The Law of Hospital and Health Care Administration

Southwick, Arthur F.; Siedel, George J.

doi:10.1097/00004010-197921000-00016

Cited by 21 publications

(18 citation statements)

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“…This emphasis on priority of the individual as distinct from the welfare of the social group originated in the Renaissance when personal rights and responsibilities assumed greater importance in society [1]. The right to privacy is defined as the right to be left alone to perform one's personal affairs without unreasonable interference from the government or others as long as one's conduct is not unlawful or indecent [2]. Confidentiality is a subset of privacy that deals with the communication of information.…”

Section: Casementioning

confidence: 99%

The Legal Implications of Healthcare Communications: What Every Pain Physician Needs to Know

Ashburn

2000

Pain Med

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Accurate and sensitive communication of health care information is essential to effective patient management in the pain clinic, operating room, other health care settings. However, information relating to the health care status of a patient is sensitive and may be embarrassing or damaging if it falls into the wrong hands. Ethical cannons of medicine and statutory provisions have emphasized the obligation of the physician to safeguard patient confidences. However, threats to the confidentiality of medical information abound and are even more significant in our age of instantaneous communication characterized by the growing use of email, facsimile, and the Internet. This article outlines legal issues relating to communication in three key areas of health care law: confidentiality/breach of privacy, informed consent, and defamation. The major principles of the law in these areas are discussed and case studies are used to illustrate key points and give simple preventive strategies to help steer the delicate balance between sharing important healthcare information and protecting sensitive patient information.Key Words. Medical-legal communications; Medical records; Privacy; Confidentiality; Defamation Dr E saw patient XY in the pain clinic of a large referral hospital. XY had previously been seen and treated for reflex sympathetic dystrophy as an outpatient by physicians in a small town several hundred miles away. Dr E wrote a note in the electronic medical record: "It is difficult to imagine how therapy prescribed previously could have any chance of helping XY. In fact, earlier mistakes may have compromised my ability to effectively treat her." D r E may have thought she was protecting herself from malpractice exposure by blaming previous physicians for XY's difficult-to-treat condition. Unfortunately, not only does a comment like this increase the likelihood of malpractice action, but it also exposes Dr E to the risk of a lawsuit for libel initiated by XY's previous physicians.Information in medical records is now read by a multitude of parties. Anything entered into the record should be considered a communication to others. The comment in this medical record is derogatory toward previous physicians. It expresses more than a different judgement regarding a particular clinical decision and goes on to express an opinion about the competence of previous caretakers.This particular case reflects an additional problem. The ability to transmit medical information widely and quickly has never been greater. The use of email, facsimile, and the Internet presents a tremendous opportunity to improve health care by putting complete, accurate, and timely patient data in the hands of practitioners when they need it. However, the rapid dissemination of information has its downside. Whereas old-fashioned paper charts are available to dozens of people who provide care or review medical records for other purposes, an electronic medical record may be accessible to hundreds if not thousands of others. The potential for damage resultin...

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Section: Casementioning

confidence: 99%

The Legal Implications of Healthcare Communications: What Every Pain Physician Needs to Know

Ashburn

2000

Pain Med

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“…This means that reasonable care must be exercised to ascertain the qualifications, training, and experience of the person or business entity recommended to the patient (ref. 26). (ERI), a professional corporation.…”

Section: Corporate Negligencementioning

confidence: 99%

Managed care: Established law finds new applications

Southwick

2000

J of Healthc Risk Manag

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“…Hogue (1986) stated that in order to be deemed compe tent, one "must have the mental capacity to make choices and understand their conse quences" (p. 48). Southwick (1978) de fined mental competence as "whether or not the patient understands his [or her] condition, the nature of the medical advice rendered, and the consequences of [a] refusal to consent" (p. 230). Mental com petency has been questioned so intensely that Korolishin and Korolishin (1985) quote the Pennsylvania Superior Court (467 A 2d 1353, 1983) in ruling that "a patient can legally give informed consent when he |or she] has a complete under standing of the nature of the surgery, its se riousness, the organs involved, the condi tion sought to be cured, and the possible results" (p. 72).…”

Section: Implication 1: Mental Competencymentioning

confidence: 99%

“…The consent form should include most, if not all, of the information discussed so that the patient can review it before the final agreement is signed. As Southwick (1978) wrote, "The form should name the physician or surgeon, authorize him [or her] to select assistants, recite that the patient understands the procedures, recite consent to the administration of anesthesia under the supervision of a named physi cian or nurse, and state that the patient has received an explanation of the contem plated procedures. In addition, the lan guage should recognize that unforeseen conditions arising during the surgery may dictate additional or different procedures from the surgery and may dictate addi tional or different procedures from those contemplated, and that the patient realizes this and consents to such additional or different procedures as may in the profes sional judgment of the surgeon or physi cian be advisable" (p. 208).…”

Section: Implication 2: Informationmentioning

confidence: 99%

‘What Have I Done?’: The Issue of Informed Consent

Cunningham¹

1989

Rehabilitation Nursing

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Patients are presented with informed consent forms at a time of stress and indecision. The patient should be treated with respect and not encouraged to sign a form that is not fully understood. Rehabilitation nurses whose patients face surgery are in a unique position to explore the implications of surgery with the patient. The nurse's role in assessing whether the patient is alert, knowledgeable of, and agreeable to all aspects regarding the surgery is vital.

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The Law of Hospital and Health Care Administration

Cited by 21 publications

References 0 publications

The Legal Implications of Healthcare Communications: What Every Pain Physician Needs to Know

The Legal Implications of Healthcare Communications: What Every Pain Physician Needs to Know

Managed care: Established law finds new applications

‘What Have I Done?’: The Issue of Informed Consent

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