UMGC Ethical Decisions Case Study

Reputation

How should providers accept responsibility for committing errors in making ethical decisions at the expense of the reputation of the organization?

Innovation Recommendation.

Make an innovative recommendation of how to modify or change the proposed recommendation to make it stronger. This recommendation for improvement should consider innovative solutions.

Common Healthcare Statues Federal Statutes Name, Abbreviation Focus of the law Web link Affordable Care Act (ACA) The law Increases access to affordable health care Summary of the Affordable Care Act (ACA) https://www.kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/ Antitrust Laws • Sherman Act prohibits mergers that allow one organization to dominate the market with a monopoly. • Federal Trade Commission Act (FTCA) bans unfair competition • Clayton Act prohibits unfair business practices that limit trade The Antitrust laws https://www.ftc.gov/tips-advice/competition-guidance/guide-antitrust-laws/antitrustlaws 21st Century Cures Act (Cures Act) The laws focuses on evidence based treatment for mental and behavioral health. 21st Century Cures Act https://www.samhsa.gov/about-us/who-we-are/laws-regulations Discrimination Laws • Title VII makes it illegal to discrimination based on race, color, national origin, sex, or religion • The pregnancy discrimination act prohibits discrimination against those who are pregnant. • The Equal Pay Act requires equal pay for equal work regardless of gender. • The ADA prohibits disability discrimination and requires reasonable accommodation that is not an undue burden. • The ADEA prohibits discrimination against those 40 and over • GINA prohibits discrimination based on genetic information. • The Rehab Act prohibits discrimination against a person with a disability in the federal government. Laws Enforced by the EEOC https://www.eeoc.gov/statutes/laws-enforced-eeoc Emergency Medical Treatment and Active Labor Act (EMTALA) The law that requires an emergency room to conduct an medical screening exam and stabilize a patient before transfer or discharge. EMTALA Law https://www.law.cornell.edu/uscode/text/42/1395dd Employment Laws • • Fair Labor Standards Act (FLSA) sets the work week at 40 hours, sets minimum wage, and establishes overtime for non-exempt employees. Family Medical leave Act (FMLA) allows for leave time to care for an immediate family members with a medical illness or for military leave. FLSA https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/FairLaborStandAct.pdf FMLA https://www.dol.gov/agencies/whd/fmla Fraud and Abuse • Fraud and abuse laws ensure health care program integrity. • The False Claims Act prohibits improper billing by federal contractors. • The Anti-kickback statutes prohibits remuneration for referrals in health care. • The Physician Self Referral Law prohibits a physician or family member from referring a patient to a designated health service (DHS) at an organization the physician or close family member owns. A Roadmap for New Physicians: Fraud and Abuse laws https://oig.hhs.gov/compliance/physician-education/01laws.asp Health Care Quality Improvement Act (HCQIA) The law established the National Practitioner Data Bank (NPDD), provides due process protections for providers, and immunity for those engaged in peer review if legal requirements are met. The Healthcare Quality Improvement Act https://www.namss.org/Portals/0/Education/Cred101 PreWork/The%20Healthcare%20Quality%20Improvement%20Act.pdf Health Insurance Portability and Accountability Act (HIPAA) The law that sets standards for privacy and security of protected health information (PHI) It also sets portability standards to transfer health insurance from one organization to another. HIPAA for Professionals https://www.hhs.gov/hipaa/for-professionals/index.html Hill Burton The federal law that allows for federal funds to help w8ith facility building in exchange for the facility providing free or reduced cost care. Hill-Burton Free and Reduced -Cost Health Care https://www.hrsa.gov/get-health-care/affordable/hill-burton/index.html Labor Laws The National Labor Relations Act (NLRA) and amendments gives workers the right to organize into unions, created the National Labor Relations Board (NLRB), and prohibits union and management unfair labor practices. NLRA https://www.nlrb.gov/guidance/key-reference-materials/national-labor-relations-act Patient Safety