Module Components

• Overview

Topics

• Ethical Health Care Issues
• Basic Concepts of Law in the Healthcare Workplace
• The Legal Environment: Healthcare Law
• Legal & Clinical Incapacity and Informed Consent
• Confidentiality and HIPPA
• Advance Directives
• Labor Relations
• Human Resources: Related Legislation

Nurs 692 Administration of Nursing and Health Care Services

Module 10: The Ethical & Legal Environment and Labor Relations

Basic Concepts of Law in the Healthcare Workplace

The healthcare industry is one of the most heavily regulated industries in the United States. Those who provide, receive, pay for, and regulate healthcare services are affected by the law. Law is a body of rules for the conduct of individuals and organizations. Law is created so that there is a minimal standard of action required by individuals and organizations. There exist laws created by federal, state, and local governments. When the judiciary system interprets previous legal decisions with respect to a case, they create common law. The minimal standard for action is federal law, although state law may be more stringent. Legislatures create laws that are called statutes. Both common law and statutes are then interpreted by administrative agencies by developing rules and regulations that interpret the law.

There exist civil and criminal laws that affect the healthcare industry. Civil law focuses on the wrongful acts against individuals and organizations based on contractual violations. In civil law, torts derived from the French word for wrong, is a category of wrongful acts or negligence that can result in different types of health-care violations. To prove a civil infraction, you do not need as much evidence as in a criminal case.

Criminal law is concerned with actions that are illegal based on court decisions. To convict someone of a criminal activity, it has to be proved without a reasonable doubt of guilt. Examples of criminal law infractions would be Medicare and Medicaid fraud.

As stated earlier, torts are wrongdoings that occur to individuals or organizations regardless of whether a contract is in place. Medical malpractice cases are examples of torts. There are several different types of violations that can apply to health care.
There are two basic healthcare torts: (1) negligence, which involves the unintentional act or omission of an act that could negatively contribute to the health of a patient, and
(2) Intentional torts, such as assault and battery and invasion of privacy.

An example of negligence is if a provider does not give appropriate care or withholds care that results in damages to the patient’s health. In the healthcare industry, intentional torts such as assault and battery would be a surgeon performing surgery on a patient without his or her consent. An example of invasion of privacy would be the violation of patients’ health records. Privacy relating to patient information is a major issue in the healthcare industry. As more information that is confidential is shared electronically, there is an increased risk of invasion of privacy. These examples are categorized under the term medical malpractice.

According to the American Heritage Dictionary, medical malpractice is the “Improper or negligent treatment of a patient by a provider which results in injury, damage or loss”. According to the Institute of Medicine’s landmark report To Err Is Human, medical malpractice results in approximately 80,000 to 100,000 deaths per year. The Congressional Budget Office (CBO) found that in 2003 there were over 180,000 severe injuries due to medical negligence. Harvard School of Medicine researchers indicate that in 2005 nearly 20% of hospital patients are injured during their care. Disputes over improper care of a patient have hurt both providers and patients. Patients have sued physicians because of the belief that the physician has not given the patient a level of care comparable with the standard of care established in the industry.