Medical Ethics, Law and Compliance in the Health Care Setting

The American Medical Association (AMA) Code of Medial Ethics

Addresses the provider's conduct in interprofessional relations, hospital relations, confidentiality. fees, records, and professional rights.

Emergency

Generally speaking, both Good Samaritan statutes and common law will protect a medical provider when he or she responds to an emergency situation. This is true for both the provider and the medical assistant. There is a key question to consider as a threshold. First, is there a relationship between the provider and the victim in an accident? If the medical assistant bypasses the accident, no relationship is established; the six-factor medical malpractice analysis does not apply, and no liability will attach to the medical assistant. If the medical assistant stops to render aid, a relationship is established, and the medical malpractice analysis applies. After that relationship is established, the medical assistant owes a victim a duty of care and will not be held liable for further injury to the accident victim unless he or she commits gross negligence in providing care.

________ represent the values by which an organization conducts its business.

Organizational ethics

Match each principle with its corresponding description. Patients have a right to make determinations for themselves. Requires people to do what is in the best interests of others. Principle by which the health care community decides to allocate resources that are in scarce supply.

Patients have a right to make determinations for themselves. - Autonomy Requires people to do what is in the best interests of others. - Beneficence Principle by which the health care community decides to allocate resources that are in scarce supply. - Distributive Justice

Complaints and Appeals

Patients have the right to a fair, fast, and objective review of any complaint they have against their health plan, doctors, hospitals, or other healthcare personnel. This includes complaints about wait times, hours available, healthcare facilities, and the conduct of healthcare personnel.

Choice of Providers and Plans

Patients have the right to choose their provider, within their health plan.

Respect and Nondiscrimination

Patients have the right to considerate, respectful care, and to not be discriminated against by their doctors, other healthcare providers, or health plan representatives.

Participation in Treatment Decisions

Patients have the right to know all of their treatment options, even if they are not covered by their health plan, and make decisions about their care. Parents, guardians, family members, or others that a patient chooses, can represent them if they cannot make their own decisions.

Information Disclosure

Patients have the right to receive accurate information they can understand about their health, treatments, health plan, providers, and healthcare facilities. If the patient speaks another language, has a physical or mental disability, or just does not understand something, they must be helped so that they can make informed healthcare decisions.

Confidentiality of Health Information

Patients have the right to talk in private with providers and to have their healthcare information protected. They also have the right to review and copy their own medical record, and ask their doctor to make corrections to their record if it is not accurate or complete, or if it has information that does not relate to their healthcare.

Storing backup data or media in an off-site location is an example of which of the following? Select one: a.) Administrative safeguard b.) Technical safeguard c.) Privacy safeguard d.) Physical safeguard

Physical Safeguard

The AMT Standards of Practice

Recognizes that medial assistants are responsible for any personal wrongdoing, and that they have an obligation to report to the proper authorities any knowledge of professional abuse or unlawful behavior.

The AAMA Code of Ethics

Respects confidential information obtained through employment unless legally authorized by responsible performance of doty to divulge such information.

Match the term to its definition. The AMT ​requires its members to "strive to increase technical knowledge" Prescribes behavior for professionals The AAMA ​requires members to "seek to continually improve knowledge and skills." Whatever your personal perspective might be regarding matters, you must adapt your views to be in complete alignment with the standards of your profession in which you are employed Regardless of your ethical view, you are expected to demonstrate the appropriate response(s) Ethical issues that arise from "a set of standards and rules promulgated by various professions and enforced against its members"

The AMT ​requires its members to "strive to increase technical knowledge" - Personal Ethics Prescribes behavior for professionals - Professional Ethics The AAMA ​requires members to "seek to continually improve knowledge and skills." - Personal Ethics Whatever your personal perspective might be regarding matters, you must adapt your views to be in complete alignment with the standards of the profession in which you are employed - Personal Ethics Regardless of your ethical view, you are expected to demonstrate the appropriate response(s) - Personal Ethics Ethical issues that arise from "a set of standards and rules promulgated by various professions and enforced against its members" - Professional Ethics

Who "owns" a patient's medical record in a private practice? Select one: a.) The provider b.) The patient c.) The medical assistant who initially created the record d.) The patient's insurance company

The provider

Contributory Negligence

This term describes an action by the plaintiff that has contributed to the injury he or she has suffered. When the plaintiff does something that has in fact contributed to his injury, the provider cannot be blamed. So the family of a person who lied to a provider about the drugs he or she had consumed and subsequently died from a drug overdose will not be able to bring a successful malpractice action because the provider unknowingly administered more of the drug on which the patient was already intoxicated. The patient has a duty to be truthful with the provider.

