LEGAL ISSUES FOR COMLEX LEVEL
1 EXAM QUESTIONS AND ANSWERS
-Patients2vhave2vthe2vright2vto2vrefuse2vlife-
sustaining2vtreatment2v(including2va2vfeeding2vtube)2v
-Like2vother2vlife-
sustaining2vtreatments,2vartificial2vnutrition2vand2vhydration2vcould2vbe2vstopped2vlegally2
vand2vethically2v-2vCruzan2vvs.2vDirector
Requires,2vthat2vat2vtime2vof2vadmission:
1)2vAsk2vpatients2vif2vthey2vhave2v*Advanced2vDirectives*
2)2vInform2vpatients2vof2vtheir2vrights2vto2vaccept2vor2vrefuse2vmedical2vtreatment2v
3)2vIncorporate2vAdvanced2vDirectives2vinto2vpatient2vmedical2vrecords2v-2vPatient2vSelf-
Determination2vAct
The2vStafford2v*Disaster2vRelief2vand2vEmergency2vAssistance2vAct*
-
Authorizes2vthe2vPresident2vto2vissue2va2vmajor2vdisaster2vor2van2vemergency2vdeclarati
on2vin2vresponse2vto2van2vevent2vthat2voverwhelms2vstate2vor2vlocal2vgovernment
-
If2venacted,2vthe2vlocal2vgovernment2vcan2vhave2vaccess2vto2v*funds2vand2vservices2vfro
m2vFEMA*2v-2vThe2vStafford2vAct
Refer2vthe2vpatient2vto2va2vdifferent2vcardiothoracic2vsurgeon2v-
2vA2vphysician2vis2vunwilling2vto2vperform2vheart2vsurgery2von2va2vpatient2vwith2vHIV.2vW
hat2vis2vyour2vnext2vstep?
Use2v*visual2vaids*
-E.g.2vdrawings,2vvideos,2vetc.2v-
2vLow2vlevels2vof2vliteracy2voften2vlead2vto2v*adverse2vhealth2voutcomes*.2vWhat2vis2vone
2vway2va2vphysician2vmay2vcommunicate2vto2va2vpatient2vwith2vlow2vliteracy2vlevels?
Report2vhim2vto2vstate2vmedical2vboard2vand2vinform2vchief2vof2vstaff,2vetc.2v-
2vA2vfellow2vphysician2vis2vsmelling2vof2valcohol2von2vthe2vjob.2vWhat2vdo2vyou2vdo?
Contract2vb/
t2va2vphysician2vand2va2vHMO2vin2vwhich2va2v*flat2vfee2vper2vpatient*2vis2vpaid2veach2vmo
nth2v-2vCapitation
Reimbursement2von2vthe2vbasis2vof2vexpected2vcost2vof2vthe2vcourse2vof2vtreatment
-
Ex:2v*if2va2vpatient2vunderwent2va2vsurgical2vprocedure,2vthe2ventire2vteam2vis2vcompens
ated2vwith2va2v"bundled2vpayment"2vinstead2vof2vseparate2vpayments2vto2veach2vprovide
r*2v-2vBundled2vpayment
, -Medical2vrecords2vare2v*owned2vby2vthe2vprovider2vthat2vconstructed2vthem*
-
However,2v*patients2vhave2vthe2vright2vto2vsee2vand2vget2va2vcopy2vof2vthese2vrecords*2v-
2vFederal2vPrivacy2vRule
Physician2vwho2vconstructed2vthem2v-2vWho2v*owns*2va2vpatient's2vmedical2vrecords?
Unlawful2vfor2van2vemployer2vto2vdiscriminate2vbased2von2vgenetic2vinformation2vor2vto2vr
equest2vgenetic2vinformation2v-2vGenetic2vInformation2vNondiscrimination2vAct2v(GINA)
Refer2vthe2vpatient2vto2vanother2vphysician2vwho2vwill2vperform2vthe2vabortion2v-
2vA2vpregnant2vwoman2vis2vwanting2vto2vhave2van2vabortion.2vHowever,2vas2va2vphysicia
n,2vyou2vhave2vmoral2vbeliefs2vthat2vyou2vwill2vNOT2vperform2van2vabortion.2vWhat2vshou
ld2vyou2vdo?
