This document discusses key concepts in healthcare law and ethics. It covers basics of healthcare law including different types of laws, how laws are created and interpreted, and civil vs criminal law. It also discusses the relationship between healthcare providers and consumers, important consumer laws like HIPAA and EMTALA, informed consent, patient bills of rights, ethical standards and considerations, and issues at the intersection of ethics and public health.

1. Healthcare Law and
Ethics
HEED 3330
MODULE 6
DR. GREEN
SLIDES DERIVED FROM PARVANTA, C. F., NELSON, D. E., & HARNER, R. N. (2018). PUBLIC HEALTH COMMUNICATION: CRITICAL TOOLS AND
STRATEGIES. BURLINGTON, MA: JONES AND BARTLETT.

2. Basics Concepts of Healthcare Law
 Law is a body of rules for the conduct of individuals and organizations
which is often interpreted differently and may change over time.
 Law is created so there is at least a minimal standard of action required by
individuals and organizations.
 There is law created by federal, state, and local governments.
 As the judiciary system interprets previous legal decisions regarding a
case, they are creating common law.
 The minimal standard for action is federal law, although state law may be
stricter.
 Legislature creates laws which are called statutes.
 Both common law and statutes are then interpreted by administrative
agencies by developing rules and regulations that interpret the law.

3. Basic Concepts of Healthcare Law
Continued
 There are civil and criminal laws that affect the healthcare industry.
 Civil law focuses on the wrongful acts against individuals and
organizations based on contractual violations.
 Torts, derived from the French word for wrong, are a category of wrongful
acts, in civil law, which may not have a preexisting contract.
 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.
 In order to convict someone of a criminal activity, it has to be proven
without a reasonable doubt of guilt.
 Examples of criminal law infractions would be Medicare and Medicaid
fraud.

4. The Relationship Between the Provider
and the Consumer
 A physician can establish a relationship with a patient in three ways:
1. Establishing a contractual relationship to care for a designated
population
2. Establishing an express contract with a patient under mutual agreement
3. Establishing a relationship under an implied contract

5. Healthcare Consumer Laws
 The Hill-Burton Act of 1946: Federal grants were provided to states for
hospital construction to ensure there were 4.5 beds per 1,000 people.
 The Emergency Medical Treatment and Active Labor Act (EMTALA) of
1986 requires Medicare participants receive emergency care for a life
threatening condition from a hospital or medical entity that provides
dedicated emergency services.
 Facilities can be fined thousands of dollars for not adhering to the
EMTALA.
 The HIPAA National Standards of 2002 to protect a patient’s personal
medical records, further protected medical records, and other personal
health information maintained by healthcare providers, hospitals,
insurance companies, and health plans.

6. Informed Consent
 The concept of informed consent is based on the patient’s right to make an
informed decision regarding medical treatment. It is a legal requirement in all
50 states. The provider is responsible for discussing with the patient:
1. The diagnosis if it has been established;
2. The nature of a proposed treatment or operation, including the risks and benefits,
any alternatives, and the risks and benefits of the alternatives;
3. And the risks and benefits of not agreeing to the procedure or treatment.
 If a patient did not provide informed consent for a procedure or treatment, it is
considered a case of negligence.

7. Patient Bill of Rights
 The Patient Self-Determination Act of 1990 requires hospitals, nursing
homes, home health providers, hospices, and managed care organizations that
provide services to Medicare- and Medicaid-eligible patients to supply
information on patient rights to patients upon admission.
 It virtually applies to every type of healthcare facility.
 The facility must provide adult patients with written information, under the
state law, about making healthcare decisions.
 Based on the concept of informed consent, in 1972 the Board of Trustees of
the American Hospital Association developed a Patient Bill of Rights.
 The Patient Bill of Rights states that the patient has the right to all
information from this provider regarding any testing, diagnoses, and
treatments.
 This information must be provided to the patient in terms that the patient will
be able to understand.

8. Ethical Standards
 The concept of ethical standards applies to actions that are hoped for
and expected by individuals.
 Actions may be considered legal but not ethical.
 There are many definitions of ethics but, basically, ethics is concerned with
what are right and wrong choices as perceived by society and its
individuals.

9. Medical Ethics and Bioethics
 Medical ethics focuses on the decisions healthcare providers make on the
patient’s medical treatment.
 Euthanasia or physician-assisted suicide would be an example of a medical
ethic.
 Bioethics focuses on the field of study concerned with the ethical
implications of certain biologic and medical procedures and technologies.
 Organ transplants and genetic engineering are examples of bioethics.

10. Suggested Ethical Values of Doctor
Patient Relationship
 Autonomy: Decision-making may be different and healthcare providers
must respect their patients’ decisions even if they differ.
 Beneficence: Patient’s best interests when making a decision is primary
 Nonmalfeasance: The healthcare provider will cause no harm when taking
action
 Justice: Healthcare providers will make fair decisions.
 Dignity: Patients should be treated with respect and dignity.

11. Ethics and Public Health
 Issues in public health include:
 Inaccessibility to health care for certain populations
 Responding to bioterrorism
 Research in developing countries
 Health promotion and its infringement on individual’s lifestyle choices
 Public health’s response to emergencies