Law & Ethics for Health Professionals: Final Review

Multi-potent stem cells

(Adult) stem cells that can become a (limited number) of types of tissue and cells in the body

Pluri-potent stem cells

(Embryonic) stem cells that can become (almost all) types of tissues and cells in the body

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

Uniform Rights of the Terminally Ill Act

*1989 *federal proposal *of the National Conference of Commissions on Uniform State Laws that all state legislatures construct laws to address advance directives *recommended by the National Conference of Commissioners on Uniform State Laws *Intended to guide state legislatures in constructing laws to address advance directives

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

In what situations might DNA testing be indicated?

*A man involved in a paternity suit *parents who suspect they brought the wrong baby home from the hospital *a woman who is a suspect in a murder

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 does Elizabeth Kubler-Ross's five stages of coping with a death or with a terminal illness include?

*Acceptance *Bargaining *Depression

Durable power of attorney

*An advance directive *allows patients to designate an individual to act on their behalf in all matters, not just healthcare issues.

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.

A physician or other health care practitioner who treats a minor in a non-emergency situation, without parental consent, risks being charged with:

*Assault and/or *Battery

What is included on a death certificate?

*Cause of death *Name of attending physician, if any *Time of death

What are broader movements that forecast the future of health care?

*Common interests *Markets *Policy *Science and Technology

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 three issues are of primary concern to stakeholders within the American health care system?

*Cost *Access *Quality

Three key issues of concern to everyone within the American health care industry are:

*Cost *Access *Quality

What are the key issues of concern to health care industry stakeholders?

*Cost *GDP *Access *Quality

What terms are necessary for the study of genetics?

*DNA *Chromosome *Gene *Genome

Areas within health care likely to change in the future include:

*Data *Connectivity

Areas for change in the future

*Data and connectivity *Prevention and population health *Personalization and participation

Briefly explain how attitudes toward death and dying in the United States have changed over the years.

*Death was more familiar to families prior to the twentieth century and, therefore, perhaps less frightening. *Modern technology, however, offers the possibility of prolonging death, which, in some situations, may be a frightening prospect. *Most deaths today occur in hospitals, which removes death and dying from the family environment of years past.

Elizabeth Kubler-Ross's stages of grief

*Denial *Anger *Bargaining *Depression *Acceptance

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?

What are the recommendations of the Uniform Anatomical Gift Act?

*Donations made through a legal will are not to be held up by probate *Except in autopsies, the donor's rights override those of others. *Survivors may speak for the deceased if no arrangements for donation were made prior to death, provided the deceased did not express an objection to donation before death *physicians who rely on donation documents for the acceptance of bodies or organs are immune from civil or criminal prosecution *hospitals, surgeons, physicians, accredited medical or dental schools, colleges and universities, and tissue banks or storage facilities may accept anatomical gifts for research, advancement of medical or dental science, therapy or transplantation *time of death of the donor must be established by a physician who is not involved in transplanting the donor's designated organs, and the donor's attending physician cannot be a member of the transplant team *Donors may revoke the gift, and gifts may be rejected

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 two federal agencies oversee drugs in the United States and even control the manufacture and standardization of drugs and their sale and use?

*Food and Drug Administration (FDA) *Drug Enforcement Agency (DEA)

Three steps for attaining access:

*Gain entry into the health care system *Find a health care provider who meets the needs of each patient and with whom patients can develop a relationship based on mutual communication and trust *access health care service sites offering ongoing care

List three steps vital to attaining access to health care.

*Gain entry into the health care system. *Find a health care provider who meets the needs of each patient and with whom patients can develop a relationship based in mutual communication and trust. *Access healthcare service sites offering ongoing care.

What federal laws are in place to protect Americans against genetic discrimination in health insurance and employment?

*Genetic information Nondiscrimination Act (GINA) of 2008 *Health Insurance Portability and Accountability Act (HIPAA) *Americans with Disabilities Act (ADA) *Patient Protection and Affordable Care Act (ACA) of 2010

What is probably most helpful to a dying person?

*Giving the person your attention *Listening well

What protective gear does the CDC recommend for laboratory employees?

*Gloves *eye masks *gowns *other protective equipment

Reportable STIs

*Gonorrhea *Syphilis *Chlamydia *Lymphogranuloma venereum *Chanchroid *Granuloma inguinale (genital warts) *Scabies *Pubic lice *Trichomoniasis

The largest purchasers of health care for most working adults are:

*Government *Employers

Euthanasia

*Greek for "good death" *mercy killing of the hopelessly ill

What is true of the stages of grief?

*Grieving people may not experience one or more of the stages of grief. *A person may experience the second stage or grief before the first, or the third stage before the second. *A person may go back and forth among the stages until resolution is accomplished.

What provisions/purposes do all public health statutes have in common? (six areas of responsibility provided by state public health laws)

*Guard against unsanitary conditions in public facilities. *Inspect establishments where food and drink are processed and sold. *Exterminate pests and vermin that can spread disease. *Check water quality. *Set up measures of control for certain diseases. *Require physicians, school nurses, and other health care workers to file certain reports for the protection of citizens.

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

You are a medical assistant in a physician office and you suspect a female patient has been abused. What signs might you look for that could indicate abuse?

*Illogical or unreasonable explanation for injuries *evidence of frequent changes of physicians *attempts to hide injuries *frequent anxiety *change in appetite *problems on the job *torn or bloody underwear *pain or bruising around the genital area and bite marks.

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

Distinguish between comatose and persistent vegitative state.

*In the former, patients can and do recover. *In the lateral, involuntary bodily functions are present and there exists no reasonable expectation of regaining significant mental function.

What four alternatives are available for infertile couples who want to become parents?

*In vitro fertilization (IVF) *Artificial insemination (homologous or hetero-logous) *Surrogacy *Adoption

As a health care practitioner, should you report abuse if a patient asks you not to, or doesn't admit that they've been abused? Explain your answer.

*It depends on the age of the patient. *You are legally required to report the abuse of a child or an elderly person. *If it is an adult, you can quietly encourage him/her to look at materials regarding abuse. *You must advise the patient of this in the kindest, gentlest way possible. *Care must be taken that it is done without the possible abuser in the room.

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.

Name four goals of the Human Genome project.

*Locate and map the location of all the genes on a person's 46 chromosomes. *Construct a database for scientists and physicians to use. *Continue to study ethical, social, and legal issues associated with genetic research. *Teach other scientists to use the technology developed to improve human health.

What is recommended for completing birth and death certificates?

*Make entries in ink or in a typewritten form. *Do not skip any blanks. *Check entries for correct spelling.

Identify six factors that have added to health care costs.

*Medical technology *Administrative costs *Widespread adoption of health information technology *wasteful spending and fraud *Unhealthy lifestyles *An aging population.

Factors adding to health care costs annually include:

*Medical technology *Administrative costs *Widespread adoption of health information technology (HIT) *Wasteful spending and fraud *Unhealthy lifestyles *Aging population

Which no-fault federal laws compensate for vaccine injury?

