👨🏾‍⚕️Healthcare Management Issues Unit 2 – Legal & Ethical Issues in Healthcare

Key Legal Concepts in Healthcare

• Duty of care requires healthcare providers to adhere to a reasonable standard of care when treating patients
• Negligence occurs when a healthcare provider fails to meet the standard of care, resulting in harm to the patient
• Vicarious liability holds healthcare organizations responsible for the actions of their employees
  • Includes physicians, nurses, and other staff members
• Tort law governs civil wrongs and allows patients to seek compensation for injuries caused by healthcare providers
• Contract law applies to agreements between healthcare providers and patients, such as informed consent documents
• Statutory law encompasses laws enacted by legislatures that regulate healthcare practices and protect patient rights (HIPAA)
• Common law refers to legal principles established through court decisions and precedents that guide healthcare legal issues

Ethical Principles in Medicine

• Autonomy respects a patient's right to make informed decisions about their own healthcare
  • Involves providing patients with complete and accurate information about their condition and treatment options
• Beneficence obligates healthcare providers to act in the best interest of their patients and promote their well-being
• Non-maleficence requires healthcare providers to avoid causing harm to patients, following the principle of "first, do no harm"
• Justice ensures that healthcare resources are distributed fairly and equitably among patients
  • Addresses issues of discrimination and access to care
• Veracity emphasizes the importance of honesty and truthfulness in the patient-provider relationship
• Confidentiality protects a patient's private health information from unauthorized disclosure
• Fidelity involves maintaining trust and loyalty in the patient-provider relationship by fulfilling professional duties and commitments

Patient Rights and Responsibilities

• Right to informed consent requires healthcare providers to obtain a patient's permission before performing any medical procedures or treatments
• Right to refuse treatment allows patients to decline recommended medical interventions, even if doing so may result in adverse health consequences
• Right to privacy protects a patient's personal health information from unauthorized access or disclosure under laws like HIPAA
• Right to access medical records enables patients to review and obtain copies of their own healthcare documentation
• Responsibility to provide accurate information obligates patients to disclose relevant medical history and symptoms to their healthcare providers
  • Ensures proper diagnosis and treatment
• Responsibility to follow treatment plans requires patients to adhere to prescribed medications, therapies, and lifestyle modifications as directed by their healthcare team
• Responsibility to respect healthcare staff and other patients by treating them with courtesy and consideration

Privacy and Confidentiality Laws

• HIPAA (Health Insurance Portability and Accountability Act) establishes national standards for the protection of patient health information
  • Requires healthcare providers to implement safeguards to ensure the confidentiality of patient data
• Privacy Rule under HIPAA regulates the use and disclosure of protected health information (PHI) by covered entities
  • Covered entities include health plans, healthcare providers, and healthcare clearinghouses
• Security Rule under HIPAA mandates the implementation of administrative, physical, and technical safeguards to protect electronic PHI
• Breach Notification Rule requires covered entities to notify patients and authorities in the event of a breach of unsecured PHI
• State privacy laws may provide additional protections for patient health information beyond the requirements of HIPAA
• Confidentiality extends beyond legal requirements and encompasses the ethical duty of healthcare providers to maintain patient trust
• Exceptions to confidentiality may apply in certain situations, such as reporting communicable diseases or suspected abuse

Informed Consent and Decision-Making

• Informed consent process involves providing patients with clear, comprehensive information about proposed treatments, risks, benefits, and alternatives
  • Allows patients to make autonomous decisions about their care
• Capacity to consent refers to a patient's ability to understand the information provided and make rational decisions
  • May be impaired by factors such as age, mental illness, or cognitive impairment
• Surrogate decision-making becomes necessary when a patient lacks the capacity to make their own healthcare decisions
  • Involves appointing a legal representative (healthcare proxy) to make decisions on the patient's behalf
• Advance directives are legal documents that allow patients to specify their preferences for medical treatment in the event they become incapacitated
  • Includes living wills and durable powers of attorney for healthcare
• Shared decision-making encourages collaboration between patients and healthcare providers in making treatment decisions
• Informed refusal occurs when a patient declines a recommended treatment after being fully informed of the risks and consequences
• Exceptions to informed consent may apply in emergency situations where immediate treatment is necessary to prevent serious harm or death

Medical Malpractice and Liability

• Medical malpractice occurs when a healthcare provider fails to meet the standard of care, resulting in harm to the patient
• Negligence is a key element of medical malpractice and requires proving duty, breach, causation, and damages
  • Duty refers to the healthcare provider's obligation to adhere to the standard of care
  • Breach occurs when the provider fails to meet that standard
  • Causation establishes a link between the breach and the resulting harm to the patient
  • Damages refer to the actual injuries or losses suffered by the patient
• Standard of care is determined by the actions that a reasonably prudent healthcare provider would take under similar circumstances
• Informed consent issues can give rise to malpractice claims if a patient is not adequately informed of the risks and alternatives to a proposed treatment
• Vicarious liability holds healthcare organizations accountable for the negligent actions of their employees
• Statute of limitations sets time limits for filing medical malpractice claims, which vary by state
• Malpractice insurance provides coverage for healthcare providers against malpractice claims and associated legal costs

End-of-Life Care Issues

• Advance care planning involves discussing and documenting a patient's preferences for end-of-life care before a crisis occurs
  • Includes completing advance directives such as living wills and durable powers of attorney for healthcare
• Palliative care focuses on relieving pain and improving quality of life for patients with serious illnesses
  • Addresses physical, emotional, and spiritual needs of patients and their families
• Hospice care provides comprehensive support for terminally ill patients and their loved ones, typically in the final months of life
• Withholding or withdrawing life-sustaining treatment may be considered when interventions no longer provide benefit or align with a patient's wishes
  • Requires careful consideration of ethical and legal implications
• Physician-assisted suicide involves a physician providing a lethal dose of medication to a terminally ill patient who requests it to end their life
  • Legal in some states with specific safeguards and requirements
• Euthanasia refers to the intentional ending of a patient's life to relieve suffering, which is illegal in most jurisdictions
• Ethical debates surrounding end-of-life care often involve balancing principles of autonomy, beneficence, non-maleficence, and justice

Emerging Challenges in Healthcare Ethics

• Genetic testing and precision medicine raise questions about privacy, discrimination, and the use of genetic information in healthcare decision-making
• Artificial intelligence and machine learning applications in healthcare require careful consideration of bias, transparency, and accountability
• Telemedicine and remote care delivery present challenges related to privacy, informed consent, and the patient-provider relationship
• Allocation of scarce resources during public health emergencies (pandemics) requires balancing individual needs with population-level considerations
• Disparities in access to healthcare and health outcomes among marginalized communities demand attention to issues of social justice and equity
• Climate change and environmental health impacts necessitate a broader understanding of the social determinants of health and the role of healthcare in promoting sustainability
• Globalization and the spread of infectious diseases across borders highlight the need for international cooperation and coordination in healthcare ethics and policy