Discussion Post II

Unit II Overview

 Chapter 4 This chapter explains that there is a difference as to the severity of misdemeanor and felony crimes and that intent is the difference as to whether the behavior is labeled criminal or civil, intentional or negligent. You will learn that if a patient is injured from an act performed with premeditation and malice, it is determined that the defendant is a criminal; if a patient is injured because of an aggressive act by the defendant carried through without premeditation or malice, the defendant is accused of an intentional tort; and, if a patient’s injury simply happened, the defendant is alleged to be negligent. This chapter discusses how statutes are laws made by legislatures.

Statutes define which acts are criminal felonies or misdemeanors and which acts are civil torts. In addition, there are common law crimes: murder, manslaughter, rape, fraud, sodomy, robbery, larceny, arson, burglary, and mayhem. Most cases in medical malpractice fall within the civil law of torts. It will be important for You to understand that civil actions differ from criminal actions in that in a civil action, one party is suing the other party for damages because of an injury committed by the other party.

These are private, civil claims rather than public claims filed by the state against an individual. And, finally, you will learn that torts include the intentional torts of assault and battery, false imprisonment, invasion of privacy, defamation of character, intentional infliction of emotional distress, and negligence, and the defenses available to defendants accused of intentionally injuring patients include privilege, consent, self-defense, the defense of others, and error.

These resources provide additional real-life stories about crimes that took place in medical offices:

Hewlett, M. (2014, June 25). Employee at doctor’s office accused of stealing prescriptions. Winston-Salem Journal. Retrieved from 33Thttp://www.journalnow.com/news/crime/employee-at-doctor-s-office-accused-of- stealing-prescriptions/article_48d3362c-fc9a-11e3-ada7-0017a43b2370.html33T

Department of Justice, U.S. Attorney’s Office, Central District of California. (2016, August 29). Two doctors faced with federal charges of illegally writing prescriptions for addictive narcotics connected to gang’s drug trafficking. Press release. Retrieved from 33Thttps://www.justice.gov/usao-cdca/pr/two-doctors-face-federal- charges-illegally-writing-prescriptions-addictive-narcotics33T

Department of Justice, U.S. Attorney’s Office, Central District of California. (2017, April 4). Gresham medical practice manager sentenced to prison for false billing and tax fraud. Press release. Retrieved from 33Thttps://www.justice.gov/usao-

or/pr/gresham-medical-practice-manager-sentenced-prison-false-billing-and-tax- fraud33T

 Chapter 5

Contracts govern almost everything we do in modern life and in the workplace. This chapter explains that a contract is a voluntary agreement between two or more parties that creates, modifies, or destroys a legal relationship. The chapter also discusses that employees are the agents of their employers and, under the law of agency, are able to contract for the principal; contracts made by an authorized agent are valid and enforceable; and, the principal is usually held responsible for any damages. In the contract between physician and patient, the patient may desire to change physicians before treatment has been completed or the physician may desire to refuse further treatment. This chapter explains how the discharged physician should memorialize the circumstances and conditions of the discharge in a certified letter sent to the patient. If a physician terminates the relationship, further provisions must be made for the care of the patient or the physician can be found to have abandoned the patient. And, finally, another type of contract discussed in this chapter is the comprehensive health care advance directive, including the provisions of a living will and a health care power of attorney, among others. These resources provide additional information about minors making health care decisions: • Jackson, M. K., Burns, K. K., & Richter, M. S. (2014, June 26). Confidentiality and treatment decisions of minor clients: A health care professional’s dilemma & policy makers challenge. Singerplus, 3. Retrieved from 33Thttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4094761/33T The American Civil Liberties Union of Ohio. (2014). Your health: A guide for teens and the law (7th ed.). Retrieved from 33Thttp://www.acluohio.org/wp- content/uploads/2014/06/TeenHealthGuide.pdf33T

 Chapter 6

When one person hurts another without intent, the legal cause of action is negligence. This chapter explains that negligence by a professional is known as malpractice. The difference between negligence and malpractice is the standard of care required of the injuring party. You will learn that if the defendant is a layperson who is held to the reasonable person standard, the act (or failure to act) is considered “negligence”; and, if the inflicting party is a professional who is held to the standard of a professional with prescribed education, training, and experience, the act (or failure to act) is considered “malpractice.”

Medical assistants are hybrid health care professionals. You will learn that receptionist and secretarial duties are categorized under a layperson standard, and clinical tasks may be labeled professional. In either case, the responsibilities extend

the effectiveness of a physician and are delegated by the employer. It will be of great interest to you that some malpractice lawsuits can be avoided simply with better communication. This chapter explains that informed consent requires that a physician communicate information to a patient regarding the treatment he or she is about to receive.

The patient has a right to refuse treatment; therefore, the physician must provide enough information to allow the patient to make an informed decision. Only a physician can accept consent from a patient. It is important for you to know that the medical assistant performs the duties of preparing and filing the consent forms, as well as listening and observing to determine whether the patient understood and accepted the proposed treatment plan. Medical malpractice insurance is available to cover monetary awards against a defendant. Medical assistants may or may not be covered under a physician’s insurance.

You will want to know that insurance is available for the protection of a medical assistant. This chapter enumerates five defenses available to a defendant in a medical malpractice cause of action: tolling of the statute of limitations, contributory negligence, comparative negligence, assumption of risk, and emergency. And, finally, you will learn that different standards of responsibility are required for trespassers, licensees, and invitees. The standard of property maintenance for a trespasser is reasonable care. The standard of maintenance increases for licensees. The highest standard of maintenance is due to invitees and requires affirmative behavior on the part of the landlord or occupier to warn the invitee about dangerous conditions or activities that are known or could be discovered with reasonable effort.