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LO 8.3 Discuss laws implemented to protect the Public Health Statutes 240
security of health care information as health LO 9.4 Cite examples of reportable diseases and
records are converted from paper to electronic injuries, and explain how they are reported. 242
form. 213
Reportable Diseases and Injuries 242
Laws Implemented to Protect the Security of Health The National Childhood Vaccine Injury Act of 1986 243
Care Information 213 Vaccination as a Bioethics Issue 246
HIPAA’s Security Rule 214 Reportable Injuries 248
HITECH Rule 216
LO 9.5 Discuss federal drug regulations, including the
LO 8.4 Discuss the federal laws that cover fraud and Controlled Substances Act. 251
abuse within the health care business environment
Drug Regulations 251
and the role of the Office of the Inspector General in
The Controlled Substances Act 252
finding billing fraud. 217
Chapter Summary 255
Controlling Health Care Fraud and
Abuse 217 Ethics Issues 257
The Fraud Patrol 218 Chapter Review 259
The Federal False Claims Act 218 Case Studies 262
The Federal Anti-Kickback Law 219
Internet Activities 263
Stark Law 220
Criminal Health Care Fraud Statute 220
Resources 263
LO 8.5 Discuss patient rights as defined by HIPAA,
10
the Patient Protection and Affordable Care Act, Chapter 10
and other health care entities. 222
Patients’ Bill of Rights 222 Workplace Legalities 265
Chapter Summary 225 LO 10.1 Identify how the workplace is affected by
federal laws regarding hiring and firing, discrimination,
Ethics Issues 227
and other workplace regulations. 266
Chapter Review 228
How the Law Affects the Workplace 266
Case Studies 231 Hiring and Firing 267
Internet Activities 231 Discrimination 267
Resources 232 Federal Labor and Employment Laws 269
LO 10.2 Identify six areas for which standards are
mandated by the Occupational Safety and Health
PART THREE PROFESSIONAL, Administration (OSHA) for work done in a clinical
setting. 272
TRANSITIONAL, AND SOCIETAL
Employee Safety and Welfare 272
HEALTH CARE ISSUES 233
9
Occupational Safety and Health Administration
Chapter 9 (OSHA) 272
LO 10.3 Discuss the role of health care practitioners in
Physicians’ Public Duties following OSHA standards for infection control in the
and Responsibilities 234 medical office. 274
LO 9.1 List at least four vital events for which OSHA Health Standards and CDC Guidelines 274
statistics are collected by the government. 235 LO 10.4 Define the role of the Clinical Laboratory
Vital Statistics 235 Improvement Act (CLIA) of 1988 in quality laboratory
LO 9.2 Discuss the procedures for filing birth and testing. 279
death certificates. 236 Clinical Laboratory Improvement Act (CLIA) 279
Records for Births and Deaths 236 LO 10.5 State the purpose of workers’ compensation
Births 236 laws and unemployment insurance. 280
Deaths 236 Workers’ Compensation and Unemployment
Forensic Medicine 238 Insurance 280
LO 9.3 Explain the purpose of public health Workers’ Compensation 280
statutes. 240 Unemployment Insurance 281
Contents vii
LO 10.6 Determine the appropriate legal process Chapter Review 317
for hiring employees and maintaining the required Case Studies 319
paperwork while the person is employed. 281
Internet Activities 320
Hiring and the New Employee 281
Resources 320
Interviews 281
12
Bonding 282
Employment Paperwork 283 Chapter 12
Chapter Summary 285
Death and Dying 322
Ethics Issues 286
LO 12.1 Discuss how attitudes toward death have
Chapter Review 287 changed over time. 323
Case Studies 291 Attitudes toward Death and Dying 323
Internet Activities 292 LO 12.2 Discuss accepted criteria for determining
Resources 292 death. 325
Determination of Death 325
11
Chapter 11 Autopsies 325
LO 12.3 Determine the health care professional’s role
The Beginning of Life in caring for the dying. 326
