Assignment Prompt & Instructions
I have instructions as the 1 attachment and the others are a reading for the assignment.
**files (6)**
– ## CodeofEthicsandConduct.docx
– ## Ch9part5of5.pdf
– Ch9part4of5.pdf
– Ch9part1of5.pdf
– Ch9part3of5.pdf
– Ch9part2of5.pdf
**## CodeofEthicsandConduct.docx**
The purpose of this assignment is to understand how ethics and the law affect a variety of health care professions. The ethical code for each profession demands a high level of honesty, integrity, and responsibility. Professional behavior facilitates the resolution of ethical dilemmas, and each health care professional should have access to the board's code of ethics regulating the specific profession. Personal behavior should be maintained at its highest standards, and health care professionals should comply with all governmental rules and regulations.
Read the "Poor Judgement" case study, located at the end of Chapter 9 of the textbook, and evaluate the ethical and legal issues in the case.
Write a 750- to 1,000-word response to the case study by addressing the following:
· Describe the different ethical codes for health care professionals.
· Identify whether the chiropractor in the case study violated the professional code of ethics. Explain your rationale.
· Apply prevailing ethical codes and principles to the case study, and describe how they impact ethical and legal responsibilities.
· Explain how to minimize bias and develop objectivity based on the different codes of ethics and codes of conduct.
Support the assignment with 2-3 scholarly resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
**## Ch9part5of5.pdf**
31305601 – Jones & Bartlett Learning ©
HELPFUL ADVICE FOR CAREGIVERS
Helpful advice for caregivers includes the following:
Break down the barriers between departments and work as a
team.
Abide by the ethical code of one’s profession.
Do not criticize the professional skills of others.
Maintain complete medical records.
Provide each patient with medical care comparable with
national standards.
Seek the aid of professional medical consultants when
indicated.
Obtain informed consent for diagnostic and therapeutic
procedures.
Inform the patient of the risks, benefits, and alternatives to
proposed procedures.
Practice the specialty in which you have been trained.
Participate in continuing education programs.
Keep patient information confidential.
Check patient equipment regularly and monitor it for safe
use.
When terminating a professional relationship, give adequate
written notice to the patient.
Authenticate all telephone orders.
Obtain a qualified substitute when you will be absent from
your practice.
Be a good listener and allow each patient sufficient time to
express fears and anxieties.
Develop and implement an interdisciplinary plan of care for
each patient.
Safely administer patient medications.
Closely monitor each patient’s response to treatment.
Provide education and teaching to patients.
Foster a sense of trust and feeling of significance.
Communicate with the patient and other caregivers.
Provide cost-effective care without sacrificing quality.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
CHAPTER REVIEW
1. The contents of codes of ethics vary depending on the
risks associated with a particular profession.
Ethical codes for psychologists, for example, define
relationships with clients in greater depth because of
the personal one-to-one relationship they have with
their clients.
Practicing outside one’s scope of practice has both
ethical and legal concerns.
2. Legislation in many states imposes a duty on hospitals
to provide emergency care. If the public is aware that a
hospital furnishes emergency services and relies on that
knowledge, the hospital has a duty to provide those
services to the public.
3. Hospitals are expected to notify specialty on-call
physicians when their particular skills are required in
the emergency department. A physician who is on call
and fails to respond to a request to attend a patient can
be liable for injuries suffered by the patient because of
his or her failure to respond.
4. There can be both ethical and legal repercussions if a
professional incorrectly interprets a physician’s orders.
5. A defense that sexual improprieties with clients did not
take place during treatment sessions is unacceptable
conduct.
6. Scope of practice refers to the permissible boundaries
of practice for healthcare professionals, as is often
defined in state statutes, which define the actions,
duties, and limits of professionals in their particular
roles.
7. A professional who exceeds his or her scope of practice
as defined by state practice acts can be found to have
violated licensure provisions or to have performed tasks
that are reserved by statute for another healthcare
professional.
31305601 – Jones & Bartlett Learning ©
8. The power and authority to regulate drugs and their
products, packaging, and distribution rest primarily with
federal and state governments.
9. Certification of healthcare professionals is the
recognition by a governmental or professional
association that an individual’s expertise meets the
standards of that group.
10. Licensure can be defined as the process by which some
competent authority grants permission to a qualified
individual or entity to perform certain specified
activities that would be illegal without a license.
31305601 – Jones & Bartlett Learning ©
TEST YOUR UNDERSTANDING
Terminology
advanced practice nurse
certification
chiropractor
clinical nurse specialist
dentist
dietitian
float nurse
laboratory medical technologist
licensure
medical assistant
nonmaleficence
nurse anesthetist
nurse midwife
nurse practitioner
nursing assistant
paramedic
patient care teams
pharmacist
physical therapy
physician assistant
psychologist
radiology technologist
registered nurse
respiratory therapist
social worker
special duty nurse
31305601 – Jones & Bartlett Learning ©
REVIEW QUESTIONS
1. Describe how ethics and the law have an impact on the
various healthcare professions discussed in this
chapter.
2. Discuss the ethical and legal implications of practicing
outside one’s scope of practice.
3. Discuss the circumstances under which a hospital has a
duty to provide emergency services to the public.
4. Are sexual encounters acceptable with clients as long as
they do not take place during treatment? Explain your
answer.
5. Consider under what circumstances a professional’s
legal responsibilities may overlap with his or her ethical
duties.
6. Describe how and why the scope of practice for various
professionals (e.g., nurses and pharmacists) is changing.
7. Discuss what action a caregiver should take, if any, if a
physician’s written orders appear questionable.
8. Describe a professional’s responsibilities when a
patient’s condition takes a turn for the worse.
9. Describe the difference between the certification and
licensing of a healthcare professional.
31305601 – Jones & Bartlett Learning ©
NOTES
1. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun (March 11, 2004).
http://www.baltimoresun.com/news/maryland/bal-
lab0311-story.html (accessed July 27, 2018).
2. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
3. U.S. Department of Transportation, National Highway Traffic
Safety Administration (NHTSA), National EMS Scope of
Practice Model.
https://www.ems.gov/education/EMSScope.pdf (accessed
July 27, 2018).
4. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
5. NHTSA, National EMS Scope of Practice Model at 9.
6. Ibid. at 10.
7. U.S. Drug Enforcement Administration, “Officer Safety Alert:
Carfenatil: A Dangerous New Factor in the U.S. Opioid Crisis.”
https://www.dea.gov/divisions/hq/2016/hq092216_attach
.pdf (accessed July 27, 2018).
8. NHTSA, National EMS Scope of Practice Model at 23.
9. Ibid. at 26.
10. Ibid. at 26.
11. Ibid. at 27-28.
12. Morena v. South Hills Health Systems, 462 A.2d 680 (Pa. 1983).
13. Riffe v. Vereb Ambulance Service, Inc., 650 A.2d 1076 (Pa.
Super. 1994).
31305601 – Jones & Bartlett Learning ©
14. Fraijo v. Hartland Hosp., 160 Cal. Rptr. 252 (Ct. App. 1979).
15. Institute of Medicine, Keeping Patients Safe: Transforming the
Work Environment of Nurses. Washington, D.C.: The National
Academies Press, at 2. Available at
http://www.nap.edu/openbook.php?isbn=0309090679
(accessed July 28, 2018).
16. HHS.gov, “HHS Awards $55.5 Million to Bolster America’s
Health Care Workforce.” http://wayback.archive-
it.org/3926/20150618190916/http://www.hhs.gov/news/p
ress/2013pres/12/20131205a.html (accessed July 28, 2018).
17. Parija Kavilanz, “Nursing Schools Are Rejecting Thousands of
Applicants—in the Middle of a Nursing Shortage,” CNN
Money (April 30, 2018).
https://money.cnn.com/2018/04/30/news/economy/nurs
ing-school-rejections/index.html (accessed July 28, 2018).
18. Ibid.
19. Jilian Mincer, “Short on Staff: Nursing Crisis Strains U.S.
Hospitals,” Reuters (October 20, 2017).
https://www.reuters.com/article/us-usa-healthcare-
nursing/short-on-staff-nursing-crisis-strains-u-s-
hospitals-idUSKBN1CP0BD (accessed July 28, 2018).
20. Code of Federal Regulations, 42 CFR Ch IV, Subpart C, §
482.23 (b). https://www.gpo.gov/fdsys/granule/CFR-2011-
title42-vol5/CFR-2011-title42-vol5-part482/content-
detail.html (accessed July 28, 2018).