Residents2vwho2vwant2vto2vmoonlight2vcan,2vand2vthese2vhours2v*will2vcount*2vtoward2vth
e2vmax2vnumber2vof2vweekly2vhours2v*802vhours/week*2v-
2vResident2vmoonlighting2vand2vduty2vhours
162vhour2vshirt2vMAXIMUM2v-
2vFirst2vyears2vresidents2vcan2vwork2vmoonlight2vshift.2vWhat2vis2vthe2vMAX2vhour2vshift2v
he2vor2vshe2vmay2vwork?
Physicians2vare2v*required*2vto2vreport2v*ALL2vmedical2verrors*
-Regardless2vif2vit2vcauses2vharm2vor2vnot2v-2vPhysicians2vreporting2vmedical2verrors
Most2vstates2v*require*2vphysicians2vto2v*alert2vthe2vlaw2venforcement2vauthorities*2vof2v
ANY2vviolence-related2vinjuries2v(i.e.2vstab2vwound,2vgunshot2vwound,2vetc.)2v-
2vPhysician2vreporting2vof2v*violence*
Ensures2vpublic2vaccess2vto2v*emergency2vservices2vregardless2vof2vability2vto2vpay*2v
-Occurs2vat2vMedicare-participating2vhospitals
-
Hospitals2vrequired2vto2vprovide2v*stabilizing2vtreatment*2vfor2vpts2vin2van2vemergency2vs
ituation2v
-Ex:2v*active2vlabor,2vworksite2vinjury*,2vetc.2v-
2vEmergency2vMedical2vTreatment2v&2vLabor2vAct
Intended2vto2v*protect2vthose*2vwho2vprovide2vcare2vto2vthose2vwho2vare2vinjured2vor2vwh
o2vare2vin2vdanger2v*from2vlegal2vliability*2v-2vGood2vSamaritan2vLaws
Provides2va2vminimum2vlevel2vof2vlegal2vliability2vto2vthose2vwho2vvolunteer2v-
2vVolunteer2vProtection2vAct
*YES*
1 EXAM QUESTIONS AND ANSWERS
-Patients2vhave2vthe2vright2vto2vrefuse2vlife-
sustaining2vtreatment2v(including2va2vfeeding2vtube)2v
-Like2vother2vlife-
sustaining2vtreatments,2vartificial2vnutrition2vand2vhydration2vcould2vbe2vstopped2vlegally2
vand2vethically2v-2vCruzan2vvs.2vDirector
Requires,2vthat2vat2vtime2vof2vadmission:
1)2vAsk2vpatients2vif2vthey2vhave2v*Advanced2vDirectives*
2)2vInform2vpatients2vof2vtheir2vrights2vto2vaccept2vor2vrefuse2vmedical2vtreatment2v
3)2vIncorporate2vAdvanced2vDirectives2vinto2vpatient2vmedical2vrecords2v-2vPatient2vSelf-
Determination2vAct
The2vStafford2v*Disaster2vRelief2vand2vEmergency2vAssistance2vAct*
-
Authorizes2vthe2vPresident2vto2vissue2va2vmajor2vdisaster2vor2van2vemergency2vdeclarati
on2vin2vresponse2vto2van2vevent2vthat2voverwhelms2vstate2vor2vlocal2vgovernment
-
If2venacted,2vthe2vlocal2vgovernment2vcan2vhave2vaccess2vto2v*funds2vand2vservices2vfro
m2vFEMA*2v-2vThe2vStafford2vAct
Refer2vthe2vpatient2vto2va2vdifferent2vcardiothoracic2vsurgeon2v-
2vA2vphysician2vis2vunwilling2vto2vperform2vheart2vsurgery2von2va2vpatient2vwith2vHIV.2vW
hat2vis2vyour2vnext2vstep?
Use2v*visual2vaids*
-E.g.2vdrawings,2vvideos,2vetc.2v-
2vLow2vlevels2vof2vliteracy2voften2vlead2vto2v*adverse2vhealth2voutcomes*.2vWhat2vis2vone
2vway2va2vphysician2vmay2vcommunicate2vto2va2vpatient2vwith2vlow2vliteracy2vlevels?
