Law and the Physician: A Practical Guide

By Edward P. Richards and Katharine C. Rathbun

• Physicians and Lawyers
  • Chapter 1 - The Legal System
    • Critical Points
    • Introduction
    • LEGAL RELATIONSHIPS
      • The State
      • Patients
      • Employees
        • Paramedical Personnel
        • Other Physicians
      • Employers
      • Institutions
    • ORIGINS OF LAW
      • The Role of Judges
      • The Appellate Process
      • The Litigation Bias
    • THE FEDERALIST SYSTEM
      • The Federal Court System
      • The State Court System
      • Determining Sovereignty
    • TYPES OF LAW
      • Criminal Law
        • Special Characteristics of Criminal Law
        • Defending a Criminal Case
        • The Citizen's Duty
        • The Right to Counsel
      • Civil Law
        • Civil Remedies
        • Nonmonetary Remedies
      • Administrative Law
    • BIBLIOGRAPHY
  • Chapter 2 - Civil Litigation
    • Critical Points
    • Introduction
    • THE COST OF LITIGATION
      • Contingent Fees
      • Problems with Contingent Fees
      • Costs in Other Countries
    • PREPARING FOR TRIAL
      • Making a Claim
      • Pleadings
        • The Plaintiff's Complaint
        • The Defendant's Answer
      • Witnesses
    • THE TRIAL
      • Pretrial Delay
      • Courtroom Formalities
      • Trying the Act or the Person
      • Attacking the Defendant
      • Trial Costs
      • Surviving a Trial
    • POSTTRIAL PROCEDURES
    • ALTERNATIVE DISPUTE RESOLUTION
      • ADR Techniques
      • Implementing ADR
    • BIBLIOGRAPHY
  • Chapter 3 - Discovery
    • Critical Points
    • Introduction
    • FORMS OF DISCOVERY
      • Interrogatories
      • Requests for Admissions
      • Depositions by Written Questions
      • Oral Depositions
      • Requests for Production
      • Subpoenas
      • Subpoena Duces Tecum
      • Contesting Discovery Orders
    • CROSS-EXAMINATION
      • The Hearsay Rule
      • Business Records Exception
        • Entry in the Regular Course of Business
        • Personal Knowledge
        • Timely Entry in the Usual Course of Business
    • THE LATITUDE FOR DISCOVERY
      • Privileged Information
      • Losing the Privilege
    • BIBLIOGRAPHY
  • Chapter 4 - Damages
    • Critical Points
    • Introduction
    • DIRECT ECONOMIC DAMAGES
      • Lost Earnings
      • Medical Expenses
      • Preexisting Illness
      • Future Medical Costs
      • Rehabilitation and Accommodation
      • The Strategic Value of Medical Expenses
    • INDIRECT ECONOMIC DAMAGES
      • Pain and Emotional Distress
      • Consortium
    • PUNITIVE DAMAGES
    • THE COLLATERAL SOURCE RULE
    • STRATEGIES FOR PAYING DAMAGES
      • Lump Sum Payments
      • Structured Settlements
    • BIBLIOGRAPHY
  • Chapter 5 - Dealing with Attorneys
    • Critical Points
    • Introduction
    • THE CONFLICT OF CULTURES
      • Physicians and Paternalism
      • Attorneys and Autonomy
    • STRUCTURE OF LEGAL SERVICES
      • Legal Bills
      • The Structure of Legal Work
        • Attorneys' Product
        • The Impact of Client-Paid Legal Fees
      • Legal Billing
        • Chronological Billing
        • The Limitations of Legal Education
        • Client-Funded Legal Education
      • Incentives against Settlement
      • Legal Practice Styles
    • CONFLICTS OF INTEREST
    • CONFLICTS WITH OTHER CLIENTS
    • BEING AN EFFECTIVE CLIENT
      • Choosing an Attorney
      • Preventive Law
        • Undetected Legal Problems
        • Legally Risky Situations
        • Potential Future Risks
        • Terms of the Relationship
      • Becoming a Partner in the Case
    • BIBLIOGRAPHY
  • Chapter 6 - Legal Standards
    • Critical Points
    • Introduction
    • PROVING MALPRACTICE
      • Duty
      • Standard of Care
        • Res Ipsa Loquitur