21. Teresa Serratt, Suzanne Meyer, and Susan A. Chapman,
“Enforcement of Hospital Nurse Staffing Regulations Across
the United States: Progress or Stalemate?” Policy, Politics, &
Nursing Practice 15 (2014): 21–29.
http://journals.sagepub.com/doi/pdf/10.1177/152715441
4532502 (accessed July 28, 2018).
22. Department of Health, Education and Welfare, Extending the
Scope of Nursing Practice: A Report of the Secretary’s
Committee to Study Roles for Nurses, Pub. No. (HSM) 73-
2037, 8 (1971).
23. Adams v. Krueger, 856 P.2d 864 (Idaho 1993).
24. Ibid. at 867.
31305601 – Jones & Bartlett Learning ©
25. Carolyn Buppert, “Reducing Liability Risk When Collaborating
with Nurse Practitioners,” Medscape (September 1, 2017).
https://www.medscape.com/viewarticle/884582
(accessed July 28, 2018).
26. Debbie LaValley, “Boy Dies After Call to NP for Flu
Symptoms.” CRICO (February 1, 2012).
https://www.rmf.harvard.edu/Clinician-Resources/Case-
Study/2012/Boy-9-Dies-After-Offhours-Call-to-NP-for-Flu-
Symptoms (accessed July 28, 2018).
27. Buppert, “Reducing Liability Risk When Collaborating with
Nurse Practitioners”
28. New York State Nurses Association, “Position on Statement
on Floating.” https://www.nysna.org/position-statement-
floating#.W1zdmS2ZPIE.
29. The Joint Commission, 2014 Hospital Accreditation
Standards, LD.03.06.04 at LD–20.
30. Cignetti v. Camel, 692 S.W.2d 329 (Mo. Ct. App. 1985).
31. Norton v. Argonaut Insurance Co., 144 So. 2d 249 (La. Ct. App.
1962).
32. Tami Dennis, “More Heparin Overdoses, This Time in Texas,”
Los Angeles Times, July 9, 2008;
http://latimesblogs.latimes.com/booster_shots/2008/07/
more-heparin-ov.html.
33. Harrison v. Axelrod, 599 N.Y.S.2d 96 (N.Y. App. Div. 1993).
34. Larrimore v. Homeopathic Hospital Association, 181 A.2d 573
(Del. 1962).
35. Cafiero v. North Carolina Board of Nursing, 403 S.E.2d 582
(N.C. Ct. App. 1991).
36. Ibid. at 584–585.
37. Goff v. Doctors General Hospital, 333 P.2d 29 (Cal. Ct. App.
1958).
38. Koeniguer v. Eckrich, 422 N.W.2d 600 (S.D. 1988).
39. Eyoma v. Falco, 589 A.2d 653 (N.J. Super. App. Div. 1991).
31305601 – Jones & Bartlett Learning ©
40. Ibid. at 655.
41. Poor Sisters of St. Francis v. Catron, 435 N.E.2d 305 (Ind. Ct.
App. 1982).
42. American Chiropractic Association, “Code of Ethics.”
http://ccodc.org/ethics.html (accessed July 28, 2018).
43. Susan Berger, “How Safe Are the Vigorous Neck
Manipulations Done by Chiropractors?” The Washington
Post. http://www.washingtonpost.com/national/health-
science/how-safe-are-the-vigorous-neck-manipulations-
done-by-chiropractors/2014/01/06/26870726-5cf7-11e3-
bc56-c6ca94801fac_story.html (accessed January 6, 2014).
44. Ibid.
45. Ibid.
46. Poor v. State, No.S-02-472, 266 Neb. 183 (Neb. 2003).
47. Brown v. Belinfante, 557 S.E.2d 339 (2001).
48. Melone v. State Education Department, 495 N.Y.S.2d 808 (N.Y.
App. Div. 1985).
49. Lowenberg v. Sobol, 594 N.Y.S.2d 874 (N.Y. App. Div. 1993).
50. Hickman v. Sexton Dental Clinic, 367 S.E.2d 453 (S.C. 1988).
51. Ibid. at 455–456.
52. University Hospitals, “Nutrition Services.”
http://www.uhhospitals.org/services/nutrition-services
(accessed July 28, 2018).
53. Massachusetts General Hospital, “Nutrition.”
http://www.massgeneral.org/nutrition/ (accessed July 28,
2018).
54. New York-Presbyterian, “Food and Nutrition.”
http://www.nyp.org/nutrition (accessed July 28, 2018).
55. The Joint Commission, 2017 Hospital Accreditation
Standards, PC.02.02.03 (element 7).
56. Lambert v. Beverly Enterprises, Inc., 753 F. Supp. 267 (W.D. Ark.
1990).
31305601 – Jones & Bartlett Learning ©
57. J. P. McWhirter and C. R. Pennington, “Incidence and
Recognition of Malnutrition in Hospital,” British Medical
Journal 308 (1994): 945–948.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539799/
(accessed July 28, 2018).
58. Fjerstad v. Knutson, 271 N.W.2d 8 (S.D. 1978).
59. Thomas v. Corso, 288 A.2d 379 (Md. 1972).
60. Marks v. Mandel, 477 So. 2d 1036 (Fla. Dist. Ct. App. 1985).
61. Baptist Mem’l Hosp. Sys. v. Sampson, 969 S.W.2d 945, 947 (Tex.
1998).
62. Martin C. McWilliams, Jr., and Hamilton E. Russell III, Hospital
Liability for Torts of Independent Contractor Physicians, 47
S.C. L. reV. 431, 473 (1996).
63. Marks v. Mandel.
64. Ibid. at 1039.
65. U.S. Food and Drug Administration, “Tests Used in Clinical
Care.”
https://www.fda.gov/MedicalDevices/ProductsandMedic
alProcedures/InVitroDiagnostics/LabTest/default.htm
(accessed July 28, 2018).
66. Mike J. Hallworth, “The ‘70%’ Claim: What Is the Evidence
Base?” Annals of Clinical Biochemistry: International Journal
of Laboratory Medicine 48 (2011).
http://journals.sagepub.com/doi/full/10.1258/acb.2011.0
11177 (accessed July 28, 2018).
67. American Society for Clinical Laboratory Science (ASCLS),
“Code of Ethics.” http://www.ascls.org/about-us/code-of-
ethics (accessed July 28, 2018).
68. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun, March 11, 2004,
http://www.baltimoresun.com/news/maryland/bal-
lab0311,0,3643424.story.
69. American Society for Clinical Pathology, State Licensure of
Laboratory Personnel (Policy Number 05-02).
http://www.pathologylearning.org/docs/default-
31305601 – Jones & Bartlett Learning ©
source/pdf/706df311-5dd9-49de-85bb-8fec4b1149b4.pdf
(accessed July 28, 2018).
70. KOMONEWS.com/Associated Press, “Spokane Woman
Suing over False HIV Diagnosis,” (December 26, 2013).
http://www.komonews.com/news/local/Spokane-
woman-suing-over-false-HIV-diagnosis-237318161.html.
71. Stepp v. Review Board of the Indiana Employment Security
Division, 521 N.E.2d 350 (Ind. Ct. App. 1988).
72. Ibid. at 352.
73. Whirlpool Corp. v. Marshall, 445 U.S. 1 (1980).
74. Stepp v. Review Board of the Indiana Employment Security
Division at 353.
75. Healthcare Careers Guide, “Medical Assistant Scope of
Practice Varies in Every State.”
http://www.healthcarecareersguide.com/medical-
assistant-scope-of-practice/ (accessed July 28, 2018).
76. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Medical Assistants
[online]. https://www.bls.gov/ooh/healthcare/medical-
assistants.htm (visited July 23, 2018).
77. Ibid.
78. Follett v. Davis, 636 N.E.2d 1282 (Ind. Ct. App. 1994).
79. Institute of Medicine, To Err Is Human: Building a Safer
Health System, supra note 1, at 194.
80. Katie Moisse, “Hospital Errors Common and Underreported,”
ABC News, April 7, 2011.
http://abcnews.go.com/Health/hospital-errors-common-
underreported-study/story?id=13310733.
81. Jesse C. Vivian, “Generic-Substitution Laws,” U.S. Pharmacist
(June 19, 2008).
https://www.uspharmacist.com/article/generic-
substitution-laws (accessed July 28, 2018).
82. Baker v. Arbor Drugs, Inc., 544 N.W.2d 727 (Mich. Ct. App.
1996).