Report2vhim2vto2vstate2vmedical2vboard2vand2vinform2vchief2vof2vstaff,2vetc.2v-
2vA2vfellow2vphysician2vis2vsmelling2vof2valcohol2von2vthe2vjob.2vWhat2vdo2vyou2vdo?
Contract2vb/
t2va2vphysician2vand2va2vHMO2vin2vwhich2va2v*flat2vfee2vper2vpatient*2vis2vpaid2veach2vmo
nth2v-2vCapitation
Reimbursement2von2vthe2vbasis2vof2vexpected2vcost2vof2vthe2vcourse2vof2vtreatment
-
Ex:2v*if2va2vpatient2vunderwent2va2vsurgical2vprocedure,2vthe2ventire2vteam2vis2vcompens
ated2vwith2va2v"bundled2vpayment"2vinstead2vof2vseparate2vpayments2vto2veach2vprovide
r*2v-2vBundled2vpayment
, -Medical2vrecords2vare2v*owned2vby2vthe2vprovider2vthat2vconstructed2vthem*
-
However,2v*patients2vhave2vthe2vright2vto2vsee2vand2vget2va2vcopy2vof2vthese2vrecords*2v-
2vFederal2vPrivacy2vRule
Physician2vwho2vconstructed2vthem2v-2vWho2v*owns*2va2vpatient's2vmedical2vrecords?
Unlawful2vfor2van2vemployer2vto2vdiscriminate2vbased2von2vgenetic2vinformation2vor2vto2vr
equest2vgenetic2vinformation2v-2vGenetic2vInformation2vNondiscrimination2vAct2v(GINA)
Refer2vthe2vpatient2vto2vanother2vphysician2vwho2vwill2vperform2vthe2vabortion2v-
2vA2vpregnant2vwoman2vis2vwanting2vto2vhave2van2vabortion.2vHowever,2vas2va2vphysicia
n,2vyou2vhave2vmoral2vbeliefs2vthat2vyou2vwill2vNOT2vperform2van2vabortion.2vWhat2vshou
ld2vyou2vdo?
Residents2vwho2vwant2vto2vmoonlight2vcan,2vand2vthese2vhours2v*will2vcount*2vtoward2vth
e2vmax2vnumber2vof2vweekly2vhours2v*802vhours/week*2v-
2vResident2vmoonlighting2vand2vduty2vhours
162vhour2vshirt2vMAXIMUM2v-
2vFirst2vyears2vresidents2vcan2vwork2vmoonlight2vshift.2vWhat2vis2vthe2vMAX2vhour2vshift2v
he2vor2vshe2vmay2vwork?
Physicians2vare2v*required*2vto2vreport2v*ALL2vmedical2verrors*
-Regardless2vif2vit2vcauses2vharm2vor2vnot2v-2vPhysicians2vreporting2vmedical2verrors
Most2vstates2v*require*2vphysicians2vto2v*alert2vthe2vlaw2venforcement2vauthorities*2vof2v
ANY2vviolence-related2vinjuries2v(i.e.2vstab2vwound,2vgunshot2vwound,2vetc.)2v-
2vPhysician2vreporting2vof2v*violence*
Ensures2vpublic2vaccess2vto2v*emergency2vservices2vregardless2vof2vability2vto2vpay*2v
-Occurs2vat2vMedicare-participating2vhospitals
-
Hospitals2vrequired2vto2vprovide2v*stabilizing2vtreatment*2vfor2vpts2vin2van2vemergency2vs
ituation2v
-Ex:2v*active2vlabor,2vworksite2vinjury*,2vetc.2v-
2vEmergency2vMedical2vTreatment2v&2vLabor2vAct
Intended2vto2v*protect2vthose*2vwho2vprovide2vcare2vto2vthose2vwho2vare2vinjured2vor2vwh
o2vare2vin2vdanger2v*from2vlegal2vliability*2v-2vGood2vSamaritan2vLaws
Provides2va2vminimum2vlevel2vof2vlegal2vliability2vto2vthose2vwho2vvolunteer2v-
2vVolunteer2vProtection2vAct
*YES*