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Copyright, iv
Preface, vii
Unit 1. Understanding the Basics, 1
Chapter 1. Medical Law, Ethics, and Bioethics, 2
Law, 4
Ethics, 4
Bioethics, 4
Ethical Issues in Modern Medicine, 5
Comparing Law, Ethics, and Bioethics, 5
The Importance of Medical Law, Ethics, and Bioethics, 6
Codes of Ethics, 8
An Ethics Check, 9
Characteristics of a Professional Health Care Employee, 10
Summary, 11
Chapter 2. Medical Practice Management, 14
Sole Proprietors, 16
Advantages of Sole Proprietorships, 16
Disadvantages of Sole Proprietorships, 17
Considerations for the Health Care Employee, 17
Partnerships, 18
Advantages of Partnerships, 18
Disadvantages of Partnerships, 18
Considerations for the Health Care Employee, 19
Professional Service Corporations, 19
Advantages of Professional Service Corporations, 19
Disadvantages of Professional Service Corporations, 20
Considerations for the Health Care Employee, 20
Group Practices, 20
Advantages of Group Practice, 21
Disadvantages of Group Practice, 21
Considerations for the Health Care Employee, 21
Managed Care, 22
Health Maintenance Organizations, 24
Other Business Arrangements, 25
Joint Ventures, 25
Preferred Provider Organizations, 27
A Word of Caution, 27
General Liability, 27
Business License, 27
Building, 27
Automobile, 28
Fire, Theft, and Burglary, 28
Employee Safety, 28
Bonding, 28
Employers' Responsibilities to Employees, 28
Summary, 29
Chapter 3. Employees in Ambulatory Care, 32
Licensure, 34
Registration, 34
Certification, 34
Licensed Personnel, 35
Nurses, 35
Nonlicensed Personnel, 36
Medical Assistants, 36
Other Employees, 38
Physician Assistant, 38
Additional Health Care Employees, 38
Considerations for Ambulatory Care Employees, 39
Summary, 40
Unit 2. Law, Liability, and Duties, 43
Chapter 4. Legal Guidelines for Health Professionals, 44
Sources of Law, 46
Types of Law, 47
Civil and Criminal Law, 48
Controlled Substances Act and Regulations, 52
Drug Schedules, 54
Issuing Prescriptions, 54
Types of Court, 56
Probate Court, 56
Small Claims Court, 57
Subpoenas, 59
The Trial Process, 59
Expert Witness, 60
Summary, 61
Chapter 5. Regulations and Professional Liability for Health Professionals, 64
Medical Practice Acts, 66
Licensure, 66
License Renewal, 66
License Revocation and Suspension, 67
Professional Liability, 67
Standard of Care, 67
The Health Insurance Portability and Accountability Act (HIPAA), 68
Confidentiality, 68
Contracts, 70
Abandonment, 71
Breach of Contract, 71
Torts, 72
Professional Negligence or Malpractice, 73
The Four Ds of Negligence, 74
Intentional Torts, 74
Doctrine of Respondeat Superior, 75
Statute of Limitations, 76
Professional Liability or Malpractice Insurance, 76
Alternatives to Litigation, 77
Risk Management, 78
Summary, 79
Chapter 6. Public Duties, 82
Births and Deaths, 84
Communicable and Notifiable Diseases, 85
Childhood and Adolescent Vaccinations, 86
Notifiable or Reportable Injury, 87
Abuse, 87
Child Abuse, 88
Intimate Partner Violence, 89
Rape, 90
Elder Abuse, 90
Evidence, 92
Substance Abuse, 93
Good Samaritan Laws, 94
Summary, 95
Chapter 7. Consent, 98
Informed and Uninformed Consent, 100
The Doctrine of Informed Consent, 101
Problems in Consent, 102
Mature Minors, 102
Emancipated Minors, 102
Others, 103
Implementing Consent, 104
Summary, 104
Unit 3. Workplace Issues, 109
Chapter 8. Medical Records, 110
Purposes, 112
Problem-Oriented Medical Records, 113
SOAP/SOAPER, 113
Legal Aspects of the Medical Record, 115
Electronic Medical Records, 118
E-Mail, 119
Fax Machines, 120
Ownership of Medical Records, 121
Retention of Medical Records, 121
Storage of Medical Records, 122
Summary, 122
Chapter 9. Reimbursement and Collection Practices, 124
Laws for Reimbursement and Collections, 126
Truth in Lending Act, 126
Equal Credit Opportunity Act, 127
Fair Credit Billing Act, 127
Fair Debt Collections Practices Act, 127
