education and ethics

1. Healthcare Law and
Ethics
HEED 3330
MODULE 6
DR. GREEN
SLIDES DERIVED FROM PARVANTA, C. F., NELSON, D. E., & HARNER, R. N. (2018). PUBLIC HEALTH COMMUNICATION: CRITICAL TOOLS AND
STRATEGIES. BURLINGTON, MA: JONES AND BARTLETT.

2. Basics Concepts of Healthcare Law
 Law is a body of rules for the conduct of individuals and organizations
which is often interpreted differently and may change over time.
 Law is created so there is at least a minimal standard of action required by
individuals and organizations.
 There is law created by federal, state, and local governments.
 As the judiciary system interprets previous legal decisions regarding a
case, they are creating common law.
 The minimal standard for action is federal law, although state law may be
stricter.
 Legislature creates laws which are called statutes.
 Both common law and statutes are then interpreted by administrative
agencies by developing rules and regulations that interpret the law.

3. Basic Concepts of Healthcare Law
Continued
 There are civil and criminal laws that affect the healthcare industry.
 Civil law focuses on the wrongful acts against individuals and
organizations based on contractual violations.
 Torts, derived from the French word for wrong, are a category of wrongful
acts, in civil law, which may not have a preexisting contract.
 To prove a civil infraction, you do not need as much evidence as in a
criminal case. Criminal law is concerned with actions that are illegal based
on court decisions.
 In order to convict someone of a criminal activity, it has to be proven
without a reasonable doubt of guilt.
 Examples of criminal law infractions would be Medicare and Medicaid
fraud.

4. The Relationship Between the Provider
and the Consumer
 A physician can establish a relationship with a patient in three ways:
1. Establishing a contractual relationship to care for a designated
population
2. Establishing an express contract with a patient under mutual agreement
3. Establishing a relationship under an implied contract

5. Healthcare Consumer Laws
 The Hill-Burton Act of 1946: Federal grants were provided to states for
hospital construction to ensure there were 4.5 beds per 1,000 people.
 The Emergency Medical Treatment and Active Labor Act (EMTALA) of
1986 requires Medicare participants receive emergency care for a life
threatening condition from a hospital or medical entity that provides
dedicated emergency services.
 Facilities can be fined thousands of dollars for not adhering to the
EMTALA.
 The HIPAA National Standards of 2002 to protect a patient’s personal
medical records, further protected medical records, and other personal
health information maintained by healthcare providers, hospitals,
insurance companies, and health plans.

6. Informed Consent
 The concept of informed consent is based on the patient’s right to make an
informed decision regarding medical treatment. It is a legal requirement in all
50 states. The provider is responsible for discussing with the patient:
1. The diagnosis if it has been established;
2. The nature of a proposed treatment or operation, including the risks and benefits,
any alternatives, and the risks and benefits of the alternatives;
3. And the risks and benefits of not agreeing to the procedure or treatment.
 If a patient did not provide informed consent for a procedure or treatment, it is
considered a case of negligence.

7. Patient Bill of Rights
 The Patient Self-Determination Act of 1990 requires hospitals, nursing
homes, home health providers, hospices, and managed care organizations that
provide services to Medicare- and Medicaid-eligible patients to supply
information on patient rights to patients upon admission.
 It virtually applies to every type of healthcare facility.
 The facility must provide adult patients with written information, under the
state law, about making healthcare decisions.
 Based on the concept of informed consent, in 1972 the Board of Trustees of
the American Hospital Association developed a Patient Bill of Rights.
 The Patient Bill of Rights states that the patient has the right to all
information from this provider regarding any testing, diagnoses, and
treatments.
 This information must be provided to the patient in terms that the patient will
be able to understand.

8. Ethical Standards
 The concept of ethical standards applies to actions that are hoped for
and expected by individuals.
 Actions may be considered legal but not ethical.
 There are many definitions of ethics but, basically, ethics is concerned with
what are right and wrong choices as perceived by society and its
individuals.

9. Medical Ethics and Bioethics
 Medical ethics focuses on the decisions healthcare providers make on the
patient’s medical treatment.
 Euthanasia or physician-assisted suicide would be an example of a medical
ethic.
 Bioethics focuses on the field of study concerned with the ethical
implications of certain biologic and medical procedures and technologies.
 Organ transplants and genetic engineering are examples of bioethics.

10. Suggested Ethical Values of Doctor
Patient Relationship
 Autonomy: Decision-making may be different and healthcare providers
must respect their patients’ decisions even if they differ.
 Beneficence: Patient’s best interests when making a decision is primary
 Nonmalfeasance: The healthcare provider will cause no harm when taking
action
 Justice: Healthcare providers will make fair decisions.
 Dignity: Patients should be treated with respect and dignity.

11. Ethics and Public Health
 Issues in public health include:
 Inaccessibility to health care for certain populations
 Responding to bioterrorism
 Research in developing countries
 Health promotion and its infringement on individual’s lifestyle choices
 Public health’s response to emergencies