AHS 205 - Study Guide CH Test 1-4

Two important reasons for studying law and ethics:

1) To help you function at the highest possible professional level, providing competent, compassionate health care to patients 2) Help you avoid legal entanglements that can threaten your ability to earn a living as a successful health care practitioner.

List and discuss each of the steps helpful to developing critical thinking skills.

1.) Identify and clarify the problem: a problem can't be solved unless you know exactly what it is. 2.) Gather information: identify all the issues causing the problem at hand. 3.) Evaluate the evidence: Look at all the information gathered and determine out of all of it what parts of the evidence is causing the problem and that there is in fact a true problem. 4.) Consider alternatives and implications: Try to come up with all possible solutions that would provide the best outcomes for everyone. Consider all the possible bad outcomes for everyone as well, so that you're prepared for them or can avoid them in general. 5.) Choose and implement the best alternative: Select the best solution and make it happen.

Solving problems through critical thinking (simple):

1.) Identifying and clarifying the problem 2.) Gathering information 3.) Evaluating the evidence 4.) Considering alternatives and implications 5.) Choosing and implementing the best alternative

List three areas where health care practitioners can gain insight through studying law and ethics.

1.) The rights, responsibilities, and concerns of health care consumers. 2.) The legal and ethical issues facing society, patients, and health care practitioners as the world changes. 3.) The impact of rising costs on the laws and ethics of health care delivery.

professional corporation

A body formed and authorized by law to act as a single person.

tort

A civil wrong committed against a person or property, excluding breach of contract.

American Medical Association Principles

A code of ethics for members of the American Medical Association, written in 1847.

protocol

A code prescribing correct behavior in a specific situation, such as a situation arising in a medical office.

registration

A credentialing procedure whereby one's name is listed on a register as having paid a fee and/or met certain criteria within a profession.

misdemeanor

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

summary judgment

A decision made by a court in a lawsuit in response to a motion that pleads there is no basis for a trial.

bioethics

A discipline dealing with the ethical implications of biological research methods and results, especially in medicine.

Patient Protection and Affordable Care Act (PPACA)

A federal law enacted in 2010, to expand health insurance coverage and otherwise regulate the health insurance industry. Many provisions of the law were scheduled to take effect in 2014 and 2015.

Health Care Education and Reconciliation Act (HCERA)

A federal law passed in 1996 to protect privacy and other health care rights for patients. The act helps workers keep continuous health insurance coverage for themselves and their dependents when they change jobs, and protects confidential medical information from unauthorized disclosure and/or use. It was also intended to help curb the rising cost of health care fraud and abuse.

Health Insurance Portability and Accountability Act (HIPAA)

A federal law passed in 1996 to protect privacy and other health care rights for patients. The act helps workers keep continuous health insurance coverage for themselves and their dependents when they change jobs, and protects confidential medical information from unauthorized disclosure and/or use. It was also intended to help curb the rising cost of health care fraud and abuse.

Sole Proprietorship

A form of medical practice management in which a physician practices alone, assuming all benefits and liabilities for the business.

partnership

A form of medical practice management system whereby two or more parties practice together under a written agreement specifying the rights, obligations, and responsibilities of each partner.

Accountable Care Organization (ACO)

A health care payment and delivery model that could reward doctors and hospitals for controlling costs and improving patient outcomes by allowing them to keep a portion of what they save if standards of quality are met.

physician-hospital organization (PHO)

A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO.

health maintenance organization (HMO)

A health plan that combines coverage of health care costs and delivery of health care for a prepaid premium.

licensure

A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors.

group practice

A medical management system in which a group of three or more licensed physicians share their collective income, expenses, facilities, equipment, records, and personnel.

associate practice

A medical management system in which two or more physicians share office space and employees but practice individually.

preferred provider organization/association (PPO/PPA)

A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer's plan. Also called preferred provider association (PPA).

utilitarianism

A person makes value decisions based on results or a rule that will produce the greatest balance of good over evil, everyone considered.

Hippocratic oath

A pledge for physicians, developed by the Greek physician Hippocrates circa 400 b.c.e.

executive order

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

patient portal

A secure online Web site that gives patients 24-hour availability to health care providers.

managed care

A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee.

code of ethics

A system of principles intended to govern behavior—here, the behavior of those entrusted with providing care to the sick.

contract

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

certification

A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate.

felony

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

negligence

An unintentional tort alleged when one may have performed or failed to perform an act that a reasonable person would not or would have done in similar circumstances.

minor

Anyone under the age of majority: 18 years in most states, 21 years in some jurisdictions.

medical boards

Bodies established by the authority of each state's medical practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation of physicians and other health care practitioners.

How is the enforcement of laws made possible?

By penalties for disobedience.

ethics committees

Committee made up of individuals who are involved in a patient's care, including health care practitioners, family members, clergy, and others, with the purpose of reviewing ethical issues in difficult cases.

precedent

Decisions made by judges in the various courts that become rule of law and apply to future cases, even though they were not enacted by a legislature; also known as case law.

legal precedents

Decisions made by judges in the various courts that become rule of law and apply to future cases, even though they were not enacted by legislation.

fraud

Dishonest or deceitful practices in depriving, or attempting to deprive, another of his or her rights.

administrative law

Enabling statutes enacted to define powers and procedures when an agency is created.

breach of contract

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

Deontological or duty-oriented theory

Focuses on the essential rightness or wrongness of an act, not the consequences of the act.

virtue ethics

Focuses on the traits, characteristics, and virtues that a moral person should have.