        • Negligence Per Se
        • Intentional Torts
        • Sexual Assault
      • Establishing the Standard of Care
        • The Expert's Role
        • Schools of Practice
        • The Locality Rule
        • Qualifying an Expert
        • The Problem with Expert Witnesses
      • Causation
    • Vicarious Liability
      • Method of Payment
      • Control
      • Licensed Professionals
      • Scope of Employment
        • Intentional Acts
        • Hospital Employees
    • PRODUCTS LIABILITY
    • THE IMPORTANCE OF SETTING OBJECTIVE STANDARDS
    • BIBLIOGRAPHY
      • Expert Witnesses
      • General References
  • Chapter 7 - The Malpractice Insurance Crisis
    • Critical Points
    • Introduction
    • RESEARCH PROBLEMS IN MALPRACTICE
    • INSURANCE COMPANY DATA
    • MYTHS OF MALPRACTICE
      • Myth 1: Getting Sued Is a Random Event
      • Myth 2: Every Physician Is King
      • Myth 3: Patients Should Be Sophisticated Consumers
      • Myth 4: Breakthroughs Are Good Public Relations
      • Myth 5: The Perfect Baby Can Be Guaranteed
      • Myth 6: The Physician's Lot Is Not a Happy One
      • Myth 7: You Cannot Set Standards Because Medicine Is an Art
      • Myth 8: Tort Reform Is the Solution
    • DEFENSIVE MEDICINE
      • Technology-Oriented Medicine
      • Diagnosis and Testing
      • Specialty Blinders
    • THE MALPRACTICE INSURANCE BUSINESS
      • Rates
      • The Reserves Game
      • Underwriting Standards
      • Competition
      • The Changing Nature of Insurance Coverage
      • Conflicts of Interest
      • Independent Representation
    • BEING AN EFFECTIVE INSURANCE BUYER
    • BIBLIOGRAPHY
  • Chapter 8 - Management of Medical Information
    • Critical Points
    • Introduction
    • MEDICAL RECORDSGood Records
      • Medical Records in Litigation
      • Medical Records as a Plaintiff's Weapon
      • Defensible Records
    • A HISTORICAL PERSPECTIVE
    • PHYSICIAN'S OFFICE RECORDS
      • Basic Patient Information
      • Maintaining the Records
        • Readability
        • Altered Records
        • Protecting Records
        • Retention of Records
        • Statutory Requirements on Record Keeping
        • Destroying Records
      • Off-Chart Records
      • Releasing Medical Records
      • Selling Medical Records
    • HOSPITAL MEDICAL RECORDS
    • APPENDIX 8A: MEDICAL RECORD SERVICES
    • BIBLIOGRAPHY
      • Problem-Oriented Medical Records
      • General References
• Physicians and Patients
  • Chapter 9 - Physician-Patient Relationship
    • Critical Points
    • Introduction
    • ESTABLISHING THE RELATIONSHIP
      • Explicitly Accepting the Patient
      • Exercising Independent Medical Judgment
        • Telephone Calls
        • Private Office Walk-in Patients
        • Invisible Patients
        • Informal Consultations
        • Free-Standing Ambulatory Care Centers
      • Refusing to Treat Patients
      • Contractual and Statutory Duties to Treat
    • SPECIALTY CARE
    • THE TREATING SPECIALIST
    • EXPECTATION OF CONTINUED TREATMENT
    • TERMINATING THE RELATIONSHIP
      • Abandoning Patients
      • Patient-Initiated Terminations
      • Physician-Initiated Termination of Care
    • DOCUMENTING THE TERMINATION
    • BIBLIOGRAPHY
      • Patient Attitudes and Behaviors
      • Physician Attitudes and Behaviors
  • Chapter 10 - Conflicts of Interest
    • Critical Points
    • Introduction
    • THE FIDUCIARY RELATIONSHIP
      • Training and Licensure
      • Market Factors
    • TRADITIONALLY RECOGNIZED CONFLICTS
      • Informed Consent
      • Treating Family Members
      • Hospitals
      • Laboratories
      • Sexual Relationships with Patients
    • TECHNICAL FRAUD: THE MEDICARE STATUTE
      • Constitutionality of the Fraud and Abuse Statute