and Quality Improvement Act (PSQIA) The laws defines patient safety work product and obligations Patient Safety and Quality Improvement Act of 2005 Statute and Rule https://www.hhs.gov/hipaa/for-professionals/patient-safety/statute-and-rule/index.html Rules of Procedure (Federal) The rules that govern the process of litigation including discovery and time frames for federal lawsuits. Federal Rules of Civil Procedure https://www.law.cornell.edu/rules/frcp Federal Rules of Criminal Procedure https://www.law.cornell.edu/rules/frcrmp Sarbanes Oxley Act (SOX) The law that requires honest and reliable financial reporting. What is the Sarbanes--Oxley Act – Summary of Key Provisions https://www.sarbanes-oxley-101.com/sarbanes-oxley-compliance.htm Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) The law to strengthen opioid response by increased addiction screening and encouraging evidence based care and treatment for addiction. SUPPORT Act https://www.samhsa.gov/about-us/who-we-are/laws-regulations Tax Exemption Laws The laws that set requires to be classified as a charitable organization and exempt from tax. IRS: Charities and Non=profits https://www.irs.gov/charities-and-nonprofits State Statutes Advanced Directives The law that gives people the right to establish a do not resuscitate order (DNR), living will, or Medical Order for Life Sustaining Treatment (MOLST) Maryland Advanced Directives https://www.marylandattorneygeneral.gov/Health%20Policy%20Documents/adirective .pdf Certificate of Need (CON) The law that regulations documentation to support the need for a health care facility or high cost medical services or equipment. CON-Certificate of Need State Laws https://www.ncsl.org/research/health/con-certificate-of-need-state-laws.aspx Corporation Laws The laws that outline the steps to form a corporate form of business in thestate. How to Form a Corporation https://www.nolo.com/legal-encyclopedia/form-corporation-how-to-incorporate30030.html Corporate Practice of Medicine ( CPOM) The law in some states that prohibits a corporation from practicing medicine by employing a physician., AMA Issue Brief: Corporate Practice of Medicine file:///C:/Users/Ann/Downloads/corporate-practice-of-medicine-issuebrief_1%20(4).pdf Informed Consent The state law that sets standards for informed consent. Maryland Informed Consent law https://www.marylandattorneygeneral.gov/Health%20Policy%20Documents/alzchap2. pdf Licensing Laws Laws that set state requirements for licensing to obtain and keep a health care professional license. Maryland Department of health licensing Boards https://health.maryland.gov/Pages/boards.ASPX Medical malpractice The laws that set the time frame and standards to file a medical negligence claim. Maryland Medical malpractice laws https://www.nolo.com/legal-encyclopedia/maryland-medical-malpractice-laws.html Medical Record laws The laws that state the obligation to create and keep, retain and destroy medical records. Medical Record laws https://statelaws.findlaw.com/health-care-laws/medical-records.html Reporting laws Laws that place requirements on health care professionals and organizations to report abuse and neglect, infectious disease. Maryland Reporting Obligations that May apply to Investigators or other members of the research team https://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/guide lines/reporting_obligations.html Rules of Civil and Criminal Procedure (State) The rules that govern the process of litigation including discovery for state lawsuits. Maryland Rules https://govt.westlaw.com/mdc/Browse/Home/Maryland/MarylandCodeCourtRules?gui d=ND4CC33B09CCE11DB9BCF9DAC28345A2A&originationContext=documenttoc&t ransitionType=Default&contextData=(sc.Default) Additional Resources Informed Consent • • • • Barstow, C., et. al. Evaluating Medical Decision-Making Capacity in Practice. Am Fam Physician. 