Hs 544 - Leagal Aspect of Healthcare

Course Project

HS 544

The Economics of Health and Health Care

Professor: Dr. Eric Oestmann

Student: Kingsley Agharese

Topic: Legal Aspect of Health Care

Summary

Why do we file a law suit against our caregivers of healthcare facilities? Healthcare has opened the door for many businesses, and as a result, ethical paradigm has to be in place to coordinate between right and wrong in this environment. The aspect of healthcare service in the present day is constantly alarmed with many ethical issue and problems arising from certain complications in the field. With this concept, is it very important in this field that individuals especially the healthcare professional possess high degree for critical thinking mainly considering the ethic aspect of each certain scenario. In addition, it is also important for healthcare professional to consider and act according to the predetermined and established guidelines in the aspect of healthcare service application. I evaluating the legal aspect of healthcare, caregivers and patients need to address a shared responsibility and accountability.

We all know in this country, that anyone has the right to sue anyone for any reason. That does not mean they will win. We must be aware that 90% of malpractice suits are settled out of court whether there is guilt or innocence. It is simply cheaper for insurance company to settle. The other 10% of these cases goes to court with 50/50 chance of winning on the average. Treble is a term used to determine damages in regards to pain and suffering. The judgment is usually three times more than the actual costs (medical, lost wages, medications, transportation, etc). Defense lawyers typically anticipate 33-50% of settlement awards.

Problem / Issue

Law suits from patients are impacting physician's ability to provide care at reasonable rates. Most physicians and care givers are highly insured and they factor the cost of law suits and insurance payments into the cost of providing care, and we all pay the price. How do we justify these cost issues in regards to accessing healthcare? The economics are simple and inter-related.

High litigation by trial lawyers drives up HC costs by forcing insurance coverage to sky rocket. This in turn forces insurance rates to sky rocket. The court costs of time and resources forces the justice system costs to go up.

Literature Review

There are many factors and aspects associate with the legal aspect of healthcare. The broadness ranges from abortion, medical malpractice, and negligence to notice of consent. When it comes to the legality of healthcare, physicians and patients are both responsible. The general aspect of healthcare profession is mainly focused on the concept of promoting the best interest for the patient. Commonly, this concept is assigned to be determined by the patient personally since it is ethically noted that he or she knows what is best for him or her. However, on some scenario, healthcare professionals can intervene to this personal concept of best interest if the involved patient lacks specific or critical knowledge pertaining to his or her healthcare situation. Thus, it is very important that the decision for the best interest be made in accordance to all of the pertaining and relevant information including in the situation.

There is no issue in medical ethics that does not have a legal version of it--a case brought to court. The theory behind most decisions is personal injury law. In medical malpractice, one must show damage that was caused by care that was less than standard.

There have been many cases that can be considered to be landmarks. Tarasoff v. The Regents of the State of California, decided in 1976, found that a psychiatrist was negligent in not warning a third party that she might be at risk from a patient. This decision changed the form of consent in psychiatry and clinical psychology limiting the confidentiality that can be offered a patient in therapy. Less dramatic but almost as far reaching is Helling v. Carey, which helped determine standards of care against which to judge physicians; on surrogate motherhood; in the Matter of Baby M; on abortion, Roe v. Wade; on brain death and persisitent vegetative state, In the Matter of Karen Quinlan, An Alleged Incompetent and Cruzan v. Director, Mo. Health Dpeartment; on privacy, Griswold v. Connecticut; on informed consent, Canterbury v. Spence.

Medical malpractice has an allocation aspect to it. Some specialties are sued much more than others. The usual reasons cited are the high-risk patients seen and the high expectations of many of these patients (here is an overlap of consent and malpractice; appropriate consent should include a realistic statement of expected outcomes). Rather than continue paying for high malpractice coverage to insurers and rather than risk what they take to be unfair assaults on their integrity, specialists will retire early or relocate to areas with low malpractice rates. Legislation proposed to limit awards in malpractice cases can be seen as trying to limit suits filed. But such legislation can also be viewed as aiding insurance companies who cover physicians (as well as aiding less than fully competent physicians).

The medical malpractice crisis continues to be a major dilemma for the health care industry. Although there have been many approaches to resolving the crisis, there appears to be no one magic formula. Increasing prominence is being given to the use of best current evidence in decision making, both in clinical practice and healthcare management. A review of the main

issues related to Evidence-Based Practice (EBP) and a discussion on how to develop, validate, promote, and use evidence and knowledge in clinical and administrative settings are presented. The role of information systems, and the challenges that must be met in the implementation of Information Systems and Information Technology (Roberto J. Rodriguez http://www.scribd.com/doc/12390445/Evidencebased-health-practice)

Problem Analysis

Issues