*National Childhood Vaccine Injury of 1986 *Established National Vaccine Injury Compensation Program (VICP) *Smallpox Emergency Personnel Protection Act of 2003

Roberta Teme's stages of grief

*Numbness *Disorganization *Reorganization

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 provisions does the Uniform Anatomical Gift Act include?

*Persons 18 and older and of sound mind may donate organs and tissues for transplantation *Donations made through a will are not to be held up in probate. *Except in autopsies, the donor's rights override the rights of others.

What is recommended as a future focus for health care?

*Policy *Common interests *Markets

High-quality health care in the US is:

*Possible *Expensive *Practical

What are different types of genetic testing?

*Predictive *Carrier *Prenatal *Amniocentesis *Pre-implantation *Forensic *Tracing lineage *Newborn screening *Diagnostic

Which of these areas do public health laws apply? a. Public restaurants b. Public swimming pools c. Public schools d. Private homes where residents have communicable diseases e. private schools

*Public restaurants *Public swimming pools *Public schools

What health care advances have been forecast for the near future?

*Rational drug design-use of computers to create drugs designed to attack specific diseased cells or to otherwise pinpoint delivery and enhance efficiency *Continuing advancement in imaging equipment and techniques *Genetic mapping and testing *Gene therapy *Use of stem cells *Personalized medicine

What are the requirements for physicians who prescribe, dispense and administer controlled substances?

*Register with the Drug Enforcement Administration through a division office *Keep records concerning the administering or dispensing or a controlled drug on file for two years. *Note on a patient's chart when controlled substances are administered or dispensed. *Make a written inventory of drug supplies every two years, and keep such records an additional two years. *Keep drugs in a locked cabinet or safe, and report any thefts immediately to the nearest DEA office and the local police.

What are some examples of the authority states have to enforce the public as health laws?

*Require investigations be conducted in infectious disease outbreaks. *Make childhood vaccinations a condition for school entry. *Ban the distribution of free cigarette samples around schools or in areas where children congregate. *Institute smoking bans or restrictions. *Involuntarily detain (quarantine) individuals who have certain infectious diseases. *Seize and/or destroy property to contain the threat of toxic substances.

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

Drug schedules for controlled substances

*Schedule I *Schedule II *Schedule III *Schedule IV *Schedule V

What injuries are re-portable to the authorities under the auspices of public health?

*Spousal abuse *Child abuse *Elder abuse

Landmark events in the right to die movement include:

*The Karen Ann Quinlan *The Nancy Cruzan case *The Terry Schiavo case

A coroner or medical examiner signs a death certificate if:

*The death is possible due to criminal causes or otherwise suspicious. *The death was not attended by a physician within a specified length of time. *The death is due to causes undetermined by the physician.

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.

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care." As the number of people age 65 and older increases, who will pay for higher Medicare spending?

*The government (taxpayers) *Cost of Medicare premiums will rise.

What are the foremost objections to embryonic stem cell research?

*The major objection to stem cell research is centered around embryonic stem cell research. *Many will argue that if an embryo is created, it is a life. *Others argue that since the embryo was not grown in the uterus, it is not a life.

Who are the major stakeholders in the American health care system?

*The public *Employers *Healthcare facilities and practitioners *Federal, state and local governments *Managed care organizations *Private insurers *Voluntary facilities and agencies that provide healthcare or influence *healthcare practitioner training institutions policies *Professional associations and other healthcare industry organizations *Medical and pharmaceutical research groups.

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 is the correct procedure for completing a birth certificate?

*Type or legally print all entries. *Leave no entries blank. *Avoid corrections and erasures. *Where requested, provide signatures. Do not use rubber stamps or initials in place of signatures. *File only originals with state registrars. *Verify the spelling of names. *Avoid abbreviations, except those recommended in instructions for specific items. *Refer any problems to the appropriate state officials.

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 are three additional areas where we should see improvement/advancement in the near future?

*Use of stem cells *Tissue engineering *Health information technologies (HITs)

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?

Health care proxy

*a durable Healthcare power of attorney *issued for purposes of health care decisions only

National Childhood Vaccine Injury Act

*a federal law passed in 1986 *created a no-fault compensation program for citizens injured or killed by vaccines, as an alternative to suing vaccine manufacturers and providers

Patient Self-Determination Act

*a federal law/act *passed in 1990 *requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions to execute advance directives

Uniform Determination of Death Act

*a federal proposal Established uniform guidelines for determining when death has occurred: *defines brain death as a means of determining when death actually occurs *circulation and respiration have irreversibly ceased *the entire brain, including the brain stem, has irreversibly ceased to function

Par-ens pat-riae

*a legal doctrine that gives the state the authority to act in a child's best interest *best interest of the child concept

Autopsy

*a postmortem examination to determine cause of death and/or to obtain physiological evidence when necessary *may confirm or correct clinical diagnoses *has results that can reveal areas that need further study *must be performed in suspicious or due to homicide

Uniform Anatomical Gift Act

*a recommendation of the National Conference of Commissioners on Uniform State Laws, that all states accepted, allowing individuals to donate their bodies or body parts, after death, for use in: *transplant surgery *tissue banks *medical research *education *a federal proposal (an act) States enact laws allowing anyone: *18 or older *of sound mind To make a gift of his or her: *body *certain organs For use in: *medical research *transplantation *storage in a tissue bank

Amniocentesis

*a test whereby the physician withdraws a sample of amniotic fluid (the fluid surrounding the developing fetus inside the mother's womb) from the uterus of a pregnant woman *The fluid is then tested for genetic or other conditions that may lead to abnormal development of the fetus. *a common prenatal test

Human Genome Project

*a worldwide scientific project funded by the US government, for the purpose of locating and mapping all of a human's genes *begun in 1990 *successfully completed in 2000

Name and briefly describe five methods of gene therapy.

*administering substances lacking in newborns and others due to inheritance *replacing a deficiency or blocking an overactive pathway in fetuses by treating the mother *the insertion of normal copies of a gene into the cells of persons with a specific genetic disease *correction of an abnormality in the genes of sperm or egg *turning off genes before their harmful properties can be expressed

Name five types of adoptions.

*agency *independent or private *identified *international *relative

Unborn Victims of Violence Act

*also called Laci and Conner's Act *a 2004 federal law that provides for the prosecution of anyone who causes injury to or the death of a fetus in utero

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

Living will

*an advance directive *specifies an individual's end-of-life wishes

Under existing child abuse amendments, physicians may, with the consent of parents, withhold treatment for those infants who:

*are chronically and irreversibly comatose *will most certainly die and treatment is considered futile *would suffer inhumanely if treatment was provided

Of the seven vital statistics, the physician should be concerned with documenting _______ and _________.

*births *deaths

What is the Drug Enforcement Administration and what does it do?

*branch of the US Department of Justice *regulates the sale and use of drugs

Name six signs for which physicians may test that indicate death has occurred.

