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Debate Surrounding Issues of Procreation

Given the contentious debate surrounding issues of procreation, develop an institutional policy, which can be applied to the range of treatment and research issues related to procreation. | C| Given the mandate for advance directives, informed consent, and the legal obligation to report, illustrate the application of these concepts in a specific area or setting, e. g. , psychopharmacology, dementia, long-term care, acute care, home-care, etc. | | Click on the links in the “Topics” section to view the discussion topics. Then, click “Respond” to add your thoughts to the discussion thread.

Topics Introductions (not graded, but required) | Intentional Torts in Healthcare (graded) | Most Pressing Ethical Issues (graded) | Q & A Forum (not graded) | | Intentional Torts in Healthcare (graded)| Select one of the intentional torts discussed in your text and provide an example of how this tort takes place in healthcare. As leader of your own healthcare facility, what steps could you take and what processes could you implement to reduce the risk of this tort occurring in your own facility? | This section lists options that can be used to view responses.

Expand All Collapse All    | Print View    | Show Options   | Hide Options   | Select:    | Mark selected as:    |  View Selected  View All | | Responses Responses are listed below in the following order: response, author and the date and time the response is posted. | | | Response | Author | Date/Time* | | | | Hello | Professor Hijazi | 3/2/2013 6:28:48 AM| | | Welcome class, Please read the text and ensure that you answer discussion questions to the fullest. This will be a very interesting class for all of us.

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| | | | | RE: Hello | Mary Claire Jennings | 3/6/2013 12:00:09 AM| | An intentional tort is one that is committed deliberately, such as assault coupled with the apparent present ability to do physical harm to another person, however no actual contact or damage is necessary. In addition, according to the text, it occurs without the consent of the other party. As a leader, I would ensure all employees know that there is a zero tolerance for this type of behavior | | | | | RE: Hello | Yolonda Thomas | 3/7/2013 12:48:21 PM| | | I will just add on to what your explaining as an intentional tort behavior or action.

With this being a physical harm to another person this is not just a assault but also an poor moral judgement call on that person or persons within the health care or any. When coming to employees this should not be push under the rug but an annally workshop or professional class that all employees take to insure what intentioanl tort is and how to report it if is is taking place . | | | | | RE: Hello | Gina Billups | 3/7/2013 8:30:01 PM| | | Modified:3/8/2013 6:18 AM | | To further add,” Intentional Torts include intentional wrongs that involve a willful act that violates another person’s interests”.

Defamation of character, fraud, invasion of privacy, false imprisonment, and infliction of emotional distress are all examples of intentional wrongs. Out of all of the intentional wrongs listed above, I would say that infliction of emotional distress is one of the most difficult to recover from. In the case where the mother was shown her premature infant, the emotional distress that was placed on this mother was unimaginable. For a mother to have lost her premature infant is emotional distress in itself and then to be shown the infant was awful.

Not to mention the fact that the infant was not placed on some sort of infant table, but was retrieved from a freezer and then presented in a jar! If I were at that hospital clear cut rules would be discussed regarding premature infant deaths along with sensitivity training. Check points would be set up so that family would not have access to the actual areas where these infants were held after their passing. A separate room would be set aside to facilitate this type of viewing. Resource:  Pozgar, G. , (2012). Legal aspects of health care administration (11th ed. ).

Jones & Bartlett Learning. | | | | | RE: Hello | Lloyreen Moss | 3/7/2013 6:59:20 PM| | | I’m wondering what everyone things about the recent news story of  a nursing home in Bakersfield California who has a policy against its employees giving CPR? I am required to have CPR certification as a massage therapist. When I went through the training, I was under the impression that once you get certified, it is your duty to provide CPR if it is needed. I assume the nurses who worked at the facility were CPR certified. Yet there is a policy that bans them from giving CPR to the residents.

I understand that there is a risk of liability when this happens, which could be deemed as an unintentional tort if someone is hurt from CPR. However, isn’t a bigger issue if you are CPR certified and refuse to give CPR? Doesn’t that open you up for negligence? I’d like to know what others think… Here’s the link to the story:  http://www. cnn. com/2013/03/04/health/california-cpr-death | | | | | RE: Hello | Gina Billups | 3/8/2013 10:13:29 PM| | | Lloyreen, I would say that in the situation of the nursing home in Bakersfield, California and its policy against its employees giving CPR, negligence would not be factor.

I state this because the policy of not providing CPR is “known”. Since the policy is known, then the nursing home has relieved itself of its duty to care in this particular area. By having a policy in place, the standard of care that is expected is that CPR will not be performed on a patient if it is needed. In order for negligence to exist, a patient would have to prove that this standard of care (not performing CPR) was not met. | | | | | RE: Hello | Cyril Mfebe | 3/7/2013 8:30:15 PM| | | Intentional torts require the proof of specific conduct that demonstrates a greater responsibility for knowledge of the near certainty of injury.

One example might be when a physician does not follow accepted procedures and fails to account for surgical instruments used during a procedure. As a result, he leaves a metal clamp behind in the patient’s body and predictably, complications ensue that require additional surgical procedures. | | | | | Intentional Tort | Donnetta Shelton | 3/3/2013 12:34:57 PM| | | One of the most common intentional torts is battery. How this occurs in healthcare and becomes a problem is when religion is involved. For example, in the jehovah witness religion, blood transfusions are not accepted.

If a physician, knowing that a patient is Jehovah witness, gives that patient a blood transfusion, the physician is legally opening himself up for a lawsuit with a charge of battery as the intentional tort. | | | | | RE: Intentional Tort | Professor Hijazi | 3/4/2013 7:12:47 AM| | | Thanks Donnetta, Good response, but please answer the discussion question to the fullest. ” As leader of your own healthcare facility, what steps could you take and what processes could you implement to reduce the risk of this tort occurring in your own facility? ” Thanks | | | | | RE: Intentional Tort | Donnetta Shelton | 3/4/2013 11:04:38 AM| | Thanks Professor. As a leader of a facility there are 2 steps that I would take to help to reduce this risk which include hiring practices and training practices. With hiring, by focusing on hiring seasoned, experienced staff with a strong knowledge of the legalities of the industry, the chances of this occurring are reduced. However, even with this in place, on-going training for new or experience staff should also be put in place. This training should cover ethics/morals as well as legal and process training. | | | | | RE: Intentional Tort | Gina Billups | 3/5/2013 2:13:56 PM| | Donnetta, looking at your example of an intentional tort of battery, I would implement the following steps and processes to reduce the risk of this tort occurring in my facility. First, I would ensure that negligence would not be a factor. In doing so, I would ensure that adequate care was given at an acceptable standard, ensuring that obligations as a professional were met. Secondly, I would ensure that procedures were in place to address deviations from the “normal” standard of care, as mentioned in your post. These procedures would include paperwork that would have to be signed by the patient or family member in charge.

This signature would represent that the patient and/or family member in charge were aware of the consequences of care being altered or changed due to the refusal of standard care. | | | | | RE: Intentional Tort | Professor Hijazi | 3/5/2013 5:47:49 PM| | | Thanks | | | | | RE: Intentional Tort | Yolonda Thomas | 3/7/2013 1:13:34 PM| | | The key words to me about this question would be my own and leader. This being that all the responsible being on me for guidance of a Healthcare facility I would see that the staff have an professional development with working lunch.

The working lunch would cut back on staff member not able because of child care or schooling. The working lunch would all me as the owner to bring in outside presentors to give informative data and the lastes technology or ethic laws to help the staff and protect the patient for the best health care at my local for success. The working lunch for workshops or training will be schedule monthly and suggestion of what food choice will be left up to the staff memebers. | | | | | RE: Intentional Tort | Tom Read | 3/6/2013 2:42:00 PM| | There has been several very large cases about a religion that believes in prayer healing in Oregon that the parents of some small children have died because they did not receive the medical care that could have saved the lives of these children. There is one case though that even though the doctors knew that this family believed in only prayer healing treated a young girl and saved her life. The parents are trying to sue the doctor and the hospital stating that they went against the wishes of the parents and used evil medicine on their little girl.

There have been a number of these cases in Oregon that I do not believe that this one will have any traction but see where this is being considered intentional tort. http://www. oregonlive. com/oregon-city/index. ssf/2011/09/parents_defend_using_prayer_no. html | | | | | RE: Intentional Tort | Lloyreen Moss | 3/9/2013 9:21:55 PM| | | Modified:3/9/2013 9:22 PM | | Tom, Thanks for the article. It is amazing how tort laws and religion sometimes clash and there are different ways to look at what is ethical or not. I have also heard of cases where people do not believe in modern medicine to treat illness, but instead use prayer.

