Evolve Resources for Legal and

Ethical Issues for Health Professions

4th edition

The United States

Legal System
Chapter 1
Lesson 1.1
The United States Legal System 2

1. Describe the differences among the executive,

judiciary, and legislative branches in the United
States.
2. Define law.
3. Identify specific sources of law.
4. Explain different types of law in the United
States.
5. Explain key laws affecting healthcare
professionals.
6. Demonstrate understanding of the various levels
of the United States court system.
Branches of Government (1 of 4) 3

• Three branches of government

• Legislative
• Executive
• Judicial
Branches of Government (2 of 4) 4

• Legislative branch
• House of Representatives and Senate
• Develops statutory(written) law
which means laws that impact all
citizens. Consists of the House of
Representatives and the Senate of
the United States. Example of a
law that impacts all citizens of the
United States is the Social Security
Act of 1965.
Branches of Government (3 of 4) 5

• Executive branch

• Consists of the President and or State

Governor who proposes laws, vetoes
laws proposed by the legislature, and
enforces the laws. They also propose
and establish agencies. OSHA
Occupational Safety and Health
Administration rules apply to
workplaces and healthcare
 Branches of Government (4 of 4) 6

• Judicial system
• Develops and interprets the law. It is also the
source of common law, which is the law that
develops from the decisions made by the courts.
Previous decisions are considered precedent
(Case Law)
• *STARE DECISIS*, which means to “stand by
things decided” which means to adhere to
decided cases for similar cases in the future.
• Each branch serves as a Check and Balance for
the other branches of government so no one
branch can become more powerful then the
other. For ex, legislative branch can override the
veto of the President or Governor.
Constitution and Bill of Rights 7

• Supreme law of the land

• Established shared powers between federal
and state governments
• Each state has its own constitution
• States have the power to regulate healthcare
Twenty Seven Amendments to the
constitution
• Bill of Rights
• Amendment 1—Freedoms, petitions, assembly
• Amendment 2—Right to bear arms
• Amendment 3—Quartering of soldiers
• Amendment 4—Search and arrest
• Amendment 5—Rights in criminal cases
• Amendment 6—Right to a fair trial
• Amendment 7—Rights in civil cases
• Amendment 8—Bail, fines, punishment
• Amendment 9—Rights retained by the People
• Amendment 10—States' rights
• Other Amendments
• Amendment 11—Lawsuits against states
• Amendment 12—Presidential elections
• Amendment 13—Abolition of slavery
• Amendment 14—Civil rights
• Amendment 15—Black suffrage
• Amendment 16—Income taxes
• Amendment 17—Senatorial elections
• Amendment 18—Prohibition of liquor
• Amendment 19—Women's suffrage
• Amendment 20—Terms of office
• Amendment 21—Repeal of prohibition
• Amendment 22—Term limits for the Presidency
• Amendment 23—Washington, DC, suffrage
• Amendment 24—Abolition of poll taxes
• Amendment 25—Presidential succession
• Amendment 26—18-year-old suffrage
• Amendment 27—Congressional pay raises Living Document
Checks and Balances 9

• Each branch serves as check and balance for

other branches
• Legislature can override veto
• Executive branch can propose legislative action or
veto, appoint, or nominate individuals to certain
courts
• Courts interpret laws and can declare laws
• Legislature can declare laws unconstitutional
What Is the Law? (1 of 2) 10

• Law is the foundation of statues, rules, and

regulations that govern people. It provides
order in resolving conflicts among individuals,
corporations, states, and other entities.
• Goal of law is to resolve disputes without
violence and to protect the health, safety, and
welfare of individuals.
• Law is constantly evolving to meet the changes
of society. For example, laws covering same
sex marriages or the right to drive while
texting.
What Is the Law? (2 of 2) 11

• Medical ethics: judgment healthcare providers

use
• Helps determine what should or should not be done
• Not all unethical acts are illegal
• Medical law: responsibilities of healthcare
provider and rights of the patient
Sources of Law (1 of 5) 12

• Four primary sources:

• Constitutional
• Statutory
• Administrative
• Common (or case) law
Sources of Law (2 of 5) 13

• Constitutional Law
• Specifically addresses the relationship between
individuals and the government
• Federal Constitution takes precedence over State
constitutions
Sources of Law (3 of 5) 14

• Statutory Laws
• Written by Federal or State legislature
• Local laws are called ordinances
Sources of Law (4 of 5) 15

• Administrative Law
• Rules and law made, adjudicated, prosecuted, and
enforced by administrative agencies
• May be at the State or Federal level
Sources of Law (5 of 5) 16

• Common law
• Develops from precedents: decisions previously
made in courts
• State courts make decisions regarding civil and
criminal cases
• Adopted by all states, except Louisiana
• Civil code
• Law is created by legislature
• Written set of rules and regulations
• Not case-by-case analysis and interpretation
• Adopted by Louisiana
 Sources of law