2018 July 1, 98(10): 40-46 https://www.aafp.org/afp/2018/0701/p40.html AMA Informed Consent. Code of medical Ethics opinion 2.1.1 https://www.amaassn.org/delivering-care/ethics/informed-consent Maryland Treatment without consent https://law.justia.com/codes/maryland/2015/article-ghg/title-5/subtitle-6/parti/section-5-607/ Sample Refusal of Consent form https://www.medicaleconomics.com/view/sample-refusal-consent-form Limited English Proficiency • • • Limited English Proficiency (LEP) https://www.lep.gov/ HHS Revised Limited English Proficiency (LEP) Guidance https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-englishproficiency/index.html Fact Sheet on the Revised LEP Guidance https://www.hhs.gov/civil-rights/forindividuals/special-topics/limited-english-proficiency/fact-sheetguidance/index.html Minor Consent • • • • • HHS Informed Consent FAQ https://www.hhs.gov/ohrp/regulations-andpolicy/guidance/faq/informed-consent/index.html Maryland Consent and Treatment of Minors https://health.maryland.gov/psych/pdfs/Treatment.pdf Maryland code and Minor Consent to Treatment https://codes.findlaw.com/md/health-general/md-code-health-gen-sect-20102.html 2.2.1 Pediatric Decision Making https://policysearch.amaassn.org/policyfinder/detail/pediatric%20decision%20making?uri=%2FAMADoc% 2FEthics.xml-E-2.2.1.xml A Guardian’s Health Care Decision -Making Authority: Statutory Restrictions https://www.americanbar.org/groups/law_aging/publications/bifocal/vol_35/issue_ 4_april2014/guardianship_health_care_decisions_statutory_restrictions/ Research Consent • • • • • Maryland Law on Human Subject Research https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/humansubject.asp x HHS 2018 Common Rule on research consent and Institutional Review Boards (IRB) https://www.ecfr.gov/cgibin/retrieveECFR?gp=&SID=83cd09e1c0f5c6937cd9d7513160fc3f&pitd=201807 19&n=pt45.1.46&r=PART&ty=HTML HHS Revision of the Common Rule https://www.hhs.gov/ohrp/regulations-andpolicy/regulations/revision-of-the-common-rule/index.html FDA Right to Try Act https://www.fda.gov/patients/learn-about-expanded-accessand-other-treatment-options/right-try FDA Informed Consent: Draft Guidance for IRBs, Clinical Investigators, and Sponsors (July 2014) https://www.fda.gov/patients/learn-about-expandedaccess-and-other-treatment-options/right-try Patient Rights • • • Maryland Patient Bill of Rights https://hscrc.maryland.gov/Pages/consumers_patientsRights.aspx Maryland Code Hospital Patient Rights https://law.justia.com/codes/maryland/2005/ghg/19-342.html and https://law.justia.com/codes/maryland/2019/health-general/title-19/subtitle-3/partvi/sect-19-343/ Maryland long term care ombudsman program Pages - Ombudsman Program (maryland.gov) • • • • Maryland Health Care Commission (MHCC) Resident’s Rights and Services https://mhcc.maryland.gov/consumerinfo/longtermcare/documents/resident_right s.pdf 42 C.F.R. 483.10 Long Term Care Resident rights https://ecfr.federalregister.gov/current/title-42/chapter-IV/subchapter-G/part483/subpart-B#483.10 Maryland Consumer Guide to Long Term Care https://mhcc.maryland.gov/consumerinfo/longtermcare/GeneralResources.aspx Medical Restraints and Seclusion • • 42 C.F.R. 483.358 Orders for the use of restraint or seclusion https://www.law.cornell.edu/cfr/text/42/483.358 Maryland Regulations Restraints COMAR 10.21.12.02 Definitions http://mdrules.elaws.us/comar/10.21.12.02 , through COMAR 10.21.12.12 Abuse and Neglect and Reporting • • • • Elder Justice Act 42 U.S.C. 1397j https://www.law.cornell.edu/uscode/text/42/1397j 42 C.F.R. 483.12 Freedom from abuse, neglect and exploitation https://ecfr.federalregister.gov/current/title-42/chapter-IV/subchapter-G/part483/subpart-B#483.12 Maryland Department of Aging: Preventing Elder Abuse and Neglect https://aging.maryland.gov/Pages/elder-abuse-prevention.aspx Mandatory Reporting Requirements: The Elderly in Maryland https://apps.rainn.org/policy/policy-state-lawsexport.cfm?state=Maryland&group=5 Infectious Disease Reporting • • • • CDC: Mandatory reporting of infectious diseases by clinicians. MMWR (June 22, 1990) 33(RR-9) 1-11, 16-17 https://www.cdc.gov/mmwr/preview/mmwrhtml/00001665.htm CDC 2021 National Notifiable Conditions https://wwwn.cdc.gov/nndss/conditions/notifiable/2021/ Maryland Department of Health Reportable Diseases https://phpa.health.maryland.gov/pages/reportable-diseases.aspx HIPAA and Public Health https://www.hhs.gov/hipaa/for-professionals/specialtopics/public-health/index.html Mental Health Duty to Warn, and Substance Use Disorder (SUD) • • NCSL Mental Health Professional’s Duty to Warn https://www.ncsl.org/research/health/mental-health-professionals-duty-towarn.aspx Treatment Guidelines: Substance Use Disorders Treatment Guidelines: Substance Use Disorders | cpnp.org • • • CMS Substance Use Disorders https://www.cms.gov/outreacheducation/american-indianalaska-native/behavioral-health/substance-usedisorders SAMHSA National Guidelines for Behavioral Health Crisis Care: Best Practice Toolkit