Medical Law and Ethics Chapter 10
Wagner Act
*1935 *protects employees who engage in union, by making it illegal to discriminate in hiring/firing, due to union membership or organizational activities
Rehabilitation Act
*1973 *applies to employers with federal contracts of $2,500 or more *prohibits discrimination in employment practices based on physical disabilities/mental health *requires federal contractors to implement affirmative action plans in hiring and promoting disabled employees *protects individuals who are disabled or mentally ill
The Clinical Laboratory Improvement Act/Amendments(CLIA):
*1988 *Federal statute *established/provides minimum quality standards for all laboratory testing *has been extensively amended since it was first written *requires laboratories to obtain certification
Lilly Ledbetter Fair Pay Act
*2009 Revised sections of the: *Civil Rights Act of 1964 *Age Discrimination in Employment Act of 1967 *Americans with Disabilities of 1990 *Rehabilitation Act of 1973 Revisions were concerned primarily with statutes of limitation trigger dates, extending the class of plaintiffs to any individual "affected by" unlawful discrimination and recovery of back-pay
What are forms of sexual harassment in the workplace?
*A supervisor promises an employee a pay raise in exchange for sexual favors. *A male employee makes unwelcome sexual advances to a male coworker. *A female employee makes unwelcome sexual advances to a male coworker.
What would an OSHA inspector do if he/she found an imminent danger situation?
*Ask the employer to voluntarily remedy the situation so employees aren't exposed to it. *If the employer fails to do so, the OSHA compliance officer may apply to the federal district court for an injunction to stop work until unsafe conditions are corrected.
As an employee in a health care facility, what are your general responsibilities under OSHA standards?
*Comply with all applicable OSHA standards *Report hazardous conditions *Follow all safety and health rules established by the employer. *Use protective equipment when necessary.
What should employees do when they use hazardous chemicals?
*Determine which hazardous chemicals are used *Initial and date new MSDSs as they are read. *Initial and date records of safety training.
What are the CDC's Guidelines for Universal Precautions for Hospitals:
*Do not contaminate the outside of containers when collecting specimens. All specimen containers should have lids. *Wear gloves when processing patients' specimens, including blood, body fluids containing blood, and other fluids. Masks and goggles should be worn if splashing or aerosolization may occur. Change gloves and wash hands after handling each specimen. *Use biological safety cabinets for blending and vigorous mixing whenever there is a potential for droplets. *Do not pipette fluids by mouth. Use mechanical pi-petting devices. *Use extreme caution when handling needles. Do not bend, recap, or remove needles from disposable syringes. Place entire needle assembly in a clearly marked puncture-resistant, leak-proof container. *Decontaminate work surfaces with a chemical germicide after spills and daily when work is completed. *Clearly and permanently label tissue or serum specimens to be stored as potentially hazardous. *Never eat, drink, smoke, or apply cosmetics or lip balm in the laboratory. *Remove protective clothing, and wash hands before leaving the laboratory.
What questions are considered to be illegal to be asked in an interview?
*Do you belong to a church? *How many children do you have and how old are they? *Are you married? *Is your husband/wife employed, and if so where? *What nationality are you? *Who will watch your children while you work?
A W-2 form typically includes:
*Employer's tax identification number *Total wages paid *Employee's Social Security number
What employment issues do federal laws generally address?
*Employment discrimination *Wages and hours *Safety and welfare
What issues affected by federal law have traditionally affected employees in the workplace?
*Employment-at-will *Wrongful discharge *Just cause *Public policy
What is the purpose of worker's compensation and unemployment insurance?
*Five types of benefits *Claimant requirements
What protective gear does the CDC recommend for laboratory employees?
*Gloves *eye masks *gowns *other protective equipment
What places govern work done in a clinical setting?
*Hazard Communication Standard *Occupational Exposure to Blood-borne Pathogen Standard *Needle-stick Safety and Prevention Act
OSHA has five priorities. What are they in order?
