Patient-Provider Relationship Scenario - Case Study Example

Affiliation: Case study – LAW Introduction A case study is a statistical method of data collection, recordingand presenting of information relating to a specific person, group of people in a specified area or a situation over a period of time. One of the iconic pioneers of law in health issues was Dr. John Snow (Goodman, et al 3). This came after an outbreak of cholera and thus states had to enact proper rules to regulate the spread of this contagious disease. The practice of Medicine is entwined to the practice of Law (Corfield, et al 1). Thus, medical practitioners at one point or another are required to give either written or oral evidence in courts of law. This study relates to the application of law in medical situations over a period of time. There are four sources of law. These are: the Constitution, Statutes, Decisions and Rules of administrative agencies and Court decisions (Stelner 5).In most states, there is a department concerned with law relating to healthcare issues. Another external source of law is the International law (Stelner 9). Under the International law, state agencies are allowed to surrender the privacy of medical information of their citizens travelling to foreign countries. This study will look into six different scenarios. Workforce scenario 1 In the first scenario, Cayce Pollard, the new African-American nurse has to undergo several health tests before being hired at Big City Hospital, BCH despite the fact that she is a licensed nurse. Licensing of health practitioners is done to ensure that only the qualified individuals undertake the delicate duty of health provision. This is to protect the interest of the public (Stelner 84). This is an example of Common Law only applying to the terms of employment in BCH. She is also not allowed to smoke, both at work and off duty and should her BMI exceed 26, she has to pay higher premiums for her insurance cover. Agreeing to these terms by both parties makes it an Implied Contract. In the first instance where a mother does not want her baby to be attended to by an African-American, she feels offended. However, this falls under Charting by Exception. Since there was a chart indicating that she could not attend to the baby, it would be a criminal offence for her to do the contrary. In the second instance, her male colleagues have been sexually harassing her which is against the code of ethics at BCH.Her senior, whom she is supposed to report to also, enjoys the sexually explicit content that the other two use to harass her sexually. Though she knows that this amounts to punishable crime, she resorts to remain silent. However, according to state laws, this does not amount to crime since Quid Pro Quo applies in instances where a senior or fellow staff solicits sexual favor in order to grant a promotion or other work related favors. Also she has noticed that Bernard, her colleague might be a drug user and might cause problems while in duty. Upon reporting the matter to the supervisor, all their lockers are searched but against their consent. This is an instance of invasion of privacy. On another instance, Cayce and her friend Ivy discriminate their colleague Robert. They both discriminate him on gender arguing that male nurses are not competent. Ivy also discriminate him racially saying she does not like the Chinese. Negligence scenario 2 In the first instance, Dr. Yang diagnoses Ms. Campbell with PCS and Compound P which are new drugs being tested on patients. This he does with the aim of prolonging her life despite her being not eligible for the drugs but only after she accepts to take it. Though the drugs did tremendously help other patients, Mrs. Campbell’s condition worsened and she developed fever and rashes. Upon realizing this, the doctor prescribes Gallacticol, a drug that is approved for treating asthma. Her conditions became worse and she died. The doctor expected her to live for three or more months even after injecting her with Compound P but due to his negligence in not prescribing Prednisone, she succumbed. This is a situation of negligence and the doctor should be charged on a malpractice case based on contract since he had promised his patient that she would get better. Malpractice case based on contract comes when a physician promises the patient a given outcome (Stelner 16). In the second instance, Mary, was transferred from Sierra hospital to BCH. Sierra failed to indicate in Mary’s medical records that she was allergic to Amoxillin. BCH also did not take time to go through her full medical records. Though she is given Amoxillin at BCH, they manage to save her from her weakened condition. This is a scenario of negligence both at Sierra and at BCH. In the third instance, John does not want treatment after having a minor accident. His doctor however feels that it’s important that he be examined. John tells him that he does not want his wife to know that he was treated but the doctor threatens that he would inform his wife of what happened should he refuse to be examined. This is a case of invasion of privacy which is against the law. In the fourth instance, Selma a nurse at BCH accidentally pricks herself with an injection needle. Upon realizing that the patient was HIVpositive, she becomes emotionally disturbed and sues the hospital for negligence on needle safety measures. Here, she is justified to sue BCH for the emotional distress she endured and for the hospital’s breach of safety measures. Patient-Provider relationship scenario 3 In the first case, Dr. Jones prescribes an over-the-counter medication for Ellen’s son. However, the boy’s condition deteriorates and he is taken to hospital. Both Dr. Jones and his partner cannot treat the boy since they are neither pediatricians nor generalists. Under this circumstance, it would be hard for Ellen, a nurse who enjoys close relationship with Dr. Jones, to sue the doctor for improper medication since he had just assumed that the symptoms were for allergy. Moreover, their relationship was not contractual but that of friendship. In the second instance, Ellen upon noting that her shift time was over and her replacement was late, she called her friend Mary to cover-up for her. Since, the supposed replacement did not report to duty, Mary had to work at two stations which made her so busy. With the patient alarm being disturbed by the children, she puts it off. Due to this, she arrives late to check a boy who had developed breathing complications. This causes the boy to die. Though this would amount to negligence, Mary did her best to save the boy’s life. It is the nurse who never reported to her station and the BCH that should be charged for negligence. The nurse should have called to say that she would not report to duty and the hospital should also have found another nurse to sit in her absence. In the third case, Mr. Cobar, the patient who only understood Spanish could not communicate to