Just as a personal belief, I often wonder why it is that modern medicine is not seen as a “gift” from above or a way that prayers have been answered. By no means am I to  judge others beliefs and I understand these notions are held and have a deep tradition. I Your example made me question torts and religion and I found some interesting information published by American Bar Association. http://www. americanbar. org/newsletter/publications/law_trends_news_practice_area_e_newsletter_home/litigation_runquist. html –Reenie | | | | | RE: Intentional Tort | Tom Read | 3/10/2013 7:46:06 AM| | I am a very strong believer and believe that God has given medicine and the knowledge of the doctors that helps save lives. I really have a very hard time letting my kids be sick if there is a cure out there. I do not want to judge these people either but see having a cure ann answer to prayer and that the Lord has sent that to us. Luke the writer of Acts was a doctor! | | | | | RE: Intentional Tort | Ellisha Finch | 3/8/2013 11:29:36 PM| | | Very interesting. It is considered a civil or wrong doing according to text. Do you believe in a law suit like this based off religious purposes, ethical and moral beliefs. | | | | Intentional tort | Sayali Patil | 3/4/2013 10:28:51 AM| | | One case where I read about intentional tort was of a patient called plaintiff. She found a pea sized mass on her right breast and went to the doctor for further help. She was attended by the nurse first. The nurse kept calling her on different dates which led to delay in the investigation. The nurse failed to measure the size of the mass and did not realize the seriousness of the condition. When finally the patient met the surgeon, the mass of grown a lot and cancer was detected. Patient had to undergo removal of her breast.

Here the medical facility not only failed to attend the patient in time but also did not realize the seriousness of the condition. The nurse should have known about serious symptoms and signs of some diseases, so that she could refer the patient immediately to the surgeon without any delay. She should have measured the size of the lump and sent her for further investigation before the condition progressed to this extent. Steps I would take to avoid intentional tort:1) Avoiding negligence and taking each condition of the patients seriously. 2) Good collaboration between the workforces. ) Avoiding delay in check up, investigations and diagnosis. 4) Monitoring of patient’s vital signs and recording them. 5) Taking corrective measures for the patient’s condition immediately. 6) Well-informed non-medical staff. (From: George Pozgar)| | | | | RE: Intentional tort | Professor Hijazi | 3/5/2013 5:48:50 PM| | | Excellent response! As healthcare professionals we always have to put the patient first and keep in constant communication. | | | | | RE: Intentional tort | Mary Claire Jennings | 3/8/2013 9:26:00 PM| | | Another intentional tort the text talks about is battery.

One example of this would be a patient giving a surgeon permission to operate on his left knee. While the patient is under anesthetic the surgeon decides to operate on the patient right knee and makes it better. This is considered battery because cutting on someone without permission is battery even if it helps them. According to Sayali one of the steps to avoid this type of intentional tort is to avoid negligence and take each condition of the patient seriously. | | | | | RE: Intentional tort | Yash Bhatt | 3/9/2013 9:20:42 PM| | | Modified:3/9/2013 9:24 PM | Mary, it is disturbing to hear about surgical errors like the one you mentioned. I just don’t seem to understand how can doctors who are considered as life saviors do such mistakes? The reason I say that is because such mistakes are preventable and controllable but still such mistakes are not uncommon these days. A simple thing such as studying patient’s chart thoroughly can avoid wrong surgery like that. There is a reason doctors are paid high and respected is due to their brilliant performance. Since they deal with human lives and not machines they carry big responsibility on their shoulders and they should therefore make sure hat they are always right when they perform. Instead, by being negligent they could kill or hurt their patients permanently or temporarily which is not acceptable and thus they should be disciplined for negligent tort accordingly. Of course, that’s not going to bring back patient’s life or cure patient’s disability but that’s going to teach lesson to other doctors that being careful is a must in the medical field in order to maintain their degree and status as doctors. They definitely have to prove themselves trustworthy. | | | | | RE: Intentional tort | Eddie Ford | 3/6/2013 11:35:12 AM| | Hello;This definitely seems as a good case of negligence on the nurse behalf. Clearly because of the nurse gross negligence that the patient had to get her breasts removed, I do agree with Prof. by saying that the patient should always come first. In addition to that, it is clear that a nurses job to a patient is to investigate and take all illness very seriously or potential illness very seriously, because of this I feel that the nurse should be removed from her position and replace by someone that is more competent on doing the job. What do you think? | | | | | RE: Intentional tort | Shawanda Herring | 3/6/2013 10:35:14 PM| | Eddie I too think removing the nurse from her position would be a responsible and ethical decision made on behalf of the patient. I wouldn’t go as far as saying the nurse wasn’t competent; however I would say she that she was negligent in doing her job, upholding the medical code of ethics, and definitely making the patient’s care her priority. Neglecting to perform her job duties correctly; make her libel for what the patient had to endure as a consequence of her negligence. Continuous training of all healthcare professionals is very important and can be viewed as a tool to eliminate or greatly reduce cases such as this. | | | | RE: Intentional tort | Eddie Ford | 3/9/2013 7:50:25 AM| | | Thank you for responding;I do agree with the nurse being negligence or should I say ordinary negligence. In this particular case where the patient is getting her breasts remove minding you I am looking at this at the patient’s point of view in this post that the nurse would completely fall under gross negligence. As far as her being competent, I am sure that the patient that had her breast removed would probably agree that this particular nurse is completely incompetent.

However I do know that the nurse has had some formal qualifications to have that position, but in saying that there is definitely a lawsuit pending. | | | | | RE: Intentional tort | Gina Billups | 3/9/2013 12:10:49 PM| | | Modified:3/9/2013 12:12 PM | | Sayali, Shawanda, and Eddie, I agree with what you have stated. I would also like to add that this case of negligence also involves the original doctor who initially examined the plaintiff. The text reads that “Dr. Evans testified that his physical evaluation included an examination of the plaintiff’s breasts.

However, he stated that his examination was very cursory”. The text also states that the plaintiff then examined her own breasts the next day and discovered a lump the size of a pea. With this being said, I believe that this is where it all started. If an examination is given by a doctor, then the examination should be thorough. The text also states that the plaintiff went back to the clinic on several occasions to be seen again, signing the clinic list with her name and her reason for being seen again. The plaintiff was not seen again until June 21, approximately three weeks since her first examination.

At this examination, the plaintiff’s right breast was not measured eventhough what was described as “a large mass” was detected. When the plaintiff was seen by Dr. Evans again, seven days later, he incorrectly documented progress notes, stating “wrist” instead of “breast”. This fact created a further delay in treatment along with the fact that Dr. Evans didn’t measure the “large mass” either. It wasn’t until the plaintiff was transferred to Franklin Release Center that the plaintiff received the expected standard of care. Once the plaintiff was seen at the Franklin Release Center, she began to receive expected care… a nurse recorded that the plaintiff had a “golf ball” sized lump in her right breast”… transported to the hospital on October 27, where she began treatment… she then received a mammogram examination and biopsy, resulting in the diagnosis of a malignant tumor and its removal approximately 2 months after being transferred. Resource:  Pozgar, G. , (2012). Legal aspects of health care administration (11th ed. ). Jones & Bartlett Learning. | | | | | RE: Intentional tort | Yash Bhatt | 3/7/2013 10:48:43 PM| | | Negligent torts results in malpractice sue.

In negligent tort a physician or provider deviates from the standard process of health care unintentionally and doesn’t perform the way another physician would have performed by being responsible in the same situation. Here the Physician is responsible to properly treat the patient but fails to do so which results in patient injury that patient has to deal with. The steps I would take in my organization to prevent such negligent medical errors would be to have physicians check the patient medical history properly and then double check the medication and dosage prescribed to the patient.

I would also have physicians verify the test results thoroughly before confirming on diagnosis and start treating the patients. | | | | | RE: Intentional tort | Ellisha Finch | 3/8/2013 11:33:00 PM| | | Bad news when you have to get your breast removed. Some type of quality care. Its a shame that health promotion and competence wasn’t utilized in this situation. | | | | | RE: Intentional tort | Ellisha Finch | 3/9/2013 9:22:20 PM| | | Modified:3/9/2013 9:23 PM | | From experience you can be misdiagnosed. I went to the doctor once had a breast exam and the nurse thought she found a lump.

To be on the safe side so she said, I was referred to a breast center. I’m not at the age where I should take a mammogram. They could have exposed me to radiation, something didn’t sir right with me. I had a second opinion, turn outcome I was pregnant. Maybe if she had done a pregnancy test since I was at a plan first clinic and was more competent. Either way I was discourage from going back there to the clinic. My baby is 2 years old and no breast problems | | | | | RE: Healthcare | Eddie Ford | 3/5/2013 12:45:40 PM| | | Modified:3/5/2013 12:46 PM | | Mr.

O’ Neill v Montefiore Hospital; where the patient is being denied medical attention because he has a different kind of insurance that is not accepted by the hospital. I am confident that this happens all over the country that people are turned away because of health insurance reasons and the hospital may very well get away with it by covering up these allegations. We know if the hospital is privately owned then they can turn you down for nonemergency reasons. The key word there is non-emergency, according to the Emergency Medical Treatment And Active Labor Act that no one can be turned down for emergency healthcare, for private or public.

However a public hospital is funded by the taxpayers and held on a different standard than those that are privately owned for-profit hospitals. In this case the best scenario would be for Mr. O’ Neil should have went to a public hospital, however because he is suffering chest pains which makes it in emergency situation he should not have been turned down. My process for reducing this sort of incident in my hospital would be to have trained and competent staff. It is my opinion you do not have to be a doctoral degree to know when someone has chest pains then clearly that is a matter of the heart and being a nurse surely shows negligence. | | | | RE: Healthcare | Professor Hijazi | 3/7/2013 6:16:44 PM| | | Dear Eddie, Good post! | | | | | RE: Healthcare | Tom Read | 3/8/2013 12:22:47 PM| | | The law states that no one can be turned away for any reason if they go to the hospital for health care. This is one of the largest strains on the health care industry because people can not go to a doctor and yet they go to the hospital and then do not pay the bill which in turn raises the cost for the individuals that do have health care insurance or do pay the bill. Hospitals are loosing millions of dollars in people going to emergency for reasons that should be seen in a doctors office.

