Download Chapter08 - WordPress.com

PowerPoint to accompany
Law & Ethics For Medical Careers
Fourth Edition
Judson · Harrison · Hicks
Chapter 8—Physicians’ Public
Duties and Responsibilities
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display
8-1
Physicians’ Public Duties and
Responsibilities
 Objectives
 List
at least four vital events for which
statistics are collected by the government
 Discuss the procedures for filing birth and
death certificates
 Explain the purpose of public health
statutes
 Tell when a medical examiner or coroner
is required to sign a death certificate
8-2
Physicians’ Public Duties and
Responsibilities

Objectives continued
 Cite
examples of reportable diseases,
and explain how they are reported
 Identify three types of reportable injuries
 Discuss federal drug regulations
 State the purpose of the Controlled
Substances Act
8-3
Vital Statistics

Collected by State and Federal governments
 Used to assess population trends and needs
 Examples include
-live births
-deaths
-fetal deaths
-changes in civil status
-marriages
-divorces
-induced terminations
of pregnancy
8-4
Vital Statistics - Births
Live births are reported to the state
registrar
 Hospitals file birth certificate for babies
born in the hospital with attending
physicians’ verification
 Non-hospital births are filed by the
person in attendance at the birth

8-5
Vital Statistics - Deaths

The attending physician completes the
medical portion of the death certificate
which includes
cause of death
 date and time
 place
 presence or absence of pregnancy (if
female)
 if an autopsy was performed

8-6
Public Health Statutes
All states have public health statutes,
and the laws vary from state to state
 All states provide for

guarding against unsanitary conditions in
public facilities
 inspecting establishments where food and
drink are processed and sold

8-7
Public Health Statutes
continued

All states have statutes that provide for
exterminating pests and vermin that can
spread disease
 checking water quality
 setting up measures of control for certain
diseases
 requiring physicians, school nurses, and
other health care workers to file certain
reports for protecting the public

8-8
Communicable Diseases
Regulations for reporting communicable
and other diseases vary by state
 Examples of reportable diseases are

-tuberculosis
-smallpox
-anthrax
-HIV/AIDS
-infectious hepatitis
-tetanus
-influenza
-certain STD’s
-meningococcal meningitis
8-9
National Childhood Vaccine Injury Act
The Act established a national
educational program about advantages
and risks of vaccines
 Established guidelines for administration
and documentation


Requires informed consent and specific
documentation
-date
-vaccine manufacturer
-vaccine lot #
-provider who administered
8-10
Reportable Injuries
Injuries resulting from an act of violence
should be reported for authorities to
investigate
 They must be reported in the case of
child or elder abuse according to federal
law
 Reporting of spousal abuse differs in
each state

8-11
Reportable Injuries – Child Abuse
The Federal Child Abuse Prevention and
Treatment Act mandates reporting of
cases of child abuse and States have
passed similar acts
 The individual reporting the abuse is
granted civil and criminal immunity
 Check with your individual State’s
Department of Health for regulations and
reporting process

8-12
Reportable Injuries – Elder Abuse
Amendments to the federal Older
Americans Act defines elder abuse,
neglect and exploitation
 All states have legislation for reporting
elder abuse
 Check with your individual State’s
Department of Health for regulations and
reporting process

8-13
Reportable Injuries – Spousal Abuse
State laws protect victims of domestic
abuse
 In many states, patient must give
permission before a report is made to the
authorities unless it is a rape, gunshot, or
stabbing
 Check with your individual State’s
Department of Health for regulations and
reporting process

8-14
Unborn Victims of Violence Act
Federal Act provides for prosecution of
anyone who causes injury to or the death
of a fetus in utero while also injuring or
killing a pregnant woman
 Passed in April, 2004

8-15
Identifying Abuse – Physical Signs
unexplained fractures
 repeated injuries or bite marks
 burns with unusual shapes or friction burns
 malnutrition, dehydration
 torn or bloody underwear
 pain or bruising in the genital area
 unexplained venereal or other genital
infection

8-16
Identifying Abuse – Behavioral Signs
illogical or unreasonable explanations for
injuries
 frequently changing physicians, missed
appointments
 attempts to hide injuries with makeup,
sunglasses
 frequent anxiety, depression, or loss of
emotional control
 changes in appetite
 problems at school or on the job

8-17
Drug Regulations

The Federal government has jurisdiction
over the manufacture and distribution of
drugs in the U.S.

Food and Drug Administration (FDA)
Tests and approves drugs before releasing them
for public use

Drug Enforcement Agency (DEA)
Regulates the sale and use of drugs
8-18
Drug Enforcement Administration
Physicians who purchase, prescribe,
dispense, or administer controlled drugs
must comply with the regulations of the
Comprehensive Drug Abuse Prevention
and Control Act, also known as the
Controlled Substances Act
 See Table 8-1 for Drugs under the Act

8-19
Table 8-1
8-20
Physician Responsibilities Under DEA

Register with the DEA
register for each office location
 DEA registration number must appear on all
prescriptions


Keep records concerning administering
or dispensing drugs for two years
8-21
Physician Responsibilities Under DEA
continued
Note in patient’s chart when controlled
substance administered or dispensed
 Prepare a written inventory of drug
supplies every two years and retain for
another two years
 Keep drugs in a locked cabinet or safe

8-22
Ethics Guide Discussion

As an office manager who has responsibility
for risk management, you routinely audit the
narcotics log in your office. Several of the
employees in the office are also patients of the
physician. You discover in a routine audit that
an employee of the practice has received
several injections of a pain medication. These
injections are not noted in the medical record
of the patient/employee. What are the various
legal and ethical issues in this case?
8-23