Law and Ethics for Medical Careers 3rd Edition

1
Law and Ethics for Medical Careers3rd Edition

• Written Consent (6)
• Emergency Medical Treatment and
• Active Labor Act (8)

2
The Case

• In July 1993 the patient went to the hospital for
  delivery of her baby. While being prepped for
  delivery, she began to leak amniotic fluid and
  experienced pain from contractions.

3
The Case, continued

• The attending physicians decided to transfer the
  patient to another hospital for a delivery by
  cesarean section.
• By the time the patient arrived at the transfer
  hospital, she was in severe distress and the baby
  was delivered spontaneously.

4
The Case, continued

• Emergency surgery was needed to repair extensive
  vaginal lacerations caused by the delivery.
• The patient survived the surgery but later
  developed complications.

5
What Do You Think?

• What charges could the patient file against the
  referring hospital?

• Do you think the referring hospital was
  negligent? Why or why not?

6
What Do You Think?

• Who should have jurisdiction over hospital
  referral patterns?
  (For example the courts, the
  state board of medical examiners, the hospitals
  board of directors, Medicare, Medicaid, etc.)

7
The Trial

• The patient brought action against the first
  hospital under the Emergency Medical Treatment
  and Active Labor Act (EMTALA). The patient
  stated that the hospital had engaged in patient
  dumping.

8
The Trial, continued

• In addition, the patient added a motion that
  would require the hospital to put policies in
  place that necessitate gaining written consent
  from a patient prior to any transfer to another
  facility.

9
The Decision

• The court was not responsible for monitoring
  internal policies of the hospital to assure that
  they were in compliance with EMTALA.
• The responsibility belonged to the executive
  branch of the state government that was empowered
  to discipline hospitals.

10
The Decision, continued

• The executive branch of state governments could
  therefore issue fines for breaches of EMTALA.
• In severe cases, suspensions from eligibility for
  Medicare and Medicaid could be issued.
• Hart v. Riverside Hospital, Inc., 899 F. Sup. 264
  (D.C.., Va., Oct. 5, 1995).