Dr.

Zubair bin Ilyas

physiotherapist
DPT - SMC
MS - SPT
CMSK
COMT
Legal and Ethical
Responsibilities:
Outline:
• Discuss legal rights, duties, and remedies.
• Discuss a manager’s role in contracts, torts, and professional
malpractice.
• patient consent, confidentiality, and rights.
• Discuss managerial ethics and the role of the American Physical
Therapy Association (APTA) Code of Ethics.
Rights and Duties:
Managers must understand that every legal right includes a duty for
themselves and others. The classic example is that the right of free
expression does not include the right to scream “Fire!” in a crowded
theater when there is no fire.
As a health-careexample, managers may have the legal right to hire
and fire employees at will, but they also have the duty to take such
actions seriously by following guidelines promulgated to enforce
employment laws.
Remedies:
Another basic legal principle that managers need to understand is that
“every wrong has a remedy.”
Legal wrongdoing is cured, or relieved, by a penalty of some kind
imposed by a court. Courts remedy criminal wrongs by a range of fines
and/or imprisonment.
A health-care example may be asituation in which a patient “contracts”
for surgery performed by a physician with a particular reputation, but
the surgery is actually performed by one of the physician’s partners or
an assistant.
Legal Concerns of Managers:
Contracts:
A contract is a legally enforceable agreement createdwhen an offer by
one party is accepted by another. Itmay be oral or written, but the
agreement must include some benefit or consideration for each party.
Professional Malpractice:
Malpractice is a particular tort based on negligence and of special
interest to health-care managers. The tort of professional malpractice
consists of the following elements:
✦ the duty to conform to a certain standard of care;
✦ a failure to conform to the required standard of care;
✦ actual injury or damage; and
✦ a legally sufficient causal connection between the conduct and the
injury.
Standard of care:
A given health-care provider must provide the level of care, skill, and
treatment which, in light of all relevant surrounding circumstances, is
recognized as acceptable and appropriate by reasonably prudent
similar health-care providers.
Managers and Harm to Patients:
When an incident occurs, managers must ensure that employees avoid
discussions of the incident.
The incident is reported first within the organization according to its
procedures.
In the absence of a risk manager, the organization may report directly to
the insurance company that isproviding professional or general malpractice
insurance, or to an attorney.
To the appropriate practice board(s) for investigation of potential
violation of a practice act.
Other Managerial Legal Issues :
Employment Laws:
• Employment Discrimination Laws.
• Collective Bargaining Laws.
• Employment Benefits Laws.
• Unemployment Insurance.
• Workers’ Compensation.
• Workplace Safety and Health Laws.
Background Checks and Other Credentials:

Managers also must attend to the verification of credentials and

criminal background checks of potential employees. These
responsibilities are directly connected to the protection of the public,
and serve to protect patients from caregivers with potential harmful
behaviors that place them at risk.
Patient Consent:
Managers must ensure that therapists seek, receive, and document
that patients consent to the care they are about to receive.
Patient Confidentiality:
Confidentiality is the right to have personal, identifiable medical
information kept private.

Patients’ Bill of Rights:

Health-care organizations develop or adopt statements that reflect
their duty to provide patients with information, offer fair treatment,
and encourage autonomy over medical decisions that affect them.
Contracts that are of most interest to health-care managers include:

✦ Service and equipment maintenance contracts.

✦ Contracts for employee benefits.
✦ Contracts with third-party payers.
✦ Contracts with registries, placement agencies, or independent contractors.
✦ Employment contracts.
✦ Implied contracts with patients.
✦ Clinical education agreements.
Torts:
contract—committed on another person, their property or reputation,
for which the injured party is entitled to seek compensation.
In health care, the duty to respect and protect patients and their
privacy is probably the most important duty. Failure to do so is taken
very seriously by the law. If reasonable care is not exercised, that failure
in duty constitutes the tort of negligence, and creates liability for any
resulting injury.