*cannot breathe without assistance *no coughing or gagging reflex *no pupil response to light *no blinking reflex when the cornea is touched *no response to pain. No grimace reflex when: *the head is rotated or *ears are flushed with ice water

What tests may be performed to determine if death has occurred?

*cannot breathe without assistance *no coughing or gagging reflex *no pupil response to light *no blinking reflex when cornea is touched *no grimace reflex when head is rotated or ears are flushed with ice water *no response to pain

Criteria for death

*cannot breathe without assistance *no coughing or gagging reflex *no pupil response to light *no blinking reflex when the cornea is touched *no grimace reflex when the head is rotated or ears are flushed with ice water *no response to pain

What is the role of the medical assistant regarding controlled substances in the medical facility?

*checking to be sure that all controlled substances are kept in a locked cabinet or safe *reminding the physician to keep his or her "black bag" in a safe place *keeping/ordering all prescription blanks that are serially numbered or otherwise printed to help detect alterations and theft *reporting to the physician any behavior by patients that would suggest an attempt to secure addictive drugs *checking patients' records to verify all prescriptions that may be questioned by a pharmacist

Hospice care

*contains bereavement services, to help patients discuss issues as: *preparing a will *planning a funeral *help surviving family members cope with grief and loss after the patient dies These bereavement services are generally provided through: *discussion groups *follow-up visits from hospice personnel *sometimes referrals to appropriate mental health professionals

In what treatment areas are minors most likely to make their own health care decisions?

*contraceptives *prenatal care *STI services *treatment for chemical dependencies

Palliative care

*directed solely toward the treatment of terminally ill patient's symptoms to make dying more comfortable and relieving pain *also called comfort care

Death certificate requirements

*disease, injury and/or complication that caused the death and how long the descendant was treated for this condition before death occurred *date and time of death *place of death *if descendant was female, presence or absence of pregnancy *whether or not autopsy was performed

What information does a death certificate generally include?

*disease, injury, and/or complication that caused the death and time treated before death *date and time of death *place of death *if descendant was female, presence or absence of pregnancy *whether or not an autopsy was performed

Medical assistants may only ______ or _____ drugs under a physician's direct order.

*dispense *administer

What does the Patient Self-Determination Act provide for?

*documenting the existence of an advance directive in the patient's medical record *Nondiscrimination regarding whether or not a patient has an advance directive *Compliance with state laws respecting advance directives

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

In Vitro Fertilization (IVF)

*fertilization that takes place outside a woman's body *literally "in glass," as in a test tube

brain death

*final cessation of bodily activity *used in most states to determine when death actually occurs *Circulatory and respiratory functions have irreversible have irreversibly ceased. *The entire brain (including the brain stem) has irreversibly ceased to function

What does the latest Agency for Healthcare Research and Quality (AHRQ) report show?

*health care quality and access are often suboptimal, especially for minority and low-income groups *Overall quality is improving, access is getting worse, and disparities are not changing Urgent attention is warranted to ensure continued improvements in: *Quality of diabetes care, maternal and child health care, and adverse events *Disparities in cancer care *Quality of care among states in the South

Recent reports also indicate a continuing decline in the number of all autopsies performed in the United States. Of what value is a non-mandatory autopsy performed after a hospital patient dies?

*helps determine cause of death *helps advance medical knowledge about disease *helps reassure family members of the deceased that everything had been done for their loved one

When may physicians, with the parent's consent, legally withhold treatment and nourishment from a newborn who is severely disabled?

*if the child is chronically and irreversibly comatose *if the child will most certainly die, and treatment is considered futile *if the child would suffer inhumanely if treatment were provided

United Network of Organ Sharing (UNOS)

*increases the effectiveness and efficiency of organ sharing and equity in the national system of organ allocation *increases the supply of donated organs available for transport

Emancipated minors

*individuals in their mid- to late teens Legally live outside parents' or guardians' control, usually through judicial decree, as long as minor is: *self supporting *legally married *serving in the armed forces

Mature minors

*individuals in their mid- to late teens *for health care purposes, are considered mature enough to comprehend a physician's recommendations and give informed consent

Describe Schedule III for drugs.:

*less potential for abuse *accepted medical uses

What are the vital elements for which the government collects statistics?

*live births *deaths *fetal deaths *marriages *divorces *induced terminations of pregnancy *any change in an individual's civil status

Seven vital statistics that the government collects are:

*live births *deaths *fetal deaths *marriages *divorces *induced terminations of pregnancy *any change in civil status that occurs during an individual's lifetime

Describe Schedule V for drugs.:

*low potential for abuse *may lead to dependancy

Describe Schedule IV for drugs.:

*low potential for abuse compared to other schedules *may lead to dependancy

Which Western rituals surrounding death have survived to the present?

*mourners wearing black *halting traffic for a funeral procession *wakes *firing a rifle volley over the deceased *funeral wreaths

Describe Schedule I for drugs.:

*no proven medical use *usually used only for research

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

What does the Food and Drug Administration do?

*oversees drug quality and standardization *must approve drugs before they are released for public use

National Organ Transplant Act

*passed in 1984 *a statute/federal law *provides grants to qualified organ procurement organizations *established an Organ Procurement and Transplantation Network (OPTN) *established the United Network of Organ Sharing (UNOS) to administer OPTN.

Under what causes do a coroner or medical examiner complete death certificates?

*possibly due to criminal causes *not attended by a physician within a specified length of time before death *due to causes undetermined by the physician *violent or otherwise suspicious

Describe Schedule II for drugs.:

*potential for abuse is high. *accepted medical use

List eight possible uses for genetic testing.

*predictive testing *carrier testing *prenatal testing *pre-implantation testing *forensic testing *tracing linage *newborn screening tests *diagnostic testing.

What are the uses of genetic testing?

*predictive testing *carrier testing *prenatal testing *pre-implantation testing *forensic testing *tracing lineage *newborn screening tests *diagnostic testing

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

How does HIPAA factor into genetics?

*prevents health insurers from denying coverage based on genetic information *applies only to individuals moving between group health insurance plans

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

Name three criteria that may be considered to determine if a minor is to be declared emancipated.

*self-supporting *married, provided the marriage is legal *serving in the armed forces

Persistent Vegetative State (PVS)

*severe mental impairment *characterized by irreversible cessation of the higher function of the brain *most often caused by damage to the cerebral cortex

Genetic testing

*testing one's DNA to discover one's genetic makeup *tests with widespread application *performed by trained technicians *conducted on many different body samples

Pre-implantation testing

*tests for harmful genes in embryos after artificial insemination but before implantation *usually offered to couples who have a reasonable chance of passing on harmful genes

What vaccination information is documented in a patient's medical record?

*the date the vaccine was administered *the vaccine manufacturer *the vaccine lot number

What information must vaccine administrators document in a patient's medical record?

*the date the vaccine was administered *the vaccine manufacturer *the vaccine lot number *the name, address, and title of the health care provider who administered the vaccine *any adverse event listed in the Vaccine Injury Table *any contraindicating event as listed in the manufacturer's package insert

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

Who must be notified if controlled substances are stolen from a medical facility?

