Ch. 05 Key Terms
Criminal Law
Criminal law is the area of law that addresses possible illegal actions taken and must be proven in court beyond reasonable doubt. Healthcare providers can be found liable or responsible for the actions.
Civil Law
Malpractice cases are a type of civil action or civil case, meaning the victim's compensation is being fought for, often without regard for punishing the defendant. Medical malpractice cases aim to gain financial support for help with medical costs, lost income, pain, suffering, and disability.
Torts
Tort law in healthcare involves medical professionals and patients. Legally speaking, a tort occurs when a medical professional acts in a negligent manner and injures someone in their care. A tort is different from a criminal act.
Malpractice
Medical malpractice is defined as any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes an injury to the patient. Medical malpractice is a specific subset of tort law that deals with professional negligence.
Negligence
Medical negligence refers to an act of carelessness, not intent to harm. Medical negligence means the practitioner made a mistake in the good faith belief that he or she was fulfilling the medical standards of care and doing the right thing by the patient.
Assault and battery
Essentially, assault is attempted battery. Medical battery is similar to battery, but the harm occurs in a medical setting and includes harmful or offensive touching of a patient by a medical professional.
invasion of privacy
Sharing the results of a test in front of family members or other patients without your permission. Taking pictures of an undressed patient under anesthesia. Mentioning a patient's medical history in a document that is open to the public.
False imprisonment
False imprisonment, as it applies in the health care delivery environment, involves an allegation that a health care professional or someone employed by the provider acted intentionally to restrict a patient's movement unlawfully.
Abuse
Abuse is inappropriate treatment of an individual. It includes physical, psychological, emotional and sexual abuse. Physical abuse is the use use of physical force that may result in bodily injury, physical pain, or impairment.
Defamation
Defamation by a patient or their representative relative to the care received or not received from a doctor or hospital is commonly understood to be a false statement of fact, published to a third party. This is harmful to the reputation of the doctor or hospital
Slander
Slander is any defamation of character that is spoken. For example, in nursing, if you were to gossip about a patient aloud to another nurse, "Did you hear that this patient did such-and-such?" while knowing that it was untrue.
Libel
Libel is a defamatory statement in writing or other visible forms, whereas slander is a spoken defamatory statement.
Contract
medical service furnished by a physician or group of physicians to a group or class of individuals under an agreement (as with an industrial plant
Breach of contract
The elements of a contract, whether written or verbal, include offer, consideration, and acceptance. An enforceable contract is legally binding. A breach of contract occurs when one or more of the terms of the contract are violated
Consent form
A consent form is a legal document that ensures an ongoing communication process between you and your health care provider.
Scope of practice
Scope of practice” is defined as the activities that an individual health care practitioner is permitted to perform within a specific profession. Those activities should be based on appropriate education, training, and experience.
Ethics
Ethics serve as the guiding principles for healthcare professionals, ensuring that they prioritize their patients' well-being, treat patients with dignity and respect, and foster trust and confidence in the healthcare system.
Power of attorney
A type of advance directive that gives a person (called a proxy) the authority to make medical decisions for another person if that person is not able to make their own decisions.
Living will
Living will. A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation.
Denial of services
when a payer, such as a health insurance company or Medicare, declines a healthcare provider's request to be reimbursed for their services
Denied payment
A claim denial is issued when a payer, such as a health insurance company or Medicare, declines a healthcare provider's request to be reimbursed for their services.
Termination of coverage
Terminating coverage refers to when the consumer has chosen a plan and effectuated coverage by paying the first premium payment and ends the coverage effective after the date the coverage was effectuated. In most cases, the process for both canceling and terminating coverage is the same.
Preexisting condition
A pre-existing medical condition (PEMC) is an illness or injury you had before your policy began or was renewed. Examples of pre-existing medical conditions include, diabetes, asthma, high cholesterol or a long-term back condition.
Omnibus Budget Reconciliation Act (OBRA)
The Omnibus Budget Reconciliation Act (OBRA), also known as the Nursing Home Reform Act of 1987, has dramatically improved the quality of care in nursing homes over the last twenty years by setting federal standards of how care should be provided to residents.
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