
-conduct elections
-establish local governments
-ratify amendments to the Constitution
-take measures for public health and safety
-may exert powers the constitution doesn't delegate to th

Other Types of Law

Constitutional
-derives from federal and state constitutions
Case
-established from common law and legal precedent
Common
-Body of unwritten law formed in England

Substantive law

the statutory or written law that defines and regulates legal rights and obligations

Procedural law

law that defines the rules used to enforce substantive law

Criminal law

law that involves crimes against the state

felony

an offense punishable by death or by imprisonment in a state or federal prison for more than one year

misdemeanor

a crime punishable by fine or by imprisonment in a facility other than a prison for less than one year

civil law

-law that involves wrongful acts against persons
-people can sue another person, a business, or the government

tort liability

-a civil wrong committed against a person or property, excluding breach of contract
-must involve injury, damage to property, or deprivation of civil liberties
-may be intentional or unintentional

Intentional torts

when one person intentionally harms another

tortfeasor

the person guilty of committing a tort

EX's of intentional tort

Assault - open threat of bodily harm to another, or acting in such a way as to put another in the "reasonable apprehension of bodily harm"
Battery -an action that causes bodily harm to another without permission
Defamation of character - involves damaging

Unintentional Torts

acts that are not intended to cause harm but are committed unreasonably or with a disregard for the consequences

negligence

- an unintentional tort
- charged when a health care practitioner fails to exercise ordinary care and a patient is injured
- can also be charged to an institution

Trespass

wrongful injury to or interfere with the property of another

nuisance

anything that interferes with the enjoyment of life or property

interference with contractual relations

intentionally causing one person not to enter into or to break a contract with another

deceit

false statement or deceptive practice done with intent to injure another

conversion

unauthorized taking or borrowing of personal property of another for the use of the taker

Misuse of legal procedure

bringing legal action with malice and without probable cause

infliction of emotional distress

intentionally or recklessly causing emotional or mental suffering to another

jurisdiction

the power of a court to hear and decide a case before it

plaintiff

the person brining charges in a lawsuit

prosecution

the government as plaintiff in a criminal case

defendant

the person or party against whom charges are brought in a criminal or civil lawsuit

judges

elected or appointed to preside over the court and in most states must be licensed attorneys

attorneys

represent plaintiffs and defendants, presenting evidence so that the jury or the judge can reach a verdict

court clerks

keep court records and seals, enter court orders, and judgments into the record and keep the papers of the court

Bailiffs

keep order in the courtroom and may remove disruptive persons from the court at the judge's request

Court reporters

make a running account of all court proceedings, using a stenotype machine that types shorthand symbols onto a tape

juries

most often selected from lists of registered voters. 6 or 12 jurors are chosen to hear the evidence presented in court and render a verdict

contract

a voluntary agreement between two parties in which specific promises are made for a consideration

Agreement

One party makes an offer and another party accepts it. Certain conditions pertain to offer:
- it can relate to the present or the future
- it must be communicated
- it must be made in good faith and not under duress or as a joke
-it must be clear enough t

void

without legal force or effect

breach of contract

failure of either party to comply with the terms of a legally valid contract

mentally incompetent

unable to fully understand all the terms and conditions of a transaction, and therefore unable to enter into a legal contract

voidable

able to be set aside or to be revalidated at a later date

minor

-anyone under the age of majority
-18 years in most states
-21 years in some jurisdictions

Contract
(4 elements to be legally binding)

-agreement: one party makes an offer and another party accepts it
-consideration : something of value is bargained for as part of the agreement
-legal subject matter : contracts are not valid and enforceable in court unless they are for legal services or

Expressed Contracts

a written or oral agreement in which all terms are explicitly stated
-Termination of contracts
-Laws governing payment of fees at fulfillment of contracts

statute of frauds

-derived from Statute for the Prevention of Frauds and Perjuries formulated in England in 1677
-state legislation governing written contracts

Termination of contracts

the contract between a physician and a patient is usually terminated when all treatment has been completed and the bill has been paid
EX's:
Failure to pay for services - physician may stop treatment of a patient and end the physician-patient relationship

third-party payer contract

a written agreement signed by a party other than the patient who promises to pay the patient's bill

Regulation Z - Truth-in-Lending Act
(4 conditions)

-credit is offered to consumers
-credit is offered on a regular basis
-the credit is subject to a finance charge (interest) or must be paid in more than 4 installments according to a written agreement
-the credit is primarily for personal, family or house

Fair Debt Collection Practices Act

(FDCPA)
-a federal statute prohibiting certain unfair and illegal practices by debt collectors and creditors
-prohibits certain methods of debt collection, including harrassment, misrepresentation, threats, disseminating false information about the debtor

Implied Contracts

unwritten or unspoken agreement whose terms result from the actions of the parties involved

Evidence of Medical Malpractice

-expert testimony
-existing federal and state laws
-hospital bylaws
-custom and community practice
-accreditation standards

Court System

Federal courts
-jurisdiction: power to hear a case
State courts
-local, trial, appellate, supreme court

Players in the court scene

Plaintiff
-person bringing charges
Prosecution
-government as plaintiff in criminal case
Defendant
-party against whom charges are brought

Managed care plan contract
(3rd element)

physicians still have contracts with their patients, but they may also have contracted with managed care programs to deliver medical services

Contractual Rights of Physicians

-make reasonable limitations on physician/patient relationship
-set up a practice based on credentials
-set up an office and determine hours
-specialize
-decide what services will be provided and how they will be provided

Patient Care Partnership/rights

-considerate and respectful care
-information on diagnosis and treatment
-information to give informed consent
-right to refuse treatment
-confidentiality
-continuity of care
-knowledge of hospital rules

Implied Duties of Patient

-follow physician instructions and cooperate as well as able
-give all relevant information to the physician to form diagnosis
-follow physician orders for treatment
-pay fees for services rendered

Law of Agency

-law governing relationship between principle and agent
-may be expressed or implied
1) agent: one who acts for another
2) respondeat superior: physician is
responsible for acts of employee