Medical Law and
Ethics
The Physician-Patient Relationship
By: Noha Alaggad
Physician–Patient Relationship
• Both must agree to form relationship
for there to be contract for services
(implied contract)
• Under contract for services, patient
can expect doctor to provide medical
service for as long as necessary
• Patient must confide truthfully to
physician
Physician’s Rights
• Right to select patients he or she will
see
• Right to refuse service to patients
• Right to determine type of service he
or she will provide
• Right to be paid for services rendered
• Right to withdraw from relationship
• Right to vacation and time off
Physician’s Responsibilities
• Human dignity ‫كرامة‬
• Honesty
• Responsibility to society
• Confidentiality ‫السرية‬
• Continued study
Physician’s Responsibilities
• Freedom of choice
• Responsibility to improve community
• Must support access to medical care
for all people
Professional Practice
Responsibilities
• Duties during a Medical emergency
• Cannot ethically or legally turn away
patient in an emergency situation
• If unable to treat patient, then must
call for emergency assistance
• Patients cannot be turned away if
indigent ‫معتاز‬or uninsured‫غير مؤمن عليه‬
Duty to Treat Indigent Patients
• Physician has right to select which
patients to treat
• Physician does not have right to
drop or abandon ‫ يهجر‬patients
once he or she agrees to treat
them
Duty Not to Abandon a Patient
• Once physician agrees to take care of
patient, contract may not be
terminated improperly ‫غير صحيح‬
• Physician may be charged with
abandonment if formal notice of
withdrawal is not given
• Physician must allow patient time to
seek service of another physician
Duty to Treat Patients
with AIDS
• Unethical to refuse to treat, work
with, or provide housing for
person who is HIV-positive or has
AIDS
• Physician, by law, must make full
report to state about any patient
who is HIV-positive or has AIDS
Ethical Considerations when
Treating AIDS Patients
• Persuade ‫ إقناع‬patient to inform his or
her partner(s)
• Notify authorities if concerned that
patient will not inform others
• As last resort, notify patient’s
partner(s)
Duty to Properly Identify
Patients
• Identify patient both by stating his or
her name and examining any other
identification
• Arm band
• Driver’s license
• Have patient state name
Duty to Tell the Truth
• Many believe principles of justice apply
when dealing with truth-telling
• Try to determine the “just” action for
patient
• Just action may be at variance with
obligation of confidentiality
• Confidentiality may be overridden when
life or safety of patient is endangered
Patient’s Rights
• Right to give informed consent ‫موافقه‬
• Right to privacy
• Right to be informed of advantages
and potential risks of treatment
• Right to refuse treatment
• Right to confidentiality
• Privileged ‫حظ‬communication
Confidentiality
• All information and records about
treatment will be kept confidential by
physician and staff unless consent to
release is obtained
• Medical Patients Rights Act: all
patients are entitled to have privacy
respected and medical records
handled confidentially
Patient Self-Determination
Acts
• Advanced directive
• Living will (including a “Do Not
Resuscitate” order)
• Durable power of attorney ‫التوكيل‬
• Uniform Anatomical Gift Act
- Patient may revoke these documents
- Family may consent on the deceased patient’s behalf
The Patient’s Responsibilities
• Follow physician’s instructions
• Make follow-up appointments and
monitor treatment and medication
use if requested by physician
• Be honest
• Pay for medical services
• Provide informed consent
Consent
• Voluntary agreement by patient to
allow medically trained person to
touch, examine, and perform
treatment
• Two types
-Informed (expressed) consent ‫التصريح بالموافقة‬
-Implied consent ‫الموافقة الضمنية‬
Informed or Expressed
Consent
• Patient agrees to course of treatment
after being told consequences of
having or not having certain
procedures and treatments
• Signature indicates patient
understands limits or risks involved as
explained by physician
Doctrine of Informed Consent
• Requires physician to explain in
understandable language
-Advantages and risks of treatment
-Alternative treatments available to
patient
-Potential outcomes of treatment
-What might occur—risk and
benefits—if treatment is refused
Implied Consent
• Patient indicates by behavior that he
or she accepts procedure (i.e., offers
arm to have blood sample drawn)
• Consent is assumed in medical
emergencies when patient cannot
respond to give consent
Refusal to Grant Consent
• Adult patients conscious and mentally
capable have right to refuse any
medical or surgical treatment
• Refusal must be honored no matter
what patient’s reasoning
• Failure to respect right of refusal
could result in liability for assault and
battery
Role of Health Care Consumer
• Do not self-medicate
• Be honest with physician
• Assist physician in prevention of
medical errors
Thank you