83. Riff v. Morgan Pharmacy, 508 A.2d 1247 (Pa. Super. Ct. 1986).
31305601 – Jones & Bartlett Learning ©
84. Hooks v. McLaughlin, 642 N.E.2d 514 (Ind. 1994).
85. Ind. Code A4 25-26-13-16(b)(3) (1993).
86. National Coordinating Council for Medication Error Reporting
and Prevention, “About Medication Errors.”
http://www.nccmerp.org/about-medication-errors
(accessed July 28, 2018).
87. David M. Benjamin, “Reducing Medication Errors and
Increasing Patient Safety: Case Studies in Clinical
Pharmacology,” Journal of Clinical Pharmacology 43 (July
2013): 768–783.
https://accp1.onlinelibrary.wiley.com/doi/full/10.1177/0
091270003254794.
88. Russell W. Steele, “Medical Error Reduction in Daily Practice,”
Medscape.
https://www.medscape.org/viewarticle/447139 (accessed
July 28, 2018).
89. Ibid.
90. Pontiff v. Pecot & Assoc., 780 So. 2d 478 (2001).
91. American Physical Therapy Association, “Code of Ethics for
the Physical Therapist.”
https://www.apta.org/uploadedFiles/APTAorg/About_Us/
Policies/Ethics/CodeofEthics.pdf (accessed July 28, 2018).
92. Zucker v. Axelrod, 527 N.Y.S.2d 937 (N.Y. App. Div. 1988).
93. National Commission on Certification of Physician Assistants
(NCCPA), “Just Released Data Registers Mobility Trends of
Certified PAs [Press Release],” (May 22, 2018).
http://prodcmsstoragesa.blob.core.windows.net/upload
s/files/PressRelease2017StatisticalReport.pdf (accessed
July 28, 2018).
94. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Physician Assistants
[online]. http://www.bls.gov/ooh/Healthcare/Physician-
assistants.htm (visited July 23, 2018).
95. Cox v. MA Primary and Urgent Care Clinic, 313 SW 3d 240 –
Tenn: Supreme Court 2010.
96. Ibid. at 262.
31305601 – Jones & Bartlett Learning ©
97. American Psychological Association (APA), “Ethical Principles
of Psychologists and Code of Conduct.”
http://www.apa.org/ethics/code/index.aspx.
98. Loomis v. Board of Psychologist Exam’rs, 954 P.2d 839 (1998).
99. APA, “Ethical Principles of Psychologists and Code of
Conduct.”
100. Gilmore v. Board of Psychologist Examiners, 725 P.2d 400 (Or.
Ct. App. 1986).
101. Ibid. at 204.
102. Michaels v. Gordon, 439 S.E.2d 722 (Ga. Ct. App. 1993).
103. Lisa Tortorello, “XRay Technicians: Missing in Malpractice
Cases,” X-Ray Schools (June 10, 2011).
http://www.xrayschools.com/articles/xray-technicians-
missing-in-malpractice-cases.html (accessed July 28,
2018).
104. Cockerton v. Mercy Hospital Medical Center 490 N.W.2d 856
(Iowa Ct. App. 1992).
105. American Association of Respiratory Care, AARC Statement
of Ethics and Professional Conduct (Revised 04/2015).
https://www.aarc.org/wp-
content/uploads/2017/03/statement-of-ethics.pdf
(accessed July 28, 2018).
106. State University v. Young, 566 N.Y.S.2d 79 (N.Y. App. Div.
1991).
107. National Association of Social Workers, “Code of Ethics.”
https://www.socialworkers.org/about/ethics/code-of-
ethics (accessed July 28, 2018).
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
© Fuse/Thinkstock.
CHAPTER 10
Physicians’ Ethical
and Legal Issues
Observation, Reason, Human Understanding, Courage; these
make the physician.
— Martin H. Fischer (1879–1962)
LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Apply the Hippocratic Oath to modern codes of medical
ethics.
Understand how the law and ethics intertwine in patient
care.
Describe common medical errors and ethical issues relative
to physician practice.
Describe important guidelines for developing positive
physician–patient relations.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
INTRODUCTION
Of all the Hippocratic writings the Oath, in spite of its
shortness, is perhaps the most interesting to the general
reader and also to the modern medical man. Whatever its
origin, it is a landmark in the ethics of medicine.
—W. H. S. Jones, Ed.
1
31305601 – Jones & Bartlett Learning ©
The Hippocratic Oath
I swear by Apollo the physician, and Asclepius, and
Hygieia and Panacea and all the gods and goddesses
as my witnesses, that, according to my ability and
judgement, I will keep this Oath and this contract:
To hold him who taught me this art equally dear to
me as my parents, to be a partner in life with him, and
to fulfill his needs when required; to look upon his
offspring as equals to my own siblings, and to teach
them this art, if they shall wish to learn it, without fee
or contract; and that by the set rules, lectures, and
every other mode of instruction, I will impart a
knowledge of the art to my own sons, and those of my
teachers, and to students bound by this contract and
having sworn this Oath to the law of medicine, but to
no others.
I will use those dietary regimens which will benefit
my patients according to my greatest ability and
judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked,
nor will I advise such a plan; and similarly, I will not give
a woman a pessary to cause an abortion.
In purity and according to divine law will I carry out
my life and my art.
I will not use the knife, even upon those suffering
from stones, but I will leave this to those who are
trained in this craft.
Into whatever homes I go, I will enter them for the
benefit of the sick, avoiding any voluntary act of
impropriety or corruption, including the seduction of
women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients,
whether in connection with my professional practice or
not, which ought not to be spoken of outside, I will
keep secret, as considering all such things to be
private.
So long as I maintain this Oath faithfully and
without corruption, may it be granted to me to partake
of life fully and the practice of my art, gaining the
respect of all men for all time.
31305601 – Jones & Bartlett Learning ©
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**## CodeofEthicsandConduct.docx**
The purpose of this assignment is to understand how ethics and the law affect a variety of health care professions. The ethical code for each profession demands a high level of honesty, integrity, and responsibility. Professional behavior facilitates the resolution of ethical dilemmas, and each health care professional should have access to the board's code of ethics regulating the specific profession. Personal behavior should be maintained at its highest standards, and health care professionals should comply with all governmental rules and regulations.
Read the "Poor Judgement" case study, located at the end of Chapter 9 of the textbook, and evaluate the ethical and legal issues in the case.
Write a 750- to 1,000-word response to the case study by addressing the following:
· Describe the different ethical codes for health care professionals.
· Identify whether the chiropractor in the case study violated the professional code of ethics. Explain your rationale.
· Apply prevailing ethical codes and principles to the case study, and describe how they impact ethical and legal responsibilities.
· Explain how to minimize bias and develop objectivity based on the different codes of ethics and codes of conduct.
Support the assignment with 2-3 scholarly resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
**## Ch9part5of5.pdf**
31305601 – Jones & Bartlett Learning ©
HELPFUL ADVICE FOR CAREGIVERS
Helpful advice for caregivers includes the following:
Break down the barriers between departments and work as a
team.
Abide by the ethical code of one’s profession.
Do not criticize the professional skills of others.
Maintain complete medical records.
Provide each patient with medical care comparable with
national standards.
Seek the aid of professional medical consultants when
indicated.
Obtain informed consent for diagnostic and therapeutic
procedures.
Inform the patient of the risks, benefits, and alternatives to
proposed procedures.
Practice the specialty in which you have been trained.
Participate in continuing education programs.
Keep patient information confidential.
Check patient equipment regularly and monitor it for safe
use.
When terminating a professional relationship, give adequate
written notice to the patient.
Authenticate all telephone orders.
Obtain a qualified substitute when you will be absent from
your practice.
Be a good listener and allow each patient sufficient time to
express fears and anxieties.
Develop and implement an interdisciplinary plan of care for
each patient.
Safely administer patient medications.
Closely monitor each patient’s response to treatment.
Provide education and teaching to patients.
Foster a sense of trust and feeling of significance.
Communicate with the patient and other caregivers.
Provide cost-effective care without sacrificing quality.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
CHAPTER REVIEW
1. The contents of codes of ethics vary depending on the
risks associated with a particular profession.
Ethical codes for psychologists, for example, define
relationships with clients in greater depth because of
the personal one-to-one relationship they have with
their clients.
Practicing outside one’s scope of practice has both
ethical and legal concerns.
2. Legislation in many states imposes a duty on hospitals
to provide emergency care. If the public is aware that a
hospital furnishes emergency services and relies on that
knowledge, the hospital has a duty to provide those
services to the public.