• Foundation of the law of the land is the

Constitution. Grants certain powers to the
federal government. If power is not granted to
the federal government, it is reserved to the
state government.
• Constitution speaks about the separation of
powers, responsibilities of federal and state
governments.
• Constitution and the bill of rights guarantee
certain fundament freedoms to individuals. It
provides fundamental rights to privacy, equal
protection, freedom of speech, and religion
Types of Law 18

• Criminal wrong
• Violates criminal statutes
• Civil wrong
• Often called a tort
• Causes harm to a person or person’s property
Criminal Law 19

• Violations against society based on criminal

statutes or code
• Misdemeanors are lesser crimes
• Felonies are serious crimes punishable by large
fines and/or imprisonment
• May be grounds for revoking a license in healthcare
• Assault and battery
Civil Law 20

• Encompasses contract issues, intentional tort,

negligence, malpractice, labor, and privacy
• Most healthcare cases are for negligence or
malpractice
• Remedies are almost always monetary
• Attempt to make the person “whole again”
Torts 21

• Private, civil, or constitutional wrong or injury

• Negligence
• Duty, dereliction of duty, direct cause,
harm/damages
• Malpractice
• Type of negligence
• Requires proof of breach of standard of care
• Standard of care: type and level of care an ordinary,
prudent, health care professional would provide
 LATIN TERMS

• Certain terms in law come from Latin. The term tort comes from Latin
meaning to twist or to be twisted, or to wrest aside. Tort is a private
or civil wrong or injury
• Respondeat superior means “Let the master answer” If a nursing
assistant is sued for actions that harm a patient, her employer can also
be sued. The employer can be sued on that basis that the employer
had control, or should have had control over the actions of the nursing
assistant
• Res ipsa loquitur- “Let the thing speak for itself” For example, if a
patient has to have his right hand amputated and the doctor amputates
the patient’s left hand, let the thing speak for itself. Negligence does
not have to be proven. Another example is a person has surgery to
correct a hernia, but when he awakes, his arm is paralyzed. Because he
had no control over his actions during surgery and a paralyzed arm is
not an expected outcome, then the law presumes that the paralysis
had to be caused by the negligence of the doctor, surgical technician,
operating room nurse, surgeon, and anesthesiologist
• Stare Decisis- “To stand by things decided” It allows courts to refer to
previously decided similar cases and to apply same rules and principles.
(CASE LAW)(COMMON LAW)
COURT CASES

• To try a specific case, the court must have

jurisdiction which means authority given by law to a
court to try cases.
• Jurisdiction can be In personam or In rem (Latin
Terms)

In personam: The court

has jurisdiction or
control over the person.
In rem: The court has
jurisdiction or control
over the thing or
property.
 Other terms

• Negligence is a tort. It is the cornerstone of a

malpractice case. Malpractice requires proof
of a breach of standard of care, and the
breach must cause damage or harm.
• Malpractice is a term used to describe the
negligence of professionals, including
healthcare providers
• Statute of limitations-Requires that a case be
brought within a specific time limit
The Court System 25

• Trial courts
• Appellate (appeals) courts
• State supreme court
• Most medical malpractice suits are tried to
state courts
State Trial Courts (1 of 3) 26

• Major trial court

• Medical malpractice, elder abuse, negligence, and
major crimes
• Specific courts may be specialized
• Court must have jurisdiction
• In personam: court has jurisdiction over the person
• In rem: court has jurisdiction over the property or
thing itself
State Trial Courts (2 of 3) 27

• Responsibility rests on the plaintiff to prove

their case
• Exception: res ipsa loquitur
• Clear evidence of negligence
• Plaintiff: person or entity who brings the suit
• Defendant: person or entity who is sued and
defending against allegations
State Trial Courts (3 of 3) 28

• Pretrial discovery
• Interrogatories
• Requests for production of documents
• Admissions of fact
Courts of Appeal 29

• Both state and federal appellate courts

• Appeal may only raise an issue of law
• Facts cannot be appealed
• Appellate decision is binding if no further
appeal is taken
State Supreme Courts 30

• Top court of the state

• Does not act on most cases
• Parties have no recourse for further review
• Writ of certiorari can be filed with U.S. Supreme
Court
• Court must choose to hear case
Federal District Court System 31

• Cases concerning federal, Constitutional law

are filed and tried in federal district court
• 94 judicial districts organized into 12 regional
circuits
• Each circuit has a U.S. Court of Appeals
The U.S. Supreme Court (1 of 2) 32

• Justices choose cases

• Appealing party files writ of certiorari
• Cases must involve a question of substantial
importance
The U.S. Supreme Court (2 of 2) 33

• Justices choose cases

• Appealing party files writ of certiorari
• Cases must involve a question of substantial
importance
Questions? 34