Protected: Professional Ethics and Qualities

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Ethics

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What is ethics?

What role do you think ethics plays in healthcare?

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Informed Consent Lawsuit

Danny Duke, as survivor and personal representative of the estate of

Darcy Duke, deceased, v. Carlos Rodriguez, M.D. and University Hospital

Points of law to consider about informed consent:

A competent individual has the categorical authority to refuse even lifesaving treatment.
A physician who treats a patient despite the patient’s refusal is civilly and criminally liable for assault and battery.
A person is presumed to be competent unless the evidence shows otherwise.

Mrs. Duke died of respiratory failure on July 24, 2007. Her breathing tube became dislodged that day and she and Mr. Duke refused, for more than four hours, to allow the medical personnel to reinsert it. After she finally consented to the re-intubation, an emergency room physician performed the procedure. Several minutes later however, Mrs. Duke coded and she was pronounced dead at 6:30 a.m.

The plaintiff argues that Dr. Rodriquez should have gone to the hospital and re-intubated Mrs. Duke despite her wishes.

During the trial, Dr. Rodriguez established that he would not have performed the re-intubation without the patient’s consent, even if he had gone to the hospital that morning. Nurse McKay, one of the ICU nurses who cared for Mrs. Duke throughout the morning, testified that patients’ breathing tubes frequently become dislodged and the emergency room physician would have been called to perform the re-intubation the moment Mrs. Duke signed the consent form.

Dr. Bone was the medical expert for the Dukes. He stated that Dr. Rodriquez’s conduct fell below the standard of care because: (1) Mrs. Duke was not competent to refuse intubation, (2) the situation was an emergency and Mrs. Duke’s consent was therefore implied, (3) Dr. Rodriquez had a duty to re-intubate Mrs. Duke, (4) Dr. Rodriguez should have gone to Mrs. Duke’s bedside to assess her competency instead of relying on the nurses to make that determination; and (5) a timely intubation would have saved Mrs. Duke’s life. According to Dr. Bone, “Mrs. Duke was in no position to judge appropriate therapy for herself and to make a rational decision.”

Nurse McKay, three other ICU nurses, and Dr. Franks, the emergency room physician who eventually re-intubated Mrs. Duke, testified that the entire period of Mrs. Duke’s extubation, she was awake, alert, oriented, and asking appropriate questions. In nurse McKay’s chart notes at 4:00 a.m. it was written that Mrs. Duke “was informed of and understood the risk of death if the tube is not timely reinserted.”

Based on what you have learned about informed consent, how would you rule in this case?

Write a one page response explaining the case and how you feel the judge would rule.

HIPAA and Law – Part 2

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Assignment:

1. Finish the HIPPA questions from last class, if you have not already done so.

2. Answer the questions below.

3. (Last 15 minutes of class) Take your quiz online on Quizlet

Read the PowerPoint presentation and then write down the following questions and answers:

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1.What federal department regulates HIPAA?

2.Must a patient sign a HIPAA authorization form before his/her physician’s office files an insurance claim for the patient?

3.Can a physician give a son confidential information about his father’s condition without the father’s written consent?

4.Karen wants a copy of her dental x-rays. Can the dental office charge her $10 to provide her with a copy?

5.Brenda has a baby but does NOT want the information made public. Can she refuse to have the birth registered?

6. If a patient legally signs a living will, can a physician refuse to cooperate?

7.What is the intent of the PSDA?

8.Robert has never been married and has no children. Can he give durable power of attorney to his cat?

9.Barney is very ill. His daughter puts a pen in his hand and bullies him into signing a Living Will. Is that legal?

10.Joe has signed a living will and the doctor writes a DNR order. What should the nurse caring for him do if he experiences cardiac arrest?

11.A physician walks into a patient’s room with three medical students. Does the patient have the right to ask the medical students to leave?

12.Does a patient have the right to challenge charges on his/her hospital bill?

13.A nurse anesthetist visits a patient before surgery, but the patient is not comfortable with the anesthetist. What should he/she do?

14.Do you think nursing homes ever violate any residents’ rights? Which ones?