*the nearest DEA office *the police

Homologous artificial insemination

*the process in which a man's sperm is mechanically injected into a woman's vagina to fertilize her eggs *partner's sperm/woman's eggs

Hetero-logous artificial insemination

*the process in which donor sperm is mechanically injected into a woman's vagina to fertilize her eggs *donor sperm/woman's eggs

Thanatology

*the study of death *the psychological methods of coping with it

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

Forensic testing

*used in law enforcement To: *eliminate or designate suspects in a crime *identify homicide victims *otherwise analyze samples for law enforcement purposes

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

Custom Rituals and Rites for Mourning

*wearing black to show grief, as well as protect against malevolent spirits that might be lurking nearby *go barefoot and wear sackcloth and ashes, to discourage the dead from becoming envious as they might be of mourner's new clothes and shoes *covering the face with a sheet, and holding the mouth and nose hoping to retain the spirit and thus delay death *halting traffic because any delay in transporting a soul might turn it into a restless ghost, reluctant to pass over into the next world *a wake, or keeping watch over the deceased, hoping that life would return *carrying the dead out of the house feet first, so that the spirit can't look back into the house and beckon family members to come with them *having funeral wreaths, to keep the dead person's spirit within bounds *throwing spears into the air to ward off spirits hovering over the deceased *sprinkling holy water to protect it from demons

What helps control infections in the medical office?

*wearing protective equipment when appropriate *disposing of sharps appropriately *cleaning/disinfecting work areas

When are autopsies performed?

*when a death is suspicious *to determine cause of death, if cause is unknown

When is a physician not allowed to sign a death certificate?

*when death is possibly due to criminal causes *when person is not attended by a physician within a specified length of time before death *when death is due to causes undetermined by the physician *in cases of violent or otherwise suspicious deaths

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

How many people may develop diabetes in the next 40 years?

1 in 3

An entity may have violated the Stark Law if they can answer yes to what 3 questions:

1)has a physician or a member of her family referred a Medicare or Medicaid patient to an entity they own? 2) is the referral for a "designated health service"? 3) Is there a financial relationship between the referring physician or family member and the entity providing service

Determine if a decision is ethical

1. have I followed laws and ethics policy 2. will it promote a win-win 3. What if it were publicized 4. What if family knew 5. Can you live with your self

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

When was the human genome project started?

1990

How long should a medical facility keep records concerning the administration or dispensing of a controlled drug on file for?

2 years

How many chromosomes are normally found inside the nucleus of every human cell except egg and sperm cells?

23

According to a survey done by IMS Institute for HC Informatics in 2014, what percentage of Americans said they % use the internet as their #1 source for information about health care?

70-75%

How long does an OSHA investigator have to determine the cause of accidents and whether existing OSHA standards were violated?

8 hours

American Recovery and Reinvestment Act (ARRA)

A 2009 act that made substantive change to HIPAA's privacy and security regulations

Treatment, Payment, and Health Care Operations (TPO)

A HIPAA term for qualified providers, disclosure of PHI to obtain reimbursement, and activities and transactions among entities. Treatment means that a health care provider can provider care; payment means that a provider can disclosure PHI to be reimbursed; health care operations refers to HIPAA-approved activities and transactions

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

What accurately describes the role of the coroner or medical examiner in the event of a violent death?

A coroner or medical examiner conducts a trial to determine the cause of death.

Rule

A document that includes the HIPAA standards or requirements

Health Insurance Portability and Accountability Act (HIPAA)

A federal law passed in 1996 to protect privacy and other health care rights for patients. This 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.

What is likely for the future of health care?

A focus on health of the entire population

Standard

A general requirement under HIPAA

Federal False Claims Act

A law that allows for individuals to bring civil actions on behalf of the US government for false claims made to the federal government, under a provision of the law called qui tam ("to bring an action for the king and for oneself")

Electronic health record (EHR)

A more comprehensive record than the EMR, focusing on the total health of the patient and traveling with the patient - Comprehensive record focused on total health of the patient - May contain information from many providers or facilities

Hippocratic oath

A pledge for physicians influenced by the practices of the Greek physician Hippocrates

Compliance Plan

A proactive program that ensure fulfillment with all applicable policies, procedures, laws and regulations. It is designed to detect and correct violations, provide employee training, routine physician auditing of documentation and establish standards and procedures that are reasonably capable of reducing the prospect of criminal conduct.

Permission

A reason under HIPAA for disclosing patient information

Health Information Technology for Economic and Clinical Health Act (HITECH)

A section of the American Recovery and Reinvestment Act (ARRA) the strengthened certain HIPAA privacy and security provisions

Criminal Health Care Fraud Statute

A section of the United States Code that prohibits fraud against any health care benefit program. -------------------------------------------------------- • Prohibits knowingly or willingly executing a scheme, or attempting to execute a scheme, with the intent to: - Defraud any health care program - Obtain by false pretenses, representations, or promises any money or property under the control of any health care benefit program

What injuries are re-portable to law enforcement or to the health department?

A woman tells her physician that her broken ribs occurred when her husband beat her.

Notice of Privacy Practices (NPP)

A written document detailing a health care provider's privacy practices

What is the name of the lead federal agency responsible for tracking and improving the quality, safety, efficiency, and effectiveness of health care for Americans?

AHRQ

What types of injuries are health care practitioners required to report?

Acts of violence such as: *assault or rape *gunshot/knife wounds.

The right to die movement is largely responsible for educating people about:

Advance directives

A test performed to determine if harmful genes are present in a fetus is called:

Amniocentesis

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

Of what significance is the percentage of the gross domestic product represented by health care spending?

As the percentage of GDP spent on healthcare grows, that means less money is spent on other things like roads, schools, research, environment and social programs.

The Uniform Determination of Death Act defines ____________ as a means of determining when death actually occurs?

Brain death

Is passive euthanasia legal in the United States?

Can potentially be if the patient has: *a legal DNR order *refused treatment.

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care." How do increasing numbers of uninsured Americans add to health care costs?

Care for the uninsured will have to continue. This increases: *government health care spending *the cost of insurance to those with coverage.

Why are certain diseases and injuries re-portable to state authorities?

Certain diseases are communicable in nature and require reporting to assist the state and local health officials in preventing additional illness and/or epidemics.

federal regulations concerning newborns who are severely disabled take their authority from which federal regulation?

Child Abuse Amendments

What organization mandates reporting of child abuse?

Child Abuse Prevention and Treatment Act of 1974

A federal law called ________ prohibits sexual harassment in the workplace.

Civil Rights Act

in the past, these laws have dictated that parents have a right to decide what medical care children receive:

Civil Rights Act

What federal law protects employees from sexual harassment in the workplace?

Civil Rights Act of 1964

CLIA License

Clinical Laboratory Improvement Amendment - this license is required by offices who perform "simple laboratory examinations and procedures that have an insignificant risk of erroneous result." (Tests that most offices are able to perform without sending to an outside laboratory).