and Childhood 293 Caring for Dying Patients 326
LO 11.1 Define genetics and heredity. 294 Hospice Care 327
Genetics and Heredity 294 Educating Health Care Practitioners about End-of-Life
Issues 328
The Human Genome Project 295
LO 12.4 Discuss benefits to end-of-life
LO 11.2 List several situations in which genetic testing
health care derived from the right to die
might be appropriate, and explain how it might lead
movement. 330
to genetic discrimination. 296
The Right to Die Movement 330
Genetic Testing 296
Euthanasia and Physician-Assisted Suicide 332
Genetic Diseases 297
Planning Ahead 334
Genetic Discrimination 298
Living Will 335
LO 11.3 Define genetic engineering, and explain
Durable Power of Attorney 335
why cloning and stem cell research are controversial
Health Care Proxy 335
issues. 300
Do-Not-Resuscitate (DNR) Order 336
Genetic Engineering 300
LO 12.5 Identify the major features of organ donation
Cloning 301
in the United States. 337
Human Stem Cell Research 303
The National Organ Transplant Act 337
Gene Therapy 304
Organ Donor Directives 338
LO 11.4 Discuss three possible remedies for couples
The Uniform Anatomical Gift Act 338
experiencing infertility problems. 305
Frequently Asked Questions about Organ
Conception and the Beginning of Life 305 Donation 339
Infertility 306 LO 12.6 Discuss the various stages of grief. 340
Surrogacy 306
The Grieving Process 340
Adoption 307
What Is Grief? 340
LO 11.5 List and discuss those laws affecting health Stages of Grief 341
care that pertain especially to children’s rights. 308 Finding Support 344
Rights of Children 308 Chapter Summary 345
Best Interest of the Child Concept 309
Ethics Issues 347
Rights of the Newborn 309
Abandoned Infants 309 Chapter Review 349
Teenagers 311 Case Studies 353
Chapter Summary 314 Internet Activities 354
Ethics Issues 316 Resources 354
viii Contents
13
Chapter 13 LO 13.4 Discuss those broader movements that
forecast the future of health care. 375
Health Care Trends Implications for the Future of Health Care 375
and Forecasts 356 Data and Connectivity 376
LO 13.1 Identify the major stakeholders in the U.S. Prevention and Population Health 377
health care system. 358 Personalization and Participation 377
Whom Does the Health Care System Serve? 358 Chapter Summary 379
LO 13.2 Describe the major areas of concern to those Ethics Issues 380
stakeholders. 359 Chapter Review 381
Cost, Access, and Quality 359 Case Studies 384
Cost 359 Internet Activities 385
Access 364
Resources 385
Quality 364
LO 13.3 Describe those trends that are likely to
Glossary 387
continue to affect patient care in the future. 368
Credits 395
Health Care Trends 368 Indexes 397
Medical Technologies 368
Health Information Technologies 373
Contents ix
About the Authors
Karen Judson, BS
Karen Judson taught biology laboratories at Black Hills University in Spearfish, South
Dakota; high school sciences in Idaho; and grades one and three in Washington state. She is
also a former laboratory and X-ray technician and completed two years of nurse’s training
while completing a degree in biology.
Judson has worked as a science writer since 1983. She has written relationship, family, and
psychology articles for a variety of magazines, including a series of high school classroom
magazines, making a total of 500 articles published. Judson writes science and relationship
books for teenagers (Enslow and Marshall Cavendish publishers). Her book for teens, Sports &
Money: It’s a Sell Out, made the New York City Public Library’s list of best books for teens in
1995. Her book for teens, Genetic Engineering, was chosen by the National Science Teachers’
Association as one of the best science books for children in 2001 and was featured on the
NSTA Web site.
Have feedback or questions for the authors? Use email address judsonlawethics@gmail.com
to reach them!