Then the people do not pay the bill and the hospital has to charge more to paying customers because they need to get reimburse for the money they are loosing. | | | | | RE: Healthcare | Mary Claire Jennings | 3/8/2013 8:44:18 PM| | | Eddie I cannot agree more with you because about three weeks ago one of my friends died due to negligence at the hospital. She started getting chest pains and her husband took her to the hospital; they did not perform and type of screening like an EKG but gave her some pills and sent her home with the instructions that she has an upset stomach and she should have something warm to eat.

While she was sitting at her dinner table waiting she collapsed and died of a heart attack 30 minutes after leaving the hospital. | | | | | RE: Healthcare | Ellisha Finch | 3/8/2013 11:36:04 PM| | | Oh my goodness. It is a lot of incompetent unprofessional health care workers. With the right support, treatment and prevention the field of health care could be interchange. | | | | | RE: Healthcare | Ellisha Finch | 3/9/2013 9:34:56 PM| | | I agree, health care training is important and necessary. We need more competent trained individuals to provide compassion and care.

For me it is imperative to have health care insurance. Although, health care providers, physicians and clinic accept insurance don’t be surprised to be turned away. | | | | | RE: Healthcare | Sherrol Niles | 3/9/2013 10:14:41 PM| | | Ellisha, I agree that being turned away due to your insurance plan, would not be a surprise in some case. From the time one calls to make a doctor’s appointment, after giving their name, the next question is ‘what insurance do you have’. If their office does not accept your insurance plan, there is no need to take any further information from the caller.

The facility wants to ensure that they will receive payment for their services. | | | | | RE: Intentional Torts in Healthcare | Yash Bhatt | 3/5/2013 5:51:11 PM| | | Modified:3/5/2013 6:02 PM | | The tort I would like to talk about is invasion of privacy intentional tort. A very recent example of intentional patient privacy invasion is of Dr. Nikita Levy from John Hopkins Hospital who is charged with class action lawsuits filed for secretly videotaping and photographing gynecology examinations through a pen wore around his neck. He had been a gynecologist doctor for over 25 years at John Hopkins Hospital seeing over 1000 patients.

A lady who had been his patient for about six years brought his misdeeds out in limelight. What he did not only brought down his image as a doctor but also John Hopkins image as a well known and respected hospital. As leader of my own healthcare facility, the steps that I could take and the processes that I could implement to reduce the risk of this tort occurring in my own facility is to have employees use hospital instruments and devices instead of personal devices which may have recording capabilities, have all employees trained and examined on HIPAA regulation and have a really strict code of conduct implemented in place for the company. ttp://www. chicagobusinesslitigationlawyerblog. com/2013/02/ | | | | | RE: Intentional Torts in Healthcare | Capriana Johnson | 3/6/2013 8:33:01 PM| | | Yash invasion of privacy is a good one. I would like to speak on that a share with you a story that I read regarding a gay employee being terminated for adding his partner to his insurance plan in the GREENWOOD v. TAFT, STETTINIUS & HOLLISTER Case. According to Fair Measures, Inc. “a gay man changed his employee benefit forms to list his male partner as the beneficiary of his insurance and pension benefits.

Shortly thereafter, he was terminated from his employment. He alleged that personnel had revealed this information to his superiors, which was an invasion of privacy, and that he was then terminated for being gay. The Ohio Court of Appeals held that he could not sue for wrongful termination, but he could sue for invasion of privacy. This case reminds us that private facts are private. Revealing private information can lead to liability not only against the employer, but also the individuals who revealed the information (Fair Measures, Inc, 2013). In my facility I would make sure all employees were well informed on the confidentiality of personal information and be sure to explain the liability the company ; employees have when it comes to discrimination on employees. Discrimination is a huge mess in the corporate world and the smallest comments could lead to big trouble. In the healthcare system we use HIPAA for our patients to protect them with privacy and from the employee standpoint we should be taking the same measures to ensure personal information isn’t leaked. http://www. fairmeasures. com/ask/enews/archive/spring96/new08. asp | | | | RE: Intentional Torts in Healthcare | Cyril Mfebe | 3/8/2013 8:35:50 PM| | | Invasion of privacy is the intrusion into the personal life of another, without just cause, which can give a person whose privacy has been invaded a right to bring a lawsuit for damages against the person or entity that intruded. Example, many people consider information about their health to be highly sensitive, deserving of the strongest protection under the law. Long-standing laws in many states and the age-old tradition of doctor-patient privilege have been the mainstay of privacy protection for decades.

In my facility Only authorized personnel will have access to the personal information of patents. Safeguards, such as locks and passwords or encryption, will be used to limit access to hard-copy and virtual employment records. | | | | | RE: Intentional Tort | Evaristo Torres | 3/5/2013 7:07:58 PM| | | Modified:3/5/2013 7:10 PM | | One of the intentional torts that could take place in the healthcare facility will be battery. This could be in a form of touching a patient in a manner that is inappropriate and without his or her consent.

For example a male nurse walks into a room where the patient is a female and without her permission decides to give her a bath. If it is not on schedule and according to the norms of the facility, without the patients permission and without a female nurse present this could turn into a battery resulting on a law suit. There should always be the patients permission before there is any typemofmphysical contact. As a measure of preventing such issue I would set up rules and policies where no male or female nurses under any circumstances would touch in any way a patient without his or her consent specially when it comes to bathing the patient.

There should always be a witness when this takes place. This will be my preventive measure. | | | | | Intentional Tort | Yasmin Rodgers | 3/5/2013 7:43:55 PM| | | Collins v. Thakkart, 552 NE2d 507 (1990)An example of Intentional Tort of Battery is in the case of Collins v. Thakkart, the patient allowed the physician to examine her and ultimately caused her to have a miscarriage due to the repeated procedure during the patients examination. The courts found that this constituted battery and the patient claimed wrongful abortion. biotech. aw. lsu. edu/Books/lbb/x134. htmOne step that could have been taken is the physician should take special care to disclose all the facts of the procedure before proceeding with the patient. However in this case I should mention there were some mitigating circumstances. One being that the patient and the physician were in a relationship which showed intent. | | | | | RE: Intentional Tort | Ricky Magee | 3/6/2013 10:07:30 PM| | | Full disclosure is important for patients to have access to information when it comes to medical procedures.

This allows the patient to make an informed decision without putting them in a life changing situation. I think the physician has an ethical obligation to give the patient all the options available for their medical care. This is definitely a case where the medical professional did not follow ethical conduct. | | | | | RE: Intentional Tort | Jazmin Hymond | 3/6/2013 11:01:07 PM| | | I can agree with you, Ricky. It is most definitely always important for patients to know there options. This, for the most part is not a problem for most physicians.

The only reason that I could think of is the fact that one physician may be opposed to a procedure while another feels differently. This problem may seem to occur when some procedures have not been approved, or are experimental. Even still, it is important for the patient to know the ends and outs to be able to make the best decisions regarding their health and how to better it. | | | | | RE: Intentional Tort | Sherrol Niles | 3/6/2013 11:22:56 PM| | | Ricky, I totally agree that full disclosure is very important. Without having all of the facts relative to one’s condition, the deciding factor can have an alternate outcome.

Patients are encouraged to be honest with their doctors when completing questionnaires or when responding directly, for the achievement of proper diagnoses. These health care providers should also provide their patients with a detailed assessment of their condition so that these patients can have a better understanding of their options. | | | | | RE: Intentional Tort | Professor Hijazi | 3/7/2013 6:17:15 PM| | | Excellent participation! | | | | | RE: Intentional Tort | Jazmin Hymond | 3/9/2013 11:49:17 PM| | | Modified:3/10/2013 7:14 PM | I can agree with you, Sherrol! I feel just as everyone else, that physicians should disclose the information. Personally, when I visit my physician, I am always honest. You never know what information that being withheld, can harm you. Truthfully a great physician will eventually ask you the about the situation and of course it is up to you to be honest. I appreciate being given a piece of paper that can help me understand specifically what can be done regarding my situation. This has to be one of the best things that technology has brought the the health industry. | | | | Intentional Torts in Healthcare | Rosa Parker | 3/5/2013 9:12:21 PM| | | False imprisonment is defined in our textbook as the unlawful restraint of an individual’s personal liberty or the unlawful restraint or confinement of an individual. We have all heard about many of the individuals who were given life sentences for crimes that they did not commit but were punished inhumanely which caused them to finally admit to something that they did not do. Many individual records were expunged and they in turn were released under former Governor Ryan.

However, before someone is arrested or at least in custody, we need to ensure that all police force are on the same page by ensuring that they have proper representation before questioning begins and a thorough investigation needs to be completed. As a healthcare leader, I would ensure that all staff including non-staff are trained and aware of our policy of providing proper care to a patient regardless if we believe that they did or did not commit a crime. It is not our responsibility to prove that but to instead provide the necessary care.

