Health Care Policy, Law, and Ethics – History of Hospitals; Development of US Health Law; Understanding of the Foundation of Law

This is the scenario

 

 

HSA515 Week 1 Scenario Script: Health Care Policy, Law, and Ethics – History of Hospitals; Development of US Health Law; Understanding of the Foundation of Law

 

Slide # Scene/Interaction Narration
Slide 1 Scene 1: Exterior Strayer University Building/Classroom  
Slide 2 Scene 2: Interior Classroom:

 

Ø  Professor Charles enters classroom and greets students and shares his background

 

Ø  Students introduce themselves and share their goals for the course

 

 

Prof Charles: Hello everyone! My name is Professor Charles Daye and welcome to Health Policy, Law, and Ethics.

 

I am excited about the opportunity to facilitate this course and look forward to engaging each of you over the next several weeks.

 

I have been a hospital CEO for many years and have obtained a law degree, a PhD in Health Administration, and a D.B.A. in Organization Development.

 

Currently, I am a CEO of a medium size consultancy firm involving corporate responsibility and institutional liability for all types of health providers.

 

I would like to get to know a little about you and your goals for the course.

 

Let’s begin with you, Casey.

 

Casey: Hi everyone. My name is Casey Williams.  I’m currently a Patient Advocate in a large hospital. I am interested in healthcare administration because I work closely with patients and senior hospital management and I find the work very stimulating.

 

After earning this degree, I would like to become a healthcare administrator. This course in legal aspects of healthcare administration will go a long way in helping me to understand that part of the job.

 

Donald:  It’s nice to meet you Casey and Professor Charles. My name is Donald Miller and I’m really looking forward to learning more about the law and healthcare administration. I have always been interested in the law and caring for people in need. Healthcare administration is my career goal as well.

 

I am currently working in a private clinic and want to major in the Health Services Administration so I may advance my career.

 

Prof Charles: When you think of healthcare administration and law management, what is the first thing that comes to mind?

 

Casey: Hopefully our future career field…(students laugh).

 

Donald: I agree.  Sounds like a challenge, but we’re up for it (sounding enthusiastic).

 

Prof Charles: Your positive attitudes are contagious, which is a good thing.  (Professor Laughs).   I’m looking forward to the next few weeks and helping you achieve your goals.  Let’s get started.

 

Slide 3 Scene 3:  Interior – Classroom

 

Ø  Prof Charles reviews the objectives of the course

 

Prof Charles: Throughout this course, you will explore health law, theory, concepts, tools, and case law in healthcare administration. We will examine real cases and their applicability to daily patient care in modern healthcare facilities and how to prevent violations and negligence from occurring.

 

In addition, we will examine emerging trends in the health care industry that affect providing a safe environment within healthcare organizations. Among the topics to be covered include criminal law, torts, theories of law, state and federal law, ERISA, negligence, risk management, informed consent, ancillary services, negligent credentialing, and continuous quality improvement in legal aspects of healthcare administration.

 

During this lecture, we will examine the first common law court case in America during 1789 and public policy as a principle of law. Public policy maintains that no one can lawfully do that which tends to be injurious to the public or against the public good. We will also discuss common law and its basis for the rule of law and the rules of culture and the public good.

 

Prof Charles:  Can someone explain the derivation of common law and its relationship to the public good?

 

Casey: I will give it a shot….I think these two concepts, though related, have very distinct differences. It is quite easy to confuse the terms.

 

Both common law and the public good go hand-in-hand.  Common law is derived from principles and rules during the trial of court cases. Public policy is the principle of the laws that says, “No one can lawfully do that which tends to do harm to the public or against the public good.

 

Donald: So, is it safe to assume that enacted laws should support common and the U.S. Constitution and the public good?

 

Prof Charles: Absolutely.  Great question, Donald.

 

Donald: Professor, I am still not sure that I fully understand how common law can be abolished.

 

Prof Charles: Well, common law as expressed in federal law, US Constitution, federal treaties take precedence over the constitutions and laws of specific states and local jurisdiction.

 

Casey: So you’re saying state and local laws can only enact and enforce laws that do not conflict with federal law?

 

Prof Charles: That’s correct, Casey. Statutory laws may be declared void by a court; for example, a statute may be found unconstitutional because it does not comply with a state or federal constitution, because it is vague or ambiguous, or, in the case of state law, because it is in conflict with a federal law.

 

Donald: Thanks Professor, it’s beginning to make sense to me. I am actually looking forward to learning more.

Slide 4 Scene 4: Interior Classroom

 

Ø  Prof Charles: Reviews the role of common law and malpractice

 

Prof Charles: Now let’s focus on the role of the common law in the 1794 first common law case Cross v. Guthrey where a physician, for the first time in America, is held responsible for negligence in patient care, or malpractice.

 

Mrs. Cross developed a pain in her breast and consulted Dr. Guthrey who amputated her breast and she subsequently died due to bleeding. Mr. Cross sued Dr. Guthrey after receiving a bill for the failed operation. The lawyer for Mr. Cross asserted that Dr. Guthrey’s bill should be dismissed and Mr. Cross should be awarded a significant amount of money for the loss of his wife’s companionship. The jury concurred.

