Notes for first exam
Notes for first exam HADM 3700
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This page Class Notes was uploaded by Kayla Notetaker on Sunday February 28, 2016. The Class Notes belongs to HADM 3700 at Auburn University taught by Debra Armstrong Wright in Fall 2015. Since its upload, it has received 184 views. For similar materials see Health Law and Bioethics in Nursing and Health Sciences at Auburn University.
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Date Created: 02/28/16
August 20 2015 Introduction to the American Legal System Federal and State Law In the US there are two primary systems of government federal system State system There are 3 branches of government in both systems There are also local laws Federal and State Legal Systems Each system has its own set of laws Each system has jurisdiction over certain issues Jurisdiction is the power to hear and decide the case at issue Subject matterjurisdiction Geographic jurisdiction Branches Three Legisative interprets the law Executive branch enforces and administers the law Judicial branch interprets the law Different powers lndependent powers Power to exercise limitations on the authority of the other branches quotchecks and balancesquot Where does the law originate 1 Constitutional Law 2 Statutory Law 3 Administrative Law 4 Common law Sources of Law the US Constitution Main body Amendments Bill of rights What is the relationship between the states and the federal government as established by the US Constitution What s the difference between the 5th and the 14th amendment Sources of Law Statutory Law Passed by legislative body at federal state or local level Federal governmentcongress Bill is submitted to house or senate by a member Assigned to appropriate committee lnvestigated debated possibly amended Reported out favorably or unfavorably After vote identical process in the other house dentica bills must be approved to submit to president Sources of Law Common Law The body of common law in the US is based on English common law Consists of those laws that come from decisions of the judiciary Also called quotcase lawquot The judicial system the courts The role of the courts is to resolve differences or con icts between parties by applying the applicable law to the particular set of facts at Issue The courts determine the rights of the parties involved in the con ict August 25 2015 Common Law 1 Common law of each state is different 2 Decision in one state is not binding on other states 3 Even within a state decisions made by courts with same level of authority are not binding on other courts at that level 4 Decisions made by courts with higher level of authority are binding on lower courts Common Law Principles State decisis common law principledoctrine meaning quotlet the decision stand Courts should look to prior decisions for guidance as to how to decide a case when the facts are the same Precedent a judicial decisions that may be used as a standard in subsequent similar cases Res judicata means the thing is decided refers to that which has been previously acted on or decided by the courts The Facts vs The Law ury trial in a jury trial the jury determines the facts and the judge determines the law Judge trial in a bench trial no jury the judge determines both the law and the facts Public Law vs Private Law Private Law governs relationships between individuals Public law governs relations between individuals and government August 27 2015 Chandler v Huntsville HospitalEqual protection claim Aa Sup Ct holding Ala statute providing immunity and hospitals organized under Articles 346 and 11did not have immunity To analyze an equal protection claim one must use one of three approaches each including a quotdifferent level of scrutinyquot Under the quotrational basisquot test the law is constitutional only if the challenged classi cation is rationally related to serving a legitimate state interest Under the intermediate scrutiny test the challenged law must quotfurther an important government interest by means that are substantially related to that interest Under strict scrutiny test the law must further a compelling governmental interest and must be narrowly tailored to achieve that interest in order to withstand an EP challenge Chapter 3 Query Is there a legally recognized right to healthcare in the US No it depends there is no constitutional quotright to healthcarequot but there are certain legally protected rights to access healthcare Emergency Medical treatment and active labor act hi burton funded facilities medicare and Medicaid insurance policies doctor patient relationship right to treatment without abandonment common law and statutory right to informed consent and self determination constitutiona issues Government Hospitals Access to Care There are hospitals established by the government pursuant to statutory law that often are intended to meet a certain need indigent care services for a speci c geographic area provision of particular specialty care Even here the right to treatment is not unlimited hospital may not provide speci c treatment HillBurton Federal law enacted in 1946 provided federal money to construct or modernize govt and NFP hospitals 1974 hill Burton amended to