Excessive force should never be used to coerce someone in admitting to a crime as it the job of the police staff not the hospital staff unless it has been determined that the person in custody may endanger themselves or surrounding people. Since physical contact will need to occur, perhaps have certain rooms’ setup with audio and visual recordings, otherwise the healthcare institution run the risk of being liable if not setup. Offer constant training and possibly real life demonstrations to help hospital staff understand clearly what steps are needed. | | | | Example of intentional and unintentional tort | Sayali Patil | 3/6/2013 10:57:13 AM| | | Example of unintentional tort- During a surgery the doctor leaves a sponge inside your body is an unintentional tort. The doctor did not intend to leave the sponge inside. It is negligence. Example of intentional tort- Selecting an unqualified doctor to perform the procedure of abortion is an intentional tort. Depending on the outcome, this intentional procedure can be a civil or criminal tort. (from: http://www. answerbag. com/q_view/1848990 )| | | | RE: Example of intentional and unintentional tort | Lloyreen Moss | 3/6/2013 12:08:17 PM| | | Thanks for the definitions. Recently as a part of my continuing education courses for massage therapy I took a 2  hour credit course on Medical Errors, which ties in nicely to our discussion as medical errors can lead to intentional or unintentional torts. The more common errors were: Medication Errors,  Communication, Infection, Surgical Errors, Pharmacy Errors, Lab Errors, and Treatment Errors. All of these medical errors could be associated with both intentional and unintentional torts.

Like in the case of your example for unintentional tort, the doctor leaving in the sponge by mistake. Another real example is a patient undergoes surgery to get his right leg amputated and the doctor amputates the wrong leg. An intentional tort could be sharing information or talking about a patient without getting his permission. So this would lead to privacy issues and violate HIPPA. Reference:  The Massage Palms Inc. (2012). Prevention of Medical Errors. The Massage Palms Inc, Tampa, Fl. | | | | | RE: Example of intentional and unintentional tort | Sayali Patil | 3/7/2013 3:04:21 PM| | Dear Lloyreen, even I am learning massage therapy. Good to know that you are also doing it. Thanks for the post. | | | | | RE: Example of intentional and unintentional tort | Lloyreen Moss | 3/7/2013 6:46:49 PM| | | Sayali, Awesome!! I like to think of us as the cool kids of the health professionals! It’s a great profession to get into. We also have to worry about our legal and ethical responsibilities and make sure we are not engaging in any intentional or unintentional torts when it comes to massage. I can think of one that I have often heard from massage therapists, especially female massage therapists.

And that is in the case that a client makes sexual comments  toward the therapist. I have heard many female massage therapists say that they then try to hurt the client by giving a really deep massage. I actually had a therapist  tell me this that has been practicing since the early 90’s. I even heard a teacher say this to a class at one point. So it’s a good thing that you and I are expanding our minds and not allowing this misconduct to continue amongst ourselves. As at this point we become liable. I have had this happen to me a few times, and I find that a simple conversation reminding the client of the rules suffices.

Then if that doesn’t work I end the massage and report the incident to a manager. –Reenie | | | | | Intentional Tort | Parul Dawra | 3/6/2013 11:00:55 AM| | | One example of an intentional tort is that of Saturday Night Live alumni, Dana Carvey who underwent a double bypass operation in 2001 that was suppose to preserve his life, But the surgeon who performed the surgery bypassed one of the wrong arteries. The hospital however stated that it was a human error. http://blog. caringlawyers. com/2011/02/13_disturbing_cases_of_medical_1. tmlTo prevent such medical mistakes which occur due to wrong sites and wrong procedures being performed, first of all I would make sure that the physicians as well as the physician assistants in my hospital are educated about the universal protocol which includes a preprocedure verification, site marking, and a time out. Secondly, regular chart reviews would be conducted to ensure compliance with the protocol. | | | | | Intentional Tort | Brittany Miller | 3/6/2013 4:37:51 PM| | | A case of Intentional Tort is Samuels v. Southern Baptist Hosp. In this case a male nurse raped a female underage patient.

This case has a twist because the facility was trying to say that they should not be held liable for the actions of their employees when they are acting outside of the scope of their jobs. This case was upheld that a facility is responsible for the actions of their employees even if they are acting outside the scope of their jobs. In order to combat this as a facility it is important to do thorough back ground checks on all employees that apply for your company. It is also very important that you do routine checks on your employees to ensure that they are acting appropriately and according to your companies business standards.

Each person you hire is an extension of yoy, so you need to be sure that they are acting accordingly at all times. Louisiana Medical Malpractice. 1992. http://biotech. law. lsu. edu/cases/la/medmal/samuels. htm | | | | | RE: Intentional Tort | Cyril Mfebe | 3/9/2013 8:41:52 AM| | | Good point Brittany, another example, assault or battery can occur when medical treatment is attempted or performed without lawful authority or consent. The act of jabbing the patient with a needle without consent would be battery. Getting the patients to turn on his or her side inevitably involves touching.

Even routine handling, a seemingly innocent and legitimate component of the job, can be construed as assault under certain conditions. Operating on the left leg when consent was obtained to operate on the right leg is considered battery. | | | | | RE: Intentional Tort | Brittany Miller | 3/10/2013 2:23:55 PM| | | Cyril your are correct that these are all very viable things that happen every day within the healthcare industry. You can’t prevent from never having anything go wrong, but as a facility you can do your best to ensure hat you minimize the amount of incidents that occur and the severity of them. I think that one thing people tend to overlook is that accidents often happen because of employees who are overlooked. Every industry is being affected by the economy and healthcare is no different. Facilities have had to learn to operate on less of a staff than they did before which can lead to nurses and doctors being overworked and tired. Making sur that your employees don’t get overworked is key in the healthcare industry. A simple mistake from being tired can lead to a loss of a life. | | | | International Torts in Healthcare | Kenneth Miller | 3/6/2013 5:23:34 PM| | | Medical malpractice occurs when a physician turns away from the accepted standard of care for the medical community. Malpractice is really a kind of medical negligence, meaning that the doctor was responsible (or had a legal duty) to care for a patient, the doctor failed to live up to that responsibility (or breached that duty), and that failure (breach) was the cause of damage or injury to the patient. The United States has developed specific medical malpractice law to resolve these cases.

Steps To Avoid Medical MistakesThere are some medical mistakes that a patient has no control of, but there are many others which can be avoided with the proper care. Here are some simple but important steps to help you avoid medical mistakes and possible malpractice. Recognize Medical Errors – To avoid medical errors, you have to first be able to recognize them. The section and the links above provides information on some of the most common errors. Take time to read through them before a visit or any medical procedure. If you have any questions about treatment, don’t be afraid to ask.

Get a Second Opinion – Before any major non-emergency medical procedure, or even a minor procedure you feel concerned about, it’s a good idea to get another doctor’s opinion. Getting a second opinion isn’t a matter of not trusting your regular doctor, it’s a matter of being as responsible as possible for your own health or the health of a loved one. Avoid the Emergency Room for Routine Illness – When there’s an emergency, the ER is almost always your best option, but for a minor injury or a common cold, it’s better to visit your family doctor or a local walk-in-clinic.

Emergency Rooms are designed to provide care for the critically ill, but the intense atmosphere and the possibility of exposing yourself to bacteria and other contagious elements makes it a place to go only when it’s absolutely needed. Bring a Loved One or Friend – When undergoing a serious medical procedure, bring a loved one or friend that can be your representative, help you think through important decisions, and ask questions that you might not occur to you. During these important times, having a “second pair of eyes and ears” and a second perspective may help keep you out of harm’s way.

Read and Understand for Yourself – Whenever you’re given a new prescription or the results of a medical test, it’s a good idea to read that information for yourself and then ask whatever questions are necessary for you to have a reasonably good understanding of what’s going on. Your health and well-being is your responsibility first, so don’t be embarrassed to ask for a doctor, nurse, or pharmacist to help you understand the medical choices you’re making. Get the Best Care Possible – Perhaps the most effective way to avoid medical error is to avoid visiting substandard physicians who may not give you proper medical treatment.

The best way to prevent this is to research potential doctors before committing to just one. If you ask the right questions, perform the right research, and consider the most important factors, you will be well on your way to finding the right doctor for your condition and reducing your chances of suffering the consequences of a medical error. Retrieved from: http://wiki. legalexaminer. com/help-center/articles/how-to-stay-safe-and-avoid-medical-malpractice. aspx| | | | | RE: International Torts in Healthcare | Yasmin Rodgers | 3/6/2013 6:13:38 PM| | Due to human error there is always room for improvement, one area that was mentioned by our classmate is to read and understand for yourself any medical prescription given to you. Due to human error one of my family members was given the wrong medication. Ever since then I personally have taken that extra step in ensuring that I ask the pharmacist questions about my prescriptions. I then go online and read about the medicine as well. Making informed decision can help reduce the chances of another physician’s careless misconduct. Great article Kenneth, it was very informative. | | | | RE: International Torts in Healthcare | Jessy Garcia | 3/6/2013 9:50:47 PM| | | Sometimes, doctors forget why they practice medicine and many times the outcome is negligence. I had a really bad experience with the orthopaedic doctor who operated my father. My father is diabetic, and he had a fracture on his foot. My father put all of his trust, in the knowledge of this doctor that was rated the best orthopaedic doctor. The irony is that he did took time to let my father know he was the best and because, my father was diabetic he was hoping the surgery would not be a failure.