      • The Everyone-Does-It Defense
      • Implications of the Safe Harbor Regulations
      • The Temptation of Business as Usual
      • The Risks of Business as Usual
      • The Politics of Prosecution
    • TECHNICAL FRAUD: RICO VIOLATIONS
      • Understanding RICO
        • Mail and Wire Fraud
        • Incentives and Commercial Bribery
        • The Pattern of Racketeering
      • Prosecuting a RICO Claim
    • PHYSICIANS AND FRAUD
    • CONCLUSIONS
    • BIBLIOGRAPHY
      • Articles
      • Cases
  • Chapter 11 - Consent to Medical Treatment
    • Critical Points
    • Introduction
    • DEFINING CONSENT
    • EXCEPTIONS TO THE REQUIREMENT OF CONSENT
      • The Emergency Exception
      • Legally Mandated Treatment
      • The Therapeutic Exception
    • INFORMED CONSENT
      • Technology-Oriented Medicine
      • The Demise of Paternalism
      • Changing Values
      • Legal Standards for Informed Consent
        • The Community Standard
      • The Uncertainty of the Community Standard
        • Reasonable-Person Standard
        • Alternative Treatments
        • Statutory Disclosure Standards
        • Fraud
      • The Commonsense Approach
        • Knowable Risks
        • Unknowable Risks
        • Voluntariness
        • Public Policy
        • Medically Unnecessary Procedures
      • The Medical Value of Informed Consent
      • The Patient's Expectations
    • DOCUMENTING CONSENT
      • The Form of the Documentation
        • Blanket Consent Forms
        • Treatment-Specific Consent Forms
        • Patient-Specific Consent Forms
        • Non-English Speakers
        • Illiterate Patients
      • Documenting the Oral Consent
    • BIBLIOGRAPHY
  • Chapter 12 - Special Consent
    • Critical Points
    • Introduction
    • PROXY CONSENT
      • Power of Attorney to Consent to Medical Care
      • Conflicts of Interest
      • Limitations
    • GUARDIANSHIPS
      • Establishing the Authority of a Guardian
      • Emergency Guardianships
        • Minors
        • Adults
        • The Interim until the Judge Rules
    • CONSENT FOR MINORS
      • Proxy Consent for Minors
      • Special Circumstances
      • Guardians
      • Conflict between Parents
      • Conflicts between Parents and Children
      • Documentation
      • Statutory Right to Treat Minors
      • Emancipated Minors
    • BIBLIOGRAPHY
      • Minors
      • Mentally Incompetent Patients
      • Power of Attorney
  • Chapter 13 - Substituted Consent and Terminal Illness
    • Critical Points
    • Introduction
    • FRAMING THE ETHICAL DEBATE
      • Patients' Interests
      • Physicians' Interests
      • Hospitals
      • Families
      • Society's Interests
    • THE CRUZAN CASE
      • The Missouri Supreme Court Ruling
      • The U.S. Supreme Court's Ruling
      • The Persistent Vegetative State
    • LIVING WITH CRUZAN
      • Formalizing the Patient's Wishes
      • The Duty to Counsel
    • COMPLYING WITH A PATIENT'S REFUSAL OF CARE
      • The Role of Courts
      • Following the Patient's Wishes
      • Judicial Intervention
      • The Simple Cases
    • THE IMPACT OF CRUZAN
      • The Drawbacks of Substituted Consent
      • The Problem of Relatives
    • BIBLIOGRAPHY
  • Chapter 14 - Medical Research
    • Critical Points
    • Introduction
    • INTERNATIONAL CODES
      • The Nuremberg Code
      • World Medical Association
      • Consent Under the International Codes
        • Private Research
    • HHS REGULATIONS ON PROTECTING HUMAN SUBJECTS
      • Scope of the Regulations
      • Research Involving Human Subjects
        • General Exceptions
        • Provisions for Children
        • Research That Will Involve Human Subjects in the Future
      • Institutional Review Boards
        • IRB Membership
        • Composition of IRBs Where Prisoners Are Involved
