Professional Documents
Culture Documents
FIFTH EDITION
The Physician-Patient
Relationship
CHAPTER 5
Journal Topic: What rights does
a physician have when
practicing medicine and
when accepting a patient.
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Learning Objectives
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Physician–Patient Relationship
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Physician's Rights
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Physician's Responsibilities
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Physician's Duties
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Professional Practice
Responsibilities
• Duties during a medical emergency
Cannot ethically or legally turn away
patient in an emergency situation
If unable to treat patient, then must call
for emergency assistance
Patients cannot be turned away if
indigent or uninsured
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty to Treat Indigent Patients
• "Dumping crisis"
EMTALA
Requires patient stabilization in an
emergency
• Physician has right to select which
patients to treat
• Physician does not have right to drop or
abandon patients once treatment is
agreed upon
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty Not to Abandon a Patient
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Noncompliant and Incompetent
Patients
• Noncompliant
Fails or refuses to cooperate
• Incompetent
Unable to provide for own needs
Status decided by court of law
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty to Treat Patients with AIDS
• Ethical considerations
Persuade patient to inform his or her
partner(s)
Notify authorities if concerned that
patient will not inform others
As last resort, notify patient's partner(s)
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Exposure of Health Care Workers
to Patient's Blood
• A 0.3 percent risk of contracting HIV
after blood exposure, according to the
CDC
• HIV testing of patient's blood allowed in
some states
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Restrictions on HIV-Infected
Healthcare Workers
• Various recommendations, but no rules
AMA
American Academy of Orthopedic
Surgeons
Federation of State Medical Boards
• Strongest statement
• Recommends names of HIV-infected
healthcare workers be reported
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty to Properly Identify Patients
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty to Respect Confidentiality
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Duty to Tell the Truth
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Patient's Rights
• Right to confidentiality
Privileged communication
• Right to give informed consent
• Right to privacy
• Right to be informed of advantages and
potential risks of treatment
• Right to refuse treatment
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Confidentiality
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Patient Self-Determination Acts
• Advanced directive
Living will
• "Do Not Resuscitate" order
Durable power of attorney
Uniform Anatomical Gift Act
• Patient may revoke these documents
• Family may consent on the deceased
patient's behalf
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Definition of Minors
• Minor
Person under the age of maturity (18 in
most states)
• In Loco parentis
Person assigned by court to stand in
place of parents
• Parens patriae
State takes over care for minor
• Mature minor
Person in mid to late teens who, for
health care purposes, is considered
mature enough to comprehend
physician recommendations and give
informed consent
• Emancipated minor
Person in mid to late teens who legally
lives outside parents' or guardian's
control
Proof should be included in medical
record
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
The Patient's Responsibilities
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Consent
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Doctrine of Informed Consent
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Implied Consent
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Exceptions to Consent
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
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Refusal to Grant Consent
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved
Role of Health Care Consumer
• Do not self-medicate
• Be honest with physician
• Assist physician in prevention of
medical errors
Medical Law and Ethics, Fifth Edition Copyright © 2016, 2012, 2009 by Pearson Education, Inc.
Bonnie F. Fremgen All Rights Reserved