Law in healthcare Seminary Course of Health and medical law Before we begin… •Convention on Human Rights and Biomedicine (European Treaty) •Consent • •Private life and right to information • •Human genome • •Scientific research • •Organ and tissue removal from living donors for transplantation purposes • •Prohibition of financial gain and disposal of a part of the human body • Before we begin… Question no. 1 •What is the purpose of the law in healthcare? What is the purpose of the rules? Výsledek obrázku pro road signs Social role? Two main masses of Law •PUBLIC LAW •Constitution •Hierarchy •Enforcement •Formal process • •PRIVATE LAW •Individual •Equality •Authonomy •Freedom • • Soudní kladívko Podání ruky The rights and obligations of citizens in health care •(citizens' rights, patient's rights, patient's right to information) • Patient has rights: Rights of the patient (§28 HCA) Rights of the patient (§28 HCA) Rights of the patient (§28 HCA) Rights of the patient (§28 HCA) Obligations of the patient (!) a)to follow a designed individualized treatment procedure b)to follow the internal rules, c)to pay the provider cost of health services provided to him with his consent d)truthfully inform healthcare professional about the development of health condition, including information on infectious diseases e)not to drink alcohol or use other addictive substances during hospitalization and undergo in justified cases examination in order to establish whether or not is the patient under the influence of alcohol or other addictive substances at the discretion of the attending physician • Refusal to provide healthcare services It is important to distinguish •transfer the patient to another healthcare provider •There are no longer reasons for the provision of healthcare services; does not apply in the case of the registering provider •patient refuse the provision of all healthcare services, •patient severely restricts the rights of other patients •deliberately and systematically fails to comply with the proposed individual medical procedure, if he gave his consent to the provision of health services, •Does not follow internal rulles •does not cooperate; Informed consent with medical performance; denial of medical care • Distinguish • •Informed consent •Free of will •Informed • •Information about health condition •notified upon admission to healthcare •Always if it is purposeful •The patient may waive Information about health condition •about the disease, •the purpose, nature, expected benefits, potential consequences and risks of the proposed health services •other possibilities, their suitability and risks • another needed treatment, •restrictions and recommendations in the way of life with regard to health conditions •options •To waive the right to be informed about health condition •identify the persons to whom the information may be given or to impose a ban on reporting on health condition according to § 33. • Written form of a consent • •Consent with hospitalization must be in writing. • •Written form of a consent must be where it is required by law or a provider. • •Remember HCA, transplantation Act, Disagreement Previously expressed wishes When it is not necessary to respect the previously expressed wishes? a)From the expression occurred such developments on which basis it can be reasonably assumed that the patient would give his consent; b) b)Patient encourages to cause his death, c) c)Its fulfillment could threaten others, d) d)If the provider started a healthcare procedures at the time he did not know previously expressed wishes and interruption of such procedures would lead to an active cause of death. Underage patient • •it is necessary to know his opinion on the planned provision of health services if it is appropriate to his age and maturity. •the importance of his opinion increases in proportion to age and degree of maturity. •The intended health services can be provided to an underage patient on the basis of his consent if the execution of such procedure is appropriate to his mental and moral maturity and corresponds with his age. • Hospitalization and provision of health services without consent The patient can not give his consent Basic rights and obligations of healthcare professionals •Basic rights and obligations of healthcare professionals Rights and obligations of healthcare professional Healthcare proffesional is… •a person performing the medical profession as defined by law Obligations of healthcare professional according to HCA Rights and obligations under the Labour Code Rights of a healthcare professional LESON 2: Liability • Assumptions of Liability Breach of legal obligations Lex artis •Procedure according to "normal" levels •Compliance with professional standards • •The patient has the right to health services on appropriate professional level. • •Lex artis is a concept that applies to providers as well as healthcare professional Parts of lege artis List of procedures lege artis •Does not exist • •Recommendation of Czech medical societies … • •Ultimately, the choice is on doctors • Problems •Retention of conscience •Rejection of healthcare by a patient •Lack of resources for treatment lege artis Obligation of prevention •Obligation to prevent unjustified harm to freedom, life, health or property of another. • •The duty of everyone who has control over dangerous situations to take action to protect the rights of another. Types of liability Liability under civil law Damages Coincidence •The obligation to pay compensation has the one who caused the circumstances leading to coincidence. • Exclusion of unlawfulness Waiver of compensation Damage caused by information or advice •Who reports himself as a member of a particular state or profession to professional performance or otherwise act as an expert, •Is responsible for Damages, if the harm is caused by an incomplete or incorrect information or harmful advice •if he received the reward for this counsel The extent of compensation • General provisions •(1) Damage should be replaced by indicating to the previous status. If it is not possible, or is asked by the damaged, the damage is payable in cash. • •(2) Non-pecuniary damage is redresses by adequate satisfaction. • Range Reimbursement of harm of health The killing • •In case of death or extremely serious injury, the one who caused it is responsible to compensate for damage caused by mental suffering of a spouse, parents, childs or other close persons. •Funeral expenses •Costs for maintenance of the residuars • • The costs associated with health care • reasonably incurred costs associated with health care of the damaged, with the care of his person or his household to anyone who's spent them •Compensation for loss of earnings •Compensation for loss of a pension • A crime A crime •A criminal offense is an unlawful act that criminal law identifies as a crime, and that has the characteristics specified therein. •The criminal liability for the offense is intentional culpability unless the Criminal Code expressly states that culpable negligence suffices. •Intentionally committed crime •Negligence • • The principle of subsidiarity •Criminal liability and criminal consequences associated with it can be applied only in socially harmful cases in which it is not sufficient to establish the liability under other legislation. Medical Authority Disciplinary liability Each member of the Chamber has the obligation •a) exercise their profession in accordance with its ethics and manner specified by law, •b) observe the organization, rules, election and Disciplinary Rules of the chamber, •c) properly fulfill defined contributions •d) notify the competent authorities of the chamber changes related to the exercise of medical or pharmaceutical profession, •e) conclude liability insurancein cases specified by the Chamber • • Disciplinary liability