Ethics committee

Committee made up of individuals who are involved in a patients care

What organization is also known as the Comprehensive Drug Abuse Prevention and Control Act of 1970?

Controlled Substances Act

What is most often cited as the reason for being uninsured or underinsured?

Costs

Is this curative or palliative? Administering antibiotics to cure an infected tooth

Curative

Is this curative or palliative? Administering radiation treatments after breast cancer surgery

Curative

Is this curative or palliative? Cosmetic surgery for a teenage patient whose face was burned in a fire

Curative

Summary judgement

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

Precedent

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

The purpose of the Uniform Determination of Death Act was to:

Define guidelines for determining when death actually occurs

What is seventh on the list of diseases that cause death in the Unites States?

Diabetes

What is the number one cause of adult blindness, kidney failure and limb amputation?

Diabetes

Bioethics

Discipline dealing with the ethical implications of biological research methods and results, especially in medicine

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

Under public health law, what diseases and conditions are generally reported to public health departments?

Diseases that if left unchecked, could threaten the health and well-being of the population: *Infectious diseases *Sexually transmitted diseases or infections *Other diseases that may have mandated reporting if a higher than normal incidence occurs

Fraud

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

A form of advance directive that allows hospital patients to tell hospital care practitioners not to revive them if breathing stops is called a:

Do-not-resuscitate order (DNR)

What organization, as a branch of the Department of Justice, regulates the sale and use of drugs?

Drug Enforcement Administration (DEA)

Covered transaction

Electronic exchanges of information between two covered-entity business partners using HIPAA-mandated transaction standards.

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

Recent reports indicate a decline in the number of non-mandatory autopsied performed in hospitals. Which of the following is a probable reason for the decline?

Family members of deceased patients are often reluctant to give permission for an autopsy.

What are reasons for the relatively high rate of infant mortality in the United States?

Fewer births than other nations

The Right to Privacy is derived from where

First, Third, Fourth, Fifth, Ninth and Fourteenth Amendments to the Constitution

What organization tests and approves drugs for public use?

Food and Drug Administration (FDA)

Privacy

Freedom from unauthorized intrusion

What is the process called that involves correcting defective genes responsible for disease?

Gene therapy

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

The science of determining how genes cause the expression of certain traits in individuals is called:

Genometrics

What is the term for the total value of all goods produced and services provided in America for one year?

Gross domestic product

In 1996, a federal law was passed that prevents health insurers from denying coverage based on genetic information for individuals moving between group health insurance plans. This federal law is known as:

HIPAA

Firewalls

Hardware, software, or both designed to prevent unauthorized persons from accessing electronic information

Why is the United States 26th on a list of life expectancies in various countries?

Health care cost, access, and quality are major issues that affect life expectancy and life span in all countries.

What is the main force expanding the federal budget?

Health care costs

Who is responsible for gathering and filing many of the vital statistics collected by the states and the federal government?

Health care practitioners

Explain Why knowledge of law & ethics is important to health care practitioners.

Health care practitioners who function at the highest possible levels have a working knowledge of law and ethics. Can help avoid legal entanglements that threaten a job. Gets you familiar rights, responsibilities, and concerns of health care consumers, Issues facing society, patients, and HC practitioners Impact of rising costs

Covered entities

Health care providers and clearinghouses that transmit HIPAA transactions electronically, and must comply with HIPAA standards and rules

What are two areas of continuing concern revealed in the most current National Healthcare Quality Report (NHQR)?

Health care quality and access are often below what is desired, especially for minority and low-income groups, and especially in the South. Over-all, improvements are urgently needed in quality of diabetes care, maternal and child health care, and adverse events.

What should be reported to the health department?

Human Immunodeficiency Virus (HIV)

Code of Ethics Creed of the AAMA

I BELIEVE, I ENDEAVOR, I ASPIRE, I PROTECT, I AM DEDICATED, I AM LOYAL, I AM TRUE, I AM STRENGTHENED

State preemption

If a state's privacy laws are stricter than HIPAA privacy standards, the state laws take precedence.

Diagnostic testing

If symptoms have appeared, doctors can order tests for patients to confirm or rule out certain genetic diseases

Name four circumstances in which an attending physician may not legally complete a death certificate.

If the death was: *due to possible criminal causes *was not attended by a physician within a specified length of time before death *was due to causes undetermined by the physician *was violent or otherwise suspect.

Protected Health Information (PHI)

Information that contains one or more patient identifiers

How do waste and fraud add to health care costs?

Insurance companies, as well as the federal and State insurance programs pay out large sums of money in fraudulent claims. Recovering the money is difficult, and simply adds to the cost of health care.

How was the decision in the Quinlan case (Her parents decided to remove her from a respirator, as she had been in a persistent vegetative state for several months) significant in the right to die movement?

It establishes the primacy of patients' wishes over the state's duty to preserve life.

Is voluntary euthanasia legal in the United States?

It is in the states of Oregon and Washington through voter initiatives, Vermont through legislation and Montana through court decision, and in New Mexico it is presently being considered within the court system

How was the decision in the Cruzan case (lost control of a vehicle without seat belts, was in a persistent vegetative state, and given a feeding tube, with the court's ruling that it could be removed due to one of her friends knowing she wouldn't want to live on artificial life support ) significant in the right to die movement?

It recognizes that the right to refuse medical treatment is guaranteed by the U.S. Constitution.

How was the decision in the Schiavo case (restored heartbeat, but remained comatose and then semi-comatose, and stayed comatose for 15 years) significant in the right to die movement?

It reinforced the primacy of a patient's wishes over the state's duty to preserve life.

Define law

Laws are considered the minimum standard necessary to keep society functioning.

Liable

Legally responsible or obligated

What is the term for the statistically probable number of years a newborn out to live, based on environment, heredity, lifestyle and health practices, risk factors, and so on?

Life expectancy

What is the number of years an individual actually lives called?

Life span

A widely circulated urban legend tells of a person who has a sexual tryst with a stranger and awakens in a bathtub minus a kidney. Why do you know the story is untrue?

Like all urban myths, this one is meant to frighten people. For this person to even know that they were minus a kidney would take more than just waking up in a strange bathtub.

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

Code of ethics

List of principles intended to to govern behavior-here, the behavior of those entrusted with providing care to the sick

A document serving to appoint an individual, chosen by the patient, to represent the patient's interests is a __________:

Living will

What falls within the supervision of a state's public health department?

Mandatory vaccinating of schoolchildren

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)

In most states, what age groups can receive some types of medical care without parental permission?

Mature minors

Define moral values

Moral values define one's personal concept of right and wrong

What is true of death in the United States in the twenty-first century?

Most deaths occur in hospitals.

A permanent change in DNA is called a:

Mutation

Which no-fault federal law compensates for childhood vaccine injury?

National Childhood Vaccine Injury Act of 1986

What law made organ donation possible in the United States?