      • Criteria for IRB Approval of Research
    • General Requirements for Informed Consent
      • Additional Elements of Informed Consent
      • Research
      • Documentation of Informed Consent
    • Preemption of Other Laws Governing Informed Consent
      • Exemption for Emergency Care
      • Pregnant Women, Fetus, In Vitro Fertilization
      • Ethical Advisory Boards
      • Pregnant Women as Subjects
      • Activities Directed toward Fetuses In Utero as Subjects
      • Fetuses Ex Utero, including Nonviable Fetuses
      • Dead Fetuses, Fetal Material, or the Placentas
      • Prisoners
        • Restrictions on Prisoner Participation
        • Permitted Research involving Prisoners
      • Children
        • Research Not Involving Greater Than Minimal Risk
        • Therapeutic Research
        • Nontherapeutic Research
        • Research Not Otherwise Approvable
        • Consent
        • Wards
      • Penalties for Noncompliance
    • FRAUD AND MISCONDUCT
      • PHS/HHS Fraud and Misconduct
        • Misconduct
        • Institutional Compliance
      • National Science Foundation Regulations
      • Final Actions
    • COMMERCIAL AND SECURITY LAW VIOLATIONS
      • Material Nonpublic Information
      • Determining Who Is an Insider
      • Misappropriation of Information
      • Avoiding Commercial Law Problems
    • BIBLIOGRAPHY
• Physicians and Other Medical Personnel
  • Chapter 15 - Delegation of Authority
    • Critical Points
    • Introduction
    • LEGAL AND ETHICAL ISSUES
    • MEDICAL JUDGMENT
    • LIMITATIONS ON DELEGATION OF AUTHORITY
      • Nursing Practice
        • Contractual Limitations
      • Drug Laws
      • Faith Healers
    • DELEGATION OF AUTHORITY
      • Explicit Delegation of Authority
      • Implicit Delegation of Authority
    • PHYSICIAN'S ORDERS
    • PROTOCOLS
      • Physician Protocols
      • Teaching Protocols
      • PE Protocols: Strict Protocols
      • Sample Protocol
        • Diagnostic Criteria
        • Examination/Laboratory
        • Treatment
        • Follow-up
        • Referral
        • Epidemiology
        • Notes
    • SUPERVISING PEs
      • Scope of Practice
      • Unreasonable Expectations
      • Nursing Diagnosis
      • Documentation
      • Quality Assurance
    • BIBLIOGRAPHY
  • Chapter 16 - Referral and Consultation
    • Critical Points
    • Introduction
    • OBTAINING A CONSULTATION
      • Requesting a Consultation
      • Patient Choice
      • Using Consultants Properly
      • Documenting a Consultation
    • REFERRAL
      • Duty to Refer
      • Duty to Refer to a Nonphysician
      • Referring to Institutions
      • The Duty to Find Care
      • Continuing Care
      • Liability for Improperly Managed Referrals
    • BEING A CONSULTANT
      • The Consultant-Patient Relationship
      • Tests and Procedures
      • Informing the Patient
      • Record Keeping
      • Public Duties
    • INSTITUTIONAL CONSULTANTS
      • Radiology
      • Pathologists
      • Cardiology
      • Intensive Care
    • WORKING WITH MIDWIVES
      • Classes of Midwives
      • Referrals and Consultations
    • BIBLIOGRAPHY
      • General
      • Institutional Consultants
  • Chapter 17 - Teaching
    • Critical Points
    • Introduction
    • PATIENTS' RIGHTS
      • Faculty Physicians
      • Fraud
    • MEDICAL STUDENTS, RESIDENTS, AND FELLOWS
      • Residents and Fellows
      • Medical Students
      • Nursing and Other Students
    • THE REALITY OF TEACHING PROGRAMS
      • Importance of the Law
      • Working with a Teaching Program
        • Maintaining Supervision
      • The Physician-Student Relationship
        • Payment for Services
    • BIBLIOGRAPHY
  • Chapter 18 - Peer Review
    • Critical Points
    • Introduction
    • CONTEMPORARY PEER REVIEW