3. Hospitals are expected to notify specialty on-call
physicians when their particular skills are required in
the emergency department. A physician who is on call
and fails to respond to a request to attend a patient can
be liable for injuries suffered by the patient because of
his or her failure to respond.
4. There can be both ethical and legal repercussions if a
professional incorrectly interprets a physician’s orders.
5. A defense that sexual improprieties with clients did not
take place during treatment sessions is unacceptable
conduct.
6. Scope of practice refers to the permissible boundaries
of practice for healthcare professionals, as is often
defined in state statutes, which define the actions,
duties, and limits of professionals in their particular
roles.
7. A professional who exceeds his or her scope of practice
as defined by state practice acts can be found to have
violated licensure provisions or to have performed tasks
that are reserved by statute for another healthcare
professional.
31305601 – Jones & Bartlett Learning ©
8. The power and authority to regulate drugs and their
products, packaging, and distribution rest primarily with
federal and state governments.
9. Certification of healthcare professionals is the
recognition by a governmental or professional
association that an individual’s expertise meets the
standards of that group.
10. Licensure can be defined as the process by which some
competent authority grants permission to a qualified
individual or entity to perform certain specified
activities that would be illegal without a license.
31305601 – Jones & Bartlett Learning ©
TEST YOUR UNDERSTANDING
Terminology
advanced practice nurse
certification
chiropractor
clinical nurse specialist
dentist
dietitian
float nurse
laboratory medical technologist
licensure
medical assistant
nonmaleficence
nurse anesthetist
nurse midwife
nurse practitioner
nursing assistant
paramedic
patient care teams
pharmacist
physical therapy
physician assistant
psychologist
radiology technologist
registered nurse
respiratory therapist
social worker
special duty nurse
31305601 – Jones & Bartlett Learning ©
REVIEW QUESTIONS
1. Describe how ethics and the law have an impact on the
various healthcare professions discussed in this
chapter.
2. Discuss the ethical and legal implications of practicing
outside one’s scope of practice.
3. Discuss the circumstances under which a hospital has a
duty to provide emergency services to the public.
4. Are sexual encounters acceptable with clients as long as
they do not take place during treatment? Explain your
answer.
5. Consider under what circumstances a professional’s
legal responsibilities may overlap with his or her ethical
duties.
6. Describe how and why the scope of practice for various
professionals (e.g., nurses and pharmacists) is changing.
7. Discuss what action a caregiver should take, if any, if a
physician’s written orders appear questionable.
8. Describe a professional’s responsibilities when a
patient’s condition takes a turn for the worse.
9. Describe the difference between the certification and
licensing of a healthcare professional.
31305601 – Jones & Bartlett Learning ©
NOTES
1. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun (March 11, 2004).
http://www.baltimoresun.com/news/maryland/bal-
lab0311-story.html (accessed July 27, 2018).
2. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
3. U.S. Department of Transportation, National Highway Traffic
Safety Administration (NHTSA), National EMS Scope of
Practice Model.
https://www.ems.gov/education/EMSScope.pdf (accessed
July 27, 2018).
4. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
5. NHTSA, National EMS Scope of Practice Model at 9.
6. Ibid. at 10.
7. U.S. Drug Enforcement Administration, “Officer Safety Alert:
Carfenatil: A Dangerous New Factor in the U.S. Opioid Crisis.”
https://www.dea.gov/divisions/hq/2016/hq092216_attach
.pdf (accessed July 27, 2018).
8. NHTSA, National EMS Scope of Practice Model at 23.
9. Ibid. at 26.
10. Ibid. at 26.
11. Ibid. at 27-28.
12. Morena v. South Hills Health Systems, 462 A.2d 680 (Pa. 1983).
13. Riffe v. Vereb Ambulance Service, Inc., 650 A.2d 1076 (Pa.
Super. 1994).
31305601 – Jones & Bartlett Learning ©
14. Fraijo v. Hartland Hosp., 160 Cal. Rptr. 252 (Ct. App. 1979).
15. Institute of Medicine, Keeping Patients Safe: Transforming the
Work Environment of Nurses. Washington, D.C.: The National
Academies Press, at 2. Available at
http://www.nap.edu/openbook.php?isbn=0309090679
(accessed July 28, 2018).
16. HHS.gov, “HHS Awards $55.5 Million to Bolster America’s
Health Care Workforce.” http://wayback.archive-
it.org/3926/20150618190916/http://www.hhs.gov/news/p
ress/2013pres/12/20131205a.html (accessed July 28, 2018).
17. Parija Kavilanz, “Nursing Schools Are Rejecting Thousands of
Applicants—in the Middle of a Nursing Shortage,” CNN
Money (April 30, 2018).
https://money.cnn.com/2018/04/30/news/economy/nurs
ing-school-rejections/index.html (accessed July 28, 2018).
18. Ibid.
19. Jilian Mincer, “Short on Staff: Nursing Crisis Strains U.S.
Hospitals,” Reuters (October 20, 2017).
https://www.reuters.com/article/us-usa-healthcare-
nursing/short-on-staff-nursing-crisis-strains-u-s-
hospitals-idUSKBN1CP0BD (accessed July 28, 2018).
20. Code of Federal Regulations, 42 CFR Ch IV, Subpart C, §
482.23 (b). https://www.gpo.gov/fdsys/granule/CFR-2011-
title42-vol5/CFR-2011-title42-vol5-part482/content-
detail.html (accessed July 28, 2018).
21. Teresa Serratt, Suzanne Meyer, and Susan A. Chapman,
“Enforcement of Hospital Nurse Staffing Regulations Across
the United States: Progress or Stalemate?” Policy, Politics, &
Nursing Practice 15 (2014): 21–29.
http://journals.sagepub.com/doi/pdf/10.1177/152715441
4532502 (accessed July 28, 2018).
22. Department of Health, Education and Welfare, Extending the
Scope of Nursing Practice: A Report of the Secretary’s
Committee to Study Roles for Nurses, Pub. No. (HSM) 73-
2037, 8 (1971).
23. Adams v. Krueger, 856 P.2d 864 (Idaho 1993).
24. Ibid. at 867.
31305601 – Jones & Bartlett Learning ©
25. Carolyn Buppert, “Reducing Liability Risk When Collaborating
with Nurse Practitioners,” Medscape (September 1, 2017).
https://www.medscape.com/viewarticle/884582
(accessed July 28, 2018).
26. Debbie LaValley, “Boy Dies After Call to NP for Flu
Symptoms.” CRICO (February 1, 2012).
https://www.rmf.harvard.edu/Clinician-Resources/Case-
Study/2012/Boy-9-Dies-After-Offhours-Call-to-NP-for-Flu-
Symptoms (accessed July 28, 2018).
27. Buppert, “Reducing Liability Risk When Collaborating with
Nurse Practitioners”
28. New York State Nurses Association, “Position on Statement
on Floating.” https://www.nysna.org/position-statement-
floating#.W1zdmS2ZPIE.
29. The Joint Commission, 2014 Hospital Accreditation
Standards, LD.03.06.04 at LD–20.
30. Cignetti v. Camel, 692 S.W.2d 329 (Mo. Ct. App. 1985).
31. Norton v. Argonaut Insurance Co., 144 So. 2d 249 (La. Ct. App.
1962).
32. Tami Dennis, “More Heparin Overdoses, This Time in Texas,”
Los Angeles Times, July 9, 2008;
http://latimesblogs.latimes.com/booster_shots/2008/07/
more-heparin-ov.html.
33. Harrison v. Axelrod, 599 N.Y.S.2d 96 (N.Y. App. Div. 1993).
34. Larrimore v. Homeopathic Hospital Association, 181 A.2d 573
(Del. 1962).
35. Cafiero v. North Carolina Board of Nursing, 403 S.E.2d 582
(N.C. Ct. App. 1991).
36. Ibid. at 584–585.
37. Goff v. Doctors General Hospital, 333 P.2d 29 (Cal. Ct. App.
1958).
38. Koeniguer v. Eckrich, 422 N.W.2d 600 (S.D. 1988).
39. Eyoma v. Falco, 589 A.2d 653 (N.J. Super. App. Div. 1991).
31305601 – Jones & Bartlett Learning ©
40. Ibid. at 655.
41. Poor Sisters of St. Francis v. Catron, 435 N.E.2d 305 (Ind. Ct.
App. 1982).
42. American Chiropractic Association, “Code of Ethics.”
http://ccodc.org/ethics.html (accessed July 28, 2018).