*Imminent danger situations *Investigating fatalities *Employee complaints *Programmed inspections *Follow-up inspections
5 Priorities of OSHA
*Imminent danger situations *Investigation of fatalities and accidents *Formal employee complaints of unsafe or unhealthful working conditions and referrals from any source about a workplace hazard *Programmed inspections aimed at specific high-hazard industries, workplaces, occupations, or health substances, or other industries identified in OSHA's current inspection procedures *Follow-up inpections
What is a follow-up inspection?
*It determines if the employer has corrected previously cited violations. *If they weren't corrected, the OSHA compliance officer informs the employer that he or she is subject to "Failure to Abate" alleged violations. This involves proposed additional daily penalties until the employer corrects the violation.
What should be done with MSDS sheets?
*Kept on file *New ones should be placed in a binder where employees can readily review them. *Manufacturers should supply them when readily requested.
For the facility described in this chapter's opening scenario, (Urine dipsticks constantly reported positive for leukocytes on every patient.) which OSHA standards, and/or CDC guidelines discussed earlier would apply?
*Occupational Exposure to Bloodborne Pathogens *The CDC's Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents.
What types of evidence may an employee produce to substantiate a wrongful discharge claim?
*Oral promises to the employee *A written contract *Company handbook
What is true of OSHA's Hazard Communication Standard?
*Requires medical offices to have a written hazard communication program *Requires employers to obtain and post a Material Safety Data Sheet for each hazardous chemical in use in the workplace *Requires a hazard communications manual be kept up to date and accessible to all employees
What is the role of the health care practitioner following OSHA standards for work done in the clinical setting and for infection control in the medical office?
*Right to know *Hazard Communication Standard *Chemical Hygiene plan *Occupational Exposure to Bloodborne Pathogen Standard *Medical Waste Tracking Act
What types of employee information is routinely collected and maintained by employers?
*Salary/hours worked *Number of exemptions *Social Security number
What are legal reasons for discharge under anti-discrimination laws?
*The employee is too old. *The employee joined a union. *The employee is too religious.
Distinguish between workers' compensation and unemployment insurance.
*The former is a form of insurance established by federal and state statutes that provides reimbursement for workers who are injured on the job. The lateral is paid to eligible unemployed workers.
What will OSHA do if someone reports a unsafe or unhealthy working condition, or anyone reports a workplace hazard?
*They will maintain confidentiality if requested. *They will inform the employee of any action taken.
What changes were made to comply with the United Nations Globally Harmonized System of Classification and Labeling of Chemicals (GHS)?
*Universal warnings (pictograms, Danger! and Warning!) and quantitative, objective criteria *Chemical Hygiene Plan *Ionizing Radiation Standard *Safe and accessible emergency exits *Electical wiring *OSHA poster explaining employees' rights to a safe workplace *Medical Waste Tracking Act *Training
What questions can you legally be asked in an interview?
*Why are you leaving your present position? *What do you hope to achieve over the next five years? *Why do you want to work for us? *How many years' experience do you have as a medical assistang/dental assistant/physician assistant/nursing assistant?
What are legal questions to ask a job applicant?
*Why did you leave your previous employment? *Why do you want to work here? *What are your 5-year employment goals?
Occupational Exposure to Bloodborne Pathogen Standards
*an OSHA regulation passed in 1991, but revised in 2001 to include new provisions requiring employees to maintain a sharps injury log and involve non-managerial employees in selecting safer medical devices *designed to protect workers in health care and related occupations from the risk of exposure to blood-borne pathogens such as HIV and HBV *requires posting of safety guidelines, exposure incident reporting, and formulation of a written exposure control plan that outlines the protective measures an employer will take to eliminate or minimize employee exposure to blood and other body fluids *must be available to OSHA inspectors and employees
Under the concept of employment-at-will, who has the right to terminate pregnancy?