15.If a patient gives permission for a procedure but is heavily drugged at the time, is that legal?

16.If a patient signs a consent form without reading the form, have the rules for informed consent been legally met?

17.If a patient signs a consent form and, while of sound mind, changes his mind about having the procedure, can the physician still perform the procedure?

18.A healthcare worker tells dirty jokes to coworkers who encourage the jokes. Is this sexual harassment?

19.A male pharmacist makes crude comments about women to nobody in particular. A pharmacy assistant who hears his remarks finds the remarks offensive. Is this sexual harassment?

20.Are workplace romances considered sexual harassment?

21.What should you do if someone at work makes sexual comments that make you uncomfortable?

22.What role does OSHA play in protecting the worker?

23.Roxy applies for a job as a medical receptionist. She is well qualified for the job, but is a double-amputee and uses a wheelchair. Can she be denied the job because her wheelchair use might require the office to make some renovations?

24.When should you file a grievance?

25.Do nursing assistants have a scope of practice?

Quizlet Quiz

http://www.quia.com/quiz/4685824.html

HIPAA and PHI

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E.Q. What are the legal responsibilities of a healthcare worker?

Reminders –

Your daily Participation Grade depends on you staying engaged and on task from bell to bell.

Engaged and on task for the whole class period=100% Participation

Engaged 1/2 of the class period =50% Participation

Classwork Grade = Completing your classwork =100%

2-20-2014 Assignment:

1.Read the following case study and respond with a one page essay, expressing your opinion (Writing assignment- explained below.)

Wrongful Death Lawsuit

Myrtle Otis, wife of Harry Otis, deceased, Petitioner v.

University Hospital, Respondent

In this case, you are to consider the following legal standard:

In a wrongful death lawsuit, the plaintiff must prove more likely than not that the death was caused by the defendant’s negligence.

On the afternoon of October 10, 1996, at 10:00 A.M., Harry Otis suffered lower abdominal pain and fainted at home. His wife called the office of his gastroenterologist, Dr. Land, to inform Dr. Land of these symptoms. Dr. Land told Mrs. Otis to call an ambulance and have Mr. Otis transported to the University Hospital emergency room. Mr. Otis was transported to the emergency room and arrived at 10:25 A.M. The emergency room staff was informed by Mrs. Otis that Dr. Land said he would meet them in the emergency room. The emergency room staff did not take a history or examine Mr. Otis in the belief that Dr. Land was coming to the emergency room and would arrive shortly. Dr. Land did not respond to being paged by the emergency room staff at 10:30 A.M. and 10:40 A.M. because he was performing a procedure on another patient in the hospital’s outpatient clinic.

Mr. Otis complained of increasing abdominal pain and asked to use a bedpan at 10:50 A.M. Soon after straining on the bedpan, Mr. Otis could not catch his breath. Dr. Land arrived in the emergency room at 10:55 A.M. and had just entered Mr. Otis’ room when Mr. Otis went into cardiac arrest. Mr. Otis died 35 minutes after arriving at the hospital. The autopsy revealed that he died from a ruptured abdominal aneurysm which caused massive internal bleeding.

Mrs. Otis brought a wrongful death action against the hospital alleging negligence by the emergency room staff in not taking a history and in failing to physically examine Mr. Otis. Mrs. Otis’ expert witness, Dr. John Baily, a cardiologist, testified that the inaction by the emergency room staff violated acceptable medical standards.

The hospital’s expert witness, Dr. Candel, a thoracic surgeon, testified that someone in Mr. Otis’ condition had a no better than even chance to survive, even had there been an immediate diagnosis of the aneurysm and emergency surgery.

Writing assignment: Based on the facts presented in this case, you are to write a one page opinion.

Is Dr. Land at fault?
Is the hospital at fault?
Is there insufficient evidence to prove the wrongful death of Mr. Otis?

You must take a stand and defend your opinion, and be sure you use good writing composition skills.

2. HIPAA relates to health information. It is an important law which affects all patients and all healthcare workers. HIPAA laws can be complex to implement and a plan must be created for each healthcare setting.

Read the following slides and answer the questions about HIPAA and PHI.

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