43. Susan Berger, “How Safe Are the Vigorous Neck
Manipulations Done by Chiropractors?” The Washington
Post. http://www.washingtonpost.com/national/health-
science/how-safe-are-the-vigorous-neck-manipulations-
done-by-chiropractors/2014/01/06/26870726-5cf7-11e3-
bc56-c6ca94801fac_story.html (accessed January 6, 2014).
44. Ibid.
45. Ibid.
46. Poor v. State, No.S-02-472, 266 Neb. 183 (Neb. 2003).
47. Brown v. Belinfante, 557 S.E.2d 339 (2001).
48. Melone v. State Education Department, 495 N.Y.S.2d 808 (N.Y.
App. Div. 1985).
49. Lowenberg v. Sobol, 594 N.Y.S.2d 874 (N.Y. App. Div. 1993).
50. Hickman v. Sexton Dental Clinic, 367 S.E.2d 453 (S.C. 1988).
51. Ibid. at 455–456.
52. University Hospitals, “Nutrition Services.”
http://www.uhhospitals.org/services/nutrition-services
(accessed July 28, 2018).
53. Massachusetts General Hospital, “Nutrition.”
http://www.massgeneral.org/nutrition/ (accessed July 28,
2018).
54. New York-Presbyterian, “Food and Nutrition.”
http://www.nyp.org/nutrition (accessed July 28, 2018).
55. The Joint Commission, 2017 Hospital Accreditation
Standards, PC.02.02.03 (element 7).
56. Lambert v. Beverly Enterprises, Inc., 753 F. Supp. 267 (W.D. Ark.
1990).
31305601 – Jones & Bartlett Learning ©
57. J. P. McWhirter and C. R. Pennington, “Incidence and
Recognition of Malnutrition in Hospital,” British Medical
Journal 308 (1994): 945–948.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539799/
(accessed July 28, 2018).
58. Fjerstad v. Knutson, 271 N.W.2d 8 (S.D. 1978).
59. Thomas v. Corso, 288 A.2d 379 (Md. 1972).
60. Marks v. Mandel, 477 So. 2d 1036 (Fla. Dist. Ct. App. 1985).
61. Baptist Mem’l Hosp. Sys. v. Sampson, 969 S.W.2d 945, 947 (Tex.
1998).
62. Martin C. McWilliams, Jr., and Hamilton E. Russell III, Hospital
Liability for Torts of Independent Contractor Physicians, 47
S.C. L. reV. 431, 473 (1996).
63. Marks v. Mandel.
64. Ibid. at 1039.
65. U.S. Food and Drug Administration, “Tests Used in Clinical
Care.”
https://www.fda.gov/MedicalDevices/ProductsandMedic
alProcedures/InVitroDiagnostics/LabTest/default.htm
(accessed July 28, 2018).
66. Mike J. Hallworth, “The ‘70%’ Claim: What Is the Evidence
Base?” Annals of Clinical Biochemistry: International Journal
of Laboratory Medicine 48 (2011).
http://journals.sagepub.com/doi/full/10.1258/acb.2011.0
11177 (accessed July 28, 2018).
67. American Society for Clinical Laboratory Science (ASCLS),
“Code of Ethics.” http://www.ascls.org/about-us/code-of-
ethics (accessed July 28, 2018).
68. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun, March 11, 2004,
http://www.baltimoresun.com/news/maryland/bal-
lab0311,0,3643424.story.
69. American Society for Clinical Pathology, State Licensure of
Laboratory Personnel (Policy Number 05-02).
http://www.pathologylearning.org/docs/default-
31305601 – Jones & Bartlett Learning ©
source/pdf/706df311-5dd9-49de-85bb-8fec4b1149b4.pdf
(accessed July 28, 2018).
70. KOMONEWS.com/Associated Press, “Spokane Woman
Suing over False HIV Diagnosis,” (December 26, 2013).
http://www.komonews.com/news/local/Spokane-
woman-suing-over-false-HIV-diagnosis-237318161.html.
71. Stepp v. Review Board of the Indiana Employment Security
Division, 521 N.E.2d 350 (Ind. Ct. App. 1988).
72. Ibid. at 352.
73. Whirlpool Corp. v. Marshall, 445 U.S. 1 (1980).
74. Stepp v. Review Board of the Indiana Employment Security
Division at 353.
75. Healthcare Careers Guide, “Medical Assistant Scope of
Practice Varies in Every State.”
http://www.healthcarecareersguide.com/medical-
assistant-scope-of-practice/ (accessed July 28, 2018).
76. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Medical Assistants
[online]. https://www.bls.gov/ooh/healthcare/medical-
assistants.htm (visited July 23, 2018).
77. Ibid.
78. Follett v. Davis, 636 N.E.2d 1282 (Ind. Ct. App. 1994).
79. Institute of Medicine, To Err Is Human: Building a Safer
Health System, supra note 1, at 194.
80. Katie Moisse, “Hospital Errors Common and Underreported,”
ABC News, April 7, 2011.
http://abcnews.go.com/Health/hospital-errors-common-
underreported-study/story?id=13310733.
81. Jesse C. Vivian, “Generic-Substitution Laws,” U.S. Pharmacist
(June 19, 2008).
https://www.uspharmacist.com/article/generic-
substitution-laws (accessed July 28, 2018).
82. Baker v. Arbor Drugs, Inc., 544 N.W.2d 727 (Mich. Ct. App.
1996).
83. Riff v. Morgan Pharmacy, 508 A.2d 1247 (Pa. Super. Ct. 1986).
31305601 – Jones & Bartlett Learning ©
84. Hooks v. McLaughlin, 642 N.E.2d 514 (Ind. 1994).
85. Ind. Code A4 25-26-13-16(b)(3) (1993).
86. National Coordinating Council for Medication Error Reporting
and Prevention, “About Medication Errors.”
http://www.nccmerp.org/about-medication-errors
(accessed July 28, 2018).
87. David M. Benjamin, “Reducing Medication Errors and
Increasing Patient Safety: Case Studies in Clinical
Pharmacology,” Journal of Clinical Pharmacology 43 (July
2013): 768–783.
https://accp1.onlinelibrary.wiley.com/doi/full/10.1177/0
091270003254794.
88. Russell W. Steele, “Medical Error Reduction in Daily Practice,”
Medscape.
https://www.medscape.org/viewarticle/447139 (accessed
July 28, 2018).
89. Ibid.
90. Pontiff v. Pecot & Assoc., 780 So. 2d 478 (2001).
91. American Physical Therapy Association, “Code of Ethics for
the Physical Therapist.”
https://www.apta.org/uploadedFiles/APTAorg/About_Us/
Policies/Ethics/CodeofEthics.pdf (accessed July 28, 2018).
92. Zucker v. Axelrod, 527 N.Y.S.2d 937 (N.Y. App. Div. 1988).
93. National Commission on Certification of Physician Assistants
(NCCPA), “Just Released Data Registers Mobility Trends of
Certified PAs [Press Release],” (May 22, 2018).
http://prodcmsstoragesa.blob.core.windows.net/upload
s/files/PressRelease2017StatisticalReport.pdf (accessed
July 28, 2018).
94. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Physician Assistants
[online]. http://www.bls.gov/ooh/Healthcare/Physician-
assistants.htm (visited July 23, 2018).
95. Cox v. MA Primary and Urgent Care Clinic, 313 SW 3d 240 –
Tenn: Supreme Court 2010.
96. Ibid. at 262.
31305601 – Jones & Bartlett Learning ©
97. American Psychological Association (APA), “Ethical Principles
of Psychologists and Code of Conduct.”
http://www.apa.org/ethics/code/index.aspx.
98. Loomis v. Board of Psychologist Exam’rs, 954 P.2d 839 (1998).
99. APA, “Ethical Principles of Psychologists and Code of
Conduct.”
100. Gilmore v. Board of Psychologist Examiners, 725 P.2d 400 (Or.
Ct. App. 1986).
101. Ibid. at 204.
102. Michaels v. Gordon, 439 S.E.2d 722 (Ga. Ct. App. 1993).
103. Lisa Tortorello, “XRay Technicians: Missing in Malpractice
Cases,” X-Ray Schools (June 10, 2011).
http://www.xrayschools.com/articles/xray-technicians-
missing-in-malpractice-cases.html (accessed July 28,
2018).
104. Cockerton v. Mercy Hospital Medical Center 490 N.W.2d 856
(Iowa Ct. App. 1992).
105. American Association of Respiratory Care, AARC Statement
of Ethics and Professional Conduct (Revised 04/2015).
https://www.aarc.org/wp-
content/uploads/2017/03/statement-of-ethics.pdf
(accessed July 28, 2018).