The surgery was done on the foot. But the doctor forgot to ask and have second opinions of his other fellow doctors. My father did not had enough circulation on the foot for it to heal. To make it worst he put a cast for 30 days without supervision on a diabetic foot. The doctor finally checked the foot and it was black,still he closed it and told him I will see you in two weeks. I saw the foot and with my little knowledge I told him I can take you to a different hospital to get another opinion because I think your foot is almost to gangrene.

And to be surprise I was right, they had to call the doctor because he was the one who performed the surgery. Then he asks my father what are you doing here when I just saw you today, then he said we are going to have to cut your leg. To have it short my father still have his two legs but not because of this orthopaedic doctor, but because of a responsible surgeron who took the time to understand my father condition. So,really Kenneth I believe the steps for avoiding medical mistakes are really neccesary in the medical field. | | | | RE: International Torts in Healthcare | Shawanda Herring | 3/7/2013 12:15:28 PM| | | Modified:3/7/2013 12:35 PM | | Jessy you made a good point. There is definitely a need for steps to prevent medical malpractice, whether it is negligence, intentional or unintentional. In the case Duncan v Scottsdale Med. Imaging, Ltd. (70 P. 3d 435) 2003 Supreme Court of Arizona  A patient (Duncan) needed a MRI done by the imaging center but due to previous back injuries, she needed a sedative to assist her with any uncomfortable pain during the test.

She stated to the nurse of the medication that she’s able to take morphine or Demerol. Initially a nurse agreed that she will receive one of those drugs, but on the day of the test another kind of drug (fentanyl) was administered to the patient after the attending nurse after Ms. Duncan gave consent to medicate her during the test, but only after the attending nurse agreed to administer the requested medications. As a result of the nurse’s actions, the patient had allergic reactions to the medication and sued the medical facility. ttp://www. lawandbioethics. com/demo/Main/LegalResources/C5/Duncan. htm To prevent cases like this from happening as being a director of a medical facility, I would have continuous training for all practicing medical personnel on how to handle procedures such as this one. I would use these cases as a tool to implement policy and procedures when faced with a dilemma such as this. I will continuously encourage my staff members to double check for any allergic reactions to medications and supplies that can potentially harm the patient.

I would also encourage my staff members to use a “second set of eyes” if they know they have worked long shifts and/or if there has been inconsistency in a patient’s information in regards to medication, procedures, tests, etc. As stated before by most of you in this post, always make the patient’s health and safety a top priority. | | | | | RE: International Torts in Healthcare | Rosa Parker | 3/7/2013 9:35:18 PM| | | Jessy, I am so glad your father received the treatment he really needed. I had a cousin who had his foot removed as a result of gangrene but then the doctors wanted to cut above his knee and this is when he said no.

I personally think they did not do it correctly and wanted to try to correct their mistake. He was always good to me and was more like an uncle than an older cousin. Strict/Products Liability is a legal doctrine that makes some persons or entity responsible for damages their actions or products caused, regardless of fault on their part. A product liability is the accountability of a manufacturer, seller, or supplier of chattels to a buyer or third party for injuries sustained because of a defect in a product.

When a company knowingly have medications that can treat a patient’s problem but in addition to, cause another condition like hair loss to occur can become taxing. Many of the commercials on television that promote products such as Chantix which is a stop smoking drug now comes with a warning label that appears to mention more side effects as oppose to really helping the patient to stop smoking. Another drug that have side effects, is Lupron which is designed to treat women  with any issue that they may have such as fibroids during their reproductive years and more recently it is now prescribed to treat men with advanced prostate cancer. ttp://www. drugs. com/sfx/chantix-side-effects. html As a healthcare leader, I would thoroughly train my staff on how to check products and/or drugs that are administered to our patients to assure that we are giving them the right drug that is going to solve their existing problem by not adding to it. I would also train my staff to ensure that they knew what to look for when researching a drug. The hospital would be liable as well as the manufacturer so we need to be sure that we know who is held accountable when drugs counteract.

The hospital wants to avoid having to pay for any liable charges. Before administering a drug to our patients, we would explain to them the possible side effects to ensure that they want to still take this drug. | | | | | RE: International Torts in Healthcare | Professor Hijazi | 3/8/2013 5:15:43 PM| | | Excellent response. In terms of checking drugs, we currently have a barcode system where nurses would scan the drug and the patient label and that would transfer to the patient record. Interesting! | | | | | RE: International Torts in Healthcare | Janice Valdez | 3/9/2013 11:36:02 PM| | Modified:3/10/2013 10:09 PM | | Yes, that it true. My hospital uses a barcode system in order to administer the correct and right drugs to all the patients. For instance, last year when my mom was doing her chemotherapy at Kaiser Permanente, she had a bracelet that had a barcode on there with her name and id code. My mom had three different types of medication given to her when she went for treatment and every time before the nurse gave her the medication, they would scan my mom’s bracelet and then scan the bag of medication.

I believe this makes the job a lot easier and more accurate when administering medication to someone, who may be asleep when medication is given. According to the article below, Kaiser started the implementation of this barcode scanning system back in 2008. Reference:http://xnet. kp. org/newscenter/pressreleases/scal/2008/070808barcode. html | | | | | RE: International Torts in Healthcare | Capriana Johnson | 3/7/2013 8:11:35 PM| | | Very good response Kenneth. I would like to add that a way to avoid medical malpractice is by using effective communication.

According to the PA Medical Malpractice blog suggests communication with the patient is important to ensure they understand the diagnoses and procedures during treatment at a healthcare facility. Working in healthcare I’ve noticed that some doctors take their time with patients and others are rushed because their heart is not in it. Giving the patient enough information to research and feel comfortable with the next steps will help prevent medical malpractice. On the other hand the patient has to inform the doctor on what’s going on with their body, the pain they feel, their reactions to the medication, etc. o that they can be diagnosed properly. * Improved Communication: As a patient it is important to ask questions, or to have a trusted friend or relative with you to act as your advocate. The more information that your doctor provides to you, and the more information that you ask for, the less likely your doctor is to make a mistake. Do not be shy. You are not responsible for your doctor’s actions, but you will bear the consequences of malpractice. Therefore, it is important to be an active participant in your own care. Retrieved from: http://pa-medical-malpractice-blog. om/medical-malpractice-prevented/| | | | | Intentional Torts | Jessy Garcia | 3/6/2013 8:59:32 PM| | | An example of intentional tort is when a patient is undergoing an ear surgery. The patient gives permission for the surgery of his left ear; while the patient is under the anesthesia after the left ear surgery, the surgeon decides to operate on the right ear. The right ear was made better. But the result of this decision is battery. The lack of damages does not invalidate the action of the intentional tort, hence, operating on someone’s ear without there permission is battery.

As a leader of my own healthcare facility I would include additional trainning for all medical personnel in their respective fields, as for the surgeons stricter supervision to minimize medical errors. The safety of both employees and patient is very important and top priority. Also helping surgeons in their decision-making can also help to minimize errors during  surgery procedures. | | | | | RE: Intentional Torts | Brittany Miller | 3/8/2013 5:34:09 PM| | | This is a good point, that even thought something might help the patient if they did not consent to the procedure your company is at risk.

Ensuring that doctor’s are only performing the surgery that the patient goes under for is very important. Aside from a doctor having to perform an additional surgery due to an emergency when something goes wrong, they need to stress the importance of only doing what is asked. I know with many surgery, where there are two of those body parts, they make sure to clearly mark either the part that is having surgery or is not. My sister had knee surgery and the nurses allowed me and my other sister to draw on the leg that was having surgery so that the doctor’s made sure not to do the wrong leg.

It seemed silly at the time, but as I have gotten older, I realize the importance of ensuring that these measures are taken. | | | | | RE: Intentional Torts | Jazmin Hymond | 3/10/2013 7:19:25 PM| | | I can agree with you, Jessy. I cam across an article that speaks on Intentional Tort it helped me wrap my head around the subject! “When someone intentionally injuries a person or interferes with a person’s property, an intentional tort has been committed. An intentional tort differs from an unintentional tort in that the perpetrator of an intentional tort intends to bring about a specific result or consequence”, as read in the text.

As example from the book: “If Sam deliberately swings a stick at Joe and hits him in the head giving him a concussion, an intentional tort has occurred. An intentional tort also has to cause injury”. another example from the book is if your neighbor spreads a false rumor that you are using your basement as headquarters for drug dealing, for example, and as a result, you are asked to resign from your coaching position on the local basketball team, your reputation has been damaged and an injury has taken place. http://wps. renhall. com/ca_ph_blair_law_1/6/1550/396913. cw/index. html | | | | | Intentional Tort | Donnetta Shelton | 3/7/2013 1:08:07 PM| | | Defamation is an intentional tort that may affect a patient’s reputation. Under the umbrella of defamation includes Libel, which is written defamation and slander, which is spoken defamation. Defamation can occur when medical records are release accidentally and inaccurately. The fine line with this is that an action is not defamation is the records the statement (written or verbal) is truthful.