*employer *employee
Occupational Safety and Health Administration (OSHA)
*established by the Occupational Safety and Health Act of 1970 *the organization that is charged with writing and enforcing compulsory standards for health and safety in the workplace
Fair Labor Standards Act
*of 1938 *prohibits/regulates child labor *also prohibits firing of employees for exercising their rights under the act's wage and hour standards Provides for: *minimum wages *overtime pay
Civil Rights Act
*of 1964 *applies to businesses with 15 or more employees working at least 20 weeks/year *prevents discrimination in hiring/firing due to race, color, religion, sex or national origin *prevents federal judges from using affirmative action plans, unless they decide an employer has discriminated against a minority group *created the EEOC/established by the EEOC
Requirements under the ionizing radiation standard:
*preparing survey of all types of radiation used, including x-rays *setting aside restricted areas where employees can limit exposures *providing personal radiation, monitors such as film badges or pocket dosimeters for employees to wear *using caution signs labeling those rooms and equipment where exposure could occur
What should health care practitioners know about hiring and paperwork for new employees?
*prohibited questions to ask job applicants *guidelines for conducting interviews *required paperwork *surety bond
What are generally reasons for an ex-employee to be denied an unemployment claim?
*quit without cause *fired for misconduct *quit when spouse was transferred
Who is liable if sexual harassment occurs in the workplace?
*the employer *the harasser
Ionizing radiation standard
*the fourth OSHA standard *applies to all medical and dental offices that have X-ray machines
Sexual harassment may involve any of the following types of interaction:
*unwelcome sexual advances *requests for sexual favors *other verbal or physical conduct of a sexual nature that constitutes sexual harassment when submission to such conduct is a condition of employment or promotion and unreasonably interferes with an individual's work performance in creating a hostile work environment
Infection control in the medical office requires employees to:
*wear protective equipment when handling hazardous materials *post Material Safety Data Sheets for hazardous chemicals in use *initial and date records of safety training
What helps control infections in the medical office?
*wearing protective equipment when appropriate *disposing of sharps appropriately *cleaning/disinfecting work areas
Who are generally eligible for unemployment benefits?
*women who quit to give birth *men who quit to care for young children *seasonal employees, such as construction workers
Social Security benefits are disbursed under the authority of which act?
1935 Social Security Act
What federal act makes it illegal for employers to discriminate against employees or potential employees on the basis of race, color, religion, sex, or national origin?
1964 Civil Rights Act
Which act protects the rights of pregnant employees?
1976 Pregnancy Discrimination Act
How long does an OSHA investigator have to determine the cause of accidents and whether existing OSHA standards were violated?
8 hours
What specific health care procedures/facilities does the Clinical Laboratory Improvement Act cover?
Any facility that performs laboratory testing on specimens derived from humans for: *diagnosing *preventing *treating disease *assessing health
A federal law called ________ prohibits sexual harassment in the workplace.
Civil Rights Act
What federal law protects employees from sexual harassment in the workplace?
Civil Rights Act of 1964
What categories do federal and state laws generally address, regarding employees in the workplace?
Discrimination: *sexual harassment *physical disability *pregnancy *age *genetic discrimination Wages and Work hours: *Equal pay *Retirement income security Safety and welfare
What federal law office can be contacted to report charges or complaints of employment discrimination?
Equal Employment Opportunity Office
What wage and hour law provides for overtime pay and a minimum wage?
Fair Labor Standard Act of 1938
What is an OSHA regulation that applies to hazardous equipment in the workplace?
General Duty Clause
Which federal act would apply if a job applicant was denied employment because she admitted a family history of Huntington's disease?
Genetic Information Non-Discrimination Act of 2008
Hazard Communication Standard (HCS)
an OSHA standard intended to increase health care practitioners' awareness or risks, improve work practices and appropriate use of personal protective equipment, and reduce injuries and illnesses in the workplace
Just cause
an employer's legal reason for firing an employee
When might an employee who is fired sue his or her former employee for wrongful discharge?
at any time if the employee was discharged for an illegal reason
The Blood-borne Pathogen Standard is designed to protect health care workers against what?
contagious diseases like HBV
Occupational Safety and Health Act
ensures a safe work environment
What is the role of the Clinical Laboratory Improvement Act (CLIA) in quality laboratory testing?
established minimum quality standards for all laboratory testing
A form of sexual harassment that means "something for something" is called:
Quid pro quo
What state laws allow employees access to information about toxic or hazardous substances?