Federal Wage Garnishing Law, 127
Tax Equity Fiscal Responsibility Act, 127
Stark I and II Regulations, 128
Civil Monetary Penalties Act, 128
Deficit Reduction Act, 128
How Physicians Are Paid, 128
Clients' Responsibility for Reimbursement, 130
Collection Guidelines, 130
Collection Do's, 131
Collection Don'ts, 132
Collection Problems, 132
Collection Agencies, 133
Reimbursement Attitudes, 134
Ethical Implications, 134
Summary, 135
Chapter 10. Employment Practices, 138
Policy Manual, 140
Personnel Policies, 141
Job Descriptions, 141
Office Hours and Workweek, 141
Benefits and Salaries, 142
The Employment Process, 142
Locating Employees, 142
Interview Process, 142
Selecting Employees, 143
Employee Termination, 144
When Employees Choose to Leave, 145
Keeping Employees, 145
Legal Implications, 146
Family and Medical Leave Act, 147
Sexual Harassment, 147
Occupational Safety and Health Act (OSHA), 147
Americans with Disabilities Act, 148
Summary, 149
Chapter 11. A Cultural Perspective for Health Professionals, 152
Understanding Cultural Diversity, 154
Components of Cultural Diversity, 155
Establishing a New Culture in Health Care, 159
Evaluating Self, 160
Cross-Cultural Communication, 160
Summary, 161
Unit 4. Bioethical Issues, 163
Chapter 12. Allocation of Scarce Medical Resources, 164
Macroallocation and Microallocation, 167
The Influence of Politics, Economics, and Ethics on Health Care, 167
Systems for Decision-Making, 169
How Would You Decide?, 170
Summary, 171
Chapter 13. Genetic Engineering, 174
Genetic Screening, Testing, and Counseling, 176
Regulating Genetic Testing, 178
Sterilization, 179
Human Genome Sequencing Consortium and Gene Therapy, 179
Assisted Reproduction, 180
Artificial Insemination, 182
Legal and Ethical Implications of AIH and AID, 182
In Vitro Fertilization and Other Forms of Assisted Reproduction, 183
Surrogacy, 184
Legal and Ethical Implications of Assisted Reproduction, 184
Definitions of Terms on Cell Tissues, 186
Fetal Tissue Research, 186
Cord Blood and Stem Cell Research, 187
Tissue and Organ Engineering, 187
Reproductive Cloning, 187
Legal and Ethical Implications of Tissue Cell Research, 188
Considerations for Health Professionals, 188
Summary, 188
Chapter 14. Abortion, 192
Fetal Development, 194
When Does Life Begin?, 194
Methods of Abortion, 196
Legal Implications, 198
U.S. Supreme Court Decisions (1973–Present), 198
Ethical Implications, 201
Are There Any Reasons to Justify Abortions?, 201
Are Current Laws Regarding Abortions Consistent, Fair, and Just?, 202
Are Abortions an Appropriate Method of Birth Control?, 203
Protocol for Health Professionals, 204
Summary, 204
Chapter 15. Life and Death, 206
Choices in Life, 209
Living Wills, Advance Directives, and the Patient Self-Determination Act, 209
Durable Power of Attorney for Health Care, 210
Choices in Dying, 211
Legal Definitions of Death, 213
Legal Implications, 215
Ethical Considerations, 216
The Role of Health Professionals, 218
Summary, 219
Chapter 16. Dying and Death, 222
Living with Dying, 224
Suffering in Dying, 224
Use of Medications, 225
Psychological Aspects of Dying, 226
Physiological Aspects of Dying, 227
Stages of Grief, 228
Denial, 228
Anger, 229
Bargaining, 229
Depression, 229
Acceptance, 229
Hospice, 230
Physician-Assisted Death, 230
Uniform Anatomical Gift Act, 232
Autopsy, 233
The Role of the Physician and Health Professionals, 233
Summary, 234
Special Section Have A Care!, 237
Appendix I. I Code of Ethics, 241
The Hippocratic Oath, 241
American Association of Medical Assistants, 242
Principles of Medical Ethics, 242
Appendix II. Sample Documents for Choices About Health Care, Life, and Death, 245
Sample Advance Directive, 246
Sample Durable Power of Attorney for Health Care, 248
Living Bank Uniform Anatomical Gift Act Donor Form, 250
Uniform Donor Card, 251
Bibliography, 253
Index, 259

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