eiminate termination of obligation after 20 years and enhanced enforcement powers of dept HEW Faciities receiving funds before 1975 were grandfathered in so 20 year limit still in place The affordable care act Poiticaly controversial subject to much disinformation by opponents more insurance reform than healthcare reform main goals increase quality of health care and affordability of health insurance ower the number of uninsured standard coverage no pre existing conditions ACA Legal challenges US Supreme Court decision National Federation of Independent Business v Sebelius challenged individual mandate and Medicaid expansion Struck down mandatory Medicaid expansion uphods the individual mandate under Congress taxing power Leaves most of the ACA intact Congressiona repeal efforts Campaign issue State Government39s Duty to Pay for Care Indigents In most states there is a statutory duty to pay Emergency Care Medicaid and the ACA Prisoners Securing care Paying for care 91015 Was their a duty in 10liver v Brock No 2 O Neill yes statutory voluntary action 3Harper No because they never admitted him into the hospital 4 Chandler yes voluntary action the nurse just like Dr O Neill All of their procedures were not all voluntary What s the difference between O Neill and Oliver What is the duty to exercise reasonable care but what does that really mean To do what a reasonable person would do during then and there What is the duty McGillivray v Rapides Iberia Management Enterprises ENT nursing home resident wandered outside and died from exposure to the elements He had a history of wandering off Ct the standard of care imposed on a nursing home is that of quotreasonable carequot considering the patients mental and physical condition How was the duty created In this case Consensual relationships What is reasonable care In medicalhealth professions it is the applicable quotStandard of Carequot It is what a reasonably prudent practitioner would do under the circumstances Not excellence or superior what the average quali ed practitioner would do Not a good faith standard ln uenced by the school of thoughtmedicine to which the defendant doctor adheres Who is this Reasonable Prudent Person Fictitious person The community ideal of reasonable behavior Should account for the personal characteristics of the individual triangle Educann Training Specialization Trend a national standard vs a community standard Why Is there ever a duty to third parties Woman who is pregnant Mother who has given birth Patient stricken w contagious condition Patient who has a non contagious condition who was subject to same environment Third parties who may be harmed by psychiatric patients Doctor hired by employer to examine employees Caveat an attempt to terminate the relationship may be considered abandonment if not done properly Doctor s Duty in terminating the physician is entitled to terminate the relationship only after he has given the patient reasonable notice and an opportunity to secure the services of another competent physician Elements BREACH The failure to conform to or the departure from a required standard of care Commission vs omission Sometimes the standard of care is a professional standard and sometimes common sense Alabama LawPlaintiff s Burden In any action for injury or damages or wrongful death whether in contract or in tort against a health care provider for breach of the standard of care the plaintiff shall have the burden of providing 1 by substantial evidence 2 that the health care provider failed to exercise such reasonable care skill and diligence 3 as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case Providing the Standard of Care by 1 Expert Witnesses Qualifications Crossing professions in a wrong prescription case is it permissible to use a pharmacist to prove a doctor ordered the wrong medicine quotConspiracy of silencequot vs quothired gunsquot Experts for Defendants Alabama Law Exceptions to Expert Testimony Rule copy quote and bullet points here Elements CAUSATION njury was caused by defendant s conduct rather than something else Moreover the defendant s breach of the standard of care must be the proximate cause of the plaintiff s cause Cases on 91715 lvy v Carraway retained foreign object and resipsa had exclusive control Foster v Charter suicide case who was sued Dr D Charter Med Corp USA Hosp Breland v Rich Dr Rich Vision Partners Dr Eyal USA Defenses to Negligence Claim 1 Contributory Negligence a Negligence by plaintiff 2 Comparative Negligence negigence by plaintiff 3 res judicata ct barred ca against nurses bc hospital had been sued Why 4 stature of limitations 5immunity governmental bodies are typically immune 6 release Intentional Torts Chapter 4 assault the threat of an offensive touching coupled with the apparent ability to make good on the threat offensive includes insulting provocative physically harmful without consent paintiff must have knowledge of the threat and actually feel threatened defendant must be able to carry out the threat no touching is required if touching occurs it is battery battery Health Care Fraud Examples Billing for trade name drugs but issuing generic Office visits double billing upcoding biing for services not rendered accepting referral fees