      • The Federal Trade Commission
      • Medical Staff Committees
      • The Legal Status of Medical Staff Committees
    • LEGAL CLIMATE FOR PEER REVIEW
      • State Law Violations
      • Federal Law Violations
        • Due Process Violations
        • Antitrust Laws
        • Market Share
        • State Action Immunity
        • RICO
    • CONCLUSIONS
    • BIBLIOGRAPHY
      • Cases
      • Articles
  • Chapter 19 - The Federal Peer Review Law
    • Critical Points
    • Introduction
    • REQUIREMENTS OF THE ACT
      • Protection from Liability
        • Standards for Professional Review Actions
        • Definition of Acceptable "Professional Review Action"
        • Limitations of the Act
      • Adequate Notice and Hearing
        • Notice of a Right to a Hearing
        • Notice of the Nature of the Hearing
        • Economic Competition
        • Rights in the Hearing
        • Rights at the Completion of the Hearing
        • Emergency Procedures
      • Reporting Malpractice Payments
        • Reporting by Boards of Medical Examiners
        • Reporting by Health Care Entities
        • Form of Reporting
        • Protection for Persons Providing Information
      • Duty of Hospitals to Obtain Information
        • Access to Information
        • Disclosure and Correction of Information
        • Confidentiality of Information
      • Definitions and Reports (Sec. 11151)
      • Attorney's Fees
    • THE PROBLEM OF GOOD FAITH
    • POTENTIAL ADVERSE IMPACTS
    • THE PROBLEM OF BIAS
    • CONDUCTING THE REVIEW
    • DOCUMENTING THE PEER REVIEW PROCESS
    • BIBLIOGRAPHY
      • Federal Laws
      • Articles
• Physicians and Public Health
  • Chapter 20 - General Public Health
    • Critical Points
    • Introduction
    • THE HISTORY OF PUBLIC HEALTH AUTHORITY
    • LEGAL STANDARDS FOR PUBLIC HEALTH AUTHORITY
      • Expert Decision Makers
      • Reviewing Public Health Orders
      • Due Process and Privacy
    • VITAL STATISTICS
      • Birth Certificates
      • Naming the Child
      • Stillbirths
      • Death Certificates
        • Declaration of Death
      • Coroner Cases and Autopsies
      • Disease Registries
    • LAW ENFORCEMENT REPORTING
      • Child Abuse
      • Violent Injuries
      • Intoxications
      • Dealing with Peace Officers
    • BIBLIOGRAPHY
      • Police Power
      • Vital Statistics
      • Reporting
  • Chapter 21 - Disease Control
    • Critical Points
    • Introduction
    • DISEASE CONTROL
      • Disease Control and the Individual
      • Epidemics and Plagues
      • Carrier State
      • Disease Control and the Physician-Patient Relationship
      • Reportable Diseases
      • Complying with Reporting Duties
      • Warning Third Parties
      • Coercive Measures
        • Involuntary Testing
        • Contact Tracing
        • Mandated Treatment
        • Quarantine and Isolation
        • Using Isolation and Quarantine
    • FOOD SANITATION
    • ENVIRONMENTAL HEALTH
    • BIBLIOGRAPHY
  • Chapter 22 - AIDS
    • Critical Points
    • Introduction
    • HISTORY
      • Hepatitis B in the Bathhouses
      • The History of AIDS and ARC
      • Origin of Infectious Disease
      • Initial Concentration in the Gay Community
    • PARALLELS WITH OTHER DISEASES
      • Fear of Disease
      • Risks Posed by HIV Infection
    • DISEASE CONTROL FOR HIV
      • Patient Education
      • Traditional Disease Control
        • The Peak Argument
        • The Community Education Argument
        • Testing
        • Reporting
        • Contact Tracing
        • Screening versus Anonymous Testing
        • Restrictions and Quarantine
    • MEDICAL DUTIES
      • Legal Discrimination
      • Consent to HIV Testing
    • BIBLIOGRAPHY
  • Chapter 23 - Communicable Diseases in the Workplace