the ER physician. The physician despite knowing his patient’s condition did not bother to look for a translator but insisted on using English. Later that day, Mr. Cobar, after leaving hospital without treatment, suffered a massive heart attack and succumbed. Under the VL Civil Rights Law, a patient should not be discriminated based on race, color or country of origin. Thus, the hospital or the doctor ought to have hired a translator. In that context, this amounts to negligence. On the contrary, it is also illegal in the State of California, to say that you only speak Spanish. As such, under the Preemption Doctrine, Mr. Cobar would be found guilty under the State of California laws for only being able to speak Spanish. The Preemption Doctrine allows the State law to supersede the State law in some instances (Stelner 6). Decision-making scenario 4 In the first case, Mr. Lambert’s health condition reduces his judgment level and thus the ability to make concrete decisions has drastically reduced. However, before becoming critically ill, he had instructed his lawyer to draft an agreement that he should only be given comfort measures only, if his conditions worsened. On the other hand, he had appointed his son Gary as his durable attorney of power. In the meantime, Gary has been insisting that his father’s pneumonia condition is not related to his Alzheimer’s. Enid, the wife on the other hand claims that her husband’s pneumonia condition is related to Alzheimer’s and thus he should only be given comfort measures. The physician on the other hand believes that the pneumonia condition is easily treatable. She also believes that her patient is well aware of his surrounding and everything that goes on. However, Mr. Lambert himself has been increasingly having difficulties with breathing and feels that he should be left to die. The other medics have also been feeling agitated by the goings on and they opt that Mr. Lambert should be put on comfort measures. According to the decision making chart, a spouse comes first followed by adult children, parents, adult siblings of the patient then others. Another factor is that Mr. Lambert had made his decision for comfort measures before a jury instead of a psychiatrist who could evaluate his choices. Therefore, given Mr. Lambert’s inability to make good decisions in his current state, his wife, Enid should be the most appropriate to decide. In the second case, Martin Probst agrees to be amputated on condition that there will be no blood transfusion due to his religious beliefs. However, the surgery goes bad and a blood transfusion has to take place in order to save the life of Probst. The doctor is determined to save the life of his patient who is the sole bread winner for his family and asks Robert, Mr. Probst’s 16-year old first born son to consent in order for Probst to receive a transfusion. This is a situation of an advance oral directive which is legally enforceable should it be written down before a witness. This oral directive under the US federal laws would be termed unenforceable if it was not written down (Stelner 14). In the third case, Louis Holland’s doctor discovers that he has testicular cancer and wants him to consent to the removal of right testicle and be cured through radiation. Though the doctor has explained to him that he will still be able to have his own children in future, he is adamant. However, his parents have consented to it since he is a minor who will be turning eighteen in two months’ time. This is a case of an involuntary treatment of a minor who has refused treatment. The surgery will have to be carried out to save the boy’s life and also to protect the doctor’s work ethics. Reproduction scenario 5 In the first case, Joan is pregnant and doesn’t want her mother to know. Her tooth cannot be extracted without using anesthesia. However, it is not recommended to be used on pregnant women. Here, the physician is the one to make a decision since he is dealing with a minor and should he act in a way that causes damage to the girl, he will be liable for his actions since in most cases, physicians are legally independent of the hospitals (Stelner 28). The most appropriate thing to do is for the physician to inform the girl’s mother in order for her to consent on her daughter’s behalf. In the second case, the new law would pose constitutional challenges in the sense that in some instances abortion is procured when: the mother’s life is in danger the foetus has genetic problems the mother was raped In these situations, it would be unrealistic to ask for the consent of the father or the parents in case of minors. In the third situation, though the pediatrician misled Robert he answered his questions and provided him with the materials that he had requested. However, he failed to give wise advice to the minor and could not even inform his parents. Here, the boy’s father is justified to sue him for negligence. Also, the doctor would be justified to sue Robert’s father for defamation since the rumors that he spread are malicious and have led to decline of his business. Defining death scenario 6 Mr. Arcturus, after being hit by a hit-and-run vehicle, is picked by two paramedics. One on seeing him says he’s dead but the other suggests that they try and rescue his life. Upon arriving at the hospital, some medics declare that he’s dead while one says that they should try to resuscitate his life. Mr. Arcturus could only survive if he was put on a ventilator. In such a scenario, had the hospital appointed a team leader, it would’ve been easier to come with a solution. An example of this is when a Florida court decided that the surgeon and not the anesthesiologist should make the final surgery decisions (Stelner36). In this case it would be too hard to determine legally whether he was indeed dead or not since the law recognizes different types of death and which can only be determined by physicians. The police also are finding a hard time charging the driver of the hit-and-run vehicle since they are not sure whether he died on the spot of the accident, in the ambulance or at the hospital. The insurance companies too are arguing that they cannot pay for services that were not rendered assuming he died on the spot. Based on these three situations, had Mr. Arcturus delivered that speech earlier on, it would be clear that he died at the scene of the accident and that the driver ought to be charged with felony and the insurance company should exempted from paying any amount of money. References Corfield, Lorraine, Granne, Ingrid, Latima-Sayer, William. ABC of Medical Law, John Wiley & Sons. 2010. Print Goodman, A. Richard, Hoffman, E. Richard, Lopez, Wilfredo, Matthews, W. Gene, Rothstain, Mark, Foster, L. Karen. Law in Public Health Practice, 2nd Edition, Oxford University Press, 2007. Print. Stelner, John. Ed. Problems in Healthcare Law: Challenges for the 21st Century, 10th Edition, Jones & Bartlett Publishers.2012. Print Read More