Law and Ethics for Health Professions explains how include the recently enacted Patient Protection and
to navigate the numerous legal and ethical issues that Affordable Care Act (usually abbreviated as ACA).
health care professionals face every day. Topics are The chapter also reveals the tremendous impact of
based upon real-world scenarios and dilemmas from health care fraud and abuse on health care costs.
a variety of health care practitioners. Through the • Chapter 13, “Health Care Trends and Forecasts,”
presentation of Learning Outcomes, Key Terms, From has been updated to evaluate the current status
the Perspective of, Ethics Issues, Chapter Reviews, of health care in the United States and to inform
Case Studies, Internet Activities, Court Cases, and students of today’s trends in health care.
Videos, students learn about current legal and ethical • All statistics and court cases have been updated,
problems and situations. In the seventh edition, as well as content relevant to laws passed since
Chapters 3 and 8 have been substantially revised the sixth edition.
to reflect changes in today’s health care world. As
• New case studies have been added. As in previous
students progress through the text, they will get the
editions, the authors made an effort to include a
opportunity to use critical thinking skills to learn
variety of allied health professions in case studies
how to resolve real-life situations and theoretical
and in other examples throughout the text.
scenarios and to decide how legal and ethical issues
• The interior design and layout have been refreshed
are relevant to the health care profession in which
to make it easier for students to navigate through
they will practice.
the content.
Law & Ethics is also available with McGraw-Hill
Education’s revolutionary adaptive learning technology, • McGraw-Hill Connect® Law & Ethics has been updated
McGraw-Hill LearnSmart® and now SmartBook®! You to reflect updates in the chapters and feedback from
can study smarter, spending your valuable time on customers. Additional Case Studies are included in
topics you don’t know and less time on the topics you Connect, as well as Video Case Scenarios, to allow
have already mastered. Succeed with LearnSmart . . . students to apply important skills learned from the
Join the learning revolution and achieve the success text. Both the Case Studies and the Video Cases
you deserve today! include related questions with immediate feedback
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• Law & Ethics is now available with the LearnSmart
New to the Seventh Edition Advantage, a series of adaptive learning products
A number of updates have been made in the seventh fueled by both LearnSmart and SmartBook.
edition to enrich the user’s experience with the product: For a detailed transition guide between the sixth and
• Chapter 3, “Working in Health Care,” has been seventh editions of Law & Ethics, visit the Instructor
extensively updated to reflect the changing Resources in Connect!
configuration of health care management and the
impact of telemedicine and social media on all
facets of health care. To the Student
• Chapter 8, “Privacy, Security, and Fraud,” moves As you study to become a health care provider, you
beyond the details of the Health Insurance have undoubtedly realized that patients are more than
Portability and Accountability Act (HIPAA) to the sum of their medical problems. In fact, they are
Preface xi
people with loved ones, professions, worries, hobbies,
and daily routines that are probably much like your
Law & Ethics Preparation
own. However, because patients’ lives and well-being in the Digital World:
are at stake as they seek and receive health care, in
Supplementary Materials for
addition to seeing each patient as an individual, you
must carefully consider the complex legal, moral, the Instructor and Student
and ethical issues that will arise as you practice your McGraw-Hill Education knows how much effort
profession. And you must learn to resolve such issues it takes for instructors to prepare for a new course.
in an acceptable manner. Through focus groups, symposia, reviews, and
Law & Ethics provides an overview of the laws and conversations with instructors like you, we have
ethics you should know to help you give competent, gathered information about what materials you
compassionate care to patients that is also within need in order to facilitate successful courses. We
acceptable legal and ethical boundaries. The text can are committed to providing you with high-quality,
also serve as a guide to help you resolve the many accurate instructor support. Knowing the importance
legal and ethical questions you may reasonably of flexibility and digital learning, McGraw-Hill
expect to face as a student and, later, as a health care Education has created multiple assets to enhance the
provider. learning experience no matter what the class format:
To derive maximum benefit from Law & Ethics: traditional, online, or hybrid. This product is designed
• Review the Learning Outcomes and Key Terms at to help instructors and students be successful, with
the beginning of each chapter for an overview of digital solutions proven to drive student success.
the material included in the chapter.
