Choose one of the historical perspective from the 1897 Cornwall General Hospital’s Rules
Assignment 1: Patient Responsibilities
Read the historical perspective and contemporary perspective patient responsibilities on pages 401, Cornwall General Hospital’s Rules,in your textbook. Answer the following questions:
Choose one of the historical perspective from the 1897 Cornwall General Hospital’s Rules. Compare and contrast the rule you selected with similar current rules in today’s hospital setting. What are the consequences of the patient not following the rules?Provide examples. Be sure to state the original rule from textbook.
Which historical perspective surprised you the most and why?
Historical Perspective The following is an excerpt from Cornwall General Hospital’s Rules for Patients,” which were posted in that hospital in 1897:
1. Patients on admission to the Hospital must have a bath, unless orders to the contrary are given by the Attending Medical Attendant.
6. Patients must be quiet and exemplary in their behavior and conform strictly to the rules and regulations of the Hospital and carry out all orders and prescriptions of the various officers of the establishment.
8. No male patient shall, under any pretense what-ever, enter the apartments or wards for the females, nor shall a female patient enter the apartments or wards for males, without express orders from the Medical Attendant or Lady Superintendent.
10. Every patient shall retire to bed at 9 P. M. from First May to First November, and at 8 P. M. from November to May; and those who are able shall rise at 6 A. M. in the Summer and 7 A. M. in the Winter.
11. Such patients as are able, in the opinion of the physicians and surgeons, shall assist in nursing others, or in such services as the Lady Superintendent may require
13. Patients must not take away bottles, labels or appliances when leaving the Hospital.
14. No patients shall enter into the basement story, operating theater, or any of the officers’ or attendants’ rooms, except by permission of an officer of the Hospital.
17. Any patient bringing spirituous liquors into the Hospital or the grounds, or found intoxicated, will be discharged.
18. Whenever patients misbehave or violate any of the standing rules of the Hospital, the Attending Physician may remove or discharge them, as provided by clauses 91 and 93 of Rules for Medical Staff.
_____________________________________________________________________
Assignment 2: Life Support
Read the case concerning removal of life support equipment on page 108Barber v. Superior Court of Pozgar textbook. Also, think back on the 2005 Terri Schiavo case. If you have not heard of it, research and become familiar with this famous case. In the United States, the withholding and withdrawal of life support is legally justified primarily by the principles of informed consent and informed refusal, both of which have strong roots in the common law. The principles hold that treatment may not be initiated without the approval of patients or their surrogates except in emergency situations, and that patients or surrogates may refuse any or all therapies.
Answer the following questions:
1. Discuss why physicians historically have been reluctant to remove a patient’s life-support systems.
- Discuss the legal aspects of withholding or withdrawing life support among each of the following: patient, family members, legal guardians, and physician.
- If the patient does not have their wishes known, who has the right to make the decisions?
____________________________________________________________________
Assignment 3: Collateral Source
Read the following court case:
Taylor suffered a ruptured disc during an automobile accident. On October 26, 1994, he underwent surgery at Louisiana State University Medical Center (LSUMC). After surgery, Taylor began to experience numbness and difficulty moving his lower extremities. An emergency surgery was performed to correct these problems. The procedure was unsuccessful, and Taylor’s condition deteriorated to quadriplegia and he eventually became ventilator dependent. Taylor was treated at LSUMC until January 1 1995, at which time he was transferred to LifeCare Hospital, as a Medicaid patient, for long-term rehabilitation treatment. Taylor remained at LifeCare until his death on May 22, 1995. Taylor’s family-plaintiffs filed suit for damages. A medical review panel determined that LSUMCbreached the applicable standard of care by failing to conduct or record neurological checks from the end of the first surgery until over three hours later. The plaintiffs and LSUMC reached a partial settlement for $630,000. The settlement did not include the plaintiffs’ claim for medical expenses contractually written off by LifeCare pursuant to Medicaid requirements. Evidence showed that Taylor’s medical expenses at LifeCare totaled $1,110,922.82 and that Medicaid paid LifeCare
$164,084.82. The difference of $946,838 was contractually written off by Life-Care as required by Medicaid. Because LifeCare accepted Taylor as a Medicaid patient, LifeCare was required by both federal and state law to accept the Medicaid payment as payment in full and was prohibited from collecting further payment from Taylor. The plaintiffs relying upon the collateral source rule claimed that contractually adjusted medical expenses are an item of damages to which they are entitled.