    • Critical Points
    • Introduction
    • THE INCREASE OF COMMUNICABLE DISEASES IN THE WORKPLACE
      • Immunizations and Antibiotic Misuse
      • Immunosuppression
    • THE LEGAL RISKS OF COMMUNICABLE DISEASES
      • Third-Party Liability
      • Productivity
    • COMMUNICABLE DISEASES AS A HANDICAP OR DISABILITY
    • ADDITIONAL REQUIREMENTS OF THE ADA
    • THE ELEMENTS OF A COMMUNICABLE DISEASE POLICY
      • Nature of the Risk
      • Methods of Transmission
        • Airborne
        • Fomites
        • Foodborne
        • Insect Vectors
        • Sexually Transmitted Diseases
        • Bloodborne
        • Direct Contact
      • Duration of the Risk
      • Severity
      • Probability of Transmission and Complications
      • Federal and State Requirements
      • Identifying Employees at Risk or Who Pose Risks
      • The Special Problems of Immunosuppression
    • BALANCING THE RISKS OF HIV IN THE WORKPLACE
      • Ungrounded Fears and Real Risks
      • Employee Screening for HIV
      • Reasonable Accommodation for HIV
    • BIBLIOGRAPHY
      • Non-Health Care Workers
      • Health Care Workers
• Physicians and the Family
  • Chapter 24 - Legal Aspects of Parental Rights
    • Critical Points
    • Introduction
    • LEGAL ASPECTS OF PARENTAL RIGHTS
      • Parental Rights
      • The Presumption of Legitimacy
      • Biological Fathers and Legitimation
      • Termination of Parental Rights
      • Adoption
      • Matchmaking
      • Evaluating Potential Adoptive Children
      • Access to Adoption-Related Records
    • LEGAL DECISIONS INVOLVING SURROGATE PARENTHOOD
      • Davis v. DavisThe Tennessee Appeals Court Decision
      • Davis v. DavisThe Tennessee Supreme Court Decision
      • In the Matter of Baby M
        • Facts
        • Invalidity and Unenforceability of Surrogacy Contract
        • A. Conflict with Statutory Provisions
        • B. Public Policy Considerations
    • BIBLIOGRAPHY
      • Cases
      • Surrogacy
      • Adoption
  • Chapter 25 - Contraception, Sterilization, and Abortion
    • Critical Points
    • Introduction
    • ETHICAL DILEMMAS IN REPRODUCTIVE CARE
      • Balancing the Physician's and the Patient's Rights
      • Contractual Limitations on Refusing to Provide Care
      • Consent for Reproductive Care
    • TAKING A SEXUAL HISTORY
    • CONTRACEPTION
      • Balancing the Risk of Pregnancy
      • Legally Mandated Warnings for Oral Contraceptives
      • IUDs
      • Implantable Contraceptives
      • Natural Family Planning
      • HIV Infection and AIDS
      • Minors' Access to Contraception
      • Medical Issues in Contraception for Minors
    • STERILIZATION
      • Determining Which Partner to Sterilize
      • The Childless Patient
      • Sterilizing Minors and Incompetents
      • Federal Law Requirements
    • ABORTION
      • The Politics of Abortion
      • The Problem of Privacy
      • Protecting Personal Beliefs
      • Limiting Governmental Support
      • The Implications of Title X Restrictions
      • Consent to Abortion
      • Informing the Patient
      • Adoption Alternatives
      • Time Constraints
      • The Changing Nature of Abortion
    • BIBLIOGRAPHY
      • Contraception
      • Sterilization
      • Abortion
  • Chapter 26 - Genetic Counseling and Fertility Treatment
    • Critical Points
    • Introduction
    • PREVENTING BIRTH-RELATED TORTS
      • Preconception Versus Postconception Remedies
      • Patients' Views about Abortion
      • Record Keeping and Consent
    • ETHICAL QUESTIONS IN GENETIC COUNSELING
      • Duty to Counsel
      • Patient Privacy
      • Screening for Neural Tube Defects as a Model
      • MSAFP and Down Syndrome
      • The Genetic History
      • Information about Specific Diseases
      • Patient Characteristics