• Complete all Check Your Progress questions
as they appear in the chapter and correct any
incorrect answers.
A ONE-STOP SPOT TO PRESENT,
• Review the legal cases to see how they apply to
DELIVER, AND ASSESS DIGITAL
topics in the text, and try to determine why the
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HILL: MCGRAW-HILL CONNECT LAW &
• Study the Ethics Issues at the end of each chapter,
ETHICS
and answer the discussion questions.
McGraw-Hill Connect ® Law & Ethics provides online
• Complete the Review questions at the end of the
presentation, assignment, and assessment solutions.
chapter, correct any incorrect answers, and review
It connects your students with the tools and resources
the material again.
they’ll need to achieve success. With Connect, you can
• Review the Case Studies and use your critical
deliver assignments, quizzes, and tests online. A robust
thinking skills to answer the questions.
set of questions and activities, including all of the
• Complete the Internet Activities at the end of the Check Your Progress and End-of-Chapter Questions,
chapter to become familiar with online resources additional Case Studies, Video Case Scenarios, and
and to see what additional information you can interactives are presented and aligned with the
find about selected topics. textbook’s learning outcomes. As an instructor, you
• Complete the Connect assignments from your can edit existing questions and author entirely new
instructor, including any LearnSmart or SmartBook problems. Connect enables you to track individual
modules assigned, as well as additional Case student performance—by question, by assignment,
Studies and Video Case Scenarios. or in relation to the class overall—with detailed
• Study each chapter until you can answer correctly grade reports. You can integrate grade reports easily
questions posed by the Learning Outcomes, Check with learning management systems (LMSs), such as
Your Progress, and Review questions. Blackboard, Desire2Learn, and eCollege, plus much
xii Preface
more. Connect Law & Ethics also provides students McGraw-Hill Education and Blackboard can now
with 24/7 online access to an ebook. This media- offer you easy access to industry-leading technology
rich version of the textbook is available through the and content, whether your campus hosts it or we do.
McGraw-Hill Connect platform and allows seamless Be sure to ask your local McGraw-Hill Education
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you receive an instant, at-a-glance view of student Campus supports Active Directory, Angel, Blackboard,
performance matched with student activity. It puts Canvas, Desire2Learn, eCollege, IMS, LDAP, Moodle,
real-time analytics in your hands so you can take Moodlerooms, Sakai, Shibboleth, WebCT, BrainHoney,
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Preface xiii
your computer, so students can use keywords to find likely to pass their classes and 35 percent less likely
exactly what they want to study. Tegrity is available as to drop out. This revolutionary learning resource is
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xiv Preface
Supplement Features
Instructor’s Manual Each chapter includes:
• Learning Outcomes
• Overview of PowerPoint Presentations
• Teaching Points
• Answer Keys for Check Your Progress and End-of-Chapter Questions
PowerPoint Presentations • Key Concepts
• References to Learning Outcomes
Electronic Test Bank • EZ Test Online (computerized)
• Word version
• These questions are also available through Connect.
• Questions are tagged with learning outcomes, level of difficulty, level
of Bloom’s taxonomy, feedback, topic, and the accrediting standards of
ABHES and CAAHEP where appropriate.
Tools to Plan Course • Transition Guide, by chapter, from Law & Ethics, 6e to 7e.
• Correlations by learning outcomes to ABHES, CAAHEP, and more
• Sample syllabi
• Asset Map—a recap of the key instructor resources, as well as information
on the content available through Connect
Preface xv
Guided Tour
Chapter Openers
The chapter opener sets the stage for what will be learned in the chapter. Key terms are first introduced in the chapter
opener so the student can see them all in one place; they are defined in the margins throughout the chapter for easy
review, as well as in the glossary. Learning Outcomes are written to reflect the revised version of Bloom’s Taxonomy,
and to establish the key points the student should focus on in the chapter. In addition, major chapter heads are structured
to reflect the Learning Outcomes and the Learning Outcomes are repeated next to these heads for easy reference. From
the Perspective of . . . boxes illustrate real-life experiences related to the text. Each quotes health care providers as they
encounter problems or situations relevant to the material about to be presented in the chapter.