National Organ Transplant Act

Which legislation established organ procurement and transplantation network in the United States?

National Organ Transplant Act

What provision has the federal government made for people who sue over vaccinations?

National Vaccine Injury Compensation Program (VICP)

Is involuntary euthanasia legal in the United States?

Never

Is active euthanasia legal in the United States?

No

Is health care listed as a right for all Americans in the 10 amendments to the U.S Constitution called the Bill of Rights?

No

Once declared emancipated, can a minor lose that status?

No

Are the Stark Law and the Federal Anti-Kickback Law the same thing?

No, the Stark Law and the Federal Anti-Kickback Law are different laws with distinct differences. Stark: physician referral to own practice Anti-Kickback: receive item of value for referral that is paid by the government.

One of a physician's patients, a well-respected citizen in a small community, saw the doctor with a complaint of blood in his urine (hematuria). The physician asked the patient if he'd had any new sexual partners recently, and the patient admitted that he had. The physician explained to the patient that his urine specimen had been positive for the STI chlamydia. The physician urged the patient to discuss his medical condition with the patient's wife, who was also the physician's patient, but the man was reluctant. What are the ethics issues in this case?

Notifying the wife

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

Moral value

Ones personal concept of right and wrong, formed through the influence of the family, culture, and society

How does HIV differ from other STIs?

Others must be notified that they had sex with them.

Technically, death results from a lack of what?

Oxygen

Is this curative or palliative? Allowing a patient who is terminally ill with lung and stomach cancer to self-administer morphine patches as needed for pain relief

Palliative

Is this curative or palliative? Counseling a terminally ill patient and his or her family concerning funeral arrangements and other end-of-life decisions

Palliative

Is this curative or palliative? Surgical severing of certain nerves to relieve suffering for a patient terminally ill with cancer of the spine

Palliative

Care provided to relieve pain and make a patient's last days as comfortable as possible is referred to as:

Palliative Care

the government serves as a child's parent

Parens patriae

One of a physician's patients, a well-respected citizen in a small community, saw the doctor with a complaint of blood in his urine (hematuria). The physician asked the patient if he'd had any new sexual partners recently, and the patient admitted that he had. The physician explained to the patient that his urine specimen had been positive for the STI chlamydia. The physician urged the patient to discuss his medical condition with the patient's wife, who was also the physician's patient, but the man was reluctant. What are the legal issues in this case?

Patient confidentiality: reporting a communicable disease.

Skills of sucess

People skills listening to others Good communication Technical skills Knowledge of computers, Science and math skills Critical thinking

The science that defines how individuals are genetically programmed to respond to drugs is:

Pharmacogenomics

Barbara, a medical assistant, noticed that her aunt, who suffered chronic pain from a neck injury, carried two bottles of Percodan in her purse. "Two doctors write prescriptions for me," Barbara's aunt confided, "but neither knows about the other. That's the only way I can get enough medication to control my pain. How can physicians guard against such abuses by patients?

Physicians should not continue to prescribe narcotics to the same patient.

Security

Policies and procedures that protect PHI from unauthorized access

Courtesy

Practice of good manners

Susan's father developed Huntington's disease when she was 28. She is healthy, but wants to be tested to see if she has the gene to develop the disease. What type of genetic testing will she have?

Predictive genetic testing

Define ethics

Principles & standards that govern behavior.

Fiscal Intermediaries

Private insurance companies that serve as the federal government;s agents int he administratioin of the Medicare program.

Unethical

Professional conduct that fails to conform to these moral standards or policies.

Litigious

Prone to engage in lawsuits

What is true of organ transplants?

Prospective donors should inform family members of their wishes.

Limited data set

Protected health information from which certain patient identifiers have been removed

Why must STIs be reported?

Public health practitioners use reported cases to find and treat others who may have been infected through sexual contact with the named individual.

What organization requires reports of communicable diseases and certain injuries, as mandated by state laws?

Public health statutes

Ethics guidelines

Publications that detail a wide variety of ethical situations that professionals might face in their work and offer principles for dealing with the situations in an ethical manner

A form of sexual harassment that means "something for something" is called:

Quid pro quo

What are the disadvantages of safe haven laws?

Raise ethical issues: *Are the parents who abandon the child guilty of child abuse and neglect? *Should parents be forced to take the child back? *What public measures are necessary to help keep the abandonment from occurring?

Designated record set

Records maintained by or for a HIPAA-covered entity

An obstetrician is caring for a young woman who wants to undergo genetic testing prior to becoming pregnant. What would be the best response to this patient?

Refer the woman to a qualified genetic counselor.

Work Plans

Released annually by the OIG and identifies areas they will focus on for review and investigations they believe are the most vulnerable programs for possible fraud and abuse.

What state laws allow employees access to information about toxic or hazardous substances?

Right-to-Know Laws

Law

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

State laws that allow a parent to abandon newborns to designated safe locations

Safe haven laws

Which schedule of drugs is used strictly for research?

Schedule I

With one exception, drugs in this category have no accepted medical use and are used for research purposes only:

Schedule I

What are schedules under which controlled substances are listed?

Schedule I-V

Which category of drug has prescriptions that may not be renewed?

Schedule II

Stem cells pros

Scientist have been able to grow: *functioning bladders *urethras *heart tissue *lung tissue from a person's own cells

What organization created a no-fault compensation program for health care practitioners and/or emergency res-ponders injured by the smallpox vaccine?

Smallpox Emergency Personnel Protection Act of 2003 (SEPPA)

Common sense

Sound practical judgement

Forensic medicine

Specialists study subjects like: *Forensic pharmacology *Doping control *Postmortem toxicology *Blood splatter interpretation *DNA analytical techniques *expert testimony procedures

Medical ethicist or bioethicist

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

Those who have a vested interest in the American Health care industry are called:

Stakeholders

Ethics

Standard of behavior developed as a result of one's concept of right and wrong

Etiquette

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

What is an infection that will most likely require notification of the appropriate health agencies?

Staph infection if higher than usual incidence occurs Phenylketonuria

Minimum necessary

Term referring to the limited amount of patient information that may be disclosed, depending on circumstances

What is UNOS?

The United Network for Organ Sharing

Critical thinking

The ability to think analytically, using fewer emotions and more rationality 1. Identify & clarify the problem 2. Gather Information 3. Evaluate the evidence 4. Consider alternatives & implications. 5. Choose & implement the best alternative

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

According to the Uniform Determination Act, what is a criteria for death?

The entire brain ceases to function.

An article by Robert J. Samuelson in the December 10, 2007, issue of Newsweek stated, "The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care." Who pays for the health care of the uninsured?

The government (taxpayer)

Compassion

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

If state and federal regulations differ concerning the abuse of certain drugs, which law will be applied?

The more stringent regulation is followed.