https://www.samhsa.gov/sites/default/files/national-guidelines-forbehavioral-health-crisis-care-02242020.pdf SAMHSA Use of Medication-Assisted Treatment in Emergency Departments Use of Medication-Assisted Treatment in Emergency Departments | SAMHSA Medical Error • • To Err is Human: Building a Safer Health System, Institute of Medicine, 2000 https://www.ncbi.nlm.nih.gov/books/NBK225182/ AHRQ Medical Error https://www.ahrq.gov/topics/medical-errors.html • • • • • • The Hastings Center Medical Error https://www.thehastingscenter.org/briefingbook/medical-error/ AHRQ Disclosure of Errors (Sept. 2019) https://psnet.ahrq.gov/primer/disclosure-errors ACEP Disclosure of Medical Errors https://www.acep.org/patient-care/policystatements/disclosure-of-medical-errors/ JCAHO Speak Up Preventing Medical Errors https://www.jointcommission.org/resources/for-consumers/speak-upcampaigns/preventing-medicine-errors/ ISMP List of Confused Drug Names https://www.ismp.org/recommendations/confused-drug-names-list ISMP Targeted Medication Safety Best Practices for Hospitals https://www.ismp.org/guidelines/best-practices-hospitals Medical Negligence • • • • • • • • Medical Malpractice Overview https://www.findlaw.com/injury/medicalmalpractice/medical-malpractice-overview.html Legal Concepts in a Medical Malpractice Case https://www.alllaw.com/articles/nolo/medical-malpractice/legal-conceptscase.html Defenses to Medical Malpractice https://www.findlaw.com/injury/medicalmalpractice/defenses-to-medical-malpractice-patients-negligence.html Maryland Medical Malpractice Laws https://www.nolo.com/legalencyclopedia/maryland-medical-malpractice-laws.html Vicarious Liability https://www.findlaw.com/injury/medical-malpractice/vicariousliability.html Respondeat superior https://www.law.cornell.edu/wex/respondeat_superior#:~:text=A%20legal%20doc trine%2C%20most%20commonly,of%20the%20employment%20or%20agency. 42 C.F.R.483.70(n) Long Term Care: Binding arbitration agreements https://ecfr.federalregister.gov/current/title-42/chapter-IV/subchapter-G/part483/subpart-B#483.70 NCSL Medical Liability/Malpractice ADR and Screening Panels Statutes https://www.ncsl.org/research/financial-services-and-commerce/medical-liabilitymalpractice-adr-and-screening-panels-statutes.aspx Fraud • Maryland fraud laws https://law.justia.com/codes/maryland/2010/criminallaw/title-8/ • • HHS OIG Fraud and Abuse Laws https://oig.hhs.gov/compliance/physicianeducation/01laws.asp#:~:text=It%20is%20illegal%20to%20submit,plus%20%241 1%2C000%20per%20claim%20filed.&text=Criminal%20penalties%20for%20sub mitting%20false%20claims%20include%20imprisonment%20and%20criminal%2 0fines. Health care Compliance Program Tips https://oig.hhs.gov/compliance/providercompliance-training/files/Compliance101tips508.pdf Patient Safety - Violence and Disruptive Behavior • OSHA Workplace Violence Workplace Violence - Overview | Occupational Safety and Health Administration (osha.gov) • • • • • • Joint Commission Sentinel Event Alert 40: Behaviors that Undermine a culture of safety (Sept 2016) https://www.jointcommission.org/resources/patient-safetytopics/sentinel-event/sentinel-event-alert-newsletters/sentinel-event-alert-issue40-behaviors-that-undermine-a-culture-of-safety/ Joint Commission Sentinel Event Alert 59: Physical and verbal violence against health care workers https://www.jointcommission.org/resources/patient-safetytopics/sentinel-event/sentinel-event-alert-newsletters/sentinel-event-alert-59physical-and-verbal-violence-against-health-care-workers/ The Joint Commission: The Consequences of Unchecked Disruptive Behaviors in Health Care (Jan 30, 2020) https://www.jointcommission.org/resources/newsand-multimedia/blogs/improvement-insights/2020/01/30/consequences-ofunchecked-disruptive-behaviors-in-health-care/ AHRQ Patient Safety network - Disruptive and Unprofessional Behavior https://psnet.ahrq.gov/primer/disruptive-and-unprofessional-behavior MGMA Dealing with Disruptive physicians (May 1, 2016) https://www.mgma.com/resources/human-resources/dealing-with-disruptivephysicians AMA Code of Medical Ethics Opinion 9.4.4 Physicians with Disruptive Behavior https://www.ama-assn.org/delivering-care/ethics/physicians-disruptive-behavior Patient Safety - Falls • • • AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention https://www.ahrq.gov/patient-safety/settings/long-termcare/resource/ontime/fallspx/index.html CMS Compliance Group Fall Prevention Resources