      • Risks of the Diagnostic Procedures
      • Reliability of Testing
      • Time Limitations
    • THE TOUGH QUESTIONS
      • Fitness
      • Medical Fitness
      • Psychiatric Problems
      • Prospects for Successful Treatment
      • Dealing with Multiple Gestation
      • Germinal Materials
      • Outsider Involvement
      • Unmarried Couples
    • ARTIFICIAL INSEMINATION
      • Consent
      • Choosing a Donor
      • The Husband as Donor
      • Related Donors
      • Unrelated Donors
      • Genetic Disease
      • Infection Control
    • ACOG RECOMMENDATIONS ON SURROGACY
      • Public Policy Recommendations
    • BIBLIOGRAPHY
      • Genetic Counseling
      • In Vitro Fertilization and Artificial Insemination
  • Chapter 27 - Delivering Babies
    • Critical Points
    • Introduction
    • MARKETING OBSTETRIC CARE
    • A STRUCTURED APPROACH TO OBSTETRIC CARE
      • Zero-Defects Management
      • Legal and Ethical Benefits of Structured Care
      • Thinking Like a Plaintiff's Attorney
    • THE BIRTH PLAN
      • Purpose of a Birth Plan
      • Contraindications
      • Authority to Consent
        • Participation of Others
      • Risk-Benefit Analysis
        • The Patient's Interests
        • Risks to the Baby
      • Emergencies
      • Availability of Facilities and Personnel
      • Custom versus Fashion
    • EVALUATING THE MOTHER'S MEDICAL CONDITION
      • Maternal Disease
      • Legally Mandated Testing
    • HOME DELIVERIES
      • The Politics of Home Deliveries
      • Participating in Home Deliveries
    • MEDICAL INTERVENTIONS
      • Past-Term Pregnancies
      • Cesarean Sections
    • BEHAVIORAL RISKS IN PREGNANCY
      • The AMA Policy Statement
      • Implications of the AMA Policy
      • Consent in High-Risk Pregnancies
      • The Self-Destructive Pregnant Woman
    • THE BIRTH-INJURED INFANT
    • BIBLIOGRAPHY
      • ACOG
      • General Obstetrics
      • Midwives and Home Births
      • Placental Pathology
  • Chapter 28 - Taking Care of Children
    • Critical Points
    • Introduction
    • IMMUNIZATIONS
      • Herd Immunity and Community Health
      • Compulsory Immunization
      • Consent for Immunizations
      • Medical Exemptions
      • The Vaccine Compensation Act
        • Recording Duties
        • Reporting Duties
        • Attorney's Duty
    • PEDIATRIC RECORDS
      • Acute Illness Observation Scale
      • Recording Physical Growth and Development
      • Recording Neuromuscular Development
    • TELEPHONE ENCOUNTERS
    • CONSENT TO TREATMENT
    • CHILD ABUSE
      • Child Neglect
      • Defending the Child
    • INTERESTS OF THE CHILD VERSUS THE PARENTS
      • Religious Objections to Medical Care
      • Specific Types of Care
    • SPECIAL LEGAL CONSIDERATIONS
      • Acute Medical Care
      • Long Statutes of Limitation
    • BIBLIOGRAPHY
      • Child Abuse
      • Immunizations
      • Malpractice Issues
• Physicians and Special Practice Areas
  • Chapter 29 - Institutional Practice: Teams, Schools, and Prisons
    • Critical Points
    • Introduction
    • THE TEAM DOCTOR
      • The Physician-Player Relationship
      • Team versus Player
      • The Child Athlete
      • Supervision of Nonphysician Personnel
      • Performance Enhancement
      • Engineering People
    • THE SCHOOL DOCTOR
      • Supervisory Responsibilities
        • School Clinics
        • Consent to Care
        • Medicines at School
        • Athletics
      • Medical and Public Health Responsibilities
      • Handicapped Children
      • College Health Programs
      • Comprehensive Care
    • THE PRISON DOCTOR
      • Prison Medical Care
        • Physician-Prisoner Relationship
        • Right to Refuse Medical Care
        • Emergency Medical Care
        • Experimentation
