School of Health and Environmental

Studies Bachelor in Health Administration

Ethical and Legal Aspects of Healthcare

(HADM208)
Spring 2025

Lecture 2-Introduction to Health Care Law

Medical Practice Acts

• Establish state medical boards

• Provide baseline for practice of medicine
• Determine prerequisites for licensure
• Forbid practice of medicine without a license
• Specify conditions for renewal, suspension, and cancellation of
licenses
• Vary from state to state
Licensure of Physician

• Examination
• National Board Medical Examination (N B M E)
• Federal Licensing Examination (F L E X)
• U.S. Medical Licensing Examination (U S M L E)
• Endorsement: An approval or sanction
• Reciprocity
• Cooperation of one state in granting license to practice
medicine to a physician already licensed in another state
• Registration
• Occurs annually or biannually
• Physicians must pay a fee
• Physicians are required to complete 75 hours of
CME in a three-year period
When Valid License Is Not Needed by a
Physician
• When employed by federal medical facilities (but must be a
licensed physician to practice medicine in some states)
• In an emergency
• While establishing residency
• When engaged solely in research
Revocation and Suspension

• Unprofessional conduct
• Falsifying records, gross immorality
• Commission of a crime
• Medicare/Medicaid fraud, rape, murder,
larceny, narcotics conviction
• Personal incapacity
• Physical or mental incapacity
Licensure and Certification of Allied
Health Professionals

• Licensure
• Graduate from accredited school and pass national exam
of competency (a document that is often legally required in order
to work in certain industries)
• Certification
• Meet standards set by accreditation body and
pass national exam of competency (Certification typically
documents your skill in a particular field).
Accreditation

• Voluntary request of official review by accrediting

agency
• Examine policy and procedures of agency
• Must demonstrate that the institution maintains
high standards
• Examples:
• The Joint Commission
Standard of Care
• Ordinary skill and care that must be used by
medical practitioners
• Must provide same knowledge, care, and skill that
similarly trained physician and/or medical
professional would provide under same
circumstances
• Perform as “reasonable and prudent” person
would perform
 Case Study: The Impact of
Healthcare Law on Patient Rights
• Scenario:
Mr. Ahmed, a 55-year-old patient, underwent a knee replacement surgery at a private hospital.
During the procedure, the surgeon performed an unexpected ligament repair without prior
discussion or consent. Although the repair was successful, Mr. Ahmed faced prolonged recovery
and additional costs, leading to a legal complaint against the hospital and surgeon.
• Key Issues
1.Violation of Informed Consent:
1. Informed consent laws require healthcare providers to inform patients about procedures, risks,
and alternatives. The ligament repair was not discussed, violating Mr. Ahmed’s autonomy.
2.Legal Implications:
1. The surgeon justified the decision under the "emergency exception," which allows bypassing
consent in life-threatening situations. However, the court ruled the repair was not urgent and
could have been postponed.
2. The hospital was ordered to compensate Mr. Ahmed, and the surgeon faced disciplinary
actions.
Case-study
• Discussion Questions
1.Should surgeons have the authority to make decisions without
patient consent in non-life-threatening scenarios? Why or why not?
2.How can healthcare organizations improve informed consent
processes to avoid similar cases?
3.What role does legal education play in minimizing errors and
enhancing patient care?
Physicians Are…

• Not obligated to treat everyone in case of

emergency
• Expected to use reasonable, ordinary skill and care
(not extraordinary)
• Expected to exhaust all resources available to them
for patient care
• Not to expose patients to undue risk
Prudent Person Rule
• Also called the “reasonable person standard”
should follow acceptable standard of care.
• Must provide following information to patient:
• Diagnosis
• Risk and consequences of treatment
• Expected benefits of treatment or procedure
• Alternative treatments
• Prognosis if no treatment
• Cost and expected pain
Patient confidentiality – A confidential relationship between physicians
and their patients is essential. Confidentiality helps create a setting of
trust in which a patient can share their private feelings and personal
history, enabling a physician to form a diagnosis. Patient information
should be available only to the physicians and other healthcare
personnel as required. A healthcare worker may be violating a patient’s
confidentiality by disclosing medical information to others who should
not have access to it.
Confidentiality
• Keeping private all information about patient
• No disclosure without written consent
• Medical Patient Rights Act
• A federal law that gives all patients right to have
privacy respected and records held confidential
Informed consent – Informed consent means providing an in-depth
understanding of the risks and benefits of a treatment to a patient. This
allows the patient to decide whether or not they wish to undergo a
procedure. Informed consent is based on the principle that patients should
have autonomy over the treatment they receive. Healthcare providers
should have a document providing proof the patient has full knowledge of
the risks, benefits and possible consequences of a particular treatment.
Physician-assisted Suicide (PAS) and euthanasia – Euthanasia refers to the
process of a deliberately ending a patient’s life in order to relieve them of
suffering. It is illegal in most countries but is still a hotly debated ethical
issue surrounding whether it should or should not be legalised. PAS is the
practice of providing a competent patient with a prescription for
medication that will end their life. In this case, the patient would have to
self-administer the medication, directly or through a machine.
Statute of Limitations
• The period patient must file lawsuit
• Usually, one to three years
• Discovery Rule
• Begins when problem discovered or when the
patient should have known of the injury
Good Samaritan Laws

• State laws help protect health care professionals

and ordinary citizens from liability while giving care
in emergency
• No one is required to provide aid
• Only required to act within limits of acquired skill
and training
Employee’s Duty to Carry out Orders

• Duty to interpret and carry out orders

• Duty to clarify ambiguous or erroneous orders
• Duty to decline orders that appear dangerous for
patient and to notify physician
Scope of Practice
• Must understand and work within scope of
practice for discipline
• Must understand and practice within guidelines of
profession
• Must understand and follow chain of command so
no employee makes decision he or she is
unqualified to make
Employer’s Duty to Employees

• Responsibility to provide safe environment for

employees and staff
• Most have liability insurance to cover accidents and
unforeseen incidents
• May bond employees who handle money
• Some have liability insurance for auto if used for
work-related business
Risk Management

• A practice used to control or minimize incidence

of problem behavior that might result in injury to
patients and employees and liability for
physician/employer
• Identify risk behaviors and practices
• Develop and follow plan of action to eliminate
problem behavior
• Address corrective actions in policy and
procedure books and employee handbooks
Incident Report

• Means of documenting problem areas

• Should be used for all unusual occurrences,
including:
• Falls
• Error in dispensing medication
• Needle sticks
• Any patient or employee complaint
 The Case of David Z. and Amyotrophic Lateral Sclerosis (ALS)
• David, who has suffered with ALS for 20 years, is now hospitalized in a private religious hospital on a respirator.
He spoke with his physician before he became incapacitated and asked that he be allowed to die if the suffering
became too much for him. The physician agreed that, while he would not give David any medications to assist a
suicide, he would discontinue David’s respirator if asked to do so. David has now indicated through a
prearranged code of blinking eye movements that he wants the respirator discontinued. David had signed his
living will before he became ill, indicating that he did not want extraordinary means keeping him alive.

• The nursing staff has alerted the hospital administrator about the impending discontinuation of the respirator.
The administrator tells the physician that this is against the hospital’s policy. She states that once a patient is
placed on a respirator, the family must seek a court order to have him or her removed from this type of life
support. In addition, it is against hospital policy to have any staff members present during such a procedure.
After consulting with the family, the physician orders an ambulance to transport the patient back to his home,
where the physician discontinues the life support.

• What were the primary concerns of the hospital?

• What was the physician’s primary concern?
• When should the discussion about the patient’s future plans have taken place with the hospital administrator?