1 Introduction to Law Barbara told Elaine, a new receptionist in the medical office, to
politely ask walk-in patients why they needed to see a doctor. Elaine
had been on the job for two weeks when an elderly man who was hard
and Ethics of hearing approached her, and she dutifully asked him the purpose
for his visit. He was obviously too embarrassed to reply, but Elaine
persisted, finally raising her voice. When the man shouted “I can’t
pee,” all heads in the busy waiting room turned toward Elaine and
Key Terms the patient. A red-faced Elaine turned to arrange for the man to see a
physician, but he quickly left the building. Barbara criticized Elaine’s
American Medical patient-handling technique, but the crux of the matter was that the
Association
patient left without seeing a doctor for his medical problem.
Principles
bioethicists
LEARNING OUTCOMES “Patients’ needs always trump office routine,” Barbara emphasizes.
bioethics After studying this chapter, you should be able to: “If we somehow hurt or hinder a patient while doggedly sticking to a
code of ethics set routine, we may have risked legal liability, but more important, we
common sense LO 1.1 Explain why knowledge of law and ethics is important haven’t done our job.”
compassion From Barbara’s perspective as the person responsible for training
to health care practitioners.
courtesy medical office personnel, Elaine failed to use common sense in com-
critical thinking municating with a patient, and as a result, the man did not receive the
defendant LO 1.2 Distinguish among law, ethics, bioethics, etiquette,
medical treatment he needed.
ethics and protocol. From Elaine’s perspective, she followed Barbara’s instructions to
ethics committees
the letter, and she failed to understand why Barbara had criticized her.
ethics guidelines LO 1.3 Define moral values and explain how they relate to law, She hadn’t meant to embarrass the man, so was it her fault that he left
etiquette
ethics, and etiquette. without making an appointment?
fraud
health care From the patient’s perspective as an elderly gentleman who seldom
practitioners LO 1.4 Discuss the characteristics and skills most likely to discussed personal matters, the young woman who was his first con-
Hippocratic oath lead to a successful career in one of the health care tact in the medical office embarrassed him, and he left rather than face
law
professions. further humiliation.
liable
litigious
medical ethicists
moral values
plaintiff As you progress through Law & Ethics for the Health Professions, try to
precedent interpret the court cases, laws, case studies, and other examples or
protocol situations cited from the perspectives of everyone involved.
summary judgment
Ethics Issues
• Jean Making Ethical
Piaget’s moral development stages: Decisions within the professional organizations
• Sensorimotor stage, during which the child is totally self-centered—birth to
age 2. for health care providers, as well as
Ethics ISSUE 1:
Joyce Weathers is a 62-year-old patient with emphysema. Mrs. Weathers is a grandmother who has smoked with bioethics experts. Each Chapter
a pack of cigarettes a day for over 40 years. She enjoys smoking and does not want to quit. Her physician has
become somewhat insistent that Mrs. Weathers quit. She tries, but each time she becomes nasty and irritable Review includes Applying Knowledge
around her family. She lives with her daughter and two young grandchildren. The family members want her
to quit, but it becomes very unpleasant at home when Mrs. Weathers tries to quit. questions that reinforce the concepts
Discussion Questions the students have just learned. These
1. Using act-utilitarianism as a model, create a pain-avoided, pleasure-gained list to determine if
Mrs. Weathers should continue smoking.
questions can be answered in Connect.
Case Studies are scenarios with
exercises that allow students to
2. If your decision is that she should quit smoking, how can Mrs. Weathers’s family help her?
practice their critical thinking skills to
decide how to resolve the real-life
Chapter 2 Review
situations and theoretical scenarios
Enhance your learning by completing these exercises and more at
http://connect.mheducation.com!
presented. Internet Activities
Applying Knowledge
include exercises designed to increase
LO 2.1 the students’ knowledge of the
1. What is another term for your personal concept of right and wrong? chapter topics and help them gain
a. Utilitarianism
more Internet research expertise.
