Reflection paper

Based on the readings here are a couple of topics to consider in your paper. Please note that some of the foundations for these questions have been established by previous discussion boards and paper topics.

Bending the Rules or Outside the Scope of Practice?

Please consider the follow scenarios that may occur every day in healthcare:

• An Emergency Medical Technician (EMT) who practices in a state where statute dictates that intubation is outside the scope of practice for EMT’s, performs this procedure on a patient. Is the EMT putting his/her license at risk even though saves the life of the patient?
• Have pharmacists been known to give patients extra pills to hold over the patient until they can get a refill?
• What about a Physical Therapist that ignores the policy about gait belts and allows the patient to move without one to foster more independence?

Are these examples of just bending the rules or are these examples of being outside the scope of practice? In light of these examples and your readings, is bending the rules okay? Please discuss.

Cost of Practicing Medicine?
My wife’s gynecologist delivered our first child and then upon learning the news of our second child, informed us that due to the cost of malpractice insurance for delivering babies, they no longer perform deliveries. As a result, the practice decided to quit delivering babies altogether. Reaction? Is that fair? Do you also think we have too much litigation in healthcare? Is it a result of more mistakes being made? Please share your thoughts.

Before responding read the following articles below and also do a little independent research on the pro and cons of tort reform before responding to the questions.

• Could malpractice reform save the U.S. healthcare system? (Links to an external site.)
• New study shows that the savings from ‘tort reform’ are mythical (Links to an external site.)
• Does Tort Reform Reduce Health Care Costs? (Links to an external site.)
• Who benefits from tort reform?

Discussion

Apologies Okay in Healthcare?

Liability and Healthcare create some interesting contrast as we continue our journey in ethics and healthcare. The questions below will help highlight and contrast the various ethical issues for the patient. The questions below are designed to get you thinking about the legal aspects of healthcare, I am interested in our thoughts and ideas on these questions.

What Would You Do?
A 16-year-old female comes to your office complaining of abdominal pain. Her parents are both patients of yours but do not accompany her to today’s visit. During your discussion, she breaks down and confides that she had unprotected sexual intercourse last week and her sexual partner has told her that he has just learned that he has gonorrhea (Links to an external site.). She states that her parents do not know that she is sexually active, and fears severe consequences if they find out (“They will like totally wig out, you know?”). Do you test her and treat her without telling her parents? What other steps/discussion/recommendations should you consider making?

You Be the Judge!
An 86 year old man arrives at the ER with a massive heart attack and is admitted to the ICU unresponsive and on a respirator. His condition is unimproved in 24 hours and the wife produces a valid living will indicating he did not want “heroic measures” and asked you to disconnect the ventilator, which you do. He expires two hours later. One hour after that, an estranged son appears, he had not been in contact with the patient in 10 years. He becomes enraged when he learns of what happened, accuses you of murder, and loudly announces his plans to sue you to the entire hospital waiting room. Does he have a case?

Is it okay to say “I am sorry” in Healthcare?

Which is better?

1. To tell the patient or their family that you made a mistake and you are sorry
2. To lawyer up and not make any admission of wrongdoing?

Should healthcare providers be allowed to apologize to a patient or family for a mistake without it being used against them in a court of law or licensure action? Please consider the cases of Mohr v. Williams (Links to an external site.) and Hall v. Hilbun (Links to an external site.). Some argue that healthcare professionals being allowed to apologize to the patient or the family would reduce chances of litigation. Thoughts?