 

Would you agree or disagree with that ruling and why?

 

Donald: I would agree that Dr. Guthrey committed malpractice. I mean Mrs. Cross died as a result of his surgery.

 

Casey: I do not agree because Dr. Guthrey tried to relieve the source of her pain and just because medical knowledge was not so advanced does not mean he was negligent.

 

Donald: Casey provides a good argument, but just because medicine was not advanced at the time does not mean Mrs. Cross did not suffer a wrongful death….

 

Prof Charles: That is a very interesting point of view…Casey what do you think of Donald’s comment about the cause of death being wrong as a result of negligence?

Casey: Donald, makes a good point. Mrs. Cross did bleed to death as a result of the surgery and Dr. Guthrey should have known this was a high probability.

 

Prof Charles: You both have made great observations.

 

Since 1794, physicians have experienced recurring periods of substantial malpractice cases. In 1941, The Journal of the American Medical Association published studies showing that 1296 malpractices had occurred between 1900 and 1940 with more than five-hundred between 1930 and 1940. The article said the increase was due to high patient expectations, new diagnostic procedures, and erosion of the physician-patient relationship.

 

Throughout this course, we will see that the most common reason for malpractice is misdiagnosis and failure to follow-up.  Let’s move on.

Scene 5 Slide 5: Interior – Classroom

 

Ø  Prof Charles: Describes the legal system

 

Prof Charles: Our reading reviews an introduction to the legal system. Who can tell us about the separation of powers?

 

Donald: From a reading standpoint, it is a system of checks and balances reflected in the relationships among the branches of government with regard to legislation. On the federal level, when a bill is passed in Congress and the president signs it, a new law is created. If the president vetoes the bill, two-thirds of Congress can vote to override the veto.

 

Prof Charles: Good job, Donald. Let’s focus on the role of the Supreme Court in this balance of powers.

 

What are your thoughts, Casey?

 

Casey: Well, I do think the Supreme Court can declare a bill that has become law inviolate if it violates the Constitution.

Prof Charles: Exactly.  Only those laws that are constitutionally sound can be declared the law of the land.

 

Even though a Supreme Court decision is final regarding a specific controversy, Congress and the president may generate new law and replace a constitutionally unsound law as declared by the Supreme Court.

 

Does anyone know what the Department of Health and Human Services or DHHS does?

 

Casey: If I recall properly, it is concerned with people and most involved with the nation’s human concerns. The DHHS is responsible for developing and implementing appropriate administrative regulations for carrying out national health and human services policy objectives.

 

Prof Charles: Correct Casey! Healthcare managers must understand this cabinet level department affects the healthcare industry.

 

Now let’s look at the organization’s structure.

Slide 6 Scene 6: Interior – Classroom

 

Ø  Professor Charles: Discusses DHHS and its function in society

 

Prof Charles: The secretary of DHHS serves as the department’s administrative head, advises the president with regard to health, welfare, and income security plans, policies, and programs. The DHHS administers the programs for senior citizens, including Social Security benefits, Medicare, and Medicaid and Public Health Service, or PHS.

 

In your experience, what do you think is the role of Public Health?

 

Casey: In my reading and experience, I think Public Health’s role is to promote the protection of the nation’s physical and mental health by coordinating with the states in setting and implementing national health policy.

 

 

Prof Charles: That’s a very accurate response Casey.

 

Within the PHS of DHHS are smaller agencies responsible for carrying out the purpose of the division and DHHS: these agencies include the following:

 

  • Agency for Healthcare Research and Quality
  • Centers for Disease Control and Prevention
  • Food and Drug Administration
  • National Institute of Health

 

What do you see as the thrust of public law?

 

Donald: I would think public law deals with relationships between individuals and government and private laws deals with relationships among individuals and government.

 

Prof Charles: Very good, Donald. The thrust of most public laws is to attain what society deems to be valid public goals. One important segment of public law, for example, is criminal law which prohibits conduct deemed injurious to public order and provides for punishment of those proven to have engaged in such conduct.

 

In contrast, private law is concerned with the rights and duties of private individuals. Torts and contract law are two basic types of private law.

 

Now, in this discussion on the introduction to the legal system, what do you think is tort law and contract law?

 

Casey: In a tort action the plaintiff asserts that the wrongful conduct of another has caused harm, and the injured party seeks compensation. Contract law involves a claim by one party that another party has breached an agreement by failing to fulfill an obligation.

 

Prof Charles: Exactly….now, do you think anarchy would ensue without a clear system of laws? What are your thoughts?

 

Casey: I guess it’s possible…

 

Donald : Yes, I do think that anarchy would be the result without a clear system of laws that regulate society.

 

Prof Charles: That’s absolutely correct, Donald.  In evaluating laws and society today, how do you think the modern hospital is affected by the challenges facing it?