      • Public Health and Safety in Prisons
      • Disease Control in Prisons
      • The Physician's Obligations to the Jailers
    • BIBLIOGRAPHY
      • Team Physicians
      • Schools
      • Prison Health
  • Chapter 30 - General Occupational Medicine Practice
    • Critical Points
    • LEGAL AND ETHICAL PROBLEMS IN OCCUPATIONAL MEDICINE
    • OCCUPATIONAL PHYSICIAN-PATIENT RELATIONSHIP
      • Confidentiality
      • Duty to Evaluate Fully
      • Duty to Inform
      • Return to Work Certifications
      • Release from Work Certifications
      • Worker's Compensation
      • Government Benefits for Disabled Workers
    • THE AMERICANS WITH DISABILITIES ACT
      • The Purpose of the ADA
      • ADA-Defined Disability
      • Preemployment Medical Examinations
        • Allowable Examinations
        • Preemployment Examination Records
        • New Duties for Occupational Medicine Physicians
        • Persons with Known Disabilities
        • Direct Threats to Health and Safety
        • Drug and Alcohol Testing
      • The Legal Risks of the ADA
        • Pregnant Workers
      • Determining Disability: Worker's Compensation versus ADA
        • Food Handlers
    • BIBLIOGRAPHY
      • Reproductive Hazards
      • General
  • Chapter 31 - Occupational Safety and Health Administration Rules on OccupationalMedicine Practice
    • Critical Points
    • Introduction
    • EMPLOYEE MEDICAL INFORMATION
    • DEFINING OSHA REGULATED OCCUPATIONAL MEDICINE
    • EMPLOYEE MEDICAL RECORDS
    • AUTHORIZATION TO RELEASE COVERED RECORDS
    • PHYSICAL ACCESS TO RECORDS
    • LIMITATIONS ON ACCESS TO MEDICAL RECORDS
    • MATERIAL SAFETY DATA SHEETS
    • TRADE SECRETS
    • BIBLIOGRAPHY
  • Chapter 32 - Access to Emergency Care
    • Critical Points
    • Introduction
    • ASSISTING AT ACCIDENTS
    • GOOD SAMARITAN LAWS
    • EMERGENCY CARE IN THE OFFICE
    • EMERGENCY ROOM STAFFING
    • ACCESS TO EMERGENCY CARE UNDER THE FEDERAL LAW
      • Medical Screening
      • Stabilization
      • Definition of Transfer
      • Restriction on Transfers
      • Appropriate Transfers
      • Labor and Delivery
      • Enforcement
    • LIVING WILLS IN THE EMERGENCY ROOM
    • BIBLIOGRAPHY
  • Chapter 33 - High-Technology Medicine and Critical Care
    • Critical Points
    • Introduction
    • THE LEGAL RISKS OF SAFETY DEVICES
      • Filtering Data
      • Fetal Monitors
      • Pulse Oximeters
      • Lessons for Technology Assessment
    • INFORMATION THEORY IN THE CCU
    • THE PROBLEM OF SAMPLING
    • THE TECHNOLOGICAL IMPERATIVE VERSUS COST CONTAINMENT
    • COST CONTAINMENT IN THE CCU
    • DEFINING THE CCU
    • RATIONING CARE
      • Effectiveness of CCUs
      • Explicit Rules
    • AUTHORITY IN THE CCU
      • The CCU Director
      • Cardiopulmonary Resuscitation
      • Identifying Who Is in Charge
      • Special Orders
      • Code Orders
    • ILLEGAL USE OF CODE
    • BIBLIOGRAPHY
  • Chapter 34 - Surgery and Anesthesia
    • Critical Points
    • Introduction
    • SURGERY
    • STANDARDS FOR SURGERY
      • Documenting Surgical Procedures
      • Operating on Bilateral Organs
      • Sponge and Instrument Counts
      • Medical Consultations
      • Surgical Assistants
    • ANESTHESIOLOGY
      • Patient Selection
      • The Problems of Certified Registered Nurse Anesthetists
      • The Malpractice Crisis
      • Technology and Anesthesia Practice
        • Learned Intermediaries
        • Determining Who Should Use a Medical Device
        • Real Users versus Ideal Users
      • The End of the Crisis
    • WORKING TOGETHER TO AVOID PROBLEMS
      • Evaluating the Patient
      • Consent
        • The Surgical Consent Form
        • Getting the Form Signed
        • Ghost Surgery
    • BIBLIOGRAPHY

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