Law and Ethics Study Guide for the Medical Assistant test

Advance Directives

Advance directives are put into place if patients are unable to make medical decisions for themselves. This can be in the form of a living will or designated POA.

Living Will: A living will can be made by a patient while in an oriented state of mind. Medical personnel can refer to the will when a patient is unable to make decisions in order to follow the person’s wishes.

Medical Durable Power of Attorney: Some people prefer to legally appoint another person to make medical decisions for them.

Patient Self-Determination Act (PSDA): This was put in place to ensure that healthcare institutions don’t discriminate against individuals without an advanced directive, inquire about advanced directives on admission, provide staff education, and provide patient summary and information about advanced directives on admission.

MOLST form: This form helps determine treatment preferences of patients concerning life-sustaining measures.

Uniform Anatomical Gift Act: This sets a framework for the gifting of body organs or other tissues for education, science, or medicine.

Confidentiality

Maintaining patient confidentiality is a must. A breach in patient confidentiality is a violation of HIPAA laws, and it is punishable by fine, jail time, or loss of licensure.

Record-keeping: Record keeping involves access to patient information. Information should be provided only to those in direct care of a patient or to those auditing patient charts.

Disclosure of Information: Information should only be disclosed with patient permission and only to those involved in medical care of the patient. Examples of secure information, or PHI, are mental health diagnoses and drug/alcohol treatment information. The sharing of some information requires a patient release form to be signed.

Consent for Examinations and Treatment: Types of consent include informed consent, implied consent, and expressed consent. Patients that are unable to give consent for a procedure may have a POA or family member give consent. Emancipated minors are no longer under care of a parent and, therefore, may provide their own consent.

Other Patient Rights

Patients are provided a document with their list of rights upon admission to the hospital. Typically, facilities have patients sign a form stating that their rights were received.

The Patient Care Partnership: This agreement informs patients of what they should expect during their hospital stay concerning patient rights and responsibilities.

A patient’s Bill of Rights (AHA): This was replaced by the patient care partnership brochure, but informs patients of their rights during hospital stay.

Terminating Patient Care Protocol: A patient may end care by a physician at any time. However, when terminating a patient from a physician’s care, there must be a definite cause. Reasonable time must be allowed for the patient to find another healthcare provider.

Emergency Care

There are laws that cover medical personnel who perform emergency care on patients. Emergency care can be CPR or treatment of an injury, whether in the hospital or at another location.

Good Samaritan Law: Good Samaritan law protects a healthcare provider who treats an emergent injury or performs CPR on a person.

First Aid: First Aid consists of care of an injury such as cuts or burns. First Aid kits are usually equipped with gauze, scissors, stitch kits, antibiotic ointments, and skin cleanser. Maintain your scope of practice when performing first aid.

Mandatory Reporting

There are laws requiring medical personnel to report certain conditions and injuries to authorities. It is important to know about these guidelines and procedures and make sure you do your part to see that the appropriate actions are taken.

Public Health Statutes: These play a significant role in reducing public illness and communicable diseases, such as TB. They mandate that records or vital statistics be kept on health-related events. Through these statutes, health departments are required to offer vaccinations against dangerous illnesses.

Reporting Laws: These laws require everyone, especially members of the healthcare team, to be responsible for reporting signs of child and elder abuse, as well as domestic abuse and violence of any kind. These include violent wounds or gunshots, stabbings, and all other forms of violence or abuse.

Miscellaneous Organizations and Acts of Medical Law

While working in any medical practice, you will hear many acronyms and reference to various laws or “acts” that govern legal medical practice. Be familiar with their abbreviations and meanings as they impact your duties. Here is an alphabetical list of some of the most important ones.

Affordable Care Act (ACA): Designed to reform healthcare and provide affordable health insurance to all citizens, the ACA also helps to curb the cost of healthcare spending.

Amendments Act (ADAAA): This includes nondiscrimination laws put into place for people with disabilities. It broadened the definition of “disability,” making more disabled Americans eligible for government assistance.

Americans with Disabilities Act (ADA): The ADA prohibits discrimination of disabled peoples by places of employment, public transportation, and government assistance.

Centers for Disease Control (CDC): This is a national public health institute in the U.S. responsible for developing and implementing disease control and prevention.

Clinical Laboratory Improvement Amendments (CLIA-1988, etc.): This regulates standards applied to all human medical laboratory testing in the U.S., with the exception of clinical trials. It is designed to ensure accuracy, reliability, and timeliness of lab testing.

Centers for Medicare/Medicaid Services (CMS): This is a federal U.S. agency that is responsible for managing Medicare services, as well as medicaid and other government health assistance programs.

Commission on Office Laboratory Accreditation (COLA): COLA is an accreditation company that promotes excellence and quality care in laboratories and helps to ensure that CLIA standards are met.

Drug Enforcement Agency (DEA) and the Controlled Substances Act of 1970: This is a drug policy under which controlled substances, such as narcotics and antidepressants, are regulated and whose regulations are enforced by the DEA.

Fair Debt Collection Practices Act: Developed by the FTC, this act protects citizens from abusive debt collection activity, such as falsifying identities or otherwise deceiving people in order to collect a debt.

Food and Drug Administration (FDA): The FDA is a federal agency responsible for promoting public health by regulating and controlling production of food products, dietary supplements, prescriptions, vaccines, etc.

Health Insurance Portability and Accountability Act (HIPAA): The HIPAA provides data safety and protection of medical records and patient health information.

Joint Commission on Medical Staff Standards (JC): This accredits healthcare organizations and programs with the purpose of improving healthcare and making sure organizations maintain standards of care.

National Committee for Quality Assurance (NCQA): NCQA is a private organization that reviews and approves components of medical practice, awarding a seal when its standards are met.

Nondiscrimination Act of 2008 (GINA-Genetic Information): This act protects individuals from discrimination by insurance companies or places of employment due to a person’s genetic makeup.

Occupational Safety and Health Administration (OSHA): Formed to ensure safe and healthful work environments for employees, OSHA provides training and education regarding safety and injury prevention.

Truth in Lending Act of 1968 (Regulation Z): This protects consumers against inaccurate and unfair credit billing and credit card practices.