What factors influence the formation of one's personal set of ethics and values?

Formed through the influence of family, culture and society.

needs-based motivation

Human behavior is based on specific human needs that must often be met in a specific order. Abraham Maslow is the best-known psychologist for this theory.

Explain how one's moral values affect one's sense of ethics.

It can differ based off an individual's background, beliefs and culture.

case law

Law established through common law and legal precedent.

statutory law

Law passed by the U.S. Congress or state legislatures.

procedural law

Law that defines the rules used to enforce substantive law.

constitutional law

Law that derives from federal and state constitutions.

criminal law

Law that involves crimes against the state.

civil law

Law that involves wrongful acts against persons.

liable

Legally responsible or obligated.

allopathic

Literally, "different suffering"; referring to the medical philosophy that dictates training physicians to intervene in the disease process, through the use of drugs and surgery.

respondeat superior

Literally, "let the master answer." A doctrine under which an employer is legally liable for the acts of his or her employees, if such acts were performed within the scope of the employees' duties.

accrediation

Official authorization or approval for conforming to a specified standard.

moral values

One's personal concept of right and wrong, formed through the influence of the family, culture, and society.

How are violations of etiquette handled?

Ostracism from chosen groups.

litigious

Prone to engage in lawsuits.

ethics guidelines

Publications that detail a wide variety of ethical situations that professionals (in this case, health care practitioners) might face in their work and offer principles for dealing with the situations in an ethical manner.

beneficence

Refers to the acts health care practitioners perform to help people stay healthy or recover from an illness.

telemedicine

Remote consultation by patients with physicians or other health professionals via telephone, closed-circuit television, or the Internet.

principle of utility

Requires that the rule used to make a decision bring about positive results when generalized to a wide variety of situations

law

Rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority.

common sense

Sound practical judgment.

bioethicists / medical ethicists

Specialists who consult with physicians, researchers, and others to help them make difficult ethical decisions regarding patient care

etiquette

Standards of behavior considered to be good manners among members of a profession as they function as individuals in society.

ethics

Standards of behavior, developed as a result of one's concept of right and wrong.

medical practice acts

State laws written for the express purpose of governing the practice of medicine.

Statue of Frauds

State legislation governing written contracts.

How is unethical behavior punished?

Suspension or eviction from medical society membership, as decided by peers.

Describe how each of the following characteristics relates to law and ethics in the health care professions:

The ability to be a good communicator and listener: Communication includes writing, speaking and listening well. Having these attributes in relation to a health care setting specifically for law and ethics would help the health care practitioner get details down right the first time allowing for proper critical thinking and assessment, keep patients calm and relaxed, and provide empathy and patience. --------------------------------- The ability to keep information confidential: It's against the law and is unethical to release a patient's health & personal information without their consent. --------------------------------- The ability to impart information clearly and accurately: This helps the patient know exact instructions on what needs to be done with their healthcare plan. If the wrong information were to be given, a patient could end up hurt or worse. --------------------------------- The ability to think critically: A clear head and following the five steps of critical thinking helps to ensure that ethical steps are being taken to think undoubtedly and precisely. This helps to avoid errors, keep patients safe, and you out of legal disputes for unnecessary mistakes.

critical thinking

The ability to think analytically, using fewer emotions and more rationality.

confidentiality

The act of holding information in confidence, not to be released to unauthorized individuals.

common law

The body of unwritten law developed in England, primarily from judicial decisions based on custom and tradition.

prosecution

The government as plaintiff in a criminal case.

compassion

The identification with and understanding of another's situation, feelings, and motives.

law of agency

The law that governs the relationship between a principal and his or her agent.

plaintiff

The person bringing charges in a lawsuit.

tortfeasor

The person guilty of committing a tort.

defendant

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

primary care physician (PCP)

The physician responsible for directing all of a patient's medical care and determining whether the patient should be referred for specialty care.

jurisdiction

The power and authority given to a court to hear a case and to make a judgment. The power of a court to hear and decide a case before it.

courtesy

The practice of good manners.

reciprocity

The process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without reexamination.

substantive law

The statutory or written law that defines and regulates legal rights and obligations.

What purpose do laws serve?

They help keep society functioning. To protect the public.

health care practitioners

Those who are trained to administer medical or health care to patients.

justice

What is due an individual.

void (null & void)

Without legal force or effect.

role fidelity

a specific scope of practice, for which practitioners are licensed, certified, or registered, and from which the law says they may not deviate.

Teleological or consequence-oriented theory

judge the rightness of a decision based on the outcome or predicted outcome of the decision.

nonmaleficence

means the duty to "do no harm."

Which state law applies specifically to the practice of medicine?

medical practice acts

categorical imperative

principle means that there are no exceptions from the rule. The right action is one based on a determined principle, regardless of outcome. (A rule that is considered universal law binding on everyone and requiring action.)

autonomy

the capacity to be one's own person, to make decisions based on one's own reasons and motives, not manipulated or dictated to by external forces

veracity

truth telling

Individual (or independent) practice associate (IPA)

type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment (capitation) from participating HMOs to provide a full range of health services for HMO members.