To minimize the risk of this particular type of defamation, I would ensure that the following are in place on an ongoing basis: – Ethics Training – Legal Training – Employee Communication – Records security – Process Reviews While this can affect patients, defamation can also affect staff and doctors at healthcare facilities. To avoid this tort affect all parties involved the items listed above should be out in place. | | | | | RE: Intentional Tort | Evaristo Torres | 3/10/2013 8:48:47 PM| | | That is a very good point Donnetta, defamation is an intentional tort that does affect the reputation of a patient.

This is so true specially when someone in the healthcare industry specially in a hospital such as a nurse talks or says something that is not true about a patient and because of that the patient receives a bad reputation. This type of publication will cause one to lose the esteem of the community and it is consider an injury to ones reputation. Anyone who defames another is liable and could be in court. Samples of reputation are: * a) a statement that was made about a plaintiff’s reputation, honesty or integrity that is not true; * b) any publication to a third party (i. . , another person hears or reads the statement); and * c) the plaintiff suffers damages as a result of the statement and can receives immunity for such damage | | | | | Unitentional tort | Sayali Patil | 3/7/2013 3:13:57 PM| | | Unintentional tort: “A type of unintended accident that leads to injury, property damage or financial loss. In the event of an unintentional tort, the person who caused the accident did so inadvertently and typically because he or she was not being careful. For example, a person causing an accident is held legally responsible for their negligence and may have to pay a plaintiff for physical injuries, property damage and/or financial loss. The plaintiff will have to prove that the person causing the accident owed the plaintiff a duty of care, that the defendant did not act as a reasonable person would have. ( http://www. investopedia. com/terms/u/unintentional-tort. asp#ixzz2MtWEURbI) | | | | | RE: Unitentional tort | Professor Hijazi | 3/9/2013 7:51:58 AM| | | Sayali, Your post is incomplete. Please answer the entire discuassion question. Thanks | | | | RE: Unitentional tort | Ellisha Finch | 3/9/2013 9:40:39 PM| | | In Michigan we have a no fault law. However with the right lawyer a law suit is not prohibited. A car accident is something unintentional, at leather most of the time. Precautions and safety measures could reduce the risk of being involved in one. | | | | | RE: Unitentional tort | Parul Dawra | 3/10/2013 1:21:32 AM| | | According to an analysis by the Wisconsin Center for Investigative Journalism, since 1986, at least 297 personal injury, wrongful death and medical malpractice lawsuits have been filed against Wisconsin nursing homes and other long-term care facilities.

In one of such cases a resident sustained numerous life-threatening bedsores and lost 30 percent of his body weight due to negligence of nursing facility. Some of the measures that can be taken to improve the quality of care being provided are:- Establishing a regulatory compliance program in nursing homes. Implementing an effective ethics program that would be helpful in preventing violations. Ensuring staff accountability. Conducting regular facility inspections and performance improvement programs. http://www. wisconsinwatch. org/2013/02/18/nursing-homes-draw-lawsuits/| | | | intentional vs. unintentional tort | Capriana Johnson | 3/8/2013 4:52:45 AM| | | Intentional torts are when you act upon something deliberately and unintentional torts are when you neglect something deliberately. For example with the four stages of torts: duty, breach of duty, causation, and damage, someone who gets in an accident because they failed to stop at the stop sign can be a unintentional tort. Another step I would take to reduce the risk of torts happening in my facility would be to ensure everyone is educated properly on HIPAA laws and violations.

HIPAA is a major entity in healthcare and I would make sure all boundaries are covered and people understood how serious keeping the patients information confidential is. Quarterly training would be required and a Q ; A session probably once a month. | | | | | RE: intentional vs. unintentional tort | Kenneth Miller | 3/9/2013 4:33:49 PM| | | The classic unintentional tort, in any field, is negligence. Negligence is an unintentional tort because the tortfeasor does not intend to cause harm, but, through careless behavior, does cause harm.

In the medical field, negligence is generally called “malpractice” – when a doctor or other medical professional fails to exercise the proper skill, judgment, or care expected of such a professional, and through this failure, causes injury to a patient. An intentional tort in the medical field could include any intentional tort that someone can commit outside the medical field – such as assault, battery, false imprisonment, fraud, etc. An example of battery that could conceivably be committed by a doctor would be the doctor performing an operation that the patient did not consent to. | | | | | RE: intentional vs. nintentional tort | Mary Claire Jennings | 3/10/2013 10:05:42 PM| | | Kenneth you said “An intentional tort in the medical field could include any intentional tort that someone can commit outside the medical field – such as assault, battery, false imprisonment, fraud, etc. and the classic  unintentional tort, in any field, is negligence. I agree with you and to add to your post an unintentional tort is an act that results not from an intention to cause harm or to perform some harmful act, but because the defendant did not conform his or her conduct to the standard of care required by common law. | | | | RE: intentional vs. unintentional tort | Evaristo Torres | 3/9/2013 5:42:14 PM| | | I agree with your input Capriana, there are two types of tort the intentional one and the unintentional one. But unfortunately physicians, healthcare facilities such as hospitals and nursing homes are not paying close attention to these issues. Here in Florida there was a report where a nurse and a care giver (CNA or PCT) where they were actually hurting a patient by physically abusing the patient. Here we see an intentional tort.

On the other hand there was a case in one hospital in Illinois where a patient went into surgery for a problem he had in his left knee and instead he got the surgery on his right or good knee. This is an unintentional tort and/or malpractice but regardless a patient suffer due to an unprofessional and poor quality of service. Like these cases I am sure that there are many more cases like that going around and may be even worst. This is actually a very serious problem that we are facing today in the health care service. | | | | | Torts in Healthcare | Parul Dawra | 3/8/2013 1:14:12 PM| | Medical malpractice tort costs is the largest area of growth among U. S. tort costs, totaling $28. 7 billion in 2004 and rising an average of 11. 7 percent annually since 1975. Higher costs and lawsuit fears has resulted in practice of defensive medicine by numerous doctors who order more tests and treatments than may be medically required just to avoid lawsuits. These unnecessary procedures are estimated to cost $70 – $126 billion per year. In addition this has also led to compromised quality and affordability of medical care and threatened patients access to medical procedures and medicines. ttp://www. instituteforlegalreform. com/issues/medical-liability-0| | | | | RE: Torts in Healthcare | Jessy Garcia | 3/8/2013 10:51:35 PM| | | Great article Parul! Then we go and wonder were our money goes. We are paying to munch in mistakes that can be avoided by re-trainning or following stablished procedures. | | | | | RE: Torts in Healthcare | Yasmin Rodgers | 3/9/2013 3:53:50 PM| | | The tort medical reform has truly become a political debate, because the American people are tired of the inflated cost.

There has been in an increased debate on whether there should combine universal coverage with tort reform. This article gave a fresh perspective that shares not only potential solutions to the medical crisis, but a way to reduce potential cost to the patient. “Approaches to lowering costs of malpractice insurance include:·         “Limiting non-economic and punitive damages. Juries now award patients not just real economic damages, representing lost opportunities, but also non-economic compensation for pain and suffering, or mental distress, or punitive damages to teach doctors a lesson. Limiting lawyers’ fees. Most lawyers take malpractice suits on a contingency basis, where their fees are percentages of their clients’ awards. This encourages them to seek larger awards. ·         Modifying or eliminating “joint and several liabilities. ” Now, even if physicians or hospitals are only partly responsible for damages, they can be required to pay the entire amount. Shortening the statute of limitations. Patients normally have years after the injury happened or was discovered in which they can file lawsuits. This interval could be shortened. If these approaches were implemented, then I feel that we could see a significant reduction in inflated cost. There is evidence that it is possible to see a significant reduction in malpractice cost, becuase the state of Texas has placed a cap on malpractice awards. This in turn reduced the need to increase cost to patients medical bills. This is because states that placed caps on malpractice awards saw a significant reduction. http://blogs. reuters. com/great-debate/2009/08/06/reduce-the-high-cost-of-medical-malpractice/| | | | | RE: Torts in Healthcare | Kenneth Miller | 3/10/2013 11:31:10 AM| | Modified:3/10/2013 11:31 AM | | Higher costs and lawsuit fears are making it more difficult for healthcare providers to practice medicine. Many doctors, particularly those performing high-risk procedures such as obstetrics and neurology, have been forced to quit or limit their practices. Many cities and towns have seen their medical facilities close or stop providing high-risk services. In some areas, people have to drive hours to visit a doctor or receive a certain medical procedure. | | | | | RE: Torts in Healthcare | Shawanda Herring | 3/10/2013 1:12:10 PM| | As stated throughout the discussion, on-going training for any medical personnel can reduce lawsuits. Any physician who performs any kind of inpatient or outpatient procedures risks a chance of having a lawsuit filed against them by families of the patients if an unexpected event occurs such as death or long-term health failure. Some practicing physicians are forced into group practices or reduce the number of days their individual practices are open due to the decline in patients’ visits as a result of the rising cost of healthcare and the lack of healthcare by a large group of people.