106. State University v. Young, 566 N.Y.S.2d 79 (N.Y. App. Div.
1991).
107. National Association of Social Workers, “Code of Ethics.”
https://www.socialworkers.org/about/ethics/code-of-
ethics (accessed July 28, 2018).
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31305601 – Jones & Bartlett Learning ©
© Fuse/Thinkstock.
CHAPTER 10
Physicians’ Ethical
and Legal Issues
Observation, Reason, Human Understanding, Courage; these
make the physician.
— Martin H. Fischer (1879–1962)
LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Apply the Hippocratic Oath to modern codes of medical
ethics.
Understand how the law and ethics intertwine in patient
care.
Describe common medical errors and ethical issues relative
to physician practice.
Describe important guidelines for developing positive
physician–patient relations.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
INTRODUCTION
Of all the Hippocratic writings the Oath, in spite of its
shortness, is perhaps the most interesting to the general
reader and also to the modern medical man. Whatever its
origin, it is a landmark in the ethics of medicine.
—W. H. S. Jones, Ed.
1
31305601 – Jones & Bartlett Learning ©
The Hippocratic Oath
I swear by Apollo the physician, and Asclepius, and
Hygieia and Panacea and all the gods and goddesses
as my witnesses, that, according to my ability and
judgement, I will keep this Oath and this contract:
To hold him who taught me this art equally dear to
me as my parents, to be a partner in life with him, and
to fulfill his needs when required; to look upon his
offspring as equals to my own siblings, and to teach
them this art, if they shall wish to learn it, without fee
or contract; and that by the set rules, lectures, and
every other mode of instruction, I will impart a
knowledge of the art to my own sons, and those of my
teachers, and to students bound by this contract and
having sworn this Oath to the law of medicine, but to
no others.
I will use those dietary regimens which will benefit
my patients according to my greatest ability and
judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked,
nor will I advise such a plan; and similarly, I will not give
a woman a pessary to cause an abortion.
In purity and according to divine law will I carry out
my life and my art.
I will not use the knife, even upon those suffering
from stones, but I will leave this to those who are
trained in this craft.
Into whatever homes I go, I will enter them for the
benefit of the sick, avoiding any voluntary act of
impropriety or corruption, including the seduction of
women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients,
whether in connection with my professional practice or
not, which ought not to be spoken of outside, I will
keep secret, as considering all such things to be
private.
So long as I maintain this Oath faithfully and
without corruption, may it be granted to me to partake
of life fully and the practice of my art, gaining the
respect of all men for all time.
31305601 – Jones & Bartlett Learning ©
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**## CodeofEthicsandConduct.docx**
The purpose of this assignment is to understand how ethics and the law affect a variety of health care professions. The ethical code for each profession demands a high level of honesty, integrity, and responsibility. Professional behavior facilitates the resolution of ethical dilemmas, and each health care professional should have access to the board's code of ethics regulating the specific profession. Personal behavior should be maintained at its highest standards, and health care professionals should comply with all governmental rules and regulations.
Read the "Poor Judgement" case study, located at the end of Chapter 9 of the textbook, and evaluate the ethical and legal issues in the case.
Write a 750- to 1,000-word response to the case study by addressing the following:
· Describe the different ethical codes for health care professionals.
· Identify whether the chiropractor in the case study violated the professional code of ethics. Explain your rationale.
· Apply prevailing ethical codes and principles to the case study, and describe how they impact ethical and legal responsibilities.
· Explain how to minimize bias and develop objectivity based on the different codes of ethics and codes of conduct.
Support the assignment with 2-3 scholarly resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
**## Ch9part5of5.pdf**
31305601 – Jones & Bartlett Learning ©
HELPFUL ADVICE FOR CAREGIVERS
Helpful advice for caregivers includes the following:
Break down the barriers between departments and work as a
team.
Abide by the ethical code of one’s profession.
Do not criticize the professional skills of others.
Maintain complete medical records.
Provide each patient with medical care comparable with
national standards.
Seek the aid of professional medical consultants when
indicated.
Obtain informed consent for diagnostic and therapeutic
procedures.
Inform the patient of the risks, benefits, and alternatives to
proposed procedures.
Practice the specialty in which you have been trained.
Participate in continuing education programs.
Keep patient information confidential.
Check patient equipment regularly and monitor it for safe
use.
When terminating a professional relationship, give adequate
written notice to the patient.
Authenticate all telephone orders.
Obtain a qualified substitute when you will be absent from
your practice.
Be a good listener and allow each patient sufficient time to
express fears and anxieties.
Develop and implement an interdisciplinary plan of care for
each patient.
Safely administer patient medications.
Closely monitor each patient’s response to treatment.
Provide education and teaching to patients.
Foster a sense of trust and feeling of significance.
Communicate with the patient and other caregivers.
Provide cost-effective care without sacrificing quality.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
CHAPTER REVIEW
1. The contents of codes of ethics vary depending on the
risks associated with a particular profession.
Ethical codes for psychologists, for example, define
relationships with clients in greater depth because of
the personal one-to-one relationship they have with
their clients.
Practicing outside one’s scope of practice has both
ethical and legal concerns.
2. Legislation in many states imposes a duty on hospitals
to provide emergency care. If the public is aware that a
hospital furnishes emergency services and relies on that
knowledge, the hospital has a duty to provide those
services to the public.
3. Hospitals are expected to notify specialty on-call
physicians when their particular skills are required in
the emergency department. A physician who is on call
and fails to respond to a request to attend a patient can
be liable for injuries suffered by the patient because of
his or her failure to respond.
4. There can be both ethical and legal repercussions if a
professional incorrectly interprets a physician’s orders.
5. A defense that sexual improprieties with clients did not
take place during treatment sessions is unacceptable
conduct.
6. Scope of practice refers to the permissible boundaries
of practice for healthcare professionals, as is often
defined in state statutes, which define the actions,
duties, and limits of professionals in their particular
roles.
7. A professional who exceeds his or her scope of practice
as defined by state practice acts can be found to have
violated licensure provisions or to have performed tasks
that are reserved by statute for another healthcare
professional.
31305601 – Jones & Bartlett Learning ©
8. The power and authority to regulate drugs and their
products, packaging, and distribution rest primarily with
federal and state governments.
9. Certification of healthcare professionals is the
recognition by a governmental or professional
association that an individual’s expertise meets the
standards of that group.
10. Licensure can be defined as the process by which some
competent authority grants permission to a qualified
individual or entity to perform certain specified
activities that would be illegal without a license.
31305601 – Jones & Bartlett Learning ©
TEST YOUR UNDERSTANDING
Terminology
advanced practice nurse
certification
chiropractor
clinical nurse specialist
dentist
dietitian
float nurse
laboratory medical technologist
licensure
medical assistant
nonmaleficence
nurse anesthetist
nurse midwife
nurse practitioner
nursing assistant
paramedic
patient care teams
pharmacist
physical therapy
physician assistant
psychologist
radiology technologist
registered nurse
respiratory therapist
social worker
special duty nurse
31305601 – Jones & Bartlett Learning ©
REVIEW QUESTIONS
1. Describe how ethics and the law have an impact on the
various healthcare professions discussed in this
chapter.
2. Discuss the ethical and legal implications of practicing
outside one’s scope of practice.
3. Discuss the circumstances under which a hospital has a
duty to provide emergency services to the public.
4. Are sexual encounters acceptable with clients as long as
they do not take place during treatment? Explain your
answer.
5. Consider under what circumstances a professional’s
legal responsibilities may overlap with his or her ethical
duties.
6. Describe how and why the scope of practice for various
professionals (e.g., nurses and pharmacists) is changing.
7. Discuss what action a caregiver should take, if any, if a
physician’s written orders appear questionable.
8. Describe a professional’s responsibilities when a
patient’s condition takes a turn for the worse.
9. Describe the difference between the certification and
licensing of a healthcare professional.
31305601 – Jones & Bartlett Learning ©
NOTES
1. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun (March 11, 2004).
http://www.baltimoresun.com/news/maryland/bal-
lab0311-story.html (accessed July 27, 2018).
2. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
3. U.S. Department of Transportation, National Highway Traffic
Safety Administration (NHTSA), National EMS Scope of
Practice Model.
https://www.ems.gov/education/EMSScope.pdf (accessed
July 27, 2018).
