LEGAL ISSUES FOR COMLEX LEVEL 1
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
-Ex: *active labor, worksite injury*, etc.
Good Samaritan Laws - Answer -Intended to *protect those* who provide care to those
who are injured or who are in danger *from legal liability*
Volunteer Protection Act - Answer -Provides a minimum level of legal liability to those
who volunteer
A pregnant pt refuses both HIV testing and C-section, even if it will potentially save the
baby's life. Can she do this? - Answer -*YES*
-Even though either could protect the baby, the pt *still has the right to refuse either*
-Pregnant pt has the same rights as a non-pregnant pt. She can refuse *any form of
treatment*
List of diseases that need to be reported to the CDC - Answer -1) Chlamydia
2) Gonorrhea
3) Hepatitis A,B,C
4) HIV
5) Influenza-associated pediatric mortality
6) Measles
7) Mumps
8) Rubella
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
-Ex: *active labor, worksite injury*, etc.
Good Samaritan Laws - Answer -Intended to *protect those* who provide care to those
who are injured or who are in danger *from legal liability*
Volunteer Protection Act - Answer -Provides a minimum level of legal liability to those
who volunteer
A pregnant pt refuses both HIV testing and C-section, even if it will potentially save the
baby's life. Can she do this? - Answer -*YES*
-Even though either could protect the baby, the pt *still has the right to refuse either*
-Pregnant pt has the same rights as a non-pregnant pt. She can refuse *any form of
treatment*
List of diseases that need to be reported to the CDC - Answer -1) Chlamydia
2) Gonorrhea
3) Hepatitis A,B,C
4) HIV
5) Influenza-associated pediatric mortality
6) Measles
7) Mumps
8) Rubella