Case Studies The Resources section presents
Use your critical thinking skills to answer the questions that follow each case study.
a listing of additional references for
LO 2.3
the chapter.
Susan is a nursing student, arguing with her friend Linda, also a nursing student, over the benefits of getting
a flu shot.
organization’s code of ethics. Does the code conform to the seven principles of health care ethics?
Explain your answer.
Resources
Edge, R., and J. Groves. Ethics of Health Care: A Guide for Clinical Practice. 3rd ed. New York: Thomson
Delmar Learning, 2006.
jud13830_ch02_030-050.indd 46 24/09/14 11:51 am
Kohlberg, L. The psychology of Moral Development: Essays on Moral Development. Vol. 2. San Francisco:
Harper and Row, 1984.
jud13830_ch02_030-050.indd 49 Kohlberg, L., and R. A. Ryncarz. “Beyond Justice Reasoning: Moral Development and
24/09/14 11:51 am Consideration of a
Seventh Stage.” In Higher Stages of Human Development: Perspectives on Adult Growth, ed. C. N. Alexander
and E. J. Langer. New York: Oxford University Press, 1990.
Yvonne Alles, DHA Diane Gryglak, AA, BS, CMA Berta Powers, AA, CCMA, CMA
Davenport (AAMA) (AAMA)
College of DuPage De Anza College
Theresa Allyn, BS, MEd
Edmonds Community College Angela Hennessy, BS, MS Debra Pressley, BA, MBA
Corning Community College Blue Ridge Community College
Doris Beran, MPH
Coconino Community College Sandy Hunter, BS, MEd, PhD Sue Pylant, CCS-P
Eastern Kentucky University Sanford-Brown College – San Antonio
Chantalle Blakesley-Boddie, BS, CMA
(AAMA) Robert Kieffer Adrienne Reaves, EdD, RMA
Lake Washington Institute of Technology Trocaire College Westwood College – DuPage
x viii Acknowledgments
Starra Robinson-Herring, AAS, AHI, Barbara C. Berger, BSN, RN, CMA, MS Terri Fleming
BA, BSHA, MS Northwestern Connecticut Community Ivy Tech Community College
Stanly Community College College
Tammy B. Foles
Donna Rowan, MA, RMA Norma Bird, MEd, CMA (AAMA) Antonelli College
Community College of Baltimore County Idaho State University
Kim Ford, AAS, MA
Mary Ann Schaefer, RNC, BAABS, Rebecca Bonefas, MA Catawba Valley Community College
MBA, MJ Kaplan University
William Rainey Harper College
Rebecca Anne French, RN, BS, CRNI,
Rebecca Britt MSN, ARNP-C, GNP-BC
Jeanne Smoczyk, MS, RHIT Northwestern State University Allen Community College (Iola, KS)
Chippewa Valley Technical College
Amelia Broussard, PhD, RN, MPH Jill Frost
Marlene Suvada, MHPE, RRT Clayton College & State University Tennessee Technology Center at
National-Louis University Murfreesboro
Joey L. Brown, MA/MS
Charlene Thiessen Great Lakes Institute of Technology Deborah Galanski-Maciak, MS, RHIT
GateWay Community College Davenport University Online
Lou Brown
Lenette Thompson, CST Wayne Community College Debbie Gilbert
Piedmont Tech College Dalton State College
Martina Forte Brown, CCMA, CPT, CET
L. Joleen VanBibber, CDPMA, CFRDA William D. Goren, JD, LLM
Brookstone College
Davis Applied Technology College Northwestern Business College
Rita Bulington, RN, AS
Stacey Wanovich, MLT James Goss, MHA, MICP
Ivy Tech Community College
Anoka Technical College Loma Linda University
Lynn Callister, RN, PhD, FAAN
Gail Warchol Gardiner M. Haight, BS Comm, JD
Brigham Young University
Mohawk Valley Community College Bryant & Stratton College
Cyndi Caviness, AAS, AHI, CMA
Claudia Williams, MS (AAMA), CRT Janet K. Henderson, CMA, AAT
Campbell University Montgomery Community College North Georgia Technical College
Veronica Zurcher, BSAS, CMA (AAMA) Linda Ciarleglio, BS Beulah A. Hofmann, RN, MSN
National College (Youngstown, OH) Stone Academy Ivy Tech Community College
Shkelzen Badivuku Dena A. Evans, BSN, MPH, RN, CMA Karmon Kingsley, BS, CMA (AAMA)
Gibbs College Richmond Community College Cleveland State Community College
Julette Barta, CphT, BSIT Cynthia Ferguson, AAS Mary Koloski, CBCS, CHI
SJVC Texas State Technical College Florida Career College
Acknowledgments xix
Lynda M. Konecny Elizabeth Salazar, AS, BS Connect, LearnSmart, and SmartBook.