4. Federal Interagency Committee on Emergency Medical
Services. 2011 National EMS Assessment. Washington, D.C.:
U.S. Department of Transportation, National Highway Traffic
Safety Administration, DOT HS 811 723.
https://www.ems.gov/pdf/811723-National-EMS-
Assessment-2011.pdf (accessed July 27, 2018).
5. NHTSA, National EMS Scope of Practice Model at 9.
6. Ibid. at 10.
7. U.S. Drug Enforcement Administration, “Officer Safety Alert:
Carfenatil: A Dangerous New Factor in the U.S. Opioid Crisis.”
https://www.dea.gov/divisions/hq/2016/hq092216_attach
.pdf (accessed July 27, 2018).
8. NHTSA, National EMS Scope of Practice Model at 23.
9. Ibid. at 26.
10. Ibid. at 26.
11. Ibid. at 27-28.
12. Morena v. South Hills Health Systems, 462 A.2d 680 (Pa. 1983).
13. Riffe v. Vereb Ambulance Service, Inc., 650 A.2d 1076 (Pa.
Super. 1994).
31305601 – Jones & Bartlett Learning ©
14. Fraijo v. Hartland Hosp., 160 Cal. Rptr. 252 (Ct. App. 1979).
15. Institute of Medicine, Keeping Patients Safe: Transforming the
Work Environment of Nurses. Washington, D.C.: The National
Academies Press, at 2. Available at
http://www.nap.edu/openbook.php?isbn=0309090679
(accessed July 28, 2018).
16. HHS.gov, “HHS Awards $55.5 Million to Bolster America’s
Health Care Workforce.” http://wayback.archive-
it.org/3926/20150618190916/http://www.hhs.gov/news/p
ress/2013pres/12/20131205a.html (accessed July 28, 2018).
17. Parija Kavilanz, “Nursing Schools Are Rejecting Thousands of
Applicants—in the Middle of a Nursing Shortage,” CNN
Money (April 30, 2018).
https://money.cnn.com/2018/04/30/news/economy/nurs
ing-school-rejections/index.html (accessed July 28, 2018).
18. Ibid.
19. Jilian Mincer, “Short on Staff: Nursing Crisis Strains U.S.
Hospitals,” Reuters (October 20, 2017).
https://www.reuters.com/article/us-usa-healthcare-
nursing/short-on-staff-nursing-crisis-strains-u-s-
hospitals-idUSKBN1CP0BD (accessed July 28, 2018).
20. Code of Federal Regulations, 42 CFR Ch IV, Subpart C, §
482.23 (b). https://www.gpo.gov/fdsys/granule/CFR-2011-
title42-vol5/CFR-2011-title42-vol5-part482/content-
detail.html (accessed July 28, 2018).
21. Teresa Serratt, Suzanne Meyer, and Susan A. Chapman,
“Enforcement of Hospital Nurse Staffing Regulations Across
the United States: Progress or Stalemate?” Policy, Politics, &
Nursing Practice 15 (2014): 21–29.
http://journals.sagepub.com/doi/pdf/10.1177/152715441
4532502 (accessed July 28, 2018).
22. Department of Health, Education and Welfare, Extending the
Scope of Nursing Practice: A Report of the Secretary’s
Committee to Study Roles for Nurses, Pub. No. (HSM) 73-
2037, 8 (1971).
23. Adams v. Krueger, 856 P.2d 864 (Idaho 1993).
24. Ibid. at 867.
31305601 – Jones & Bartlett Learning ©
25. Carolyn Buppert, “Reducing Liability Risk When Collaborating
with Nurse Practitioners,” Medscape (September 1, 2017).
https://www.medscape.com/viewarticle/884582
(accessed July 28, 2018).
26. Debbie LaValley, “Boy Dies After Call to NP for Flu
Symptoms.” CRICO (February 1, 2012).
https://www.rmf.harvard.edu/Clinician-Resources/Case-
Study/2012/Boy-9-Dies-After-Offhours-Call-to-NP-for-Flu-
Symptoms (accessed July 28, 2018).
27. Buppert, “Reducing Liability Risk When Collaborating with
Nurse Practitioners”
28. New York State Nurses Association, “Position on Statement
on Floating.” https://www.nysna.org/position-statement-
floating#.W1zdmS2ZPIE.
29. The Joint Commission, 2014 Hospital Accreditation
Standards, LD.03.06.04 at LD–20.
30. Cignetti v. Camel, 692 S.W.2d 329 (Mo. Ct. App. 1985).
31. Norton v. Argonaut Insurance Co., 144 So. 2d 249 (La. Ct. App.
1962).
32. Tami Dennis, “More Heparin Overdoses, This Time in Texas,”
Los Angeles Times, July 9, 2008;
http://latimesblogs.latimes.com/booster_shots/2008/07/
more-heparin-ov.html.
33. Harrison v. Axelrod, 599 N.Y.S.2d 96 (N.Y. App. Div. 1993).
34. Larrimore v. Homeopathic Hospital Association, 181 A.2d 573
(Del. 1962).
35. Cafiero v. North Carolina Board of Nursing, 403 S.E.2d 582
(N.C. Ct. App. 1991).
36. Ibid. at 584–585.
37. Goff v. Doctors General Hospital, 333 P.2d 29 (Cal. Ct. App.
1958).
38. Koeniguer v. Eckrich, 422 N.W.2d 600 (S.D. 1988).
39. Eyoma v. Falco, 589 A.2d 653 (N.J. Super. App. Div. 1991).
31305601 – Jones & Bartlett Learning ©
40. Ibid. at 655.
41. Poor Sisters of St. Francis v. Catron, 435 N.E.2d 305 (Ind. Ct.
App. 1982).
42. American Chiropractic Association, “Code of Ethics.”
http://ccodc.org/ethics.html (accessed July 28, 2018).
43. Susan Berger, “How Safe Are the Vigorous Neck
Manipulations Done by Chiropractors?” The Washington
Post. http://www.washingtonpost.com/national/health-
science/how-safe-are-the-vigorous-neck-manipulations-
done-by-chiropractors/2014/01/06/26870726-5cf7-11e3-
bc56-c6ca94801fac_story.html (accessed January 6, 2014).
44. Ibid.
45. Ibid.
46. Poor v. State, No.S-02-472, 266 Neb. 183 (Neb. 2003).
47. Brown v. Belinfante, 557 S.E.2d 339 (2001).
48. Melone v. State Education Department, 495 N.Y.S.2d 808 (N.Y.
App. Div. 1985).
49. Lowenberg v. Sobol, 594 N.Y.S.2d 874 (N.Y. App. Div. 1993).
50. Hickman v. Sexton Dental Clinic, 367 S.E.2d 453 (S.C. 1988).
51. Ibid. at 455–456.
52. University Hospitals, “Nutrition Services.”
http://www.uhhospitals.org/services/nutrition-services
(accessed July 28, 2018).
53. Massachusetts General Hospital, “Nutrition.”
http://www.massgeneral.org/nutrition/ (accessed July 28,
2018).
54. New York-Presbyterian, “Food and Nutrition.”
http://www.nyp.org/nutrition (accessed July 28, 2018).
55. The Joint Commission, 2017 Hospital Accreditation
Standards, PC.02.02.03 (element 7).
56. Lambert v. Beverly Enterprises, Inc., 753 F. Supp. 267 (W.D. Ark.
1990).
31305601 – Jones & Bartlett Learning ©
57. J. P. McWhirter and C. R. Pennington, “Incidence and
Recognition of Malnutrition in Hospital,” British Medical
Journal 308 (1994): 945–948.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539799/
(accessed July 28, 2018).
58. Fjerstad v. Knutson, 271 N.W.2d 8 (S.D. 1978).
59. Thomas v. Corso, 288 A.2d 379 (Md. 1972).
60. Marks v. Mandel, 477 So. 2d 1036 (Fla. Dist. Ct. App. 1985).
61. Baptist Mem’l Hosp. Sys. v. Sampson, 969 S.W.2d 945, 947 (Tex.
1998).
62. Martin C. McWilliams, Jr., and Hamilton E. Russell III, Hospital
Liability for Torts of Independent Contractor Physicians, 47
S.C. L. reV. 431, 473 (1996).
63. Marks v. Mandel.
64. Ibid. at 1039.
65. U.S. Food and Drug Administration, “Tests Used in Clinical
Care.”
https://www.fda.gov/MedicalDevices/ProductsandMedic
alProcedures/InVitroDiagnostics/LabTest/default.htm
(accessed July 28, 2018).
