Medical Law and EthicsMedical Law and EthicsLesson 2:Lesson 2:Patient/Physician RelationshipPatient/Physician Relationship

Lesson ObjectivesLesson ObjectivesLesson Objectives

Upon completion of this lesson, students should be able to …

Discuss informed consent.

Physician RightsPhysician RightsA physician and patient form a

contractThe patient must confide

truthfullyIf the physician does not know all

the facts, there could be serious consequences

Physician RightsPhysician RightsPhysicians have the right to:

◦Select the patients they wish to treat◦State the types of services they will

provide◦State the hours their offices will be open◦Determine where their offices will be

located◦Expect payment for the treatment given◦Take vacations and time off from

practices

Patient RightsPatient RightsPatients have the right to:

◦Approve or give consent for all treatment

◦Expect the standard of care◦Expect confidentiality by the

physician and employees◦Privacy

Informed ConsentInformed Consent

Involves informing the patient about the possible consequences of both having and not having certain procedures and treatments

Doctrine of Informed ConsentDoctrine of Informed ConsentExplanation of advantages and

risksAlternativesPotential outcomesWhat might occur if there is no

treatmentThe use of understandable

language

Implied ConsentImplied Consent

When a patient is seen for a routine examination for medical treatment, there is implied consent that the physician will touch the person during the examination

Implied ConsentImplied Consent

emergency situation

Refusal of TreatmentRefusal of Treatment

Patients have the right to refuse treatment

Rights of MinorsRights of MinorsMinor: Under 18 in most states

(though this varies in some states)

Minors are unable to give consent for treatment

Exceptions:

Categories of Minors Who Can Categories of Minors Who Can Give ConsentGive Consent

Mature minors:Emancipated

Situation #1Situation #1Think About It!Think About It!

Situation #1A teenager is seeking birth

control. She has the right to confidentiality.

The girl cannot pay for services. How does your office get

payment?

Think About It!Think About It!

Situation #2A teenager living with her mother

needs treatment for an STI.The patient has a right to

confidentiality.The parents are divorced and the

father has financial responsibility for care and treatment.

Patient Self-Determination ActPatient Self-Determination Act

Documents that provide protection to both the patient and physician

Requirements of Health Care Requirements of Health Care InstitutionsInstitutionsProvide patients a written summary

of their rightsGive written policy with respect

advance directivesAsk and document if patients have

an advance directiveEducate staff about advance

directivesNever discriminate based on whether

patients have advance directives

Living WillLiving WillAllows patients to request that life-

sustaining treatments and nutritional support not be used to prolong their life

Gives patients the legal right to direct the type of care they wish to receive when death is imminent

Protects physicians and hospitals when they follow the patient’s wishes

Copy of living will should be kept with the patient’s records

Durable Power of Attorney (DPOA)Durable Power of Attorney (DPOA)

Allows an agent to act on behalf of the patient

Can be for health care only or other legal things

Agent may be a spouse, grown child, friend, or an attorney

Durable Power of Attorney Durable Power of Attorney (DPOA)(DPOA)Used when a patient becomes

mentally incapacitatedDocument is in effect until the

patient cancels it or until the patient is able to make their own decisions again

Uniform Anatomical Gift ActUniform Anatomical Gift ActAllows a person 18 yrs or older and of

sound mind to make a gift of any or all parts of their body for the purposes of organ transplantation or medical research

A physician who is not involved in the transplant will determine the time of death

No money is allowed to change hands for organ donations

Donor carries a card signed by 2 witnessesThe family can make this decision in some

cases

Go to Go to ppt 3 Documentation and RegulationDocumentation and Regulation