Risk Management

The identification of all exposure to financial loss of a business and includes the selection of techniques to manage those exposures; The Joint Commission defines risk management in health care as "clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury to patients, staff, and visitors and the risk of loss to the organization itself."

Preamble

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honorable behavior for the physician.

The security rule only applies to PHI that is transmitted electronically. Select one: True False

True

A provider is required to report the following to the local health department: Select one: a.) All infectious diseases, such as measles b.) Communicable diseases; sexually transmitted diseases (STDs), such as herpes, HIV, and syphilis c.) Certain crimes (rape, domestic abuse, elder abuse, child abuse, neglect, exploitation, wounds of violence, assault, physical injury due to a firearm) d.) All of the above

d.) All of the above

An example of a HIPAA violation and a possible breach of unsecured PHI would be: Select one: a.) Accessing the computer to get information on a neighbor b.) Releasing a copy of a record to an unauthorized recipient c.) Disclosing PHI in a conversation with someone outside of the Health Dep d.) All of the above

d.) All of the above

Protected Health Information (PHI) applies to which of the following? Select one: a.) Paper records b.) Electronic records c.) Verbal records d.) All of the above e.) None of the above

d.) All of the above

​The Americans with Disabilities Act of 1990 is referred to as civil rights legislation designed to prohibit discrimination against individuals based on disability. The act defined "disability" as "a physical or mental impairment that substantially limits a major life activity" (42 U.S.C. sec. 12112, 1990). On September 25, 2008, President Bush signed the Americans with Disabilities Act Amendments Act (ADAAA) of 2008. The act became effective January 1, 2009. The act emphasizes that the definition of disability should: Select one: a.) make it easier for an individual seeking protection under the ADA to establish that he or she has a disability within the meaning of the ADA b.) be construed in favor of broad coverage of individuals to the maximum extent permitted by the terms of the ADA and generally will not require extensive analysis c.) change to the definition of the term disability by rejecting the holdings in several Supreme Court decisions and portions of EEOC's ADA regulations d.) ​All of the above

d.) All of the above

Which act prohibits discrimination in group health plan coverage based on genetic information? Select one: a.) HIPAA b.) ADAAA c.) PSDA d.) GINA

d.) GINA

The FDA requires health care providers of ALL types and ALL offices to report adverse events resulting from the use of: Select one: a.) Neither prescription drugs nor medical devices b.) Both prescription drugs and medical devices c.) Medical devices d.) Prescription drugs

d.) Prescription drugs

Elements of a Contract

1.) Agreement 2.) Consideration 3.) Legal Subject Matter 4.) Contractual Capacity

Plausible defenses to medical malpractice allegations include all but which of the following? a. Statute of limitation b. Contributory negligence c. Good Samaritan statutes d. A provider/patient relationship

A provider/patient relationship

The artificial termination of a pregnancy is called a(n): Select one: a.) Abortion b.) Ectopic pregnancy c.) Stillbirth d. Miscarriage

Abortion

The relationship between doctor and patient is in the nature of a "doctor-patient" contract. All that is required to form a contract is: a. an offer. b. acceptance. c. consideration. d. All of the above are necessary

An offer, acceptance, and consideration.

As medical professionals, you have a responsibility to care for all people equally without regard to race, creed, or color. Which of the following is not an example of cultural communication considerations? a. Body language b. Legal and ethical behavior c. Decision-making customs d. Being ambiguous

Being ambiguous

The term _______, with its origins in the implications of scientific research as well as in medical practice, is used when discussing ethical issues of significance such as life-or-death ramifications for the patient.

Bioethics

Transactions & Code Set

Establish standers for electronic transactions and external medical data code sets.