Plaintiff

The person bringing charges in a lawsuit

Defendant

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

One of a physician's patients, a well-respected citizen in a small community, saw the doctor with a complaint of blood in his urine (hematuria). The physician asked the patient if he'd had any new sexual partners recently, and the patient admitted that he had. The physician explained to the patient that his urine specimen had been positive for the STI chlamydia. The physician urged the patient to discuss his medical condition with the patient's wife, who was also the physician's patient, but the man was reluctant. If the patient refused to confide in the wife, what should the physician do?

The physician must: *report the communicable disease to the appropriate authorities *Warn the patient that he must do so. *Hopefully, the patient will speak with his wife.

Encryption

The scrambling or encoding of information before sending it electronically

Electronic transmission

The sending of information from one network-connected computer to another

Electronic Data Interchange (EDI)

The use of uniform electronic network protocols to transfer business information between organizations via computer networks

What is the function of UNOS?

They administers the Organ Procurement and Transplantation Network (OPTN).

What purpose do advance directives serve?

They allow an individual to make known his or her wishes with regard to end of life care.

What effect do the previous designations mature minor and emancipated minor have on a minor's health care decisions?

They are allowed to make their own healthcare decisions.

How must health care practitioners proceed if a patient has a do-not-resuscitate order in place?

They must not make an effort to revive the patient if the patient's heart stops.

Health care practitioners

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

Stem cells cons

Tissue-engineered hearts and lungs are still in the experimental stage

What federal law protects employees from potential discrimination?

Title VII of the Civil Rights Act of 1964

De-identify

To remove from health care transactions all information that identifies patients

What is the primary purpose of the HITECH rule?

To strengthen privacy and security for electronic health information.

Transaction

Transmission of information between two parties for financial or administrative activities

What is the federal law that makes killing or injuring a fetus a crime separate from killing or injuring the pregnant mother, in cases where the federal government has jurisdiction?

Unborn Victims of Violence Act

Code set

Under HIPAA, terms that provide for uniformity and simplification of health care billing and record keeping

Which legislation paved the way for organ transplantation in the United States?

Uniform Anatomical Gift Act

States have their own criteria for determining when death actually occurs, but most have adopted the definition of brain death proposed by which of the following?

Uniform Determination of Death Act

The _____________, while not a law, was proposed as a universal means of determining when death actually occurs.

Uniform Determination of Death Act

When may a physician not sign a death certificate?

When the death is suspicious

Where are birth certificates and death certificates filed?

With the state registrar - or responsible agency for the state in question.

What law allows an injured employee to file a claim with the state or federal government?

Workers' Compensation

While many people think of the health care industry as "clean," medical providers continue to accidentally contract diseases from incidents in the workplace. For example, Sheila, an emergency room nurse with 15 years' experience, had just finished drawing blood from a patient when she disposed of the needle in the sharps container lid and felt a prick through her glove from a used needle that had hung in the drop-down sharps lid. Several months later, Sheila learned that she had not only been infected with the human immunodeficiency virus (HIV), but also the hepatitis C virus (HCV). Other diseases health care practitioners often contract through needle-sticks include meth-icillin-resistant Staphylococcus aureus (MRSA), hepatitis B, malaria, syphilis, herpes, and many less common diseases. Were there precautions that Sheila could have taken in the emergency room where she worked to prevent her accidental infection? Explain your answer.

Yes. *The disposal of needles by its very nature is hazardous. Sheila should have been more careful. *She should have reported the finger-stick immediately. *There are protocols in place for finger-sticks that may not prevent the illness, but will help to cover her expenses under workers' compensation. *By not reporting it immediately, she cannot prove that the finger stick was the source of the illness.

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.

Amendments to the Older Americans Act

a 1987 federal act that defines elder abuse, neglect, and exploitation but does not deal with enforcement

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

coma

a condition of deep stupor from which the patient cannot be roused by external stimuli

Active euthanasia

a conscious medical act that results in the death of a dying person

Who completes death certificates?

a coroner or medical examiner

Forensics

a division of medicine that incorporates law and medicine and involves medical issues or medical proof at trials having to do with malpractice, crimes and accidents

Hospice

a facility or program (often carried out in a patient's home) in which teams of health care practitioners and volunteers provide a continuing environment directed toward compassionate, palliative care for dying patients and their families, such as: *physical *emotional *psychological needs of the dying patient

Food and Drug Administration (FDA)

a federal agency with the Department of Health and Human Services that oversees drug quality and standardization and must approve drugs before they are released for public use

Child Abuse Prevention and Treatment Act

a federal law passed in 1974 requiring physicians to report cases of child abuse

Workers' compensation

a form of insurance established by federal and state statutes that provides reimbursement for workers who are injured on the job

Chromosome

a microscopic, thread-like structure, found within the nucleus of all living cells that is composed of DNA, and carries genes responsible for the organism's characteristics

Smallpox Emergency Personnel Protection Act (SEPPA)

a no-fault program to provide benefits and/or compensation to certain individuals, including health care workers and emergency responders, who are injured as the result of the administration of smallpox countermeasures, including the smallpox vaccine.

National Vaccine Injury Compensation Act (VICP)

a no-fault system of compensation for individuals or families of individuals injured by childhood vaccination

Mutation

a permanent change in DNA

Medical Examiner

a physician who investigates suspicious or unexplained deaths

Autopsy

a postmortem examination to determine the cause of death or to obtain physiological evidence, as in the case of a suspicious death

Coroner

a public official who investigates and holds inquests over those who die from unknown or violent causes; he or she may or may not be a physician, depending on state law

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

Gene

a tiny segment of DNA, found on a chromosome within a cell's nucleus, that holds the formula for making a specific enzyme or protein

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

Surrogate mother

a woman who becomes pregnant, usually by artificial insemination or surgical implantation of a fertilized egg, and bears a child for another woman

Dr. Wellness will _____ the drug to his patient, Mrs. Doe, when he starts an intravenous injection.

administer

Birth certificates may be filed for:

all live births

Genome

all the DNA in an organism, including its genes, necessary to replicate a human

In 2013, how many children and adolescents were overweight or obese?

almost 1/3rd

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

An authorization in advance to withdraw artificial life support is:

an advance directive

What best describes grief?

an emotion one feels when loss has occurred

Just cause

an employer's legal reason for firing an employee

Genetic counselor

an expert in human genetics who is qualified to counsel individuals, who may have inherited genes for certain diseases or conditions, before and after genetic testing

Clone

an organism produced asexually usually from a single cell of the parent

Physician assisted suicide

any type of euthanasia, in which a physician takes part in the patient's suicide

breach

any unauthorized acquisition, access, use, or disclosure of personal health information which compromise the security or privacy of such information

About how many adults 20-years and over are obese (at least 20% over their ideal body weight?

approximately 35.7 %

Minors may be declared emancipated if they:

are self supporting

Generic living will forms are acceptable legal documents with what causes?

as long as state specific requirements are met.