Right-to-Know Laws
How does OSHA select industries for inspection?
The basis of factors such as: *injury incidence rates *previous citation history *employee exposure to toxic substances *random selection
What federal law protects employees from potential discrimination?
Title VII of the Civil Rights Act of 1964
What law allows an injured employee to file a claim with the state or federal government?
Workers' Compensation
Is it permissible for an employer to ask a job applicant to take a physical exam? Why might such a requirement exist?
Yes. Job requirements such as heavy lifting or other physical skills necessary to perform the job. Employers may also ask for a drug screen test.
Are there penalties for violating any of the OSHA standards concerned with safety in the workplace? Explain your answer?
Yes. OSHA may assess fines for violations of various standards.
Who gathers vital statistics for state and local governments?
health care practitioners
United Nations Globally Harmonized System of Classification and Labeling Chemicals (GHS)
led to a 2012 revision of the Hazard Communication Standard, in order to transform "right to know" to "right to understand" in line with GHS.
Pregnancy Discrimination Act
makes it illegal to discriminate because of: *pregnancy *childbirth *related medical conditions
Discrimination
prejudiced or prejudicial outlook, action, or treatment
Affirmative action
programs that use goals and quotas to provide preferential treatment for minority persons determined to have been underutilized in the past
Age Discrimination in Employment Act
protects employees aged 40 or older
What common law concept protects an employee who reports his employer's illegal chemical dumping activities?
public policy
The demand for sexual favors in exchange for employment benefits is called:
quid pro quo
Employee Retirement Income Security Act
regulates private pension funds and employer benefit programs
Material Safety Data Sheets (MSDS) are:
required in any business that has any hazardous material.
Equal Pay Act
requires equal pay for equal work
OSHA provides for __________ in the workplace.
safety
Right-to-know laws
state laws that allow employees access to information about toxic or hazardous substances, employer duties, employee rights, and other workplace health and safety issues
Public policy
the common law concept of wrongful discharge when an employee has acted for the "common good."
Medical Waste Tracking Act
the federal law that authorizes OSHA to inspect hazardous medical wastes and to cite offices for unsafe or unhealthy practices regarding these wastes
Chemical Hygiene Plan
the standard for Occupational Exposures to Hazardous Chemicals in Laboratories, which clarifies the handling of hazardous chemicals in medical laboratories
The primary source of information for OSHA standards is:
www.osha.gov
What federal publication is the primary source for locating OSHA standards?
www.osha.gov
The OSHA Ionizing Radiation Standard applies to all medical and dental offices that have:
x-ray machines
Wrongful discharge
a concept established by precedent that says an employer risks litigation if he or she does not have just cause for firing an employee
Employment-at-will
a concept of employment whereby either the employer or the employee can end the employment at any time for any reason
What is a hazard label?
a condensed version of the MSDS
Workers' compensation
a form of insurance established by federal and state statutes that provides reimbursement for workers who are injured on the job
General Duty Clause
a section of the Hazard Communication Standard stating that any equipment that may pose a health risk must be specified as a hazard
Surety bond
a type of insurance that allows employers, if covered, to collect up to the specified amount of the bond if an employee embezzles or otherwise absconds with business funds
Which law affected trigger dates for the statute of limitations on alleged acts of discrimination in the workplace?
Lilly Ledbetter Fair Pay Act of 2009
What must employers obtain for each hazardous chemical in use in the office?
Material Safety Data Sheet (MSDS or SDS)
What does GHS include 16-section formats for?
Material Safety Data Sheets (SDS)
Under whose regulation must health care employers offer the hepatitis B vaccination free of charge?
OSHA
What act mandated that employers maintain a sharps injury log and involved non-managerial employees in selecting safer medical devices?
Occupational Exposure to Blood-borne Pathogens Standard