66. Mike J. Hallworth, “The ‘70%’ Claim: What Is the Evidence
Base?” Annals of Clinical Biochemistry: International Journal
of Laboratory Medicine 48 (2011).
http://journals.sagepub.com/doi/full/10.1258/acb.2011.0
11177 (accessed July 28, 2018).
67. American Society for Clinical Laboratory Science (ASCLS),
“Code of Ethics.” http://www.ascls.org/about-us/code-of-
ethics (accessed July 28, 2018).
68. Walter F. Roche, Jr., “City Hospital’s HIV Testing Manipulated,”
The Baltimore Sun, March 11, 2004,
http://www.baltimoresun.com/news/maryland/bal-
lab0311,0,3643424.story.
69. American Society for Clinical Pathology, State Licensure of
Laboratory Personnel (Policy Number 05-02).
http://www.pathologylearning.org/docs/default-
31305601 – Jones & Bartlett Learning ©
source/pdf/706df311-5dd9-49de-85bb-8fec4b1149b4.pdf
(accessed July 28, 2018).
70. KOMONEWS.com/Associated Press, “Spokane Woman
Suing over False HIV Diagnosis,” (December 26, 2013).
http://www.komonews.com/news/local/Spokane-
woman-suing-over-false-HIV-diagnosis-237318161.html.
71. Stepp v. Review Board of the Indiana Employment Security
Division, 521 N.E.2d 350 (Ind. Ct. App. 1988).
72. Ibid. at 352.
73. Whirlpool Corp. v. Marshall, 445 U.S. 1 (1980).
74. Stepp v. Review Board of the Indiana Employment Security
Division at 353.
75. Healthcare Careers Guide, “Medical Assistant Scope of
Practice Varies in Every State.”
http://www.healthcarecareersguide.com/medical-
assistant-scope-of-practice/ (accessed July 28, 2018).
76. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Medical Assistants
[online]. https://www.bls.gov/ooh/healthcare/medical-
assistants.htm (visited July 23, 2018).
77. Ibid.
78. Follett v. Davis, 636 N.E.2d 1282 (Ind. Ct. App. 1994).
79. Institute of Medicine, To Err Is Human: Building a Safer
Health System, supra note 1, at 194.
80. Katie Moisse, “Hospital Errors Common and Underreported,”
ABC News, April 7, 2011.
http://abcnews.go.com/Health/hospital-errors-common-
underreported-study/story?id=13310733.
81. Jesse C. Vivian, “Generic-Substitution Laws,” U.S. Pharmacist
(June 19, 2008).
https://www.uspharmacist.com/article/generic-
substitution-laws (accessed July 28, 2018).
82. Baker v. Arbor Drugs, Inc., 544 N.W.2d 727 (Mich. Ct. App.
1996).
83. Riff v. Morgan Pharmacy, 508 A.2d 1247 (Pa. Super. Ct. 1986).
31305601 – Jones & Bartlett Learning ©
84. Hooks v. McLaughlin, 642 N.E.2d 514 (Ind. 1994).
85. Ind. Code A4 25-26-13-16(b)(3) (1993).
86. National Coordinating Council for Medication Error Reporting
and Prevention, “About Medication Errors.”
http://www.nccmerp.org/about-medication-errors
(accessed July 28, 2018).
87. David M. Benjamin, “Reducing Medication Errors and
Increasing Patient Safety: Case Studies in Clinical
Pharmacology,” Journal of Clinical Pharmacology 43 (July
2013): 768–783.
https://accp1.onlinelibrary.wiley.com/doi/full/10.1177/0
091270003254794.
88. Russell W. Steele, “Medical Error Reduction in Daily Practice,”
Medscape.
https://www.medscape.org/viewarticle/447139 (accessed
July 28, 2018).
89. Ibid.
90. Pontiff v. Pecot & Assoc., 780 So. 2d 478 (2001).
91. American Physical Therapy Association, “Code of Ethics for
the Physical Therapist.”
https://www.apta.org/uploadedFiles/APTAorg/About_Us/
Policies/Ethics/CodeofEthics.pdf (accessed July 28, 2018).
92. Zucker v. Axelrod, 527 N.Y.S.2d 937 (N.Y. App. Div. 1988).
93. National Commission on Certification of Physician Assistants
(NCCPA), “Just Released Data Registers Mobility Trends of
Certified PAs [Press Release],” (May 22, 2018).
http://prodcmsstoragesa.blob.core.windows.net/upload
s/files/PressRelease2017StatisticalReport.pdf (accessed
July 28, 2018).
94. Bureau of Labor Statistics, U.S. Department of Labor,
Occupational Outlook Handbook: Physician Assistants
[online]. http://www.bls.gov/ooh/Healthcare/Physician-
assistants.htm (visited July 23, 2018).
95. Cox v. MA Primary and Urgent Care Clinic, 313 SW 3d 240 –
Tenn: Supreme Court 2010.
96. Ibid. at 262.
31305601 – Jones & Bartlett Learning ©
97. American Psychological Association (APA), “Ethical Principles
of Psychologists and Code of Conduct.”
http://www.apa.org/ethics/code/index.aspx.
98. Loomis v. Board of Psychologist Exam’rs, 954 P.2d 839 (1998).
99. APA, “Ethical Principles of Psychologists and Code of
Conduct.”
100. Gilmore v. Board of Psychologist Examiners, 725 P.2d 400 (Or.
Ct. App. 1986).
101. Ibid. at 204.
102. Michaels v. Gordon, 439 S.E.2d 722 (Ga. Ct. App. 1993).
103. Lisa Tortorello, “XRay Technicians: Missing in Malpractice
Cases,” X-Ray Schools (June 10, 2011).
http://www.xrayschools.com/articles/xray-technicians-
missing-in-malpractice-cases.html (accessed July 28,
2018).
104. Cockerton v. Mercy Hospital Medical Center 490 N.W.2d 856
(Iowa Ct. App. 1992).
105. American Association of Respiratory Care, AARC Statement
of Ethics and Professional Conduct (Revised 04/2015).
https://www.aarc.org/wp-
content/uploads/2017/03/statement-of-ethics.pdf
(accessed July 28, 2018).
106. State University v. Young, 566 N.Y.S.2d 79 (N.Y. App. Div.
1991).
107. National Association of Social Workers, “Code of Ethics.”
https://www.socialworkers.org/about/ethics/code-of-
ethics (accessed July 28, 2018).
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
© Fuse/Thinkstock.
CHAPTER 10
Physicians’ Ethical
and Legal Issues
Observation, Reason, Human Understanding, Courage; these
make the physician.
— Martin H. Fischer (1879–1962)
LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Apply the Hippocratic Oath to modern codes of medical
ethics.
Understand how the law and ethics intertwine in patient
care.
Describe common medical errors and ethical issues relative
to physician practice.
Describe important guidelines for developing positive
physician–patient relations.
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
31305601 – Jones & Bartlett Learning ©
INTRODUCTION
Of all the Hippocratic writings the Oath, in spite of its
shortness, is perhaps the most interesting to the general
reader and also to the modern medical man. Whatever its
origin, it is a landmark in the ethics of medicine.
—W. H. S. Jones, Ed.
1
31305601 – Jones & Bartlett Learning ©
The Hippocratic Oath
I swear by Apollo the physician, and Asclepius, and
Hygieia and Panacea and all the gods and goddesses
as my witnesses, that, according to my ability and
judgement, I will keep this Oath and this contract:
To hold him who taught me this art equally dear to
me as my parents, to be a partner in life with him, and
to fulfill his needs when required; to look upon his
offspring as equals to my own siblings, and to teach
them this art, if they shall wish to learn it, without fee
or contract; and that by the set rules, lectures, and
every other mode of instruction, I will impart a
knowledge of the art to my own sons, and those of my
teachers, and to students bound by this contract and
having sworn this Oath to the law of medicine, but to
no others.
I will use those dietary regimens which will benefit
my patients according to my greatest ability and
judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked,
nor will I advise such a plan; and similarly, I will not give
a woman a pessary to cause an abortion.
In purity and according to divine law will I carry out
my life and my art.
I will not use the knife, even upon those suffering
from stones, but I will leave this to those who are
trained in this craft.
Into whatever homes I go, I will enter them for the
benefit of the sick, avoiding any voluntary act of
impropriety or corruption, including the seduction of
women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients,
whether in connection with my professional practice or
not, which ought not to be spoken of outside, I will
keep secret, as considering all such things to be
private.
So long as I maintain this Oath faithfully and
without corruption, may it be granted to me to partake
of life fully and the practice of my art, gaining the
respect of all men for all time.
31305601 – Jones & Bartlett Learning ©
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