The long distance driving to receive medical care is a result of the plans the employers has chosen for their employees. For instance, an individual insurance provider may be a PPO instead of HMO and therefore aren’t allowed to use the doctor that may be ten miles from their home (out-of-network); instead they have to drive 40 miles to see a physician who is in their network of doctors or specialists. | | | | | RE: Torts in Healthcare | Janice Valdez | 3/10/2013 10:49:43 PM| | | I would like to add that there is the Emergency Medical Treatment and Active Labor Act for those patients that are deemed to have an emergency medical condition.

With the emergency medical treatment and active labor act, if any individual (US citizen or not) is seen by the physician and they state that the patient has a EMC, then the hospital must treat the patient regardless of what kind of insurance they carry. Also, it states in this act that the physician’s may not delay the treatment in order to verify insurance (such as calling the insurance company to see what kind of insurance the patient currently has). However, they can ask the patient questions about their insurance.

Therefore, it is very different if the patient is deemed to have an EMC rather than an “urgent care” kind of condition. Reference: http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1305897/  | | | | | RE: Example | Janice Valdez | 3/8/2013 11:08:11 PM| | | Modified:3/10/2013 10:33 PM | | Here is a case of negligence on the hospital, which the court views as falling under the Lousiana Medical Malpractice Act. Apparently a patient, Buford, was raped by an employee on the hospital named Williams. Although Buford is trying to sue Williams for non-consensual sex and the hospital for “… cts of its employee under respondeat superior, and for the hospital’s own negligence in failing to properly supervise, failing to properly train, failing to perform proper background checks, failing to take positive action to prevent the incident, failure to provide Dolores Buford a safe and secure room after being admitted, and other acts to be shown at trial… ” There should be a thorough background check on all employees before being hired because of the sensitivity and confidentiality with patient information and safety.

All the patients should know that the employees are people they can trust to be professional in their jobs. Otherwise many patients will not feel safe and will not seek care at my facility. To add, all the employees should have someone to report to and supervise all actions. To include in that process, there should be a hotline that any employee or patient can call into to report anything they feel is not abiding by the rules of the hospital. This will enable everyone to have a voice and to be aware that this type of behavior is not allowed in the hospital.

Reference:http://caselaw. findlaw. com/la-court-of-appeal/1594710. html | | | | | RE: Intentional Torts in Healthcare | Rosa Parker | 3/9/2013 6:03:45 PM| | | Modified:3/9/2013 6:06 PM | | Invasion of privacy is a wrong that invades the right of a person to personal privacy. Absolute privacy has to be tempered with reality in the care of any patient and the courts recognize this fact. Disregard for a patient’s right to privacy is legally actionable, particularly when patients are unable to protect themselves adequately because of unconsciousness or immobility.

For example, when a well-known actress/actor is hospitalized they are entitled to the same privacy as a non-actress/actor has. The physician, staff and other employees have a responsibility to ensure that their privacy is not invaded nor safety compromised. As a healthcare leader, I would hold my staff accountable so that they would not be willing to settle for a cash reward if they secretly advised the paparazzi of the celebrities whereabouts. Celebrities should be treated with dignity, respect and have the right to privacy.

All of the hospital staff including security who are assigned to this patient’s case would have to sign an agreement that they would not disclose or oust the celebrity’s whereabouts. Anyone that is found negligent would be a cause for dismissal. The healthcare facility is a place where patients should always feel safe and that we take their health serious especially when they are in our care and it should not be jeopardized in any way. | | | | | Intentional Tort in Healthcare | Sherrol Niles | 3/10/2013 11:18:34 PM| | | An intentional tort that takes place in healthcare is negligence by nursing staff to their patients.

Negligence includes “malnutrition, inadequate hydration, physical abuse, medication errors, and mental and emotional abuse. ” When in-patients are totally dependent on nurses to care for their physical needs, and these needs are not met, this is a form of negligence. This results in unnecessary harm to these patients which could have been avoided if these patients were not ignored. Plenty of times I have visited a friend/family member in the hospital and even though the nurse answered the ‘call button’ waiting for the nurse to appear took longer that it should.

As a leader of my own healthcare facility, I would ensure that nurses respond to patients when the call button is being used. A log would be kept at the nurses’ station which corresponds to the white board in patients rooms, of the times rounds were made checking on each patient. Patients having options to complete surveys of their nurses at the end of their shifts. http://www. ehow. com/about_5539103_example-negligence-nursing. html | | | * Times are displayed in (GMT-07:00) Mountain Time (US ; Canada) Bottom of Form Top of Form

Week 1: Introductions/Overview: An Ethical and Legal Framework – Discussion This week’s graded topics relate to the following Terminal Course Objectives (TCOs): A| Given a situation related to reproductive genetics, genetic research, or the human genome project, develop a set of legal and ethical guidelines, which can be applied to genetic issues for the conduct of medical practice and/or research. | B| Given the contentious debate surrounding issues of procreation, develop an institutional policy, which can be applied to the range of treatment and research issues related to procreation. |

C| Given the mandate for advance directives, informed consent, and the legal obligation to report, illustrate the application of these concepts in a specific area or setting, e. g. , psychopharmacology, dementia, long-term care, acute care, home-care, etc. | | Click on the links in the “Topics” section to view the discussion topics. Then, click “Respond” to add your thoughts to the discussion thread. | Topics Introductions (not graded, but required) | Intentional Torts in Healthcare (graded) | Most Pressing Ethical Issues (graded) | Q & A Forum (not graded) | | Most Pressing Ethical Issues (graded)|

What do you see as the most pressing ethical issue in healthcare today? Tell us why you see this issue as particularly compelling from an ethical perspective. | This section lists options that can be used to view responses. Expand All Collapse All    | Print View    | Show Options   | Hide Options   | Select:    | Mark selected as:    |  View Selected  View All | | Responses Responses are listed below in the following order: response, author and the date and time the response is posted. | | | Response | Author | Date/Time* | | | | Discussion | Professor Hijazi | 3/2/2013 6:29:39 AM| | | Ethics is very important in any field.

I look forward to reading your posts… | | | | | RE: Discussion | Yasmin Rodgers | 3/5/2013 8:28:08 PM| | | I would have to agree with the consensus of the class, that confidentiality is an important breach of ethical medical trust. With technology growing, there is a constant struggle to protect patient information. Most medical facilities have found that it must increase the security of patient’s private information due to the legal privacy acts implemented by the Department of Health and Human Services. Health IT has been implemented to ensure continued efforts to protect the medical privacy of all patients.

However it seems to be an ongoing developmental effort by government and private sectors involved. That is why there must be a continued voice among the people and committees to promote change and improvements of our medical IT initiatives. www. hhs. gov/asl/testify/2007/06/t20070619b. htm| | | | | RE: Discussion | Shawanda Herring | 3/6/2013 10:49:58 PM| | | The correct implementation of EMR is a huge issue for many small physicians’ offices and other medical facilities. There is a lack of ethical morality on behalf of the staff members that shares private, medical information with an unauthorized third party.

Yes, as we all know, HIPAA was enacted to eliminate the sharing of medical information without proper consent and prosecute those who violates the rules and regulations of this act; however there are some situations that continue to slip through that violates this act. Therefore, proper training and resources can reduce and eliminate these problems if implemented correctly. The EMR system was originally designed to transport a patient’s medical history instantly without delay to medical professionals and not for “show and tell” to unauthorized person(s). | | | | RE: Discussion | Kenneth Miller | 3/6/2013 5:25:45 PM| | | Beneficence is a term which literally means to put good health of others as your priority. In terms of medical world, this translates to serve the patients and take actions necessary for their survival. The problem of ethical issues in health care arises when good action performed on a patient does not meet with the patients’ enthusiasm or thankfulness. For example, the doctor has to amputate one’s leg in order to save a person’s life. But will the person be thankful? No!

This is because for him, his ability to move around, all by himself, is much more preferred than staying alive. Many people prefer death to immobility. This means for his entire life, he has to rely on others to do his work and this robs a person of his independence and confidence. | | | | | RE: Discussion | Jazmin Hymond | 3/6/2013 11:25:55 PM| | | I could agree with you, Kenneth! You have provided a great example! This is the case with some patients. Another example as far is ethics is when a physician may do a procedure that has yet to, or is in the process of being approved.

This means that ethically it is right but on paper it may be wrong. Situations of the sort typically go well or just terribly wrong. I feel that it is important to weigh the options. At the end of the day, most the physician knows best. Truthfully I do not know anyone who would rather be dead instead of missing a leg. There are ways around the disability. | | | | | RE: Discussion | Gina Billups | 3/10/2013 2:23:46 PM| | | Kenneth to further add to your post, I would say that although a physician amputates a patient’s leg, it is ultimately to save the life of an individual.

