LEGAL/ETHICAL ISS/HLTH CR PF

(10806)

ASSIGNMENT 1 DUE 6-6-16

Using the file entitled "Healthcare Ethics" complete the following course

assignment Located under files)

Comprehensively answer each of the below questions. Include APA format,

references and deductions from current research. ((550 words)

1. Under HIPAA, what rights do patients have regarding confidentiality and

ownership of their medical records? When does a patient give up the right to
confidentiality? Research an incidence that set precedence to this.
2. Are health-care professionals legally liable for all unsatisfactory
outcomes?
3. What are two scenarios that would void a contract between physician and
patient?
4. What is an example of a bioethical issue? Give two opposing views of the
issue.
5. What are two different situations that could turn into a malpractice or
abandonment suit if committed by physicians or their medical staff members?
6. Describe implied consent and two ways that a patient can accept
treatment by implied consent.

Case Study 1 Due June 8th (850 words)

Answer the preceding questions, respond accordingly to your classmates

answers

Our Pregnant Daughter Didn’t Want This...

 http://www.practicalbioethics.org/case-studies-our-pregnant-daughter-didn-t-
want-this

By Tarris Rosell, PhD, DMin

LEGAL/ETHICAL ISS/HLTH CR PF
(10806)
 

Twenty-nine year old Janet and her husband Jack were driving home from her
ob-gyn appointment when tragedy struck. Another driver, elderly and distracted
by an incoming text message, ran a red light and T-boned Janet and Jack’s Mini-
Cooper. Both young people sustained severe injuries.   Jack died enroute to the
hospital. Janet survives, having escaped injury except to her head; but that was
unfortunately massive. Her physicians now say, a month after the accident, that
the prognosis is grim. The best one could hope for—or perhaps the worst—is
continuation for some time in a persistent vegetative state.   Just before leaving
the doctor’s office, Janet had sent a jubilant text message to her parents.
“Guess what?! We’re pregnant!!! ”   So Janet was pregnant—and prescient.
Unlike most young adults, Janet had thought about mortality in advance of this
accident. She is, or was, a nurse. She had gone to continuing education
workshops about end of life care and advance care planning. Janet then had
completed her own advance directives some months ago, naming Jack as her
primary agent and durable power of attorney for healthcare decisions. She
named her parents as secondary agents.   Janet also had completed, with
notarized signature, a healthcare treatment directive. Among her directives was
a clear, handwritten statement about life prolongation if she were, somehow, “to
end up in anything like PVS, from which I am not apt to recover.” Janet had
written that, in such a condition, “I do NOT want my life to be extended by
means of medically assisted nutrition and hydration, ventilator, or other life
support.”   And then it happened.   With Jack gone, treatment decisions are left
up to Janet’s parents. They both are thoughtful people, healthcare professionals
also, who take very seriously their difficult responsibility of acting as surrogates
on Janet’s behalf. After consulting her physicians, other family members, and
even their priest, a decision is made to stop everything except palliative care.
Janet’s parents had received a copy of their daughter’s advance directives, and
they have determined that this is what she would have wanted, what in fact she
had conveyed with such tragic prescience. Plans are made to transfer Janet to a
hospice unit in another part of the hospital. It would take place the following
day.   That evening, a resident physician notices in the patient’s chart that
Janet is pregnant. Probably about nine weeks, it appears. He wonders if this
matters, legally or ethically or religiously, for his patient’s transfer to hospice,
especially when Janet is not imminently dying otherwise. The resident does a bit
of online research and learns that in the State of Kansas, a woman’s healthcare
directives about “withholding or withdrawal of life-sustaining procedures in a
LEGAL/ETHICAL ISS/HLTH CR PF
(10806)
terminal condition” may not legally be in effect while pregnant.   “The
declaration of a qualified patient diagnosed as pregnant by the attending
physician shall have no effect during the course of the qualified patient’s
pregnancy” (KSA 65-28, 103, (4)B). A note in the patient’s medical record the
next morning references this statute, with a question about how it potentially
impacts the impending transfer to hospice care. When the attending physician
reads the note, she calls Janet’s parents and says hesitatingly, “We have a bit of
a problem here. It appears we may need some legal assistance, perhaps an
ethics consultation, and must postpone Janet’s transfer of care.” The doctor
explains further what her young resident colleague had discovered, and
questioned.   The parents had spent a sleepless night anticipating today. It
would be the hardest thing they’ve ever done, and yet the right thing in keeping
with their daughter’s wishes. Now they can’t believe what they’re hearing.  
Postpone? Ineffective advance directives? Continued life support? Did the doctor
really say that? That there may even need to be surgery for a feeding tube and a
tracheostomy while this legal glitch is being discussed and gets clarified?  
Almost in unison, Janet’s mother and father protest, “But, Doctor, our daughter
didn’t want this!”

Questions for discussion

1. What should be done now for Janet and her parents, and on what grounds?

2. What values underlie the statute making a pregnant woman’s healthcare

treatment declarations of “no effect” while pregnant?

3. Do you agree or disagree with this statute, and on what grounds?

4. What decision would you be making as Janet’s parental surrogate, and why?

5. Ought someone to be a surrogate for Janet’s fetus, or not? And why or why
not?

Discussion Topic 1 DUE 10-june-16

Discuss the ethical implications in genetics and human reproduction. What are
the current arguments supporting or refuting the idea. Summarize your thoughts
LEGAL/ETHICAL ISS/HLTH CR PF
(10806)
in a manner either supporting its use or refuting its use in healthcare in a
concise page. Please respond to a classmates post. Support your argument with
research. (300 Words)

ASSIGNMENT 2 DUE 11-June-16

Comprehensively answer each of the below questions. Include APA format,
references and deductions from current research.

Research a piece of legislation on a health-care issue or practice, either a bill

passed in the last 5 years or a bill currently being considered in Washington.
What impact has this bill had or might this bill have on the medical profession in
terms of ethics? Summarize your findings in a one- to two-page report.

Discussion Topic 2 Due 12-June-16

Ethical issues in health care policy (350 words)

What ethical obligation or responsibility does society and government have for
health care? Should all people have equal access to health care regardless of
their ability to pay or their social status? Can health-care rationing be ethically
justified? If not, what about those situations in which failure to
ration bankrupts health care systems or hospitals? What are fair procedures
for managed care systems? Answer each posed question backing each with
research.