Introduction to Health Science
UNIT 1 - INTRODUCTION
Medical Law and Ethics
Lecture Notes
I.
Differentiate Between Law and Ethics
A.
Medical Law
Law provides people with a minimum standard of conduct. It governs the
interactions between people in an attempt to create an orderly society.
B.
Medical Ethics
Medical ethics is a field of applied ethics that applies to the field of
medicine and health care.
Ethics refers to beliefs that are morally right or wrong; provides standards
for how one should behave. Morals are beliefs of what is correct and not
correct based on our family, religion, and society influences. Ethics It is
based on the beliefs of a society on what is acceptable and what is not
acceptable. Ethics helps us develop goodness, standards, and beliefs.
Although ethical behavior is a personal choice, they are also decided upon
by professional associations to help govern the conduct of its members
One of earliest documents setting the standard for ethical behavior was
the Hippocratic Oath formulated by the Father of Medicine, Hippocrates.
Hippocrates was one of our ancient Greek philosophers and scientists.
This Hippocratic Oath has been the basis of ethical behavior and ethical
conflict in medicine. Many students graduating from medical schools recite
the code
We generally consider ethics in the realm of bioethics or ethics in
medicine. Bioethics seems to help bring compassion and orderly
processes to very delicate situations where life hands in the balance.
However, we each come with our own personal code of ethics created by
our experiences and our environmental influences. What we consider to
be a proper code of conduct and behavior as well as principle that govern
our decisions.
There are several steps that are followed during the ethical decisionmaking process.
a.
Determine what the problem is and who are the people involved in
the decision-making process.
b.
Determine what are the truths and the hard evidences versus what
are assumptions.
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Introduction to Health Science
c.
d.
e.
f.
g.
Is there a precedence in this case? (previous cases that are similar)
What are possible choices that can be made?
What are the effects of each of the choices? How does that affect
the individual? Have all the stakeholders been treated fairly? Have
they all had a choice?
Make the choice and carry it out.
Assess what happened.
In order to answer these questions, many health care facilities have Ethics
Boards which meet to discuss what to do in tough cases. These cases
arise because there are more choices to make -- choices that are the
result of our unbelievable outstanding advancements in techniques,
medications, and technology. Many organizations also have their own
code of ethics which provide guiding principles to the board when those
tough decisions need to be made. The codes generally contain similar
basic doctrines including:
•Life is valuable and worth saving.
•Patients should be treated with dignity
C.
Scope of Practice
Scope of practice defines the procedures, actions, and processes that are
permitted for the health care professional.
D.
Battery
Battery is the actual physical harm or unwarranted touching of
another person. The charge usually accompanies assault; many
times there were threats of physical harm before the actual fighting
began. If a medical procedure is done on a patient without getting
permission, it may be considered battery.
E.
Invasion of Privacy
Invasion of privacy helps to ensure that you will have your
privacy maintained. Confidentiality policies help to protect people’s
privacy. This also involves maintaining a person’s modesty during
their care. As you probably know, hospital gowns are usually open
in the back which may unnecessarily expose the patient when they
are walking or lying in bed. Care must be taken to make sure the
patient is appropriately covered.
F.
Negligence
Negligence if the failure to do something that a prudent person would
ordinarily do OR not doing something you have been trained to do. Giving
the wrong medication to the wrong patient because the nurse did not
check the patient’s arm band would be an example.
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G.
Malpractice
Malpractice is professional negligence. It literally means “bad practice.” It
has come to mean professional care that has led to injury, due to faulty
practice or neglect.
H.
Informed Consent is a principle that means literally telling people what
medical procedure will be performed, the expected outcome, and the
possible complications. Before an invasive procedure is performed, a
consent form is signed by the patient and verified by a witness indicating
the patient knows what procedure will be performed, by whom, and what
are the potential risks of the procedure. If the patient is not of legal age, a
parent or legal guardian must sign the document. Others who may not be
able to sign the document for themselves include people who have been
declared mentally incompetent, people who do not understand English,
and people who are under the influence of medications/drugs and/or
alcohol.
a. Procedures that require informed consent include any surgery,
biopsies, vaccinations/immunizations, any procedure to view the
internal digestive system, HIV testing, placing sutures, childbirth,
circumcision, etc.
I.
Health Insurance Portability and Accountability Act (HIPAA)
Passed into law in 1996, HIPAA did not seem to make much of an impact
on the average citizen, until 2003 when those seeking treatment had to
sign forms at every health care facility indicating they had read about the
new confidentiality practices. In order to update and streamline the
insurance reimbursement process, HIPAA was created for “electronic
health care transactions, codes, identifiers, and security.” It also set a
time line for implementation of confidentiality guidelines to safeguard
medical records and individual medical information.
There are some exceptions to confidentiality. Some incidents need
to be reported to the county and state health departments including
births, deaths, communicable diseases (AIDS, hepatitis,
tuberculosis), sexually transmitted diseases, cancers, and traffic
accidents involving the use of drugs or alcohol. Other infection
such as West Nile Virus, SARS, and hepatitis would be reportable
conditions
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Introduction to Health Science
Below is a list some of the current bioethical dilemmas. There are many and you
probably know of other issues that are not on this list. What do you think? Why?
What experiences in your life have helped shaped the way you think and feel?
(You may need to do more research in order to make an informed decision. Feel
free to discuss these issues and your ideas with others.).
1.
Should we perform medical tests, like blood tests, to determine whether or
not a person should be eligible for health insurance? Should we perform
genetic tests to rule out coverage for certain diseases? (For example, if
you are a women with the breast cancer gene, should your insurance
policy exclude coverage for you if you should be diagnosed with breast
cancer?
2.
Should we alter a person’s genes in the eggs and sperm to prevent
genetic disorders and diseases in their offspring?
3.
Should we change genes in eggs and sperm to enrich an offspring’s life by
making them more athletic and intelligent?
4.
What rights does a fetus have? When does life begin? Should parents be
allowed to determine the gender of their offspring?
5.
Should insurance companies terminate the policies of those diagnosed
with HIV/AIDS?
6.
Should we put fluoride in the water since we know that fluorine decreases
dental decay?
7.
How do you feel about organ donation?
8.
Should stem cell research be expanded or reduced?
9.
Should we conceive children to be used as spare parts for another sick
child?
10.
Do you believe in the right to die?
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