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

Before the twentieth century, death most likely occurred:

at home

If a patient dies of natural causes while under his or her physician's care, who is responsible for completion of the medical portion of the death certificate?

attending physician

the common standard when the government makes decisions for minor children

best interest of the child

Before pronouncing a non-responsive and unconscious patient dead, physicians may perform certain tests. What is not a condition denoting death has occurred?

cannot stand unaided

Stem cells

cells that have the potential to become any type of body cell

the process that produced Dolly the sheep

cloning

The Blood-borne Pathogen Standard is designed to protect health care workers against what?

contagious diseases like HBV

Electronic medical record (EMR)

contains all patient medical records for one practice Contains information from just one provider or facility

Genetic discrimination

differential treatment of individuals based on their actual or presumed genetic differences

When a pharamacist fills a patient's prescription, he or she will then ________ the drug to the patient.

dispense

Adoptions are regulated primarily by:

each state

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

an experimental treatment for hereditary diseases

gene therapy

Persons said to be in a persistent vegetative state:

have severe brain damage

What rises yearly?

health care costs as a percentage of gross national product (GDP)

Who gathers vital statistics for state and local governments?

health care practitioners

Artificial insemination may be an acceptable remedy for:

infertility

From which ancient custom do wakes held today originate?

keeping watch over the deceased hoping life would return

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

The False Claim Act provides for

making it a criminal offense to defraud any health care benefit program

Genetic engineering

manipulation of DNA within an organism's cells (plants, animals, and other organisms) through: *synthesis *alteration *repair to ensure that certain harmful traits will be eliminated in offspring and that desirable traits will appear and be passed on

Curative care

medical treatment directed toward curing a patient's disease or condition

When did the human genome project end?

mid-2000

What are safe haven laws designed to prevent?

mothers abandoning their newborns to die

those cells that can become only one type of body cell

multipotent

Vital statistics

numbers collected for the population of live births, deaths, fetal deaths, marriages, divorces, induced terminations of pregnancy, and any change in civil status that occurs during an individual's lifetime

those specialized cells that can become almost any kind of cell

pluripotent

Discrimination

prejudiced or prejudicial outlook, action, or treatment

Amniocentesis is what type of genetic testing?

prenatal testing

Under the law, medical assistants may not ______ drugs for patients.

prescribe

Physician-assisted suicide is legal:

presently only in 4 states

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

Social Security Act

provides for: *Medicare *unemployment insurance *disability *OASI through FICA funding

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

Terminally ill

referring to patients who are expected to die within six months or less

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

Voluntary euthanasia

requires the patient's consent or that of his or her designated/legal representative to implement the act of ending a dying patient's life by medical means

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

Safe haven laws

state laws that allows mothers to abandon newborns to designated safe facilities without penalty

specialized cells considered most valuable for purposes of genetic manipulation

stem cells

Requirements vary with states for:

stillbirths

Prenatal testing

testing used to see (with amniocentesis), if harmful genes are present are present in a fetus

State public health laws derive indirectly from:

the Tenth Amendment to the US Constitution

Passive euthanasia

the act of allowing a dying patient to die naturally, without prolinging, but essentially ineffective medical treatments

Involuntary euthanasia

the act of ending a patient's life by medical means without the consent of the patient or his or her representative

Cost

the amount individuals, employers, state and federal governments, HMOs, and insurers spend on health care in the United States

Access

the availability of health care and the means to purchase health care services

DNA (deoxy-rib-o-nucleic acid)

the combination of proteins, called nucleo-tides, that is arranged to make up an organism's chromosomes

Public policy

the common law concept of wrongful discharge when an employee has acted for the "common good."

Quality

the degree of excellence of health care services offered

Infertility

the failure to conceive for a period of 12 months or longer due to a deviation from or interruption of the normal structure or function of any reproductive part, organ or system

Controlled Substances Act

the federal law giving authority to the Drug Enforcement Administration to regulate the sale and use of drugs

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

Grief

the human reaction to loss

Agency for Healthcare Research and Quality (AHRQ)

the lead federal agency responsible for tracking and improving the: *quality *safety *efficiency *effectiveness of health care for Americans

Artificial insemination

the mechanical injection of viable semen into the vagina

Life span

the number of years an individual actually lives

do-not-resuscitate (DNR) order

the patient specifies in writing that he or she does not wish to be resuscitated if his or her heart stops

Cloning

the process by which organisms are created asexually, usually from a single cell of the parent organism

Heredity

the process by which organisms pass genetic traits on to their offspring

Personalized medicine

the products and services that leverage the science of genomics and proteomics and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care

Genometrics

the science of determining how genes cause the expression of certain traits in individuals

Genetics

the science that accounts for natural differences and resemblances among organisms related by descent (studies inherited traits)

Pharmacogenomics

the science that defines how individuals are genetically programmed to respond to drugs

Federalism

the sharing of power among national, state, and local governments

Chemical Hygiene Plan

the standard for Occupational Exposures to Hazardous Chemicals in Laboratories, which clarifies the handling of hazardous chemicals in medical laboratories

Life expectancy

the statistical probable number of years an individual can expect to live, calculated from his or her birth

Epigenetics

the study of changes in gene activity that do not involve alterations to the genetic code, but are still passed down to at least one successive generation

Proteomics

the study of the proteins that genes create or "express"

Gross-Domestic Product (GDP)

the total value of all goods produced and services provided in America during one year

Rational Drug Design

the use of increasingly powerful computers to develop new drugs by looking at the molecular structure and chemical composition of target cells and creating substances that will bind to certain molecules, affecting their function inside the body

Stakeholders

those who have: *a vested interest in the health care industry in the United States and *any efforts to reform the industry

An early custom for mourners was to go barefoot and to wear sackcloth and ashes. What was the purpose of this practice?

to avoid making the dead envious

Dispense

to deliver controlled substances in some type of bottle, box, or other container to the patient

What is the purpose of public health statutes?

to help guarantee the health and well-being of citizens

Administer

to instill a drug into the body of a patient

Prescribe

to issue a medical prescription for a patient

What is the main reason health care practitioners must report sexually transmitted infections (STIs) to the state health department?

to treat others who may be infected

Xeno-transplantation

transplantation of animal tissues and organs into humans

Gene therapy

treating harmful genetic diseases or traits by eliminating or modifying the harmful gene

Tracing lineage

used in determining parentage or other relationships with families

Carrier testing

used to determine if individuals carry harmful genes that could be passed on to offspring

Predictive testing

used to see if genes are present that could lead to hereditary diseases or other harmful genetic conditions

Newborn screening tests

usually performed routinely to check for treatable, harmful genetic conditions or diseases

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

Federal Anti-Kickback Law

• Knowingly and willfully receiving or paying anything of value to influence referral of federal health care program business is against the law • Possible punishment: - Fines - Prison term - Loss of participation in federal programs

Office of the Inspector General

• Nationwide network of auditors, investigators, and evaluators • Responsible for more than 300 federal health care programs • Oversees enforcement of: - Federal False Claims Act - Federal Anti-Kickback Law - Stark Law - Criminal Health Care Fraud Statute

Stark Law

• Physicians or members of their immediate family with a financial interest are restricted from referring patients to entities owned by the physician • Applies to Medicare and Medicaid programs