 

Casey:  Well, the reading tells us hospitals are more complex than any other institution in our society. The challenges are enormous. Hospital challenges carried forward from the twentieth century are exorbitant malpractice awards, skyrocketing insurance premiums, high expectations of patients for miracle drugs and treatments, negative press that increase public fear, ethical dilemmas of abortions, sterilization, human cloning, shortages of nurses, physicians, technicians, and other health caregivers.

 

Donald: I agree with Casey, and, boy, I realize how important the job of a healthcare administrator is and the vital need to understand the law and health care.

 

Prof Charles:  Excellent discussion class. The pinnacle of the hospital evolution has not yet been reached nor has the final page of its colorful history been written. This is an exciting time to be in healthcare administration.

 

Healthcare leaders of the twenty-first century must understand their roots and historical value of knowing the past, have a vision to preserve the good and have the passion to create an even better healthcare system to provide superior care for patients every day.  Before we move on, let’s check our understanding with a couple of quiz questions.

 

Slide 7 Check Your Understanding

 

Medical malpractice is a 20th century phenomena. = False

 

With this law, the plaintiff asserts that the wrongful conduct of another has caused harm, and the injured party seeks compensation. – Tort Law

This law involves a claim by one party that another party has breached an agreement by failing to fulfill an obligation. – Contract Law

 

This law deals with relationships between individuals and government. – Public Law

 

This law deals with relationships among individuals and government. – Private law

 

 

Prof Charles:  Choose the best answer to the question and click the SUBMIT button when finished.

 

Prof Charles: Medical malpractice is a twentieth century phenomena. True or False?

 

Prof Charles: Correct!  Since 1794, physicians have experienced recurring periods of substantial malpractice cases. In 1941, The Journal of the American Medical Association published studies showing that 1296 malpractices had occurred between 1900 and 1940 with more than five-hundred between 1930 and 1940. The article said the increase was due to high patient expectations, new diagnostic procedures, and erosion of the physician-patient relationship.

 

Prof Charles: Incorrect.  Since 1794, physicians have experienced recurring periods of substantial malpractice cases. In 1941, The Journal of the American Medical Association published studies showing that 1296 malpractices had occurred between 1900 and 1940 with more than five-hundred between 1930 and 1940. The article said the increase was due to high patient expectations, new diagnostic procedures, and erosion of the physician-patient relationship.

 

Prof Charles:  Match each term with its correct definition and click the SUBMIT button when finished.

 

Prof Charles:  Correct!  In a tort action the plaintiff asserts that the wrongful conduct of another has caused harm, and the injured party seeks compensation. Contract law involves a claim by one party that another party has breached an agreement by failing to fulfill an obligation.  Public law deals with relationships between individuals and government and private laws deals with relationships among individuals and government.

 

 

Prof Charles:  Incorrect.  In a tort action the plaintiff asserts that the wrongful conduct of another has caused harm, and the injured party seeks compensation. Contract law involves a claim by one party that another party has breached an agreement by failing to fulfill an obligation.  Public law deals with relationships between individuals and government and private laws deals with relationships among individuals and government.

 

 

 

 

Slide 8 Slide 8: Interior – Classroom

 

Ø  Professor Charles: Reviews the sources of law

Prof Charles: Can someone describe the sources of law?

 

Donald: The sources of law are common law which is derived from judicial decisions. The second is statutory law which comes from federal and state statutes. And the third is administrative law which is prescribed by administrative agencies.

 

Prof Charles: Good Donald. Now, let’s take a closer look at common law.

 

Today, cases are tried using common law principles unless a stature governs otherwise. Although statutory law has affirmed many of the legal rules and principles initially established by the courts, new issues continue to arise, especially in private law disputes, which require decision making according to common law principles. Common law actions are initiated mainly to recover damages or possessions of real or personal property.

 

Casey:  Do the lower state courts have to follow higher state court common law principles?

 

Donald: I’ve read that lower state courts must follow higher state court principles of common law.

Prof. Charles: That is correct.  Consider the fact that a decision in a case in higher state court that sets forth a new legal principle establishes a precedent. Trail courts or those on equal footing are not bound by the decision of other trial courts. Also, a principle established in one state does not set precedent for another state.

 

Casey: OK…that makes sense….

Slide 9 Scene  9: Interior – Classroom

 

Ø  Summary

Prof Charles: Today, we have had a great discussion on the basics of the history of hospitals and an introduction to the legal system as it relates to health care.

 

To recap today’s highlights, we discussed the sources of law and government organizations and how laws seek to solve problems, seeking to settle them without resorting to force. The history of hospitals we have seen reveals errors that then can be avoided, customs that persist only because of tradition, and practices that have been superseded by other that are more effectual.

 

During the next lecture, we will discuss tort law, negligence, and criminal aspects of health care and its place in preserving the peace. I look forward to another great discussion during our next meeting.

 

Before we adjourn, are there any questions?

 

Donald:  No questions for me.  I learned so much today and I’m ready for more.

 

Casey: Same here, I’m looking forward to our next meeting.

 

Professor Charles: Excellent! Don’t forget to participate in this week’s discussion and complete the e-Activity as well. If there are no further questions, I will say good evening and I will see you next time.

 

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