Medical Practice: Legal and Ethical Responsibilities

Abstract

Physicians and other medical staff are often faced with a plethora of legal and ethical medical professional practice issues that are so plentiful to discus in this research paper. As a result, only the key professional legal and ethical matters will be addressed. The main duties of care are in general considered to be respect for patient autonomy, recognizing the practitioners owe patients duty of care and that patients are entitled to confidentiality. These main duties are professional responsibilities, nonetheless, when breached, there are legal implications to be faced hence they are also legal obligations. On the other hand, ethical concerns arise from contemplation of these responsibilities like debating when these duties can be beached this makes them ethical responsibilities.

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Introduction

Medical law and ethics subject is very crucial for healthcare service delivery and play an important function in medical facility functioning and the way patients are taken care of. The society has turned out to be very litigious and the patients, their family or friends and other parties are likely to initiate a lawsuit against a practitioner, healthcare facility and even manufacturers of medical products when they observe unacceptable medical outcomes. It is hence very important that practitioner comprehend medical laws and ethics and provided by various medical regulatory bodies. Understanding these would enable professional to work with the highest sense of competence and empathy and hence enable them to avoid legal implications that could be a threat to their careers.

To identify with what medical law and ethics entails it’s proper to note the distinction between law and ethics. A law is a canon of behavior or the way actions are prescribed or a formal way of doing things enforced by a regulatory agency. Ethics are on the other hand the standard values and norms of identifying right and wrong and goes beyond the statute consideration of any circumstance (Dimond, 2005, p. 56).

As the caretakers of the public’s health, physicians and medical staff are expected to exercise the highest level of moral standards and legal principles. To a certain level, this is consistent with education and training over the issue that concern policy, protocol, state laws and healthcare regulation (Dimond, 2005, p. 56).

Observing these laws and ethics increases the standards of care for patients. In the recent times, many people are concerned about patient safety and quality of care in the healthcare settings, associating quality care and medical errors to direct detrimental outcomes and also long-term unpleasant effects. In order to be able to deal with these problems at the individual and national level, a holistic or multifaceted strategy has been put forward by the Institute of Medicine where policy review, legal issue consideration and confidentially issues are to be examined and reinforced (Dimond, 2005, p. 56).

Finding/Discussion

Legal principles and ethical concerns in medical care are usually intricate and multi-dimensional and at times some medical cases fail to be addressed under state statute or professional code of ethics (Dimond, 2005, p. 61). However, despite this, these concerns have to be observed. The codes only act as a guideline to educate and inform the medical care professional on rational conduct. They set the lowest standard of care though the professional have to aspire always to give the highest standards of care of the best practice which is rated by the quality of care.

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Moral principles are the central dogma for this kind of care to ensure that autonomy, veracity, beneficence, justice, fidelity and non-malfeasance principles are observed (Dimond, 2005, p. 66).

Important factors to consider include; autonomy – respecting person’s ability to make their own decisions on their health (Pozgar, 2005, p. 275); beneficence – allowing actions that benefit clients and other people; justice – providing equitable treatment to everyone; -nonmalfeasance – ensuring that actions to not cause damage to other people or the patients (Pozgar et al, 2009, p. 312); fidelity – the act of honoring promises and commitment and veracity which is to exercise truthfulness.

Confidentiality

Confidentially as a medical principle is interlinked to a number of other ethical principles in healthcare and it is therefore applied in relation to these other codes. Accordingly, patients have the right to suppose that their personal information will be treated with high level of confidentiality by the physician or other medical staff (Goldberg, 1997, p. 1095). This concept is key to the trust that has to exist between physicians and their patients.

In the case of W v Egdell [1990], medical law confirmed that just like other professionals, physicians and nurses are under obligation not to disclose their patient’s information to a third party without the consent of the patient (AMA, 2011b, para. 2). This specifically refers to the type of information that the physician is able to obtain from the patient by virtue of the professional position (Goldberg, 1997, p. 1097). The information can only be disclosed in exceptional situations especially when it is for the public’s interests but few such cases usually come up.

Confidentially is demonstration of respect to the patient’s autonomy as well and the patient’s right to control personal information especially their health (Pozgar, 2005, p. 275). By ensuring that the information stays confidential, the physician is said to be acting beneficently (Goldberg, 1997, p. 1098). Breach of this principle is only when the third party are at risk like victim of abuse patients, or when withholding the information would not be in the best interests of a child incapable of consenting etc.

Duty of Care

Many practitioner and scholars argue that duty is the only correct evaluation of ethical obligation. There are a number of responsibilities that are linked to duty – duty to act to protect the public, duty to provide services that are in the interest of the patient and duty to exercise confidentiality, AMA (2011a, para. 2). Emphasize has however been given to duty of care.

