Q1
For one, a person may not be able to give
informed consent in times of an emergency. It is not uncommon for people to be
unconscious, disoriented, sedated or simply not capable of giving an effective consent
(White, Rosoff&LeBlang,2010). In such cases, other people like the next of
kin may be authorized to give consent on behalf of the patient. In the absence
of such other authorized persons, the law presumes that the patient would want
to be treated as necessary so as to preserve his life or function. It is
incumbent upon the physician to establish that there was an emergency, that
there was an immediate need to administer care, that there were attempts to
contact next of kin or any other persons authorized to give consent, and lastly
that the care given never went beyond the necessary until full consent can be
obtained.
Secondly, the extension doctrine allows the
physician to dispense of the need for consent in the event of an unexpected complication
making it medically advisable to go beyond the initial consent given. Thus in Kennedy v Parrot, the North Carolina
Supreme Court saw a physician’s decision to remove as cyst as part of an
appendectomy. Elective or non essential
procedures are not covered within this doctrine.
Lastly, a physician may determine than giving
certain information to the patient will be harmful and thereby withhold such
information. Under the principle of therapeutic privilege, a number of
jurisdictions recognize that a physician may indeed have a right to withhold
information in those circumstances.
Q2
For along time, Michigan law did not allow
any person other than the patient to make treatment decisions. This has since
changed with the Michigan Designation of
Patient Advocate for Health Care. That law now allows any person who is at
least 18 years old to appoint a surrogate decision maker in the event that they
are no longer able to make those decisions. The appointment of such a surrogate
is accomplished through what is called a Durable Power of Attorney. Through
this power of attorney, the patient can appoint almost any person to make
healthcare decisions on their behalf so long as that other person is 18 years
and above. The person appointed under
this document is called a patient advocate. A durable power of attorney for
healthcare only comes into force when the patient is unable to make healthcare
decisions. The existence of a durable power of attorney for healthcare is,
however, not a precondition for receiving treatment. It is not even an obligation
on the part of the patient to have this legal document.
Besides a patient advocate, the Michigan
Healthcare Disclosure and Consent Act list certain family members that can make
healthcare decisions on behalf of the patient. Those listed are a member of the
immediate family, the next of kin or the guardian. The law does not provide any
guidance as to who among those in the list should take priority over the
others. This law only applies when the patient has a reduced life expectancy
arising from an advanced illness.
Q3
For the present purposes, the institution
will be “A” while Privacy and Confidentiality are the chosen rights.
Privacy and Confidentiality Policy
At “A,” we are committed to safeguarding the
privacy of our patients and staff. To
that objective, the protection of private and confidential information is our
priority.
Patient Information
We follow two key values at “A” in maintaining protected
health information (PHI): caring and integrity. All uses and disclosures of PHI
are made with respect and sensitivity for our patients and the law. We
recognize that some sensitive aspects of a patient’s life may be documented, it
is for this that privacy and confidentiality is a priority to all our clients. As
such, all members of the workforce must understand their role in protecting PHI
and compliance with privacy laws.
Inappropriate disclosure of PHI is a violation of “A”
policies besides the fact that such a violation may also be a violation of both
federal and state privacy laws. Consequences of such a violation will lead to
disciplinary action including the termination of employment.
Examples of Inappropriate Disclosures
Ø Accessing the medical records of another
worker to determine his/her diagnosis
Ø Disclosing PHI about a patient or any other person
to the media without approval from the patient.
Ø Using PHI in the medical record or any other
“A” database for research purposes without patient authorization.
Q4
In dealing with some of the most important rights
of patients such as that on privacy and confidentiality, healthcare workers must
discharge a number of responsibilities. In collecting information from clients,
healthcare workers must ensure that patients give their consent for the
collection. Healthcare workers must do proper documentation of the information
they take as they may need it for their defense in the eventuality that a case
is brought against them.
Secondly, healthy workers should also ensure
that the consent from patients is informed. The consequences of any treatment
option may be very substantial and it is only necessary that the healthcare
discuss all the relevant information with the patient. This requirement aims to
put the patient at the centre of care. Understanding the risks associated with
treatments allows the patient to make a decision from a point of knowledge.
Furthermore, the healthcare workers have a
duty to provide patients with their medical records when a request for such is
made. Under HIPPA, healthcare workers are allowed to charge patients for the
cost of copying such information. The
original records often belong to the healthcare provider while the patient has
a right to obtain a copy.
Reference
White, C., Rosoff, A.J.& LeBlang, T.R. (2010).Informed Consent to Medical and Surgical Treatment. Retrieved 26 May
2012,from http://www.google.co.ke/url?sa=t&rct=j&q=&esrc=s&source=web&cd=117&ved=0CG YQFjAGOG4&url=http%3A%2F%2Fwww.ablminc.org%2FModel_Curriculum_LMME _2010%2FBOOK_Legal%2520Medicine-7th_2007%2FCh33- Informed%2520Consent%2520to%2520Medical%2520and%2520Surgical%2520Treatm ent.pdf&ei=UyihUcmgF8X-rAeGz4GACQ&usg=AFQjCNGBm5fn1_cG- ZmedRXQaVKKANtJQA
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