The collateral source rule prevents a wrongdoer from reducing its financial responsibility for the injuries it causes by the amount an injured party receives from outside sources. Payments from outside sources are those unrelated to the wrongdoer, like health or disability insurance, for which the injured party has already paid premiums or taxes. The rule also prevents juries from learning about such collateral payments, so as not to unfairly influence the verdict. States that have modified this rule have either completely repealed it, mandating that payments received from health insurance, social security or other sources be used to reduce the wrongdoer’s liability. Or, they allow juries to hear during trial about collateral payments.
For example, in a lawsuit on personal injury, the one being accused cannot show paid medical bills (that were paid by medical insurance) as proof that payment has been made for part of the damages being paid against him. When the court awards the complainant with a specified amount in damages (for issues such as accident, illness, injury and sickness), the plaintiff cannot use other financial sources such as Disability Income Insurance, Workers’ Compensation and Health Insurance.
In other words, a plaintiff may recover compensatory damages that include amounts for which the plaintiff has already received compensation from sources independent or and collateral to the defendant tort-feasor. Accordingly, defendants may not introduce evidence that plaintiffs have access to insurance benefits, or to other benefits through their employment or have received gifts from independent third-parties, all of which may be used by plaintiffs to offset their personal losses resulting from the defendant’s negligent conduct.
Based on your readings of the statutes and general intuition, discuss your opinion of collateral source rule by answering the following questions:
Are you in favor or against this collateral source rule?
Do you feel that the court should have awarded Taylor’s family for medical expenses that was paid for by Medicaid? Keep in mind that the collateral source rule allows full payment for damages/medical expenses even though the medical bills are paid by insurance etc. The statute is pretty clear that the judgment should not be reduced by “Retirement, disability or pension plan benefits.”
- What’s your verdict?
______________________________________________________________________
Assignment 4: Minor ConsentRead “Guardianship” on page 380. Read “Parental Consent” “Emancipated Minor” and “The Right to Choose” on page 381.When a medical or surgical procedure is to be performed on a minor, the question arises as to whether the minor’s consent alone is sufficient and, if not, from whom consent should be obtained. Research beyond your textbook and answer the following questions. Provide anexplanation/justification for each answer.I recommend that you answer the questions as you read.
Here is a sample case that made national headlines:
Brain dead teen Jahi McMath’s mom says girl’s “much better physically” since being moved
http://www.cbsnews.com/news/brain-dead-teen-jahi-mcmaths-mom-says-shes-much-better-physicially-since-being-moved/
Answer the following questions:
Can a parent refuse to consent to a lifesaving procedure for his or her child?
Are parents at risk for parental neglect?
When may adolescents consent to their own treatment and under what conditions does your state not require parental consent?
If a legal problem arises concerning minors, who may be liable?
Can the parent’s consent to a treatment even if their child has refused?
Can the courts consent on behalf of a child?
Can the court overrule a refusal to consent given by the child and the parents?
Under HIPAA, can parents access information regarding health services provided to their children?
______________________________________________________________________
Assignment 5. Two Schools of Thought Doctrine
First read the “Choice of Treatment” on page 241.
Second, read “Misdiagnosis” on page 237.
Answer the following questions and justify/explain your answers:
When two physicians have opposing views as to a patient’s medical needs, what course of action should the patient’s attending physician follow?
Does misdiagnosis always end in the favor of the plaintiff?
Is a poor outcome always an indication of a negligent act?
Answer preview to Choose one of the historical perspective from the 1897 Cornwall General Hospital’s Rules
APA
2788 words