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The moment the patient and a physician begin consultation, they are already bound in a contract (formal or informal) and consequently the physician owes the patient duty of care. According to law, the doctor/nurse-patient relationship assures responsibility was already assumed by the practitioner. Whether actually duty of care existed can then be decided by the legal guideline AMA (2011a, para. 2).

Testing whether there was breach of this principle, regulatory bodies’ guidelines and opinions is sought. However Bolam test which was devised from Bolam v Friern Barnet [1957] suit is elemental for such cases. To determine whether there was negligence, then the test is to whether or not is the normal person performing and professing to be a specialist. For instance, is a surgeon fails to measure up to the professional standard; therefore, she/he should face the law (AMA, 2011a, para. 2).

Negligence is a tort and it is a serious medical malpractice involving professional mistakes in diagnosing and treating a patient. These are the cases where the patient believes that the physician or nurse failed to perform a crucial process or performed a wrong process hence leading to harm. An example is when a patient suffers post operative complications while in the recovery room and starts bleeding and when the incision is checked, it is found that the surgeon failed to complete the stitching and closure of all the blood vessels at the operation site.

Autonomy

This is one of the most powerful principles of medical law and ethics. Patients have inalienable right to make decision on what happens to their body and physicians have a duty to respect that decision (Pozgar, 2005, p. 275). There is only one justification for contravening this principle and imposing treatment to a patient and that is when that would prevent harm to other people. It is a fundamental principle in medical practice that patients should be given informed consent before they are treated with any form of medication (AMA, 2011b, para. 2). They are then to react to this with accepting or refusing.

However, developing good relationship with patients, physical are required to develop trust. This can be well developed when patient autonomy is respected (Pozgar et al, 2009, p. 312). The information should be given to them in the simplest form so that they can comprehend and therefore enable them to be able to exercise their autonomy and make informed decisions (Pozgar, 2005, p. 276).

Informed Consent

It is mandatory in most states that before physicians and health professional can begin administering any medication to patients they must obtain the informed consent for the medication process (AMA, 2011b, para. 3). Failure to obtain it utterly amounts to malpractice regardless of the quality of care provided. The informed consent is a document that explains the medication to be give, the foreseeable risks, benefits, alternative medications, description of the confidentiality conditions, expense to the client, impact in case of withdrawal from treatment and the person to seek advice or ask pertinent question in the event of emergency (Beahrs & Gutheil, 2001, p. 5).

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The practitioner should be able to explain all the details include on the informed consent report so that by the time the patient makes the crucial decision of whether or not to accept medication, he/she has all the information needed.

Informed therefore is not merely getting the patient to sign the form but it is extensive communication process between the practitioner and the patient that ends up in agreeing to undergo the treatment or not (Beahrs & Gutheil, 2001, p. 5). When all the aspects of the consent form have been explained, the patient must be given the chance to ask question for clarification before making a decision. This is there a legal and ethical obligation that is closely stated and exercised in 50 states under medical statute.

Conclusion

This paper delineates the medical laws and ethics that physicians face. There are several guidelines established by regulatory bodies like AMA and they offer the framework of working. Basically medical ethics are the process for considering implications of treatment procedures and what ought to be. The study therefore though descriptive, elicits many questions that surround adequacy of state law and institutional policies that concern patient care and ethical issues. In order to optimize care, it is pertinent that the physician and other medical staff are aware of the medical legal and ethical implication.

There needs to be more research on the matter and more study of the statute cases and future effort should seek to develop greater congruency between state laws and the institutional processes. Indeed, medical care for the patients in this 21st century now extends beyond the traditional practice of patient-centered medical intervention and now there needs to be are cognition of the law, polices and confidentially. All these aspects are complimentary to each other and also very vital in the delivery of care.

Reference List

AMA, (2011a) Patient Physician Relationship Topics, Patient Physician relationship. American Medical Association. Web.

AMA, (2011b). Patient Physician Relationship Topics, Informed Consent. American Medical Association. Web.

Beahrs, J.O., & Gutheil, T.G. (2001) ‘Informed consent in psychotherapy’, American Journal of Psychiatry, 158, pp. 4-10.

Dimond, B., (2005) Legal Aspects of Nursing, 4th Edition, London: Longman Press.

Goldberg, D.J. (1997) ‘Physician-Patient Confidentiality. Legal and Ethical Implications in the Setting of Basal Cell Nevus Syndrome’, Dermatol Surg. 23 (11): 1095-7.

Pozgar, G., (2005) Legal and Ethical Issues For Health Professionals, Sudbury, MA: Jones and Bartlett Learning.

Pozgar, G.D., Santucci, N & Pinnella, J.W. (2009) Legal and Ethical Issues For Health Care Professionals, Sudbury, MA: Jones and Bartlett Learning.

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