They include:
New York City College of Technology Centura College
xx Acknowledgments
PA R T ONE
The Foundations of
Law and Ethics
1
Key Terms
1 Introduction to Law
and Ethics
American Medical
Association
Principles
bioethicists
LEARNING OUTCOMES
bioethics After studying this chapter, you should be able to:
code of ethics
common sense LO 1.1 Explain why knowledge of law and ethics is important
compassion
to health care practitioners.
courtesy
critical thinking
defendant LO 1.2 Distinguish among law, ethics, bioethics, etiquette,
ethics and protocol.
ethics committees
ethics guidelines LO 1.3 Define moral values and explain how they relate to law,
etiquette
ethics, and etiquette.
fraud
health care
practitioners LO 1.4 Discuss the characteristics and skills most likely to
Hippocratic oath lead to a successful career in one of the health care
law
professions.
liable
litigious
medical ethicists
moral values
plaintiff
precedent
protocol
summary judgment
2
FROM THE PERSPECTIVE OF. . .
BARBARA, AN EXPERIENCED CERTIFIED MEDICAL ASSISTANT
( C M A ) ( A AM A) in a medical office with a walk-in clinic, instructs
new employees in the reception area of the office to follow the medical
office procedures whenever possible and prudent, but, above all, to
use common sense in dealing with patients.
Barbara told Elaine, a new receptionist in the medical office, to
politely ask walk-in patients why they needed to see a doctor. Elaine
had been on the job for two weeks when an elderly man who was hard
of hearing approached her, and she dutifully asked him the purpose
for his visit. He was obviously too embarrassed to reply, but Elaine
persisted, finally raising her voice. When the man shouted “I can’t
pee,” all heads in the busy waiting room turned toward Elaine and
the patient. A red-faced Elaine turned to arrange for the man to see a
physician, but he quickly left the building. Barbara criticized Elaine’s
patient-handling technique, but the crux of the matter was that the
patient left without seeing a doctor for his medical problem.
“Patients’ needs always trump office routine,” Barbara emphasizes.
“If we somehow hurt or hinder a patient while doggedly sticking to a
set routine, we may have risked legal liability, but more important, we
haven’t done our job.”
From Barbara’s perspective as the person responsible for training
medical office personnel, Elaine failed to use common sense in com-
municating with a patient, and as a result, the man did not receive the
medical treatment he needed.
From Elaine’s perspective, she followed Barbara’s instructions to
the letter, and she failed to understand why Barbara had criticized her.
She hadn’t meant to embarrass the man, so was it her fault that he left
without making an appointment?
From the patient’s perspective as an elderly gentleman who seldom
discussed personal matters, the young woman who was his first con-
tact in the medical office embarrassed him, and he left rather than face
further humiliation.
As you progress through Law & Ethics for the Health Professions, try to
interpret the court cases, laws, case studies, and other examples or
situations cited from the perspectives of everyone involved.