A(n) ________ is where two moral principles are in conflict, such as when there is no clear-cut right or wrong on any matter or when the right behavior leads to the wrong outcome.

Ethical Dilemma

_____ is when the patient directly communicates his or her consent to the doctor.

Express consent

Which of the following federal acts mandates physical, technical, and administrative safeguards? Select one: a.) HIPAA Title I b.) HITECH c.) HIPAA Title II d.) MMA

HIPPA Title II

Principles of Medical Ethics

I. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights. II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities. III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient. IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidence and privacy within the constraints of the law. V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated. VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care. VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health. VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount. IX. A physician shall support access to medical care for all people.

Access to Emergency Services

If a patient is in severe pain, has an injury, or sudden illness and they are concerned that they could be seriously ill, hurt, or could die, they have the right to get emergency services whenever and wherever needed, to be seen by a doctor and get services, even if they do not ask their health plan first. They will not be charged a penalty.

The Medical Assisting Creed

Medical assistants' pledge to be more effective.

Statute of Limitations

Most states have a statute of limitations law. This tells all who would file a lawsuit that they have a limited period of time in which to bring their claim. In the case of medical malpractice claims, an injured patient generally has two years from the date the injury is discovered in which to file his or her lawsuit. The theory is that two years should be sufficient time to discover whether one has been injured at the hands of his or her provider or other medical provider. If one does not bring suit within the statutory time period, the case will be dismissed

There often are no clear-cut lines separating law, ethics, and morals—three types of categorizing principles. If there is no legal guidance, the question is not one of law but one of ethical conduct. Thus, when you see an ethical issue that causes you to ask, "What's the right thing to do?" you will look to answer all but which of the following? a. What is documented in the patient's Notice of Privacy Practices (NPP)? b. What promotes the right of the patient's determination about his or her own health care? c. Is performing (or not performing) the act in question fair to others? d. What is in the best health interest of the patient?

What is documented in the patient's Notice of Privacy Practices (NPP)?

There is an overall framework for an organization to facilitate ethical behavior. Generally, four characteristics in the organization (not in the leader) encourage ethical behavior. Which of the following would not be considered one of those characteristics? a.) A verbal code of standards b.) Training for officers, managers, and employees in the subject of ethics c.) Availability of advice for employees confronting ethical issues d.) A system for confidential reporting

a.) A verbal code of standards

Health care providers most often interact with which office within the Drug Enforcement Administration (DEA)? Select one: a.) Office of Diversion Control b.) Office of Training c.) Office of Strategic Intelligence d.) Office of Resource Management

a.) Office of Diversion Control

Which of these is an example of a misdemeanor? Select one: a.) Public intoxication b.) Robbery c.) Manslaughter d.) Burglary

a.) Public intoxication

A(n) ____ issue is one that arises from societal norms "found" as a part of common law or enacted into statute. Select one: a.) Ethical b.) Legal c.) Moral d.) Medical

b. Legal

Professional liability refers to the liability that arises from a failure to use due care and __________________ expected from a person in a particular profession (in this case a health care provider). Select one: a.) Consent b.) The standard of care c.) Capacity d.) The scope of practice

b.) The standard of care

The physician-patient relationship is created when the: Select one: a.) Physician offers care to a patient b.) Patient requests care from a physician c. Physician offers care to a patient, and the offer is accepted d.) Patient needs care, regardless of whether that care if offered

c. Physician offers care to a patient, and the offer is accepted

A patient was recently diagnosed with Alzheimer's disease. They decide that they may need another individual to make informed medical decisions on their behalf should they not be able to in the future. What document does the patient need to sign? Select one: a.) Living Will b.) Notice of Privacy Practices c.) Durable Power of Attorney d.) Release form

c.) Durable Power of Attorney

A medical assistant owes the duty of ___________, meaning he or she must take appropriate steps to check the type and dosage of medication before administering it to the patient and must take appropriate steps to ensure that the paperwork regarding charts and follow-up appointments is completed accurately. Select one: a.) Standard of care b.) Standard practice c.) Reasonable care d.) Scope of practice

c.) Reasonable care

Whatever your personal perspective might be regarding ethical matters, you must adapt your personal views _____ with the ethical standards of your profession and the organization in which you are employed.

to be in complete alignment