LEGAL ISSUES FOR COMLEX LEVEL 1
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Cruzan vs. Director - ANSWER -Patients have the right to refuse life-sustaining treatment (including a
feeding tube)
-Like other life-sustaining treatments, artificial nutrition and hydration could be stopped legally and
ethically
Patient Self-Determination Act - ANSWER Requires, that at time of admission:
1) Ask patients if they have *Advanced Directives*
2) Inform patients of their rights to accept or refuse medical treatment
3) Incorporate Advanced Directives into patient medical records
The Stafford Act - ANSWER The Stafford *Disaster Relief and Emergency Assistance Act*
-Authorizes the President to issue a major disaster or an emergency declaration in response to an event
that overwhelms state or local government
-If enacted, the local government can have access to *funds and services from FEMA*
A physician is unwilling to perform heart surgery on a patient with HIV. What is your next step? -
ANSWER Refer the patient to a different cardiothoracic surgeon
Low levels of literacy often lead to *adverse health outcomes*. What is one way a physician may
communicate to a patient with low literacy levels? - ANSWER Use *visual aids*
-E.g. drawings, videos, etc.
A fellow physician is smelling of alcohol on the job. What do you do? - ANSWER Report him to state
medical board and inform chief of staff, etc.
Capitation - ANSWER Contract b/t a physician and a HMO in which a *flat fee per patient* is paid each
month
, Bundled payment - ANSWER Reimbursement on the basis of expected cost of the course of treatment
-Ex: *if a patient underwent a surgical procedure, the entire team is compensated with a "bundled
payment" instead of separate payments to each provider*
Federal Privacy Rule - ANSWER -Medical records are *owned by the provider that constructed them*
-However, *patients have the right to see and get a copy of these records*
Who *owns* a patient's medical records? - ANSWER Physician who constructed them
Genetic Information Nondiscrimination Act (GINA) - ANSWER Unlawful for an employer to discriminate
based on genetic information or to request genetic information
A pregnant woman is wanting to have an abortion. However, as a physician, you have moral beliefs that
you will NOT perform an abortion. What should you do? - ANSWER Refer the patient to another
physician who will perform the abortion
Resident moonlighting and duty hours - ANSWER Residents who want to moonlight can, and these hours
*will count* toward the max number of weekly hours *80 hours/week*
First years residents can work moonlight shift. What is the MAX hour shift he or she may work? -
ANSWER 16 hour shirt MAXIMUM
Physicians reporting medical errors - ANSWER Physicians are *required* to report *ALL medical errors*
-Regardless if it causes harm or not
Physician reporting of *violence* - ANSWER Most states *require* physicians to *alert the law
enforcement authorities* of ANY violence-related injuries (i.e. stab wound, gunshot wound, etc.)
Emergency Medical Treatment & Labor Act - ANSWER Ensures public access to *emergency services
regardless of ability to pay*
-Occurs at Medicare-participating hospitals
-Hospitals required to provide *stabilizing treatment* for pts in an emergency situation
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Cruzan vs. Director - ANSWER -Patients have the right to refuse life-sustaining treatment (including a
feeding tube)
-Like other life-sustaining treatments, artificial nutrition and hydration could be stopped legally and
ethically
Patient Self-Determination Act - ANSWER Requires, that at time of admission:
1) Ask patients if they have *Advanced Directives*
2) Inform patients of their rights to accept or refuse medical treatment
3) Incorporate Advanced Directives into patient medical records
The Stafford Act - ANSWER The Stafford *Disaster Relief and Emergency Assistance Act*
-Authorizes the President to issue a major disaster or an emergency declaration in response to an event
that overwhelms state or local government
-If enacted, the local government can have access to *funds and services from FEMA*
A physician is unwilling to perform heart surgery on a patient with HIV. What is your next step? -
ANSWER Refer the patient to a different cardiothoracic surgeon
Low levels of literacy often lead to *adverse health outcomes*. What is one way a physician may
communicate to a patient with low literacy levels? - ANSWER Use *visual aids*
-E.g. drawings, videos, etc.
A fellow physician is smelling of alcohol on the job. What do you do? - ANSWER Report him to state
medical board and inform chief of staff, etc.
Capitation - ANSWER Contract b/t a physician and a HMO in which a *flat fee per patient* is paid each
month
, Bundled payment - ANSWER Reimbursement on the basis of expected cost of the course of treatment
-Ex: *if a patient underwent a surgical procedure, the entire team is compensated with a "bundled
payment" instead of separate payments to each provider*
Federal Privacy Rule - ANSWER -Medical records are *owned by the provider that constructed them*
-However, *patients have the right to see and get a copy of these records*
Who *owns* a patient's medical records? - ANSWER Physician who constructed them
Genetic Information Nondiscrimination Act (GINA) - ANSWER Unlawful for an employer to discriminate
based on genetic information or to request genetic information
A pregnant woman is wanting to have an abortion. However, as a physician, you have moral beliefs that
you will NOT perform an abortion. What should you do? - ANSWER Refer the patient to another
physician who will perform the abortion
Resident moonlighting and duty hours - ANSWER Residents who want to moonlight can, and these hours
*will count* toward the max number of weekly hours *80 hours/week*
First years residents can work moonlight shift. What is the MAX hour shift he or she may work? -
ANSWER 16 hour shirt MAXIMUM
Physicians reporting medical errors - ANSWER Physicians are *required* to report *ALL medical errors*
-Regardless if it causes harm or not
Physician reporting of *violence* - ANSWER Most states *require* physicians to *alert the law
enforcement authorities* of ANY violence-related injuries (i.e. stab wound, gunshot wound, etc.)
Emergency Medical Treatment & Labor Act - ANSWER Ensures public access to *emergency services
regardless of ability to pay*
-Occurs at Medicare-participating hospitals
-Hospitals required to provide *stabilizing treatment* for pts in an emergency situation