That is the physician’s duty to care. When looking at the situation, the physician must first think ethically, and that would be to save his patient’s life. The patient may not initially be pleased with the decision of the physician, however, in the long run, the patient will recover physically. As for the mental and emotional effects that the patient may have to overcome, this process may take some time. This would depend upon the stability and the support system of family and friends that surrounds the patient. | | | | | RE: Discussion | Cyril Mfebe | 3/7/2013 8:47:28 PM| | One important ethical concern in health care is the need to protect oneself from the very real danger of the transmission of communicable diseases in bodily fluids. Especially in cases where a patients history is not available, health care providers have the right and the responsibility to protect themselves from viruses and bacteria that may be present in the body fluids of patients to which they are exposed taking care of these patients. However, this must be balanced with the possibility of making patients feel accused or uncomfortable by these same protective measures. | | | | RE: Discussion | Gina Billups | 3/9/2013 9:13:14 PM| | | Cryil, I agree. The ethical concern of preventing the transmission of communicable diseases is very important. Healthcare providers do have the right and the responsibility to protect themselves from the bodily fluids of the patients that they care for. Along with prevention of communicable diseases healthcare providers must also exercise an extensive level of hygiene. Many healthcare providers do not exercise an ideal level of hand washing when moving from one patient to another.

They don’t utilize gloves when examining patients and touching charts and bedding in an effort to make the patient feel comfortable and discriminated against because of their illness. | | | | | RE: Discussion | Jazmin Hymond | 3/9/2013 11:49:51 PM| | | Modified:3/10/2013 7:32 PM | | I can agree with you, Gina!!! I have noticed the same thing when I visit my physician. I mean when I go for a check up I never see him wash his hands. Even though it is just a follow up, I must say that a physician should wash his or her hands while they are in the presence of a patient.

I do know for sure that I understand why a doctor wouldn’t continue to wash his hands unless he knows he has to touch the patient. This is bad for thier skin and can be a very tedious process. Even still, I guess a physician will be aware if they have to have physical contact with the a patient. | | | | | RE: Discussion | Janice Valdez | 3/8/2013 11:09:12 PM| | | Modified:3/10/2013 11:02 PM | | The most pressing ethics issue I have seen today in healthcare is how much people abuse the government programs. These programs are designed to elp people in this country that need it and they should not be abused because it does cost the rest of us money when these government programs are mistreated. An example of this is a man who tried ordering a motorized wheelchair and instead received a unstable one. When his daughter reported it to the Medicare patrol, he helped her family to figure out that “someone” had purchased the wrong chair for Mr. Gilman but was acquiring the money for the upgraded machine. It is stunts like this that make me upset with how much our country is trying to help everyone and people have to turn it into something bad for everyone.

It is unethical to use programs, which are intended to help people, instead to use them for your own profit. Reference: http://www. nytimes. com/2012/09/12/business/retirementspecial/medicare-fraud-victimizes-patients-and-taxpayers. html? _r=0 | | | | | Ethics Issue | Donnetta Shelton | 3/3/2013 12:50:30 PM| | | One of the first ethical issues in healthcare that comes to mind is confidentiality. In the past many people could access patient records without any recourse, which poses a major privacy issue. Now since the passing of privacy laws (HIPAA), national rules and regulations are in place to protect patients.

The law gives patients control over their health information, ability to review their health records and control who else sees the records. Although this is in place, confidentiality remains a top ethical issue in healthcare. | | | | | RE: Ethics Issue | Brittany Miller | 3/3/2013 4:13:30 PM| | | You are correct in saying that even with all the laws it is still a very pertinant issue. I think that anyone who has worked with any type of health information has to have Hipaa engrained in there brain if they want to be successful.

I was talking with a young lady who is doing her undergrad in health services and in her class all they had talked about was hipaa. She was complaining and didn’t know why all they spoke about was that one topic. I had to laugh because if she only knew that the topic at hand would not just continue through that class but through her whole career in healthcare. | | | | | RE: Ethics Issue | Professor Hijazi | 3/4/2013 7:13:51 AM| | | Good response! What about patient information storage, USB sticks, non-encrypted hard drives… | | | | | RE: Ethics Issue | Yash Bhatt | 3/5/2013 4:58:47 PM| | Modified:3/5/2013 5:02 PM | | Professor, whether it’s protecting information on campus or protecting data on technical devices – both are looked up the same way when it comes to U. S. Department of Health and Human Services’ Office of Civil Rights. Yes, it is true that inside a hospital or a healthcare clinic HIPAA law should be followed very strictly to safeguard patient information but the data should also be protected electronically when stored in hardware devices otherwise Health Information Technology for Economic and Clinical Health (HITECH) Act will be violated.

The prime example is of Blue Cross Blue Shield data breach in which patient information stored in 57 hard drives was stolen and due to which it had to incur loss of about $17 million dollars in corrective actions and penalties. “The hard drives were “encoded but not encrypted,” according to a statement by BlueCross” so the company said it required highly specialized expertise and software to reveal the data. However, that that did not save the company from suffering a big loss due to it being irresponsible. A more detailed information is available on this story in the below mentioned web site. http://www. insidearm. om/daily/collection-technologies/data-security/bluecross-blueshields-data-breach-leads-to-costly-hitech-infraction/ | | | | | RE: Ethics Issue | Professor Hijazi | 3/5/2013 5:49:41 PM| | | Excellent Yash! Encrypted devices are the way to go! | | | | | RE: Ethics Issue | Lloyreen Moss | 3/6/2013 12:12:06 PM| | | I agree about the encrypted devices. I have been trying to get the wellness center where I work to move all of the massage client forms onto a computer database. We do follow HIPPA guidelines by keeping them under lock and key in the locked massage rooms, but I still don’t feel like this is good enough.

Anyone can get the key because we keep a spare key up front at the desk in case the door gets locked by mistake. –Reenie | | | | | RE: Ethics Issue | Gina Billups | 3/8/2013 11:46:53 PM| | | Based upon this question, I needed to look further into encoding vs. encryption. As stated above, encryption is the better choice. This is so because encoding is a system where data is transformed into a format that is more easily used by different systems. Encoding is also a format that is used publicly, therefore, the issue of privacy is still evident.

Encryption, however, is not as widely used and the feature that gives it the advantage is, there is also a key that is used to create that needed level of privacy. No one can view the encrypted information without the key creating an added level of security. Resource:  Retrieved on March 8, 2013, from:  http://www. differencebetween. com/difference-between-encoding-and-vs-encryption/ | | | | | RE: Ethics Issue | Jessy Garcia | 3/8/2013 10:26:22 PM| | | Great, Yash I learned something new. Great article! | | | | | RE: Ethics Issue | Capriana Johnson | 3/6/2013 8:40:36 PM| | Professsor Hijazi I would have to say patient information. As a manager of a department, patient information is so easily accessed and can be stolen within minutes. When we get up from our desk the best preventative method is to lock our computer but sometimes it slips your mind. At MD Anderson Cancer Center “a laptop computer containing information on 30,000 patients at the University of Texas M. D. Anderson Cancer Center has been stolen. The data included specific medical information on about 10,000 of the patients, and was on an unencrypted computer stolen from an M. D.

Anderson faculty member’s home on April 30 (Chron, 2012). ” Had the computer been locked and encrypted, the data wouldn’t have been so easy to obtain. This is a growing issue that I believe will continue growing because of the use of non-encrypted drives and faculty members putting valuable information on USB drives and losing them or simply leaving them laying around. Patient information is in a database which is secure to a certain point but if an employee gives the information to an outsider it can be easily obtained. http://www. chron. com/news/houston-texas/article/Stolen-computer-contained-data-on-30-000-M-D-3670695. hp | | | | | RE: Ethics Issue | Mary Claire Jennings | 3/8/2013 9:52:47 PM| | | Medical facilities should at all times protect their patients data and information. The most common use for these USB hard drives with encryption is to transport and store personal information. One extremely beneficial use of these devices is in the care of the elderly, when medical records can be stored on a flash drive that will allow any hospital to access a person’s medical history in the case of an emergency if the patient is unable to provide the information himself.

Having this information non-encrypted means that anyone can have access to the patient information. However,HIPAA  now requires covered entities disclose if and when they have a security breach and client data is exposed. All individuals affected by the breach must be notified, and if more then 500 users’ data has been compromised, the organization must notify the Secretary of the Department of Health and Human Services (HHS) who must then publicly post the breach on the HHS website. | | | | | RE: Ethics Issue | Tom Read | 3/6/2013 3:04:04 PM| | I have two concerns that are around this issue that you have brought up. There is talk of moving everyone record to where it is in one place for everyone. This scares me with the identity theft that is going on in our day and age. With all this information being in one spot it makes it so much easier to steel someone information. The second is I have spent a great deal of time in the hospital over the last year and you always hear communication between people about patients. This is another issue that I do not see how you would stop it or even slow it down. | | | | RE: Ethics Issue | Yolonda Thomas | 3/7/2013 8:51:57 PM| | | Tom, I do see what your two concerns are and this is a problem with me also. I hate to hear a nurse or doctor friend discussing  situations by giving patient identic . I understand that your work is your life, but telling other friends who in the health care . to me this is surely a ethical matter , respect   and   discussion of patients. When it comes to having all the information in a central place. I think of the Credit Reporting systems.

This systems is great with giving out data that is report about you from your creditor but its also the  only one way to get a response to correct mistake. In guess, what you may be waiting forever to change the wrong information. | | | | | RE: Ethics Issue | Tom Read | 3/8/2013 12:28:22 PM| | | When my father was in the hospital and dyeing his information was taken and they charged several thousand dollars to his credit. It was hard for my mom because she had just lost the man of 60 years and now she is getting bills for things that did not belong to them. After investigating they found

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