https://cmscompliancegroup.com/2013/06/24/24-fall-prevention-resources/ Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. | PSNet (ahrq.gov) • AHRQ Long Term Care Facility – Patient Safety Tools https://www.ahrq.gov/patient-safety/resources/pstools/index.html#facilities • • AHRQ Ambulatory Care Settings Patient Safety Tools https://www.ahrq.gov/patient-safety/resources/pstools/index.html#ambulatory AHRQ Emergency Room Patient Safety Tools https://www.ahrq.gov/patientsafety/resources/pstools/index.html#dept Health Care Quality Improvement Act (HCQIA) • The Healthcare Quality Improvement Act (HCQIA) 42 U.S. Code § 11101 - Findings | U.S. Code | US Law | LII / Legal Information Institute (cornell.edu) • • • • Maryland Medical Review Committees (peer review) https://law.justia.com/codes/maryland/2013/article-gho/section-1-401/ AMA Peer Review Survival Kit: Is your peer review process safe? https://www.ama-assn.org/system/files/2019-11/i19-peer-review-survival-kit.pdf Defending the Peer Review privilege: Guidance for Health are Providers and Counsel After Wheeling Hospital, West Virginia Law Review (2017) https://wvlawreview.wvu.edu/west-virginia-law-reviewonline/2017/11/17/defending-the-peer-review-privilege-guidance-for-health-careproviders-and-counsel-after-wheeling-hospital Credentials Committee: Essentials Handbook https://hcmarketplace.com/media/browse/10552_browse.pdf Patient Safety and Quality Improvement Act (PSQIA) • • • • • • HHS PSQIA https://www.hhs.gov/hipaa/for-professionals/patient-safety/statuteand-rule/index.html Patient Safety Improvement Act (PSIA)of 2020 https://psnet.ahrq.gov/issue/patient-safety-improvement-act-2020 Patient Safety Organization (PSO) https://www.pso.ahrq.gov/ Patient Safety Rule https://www.hhs.gov/hipaa/for-professionals/patientsafety/patient-safety-rule/index.html Patient Safety Organizations and Patient Safety work product https://www.law.cornell.edu/cfr/text/42/part-3 HHS Guidance for Patient Safety Rules https://www.hhs.gov/hipaa/forprofessionals/patient-safety/guidance/index.html National Practitioner Data Bank (NPDB) • • • National Practitioner Data Bank (NPDB) https://www.npdb.hrsa.gov/ National Practitioner Data Bank (NPDB) Guidebook https://www.npdb.hrsa.gov/resources/aboutGuidebooks.jsp National Practitioner Data Bank ( NPDB) What you Must Report to the NPDB https://www.npdb.hrsa.gov/hcorg/whatYouMustReportToTheDataBank.jsp • Reporting Peer Review Organization Negative Actions or Findings https://www.npdb.hrsa.gov/guidebook/EPeerReviewOrgQA.jsp Medical Record Access and Reporting • • • • • • • • Maryland Department of Health For your Information: Medical Records https://health.maryland.gov/mbpme/Pages/records.aspx Maryland Record Retention and fees FAQs https://www.mbp.state.md.us/resource_information/faqs/resource_faqs_medical_ records.aspx Maryland Code, Health-General 4-304 https://codes.findlaw.com/md/healthgeneral/md-code-health-gen-sect-4-304.html CMS 2021 Medicare Promoting Interoperability Program: Certified Electronic Health Record Technology Fact Sheet https://www.cms.gov/files/document/2021cehrt-fact-sheet.pdf Federal Rule 502 Attorney-Client Privilege and Work Product https://sterlingmiller2014.wordpress.com/2019/06/05/ten-things-a-primer-on-thework-product-privilege/ Maryland Rule 2-402 Scope of Discovery https://sterlingmiller2014.wordpress.com/2019/06/05/ten-things-a-primer-on-thework-product-privilege/ The Work Product Doctrine https://content.next.westlaw.com/1-5018810?__lrTS=20210326135741218&transitionType=Default&contextData=(sc.De fault)&firstPage=true Ten Things: A Primer on the Work Product Privilege https://sterlingmiller2014.wordpress.com/2019/06/05/ten-things-a-primer-on-thework-product-privilege/ HIPAA and medical record release • • • • HIPAA Medical Records Access https://www.hhs.gov/hipaa/forindividuals/medicalrecords/index.html#:~:text=Only%20you%20or%20your%20personal,payment%2 0or%20with%20your%20permission. HIPAA and Research https://www.hhs.gov/hipaa/for-professionals/specialtopics/research/index.html Special Topics in Health Information Privacy https://www.hhs.gov/hipaa/forprofessionals/special-topics/index.html Employers and Health Information in the Workplace https://www.hhs.gov/hipaa/for-individuals/employers-health-informationworkplace/index.html • • • • HIPAA and family members and friends https://www.hhs.gov/hipaa/forindividuals/family-members-friends/index.html HIPAA Court Orders and Subpoenas https://www.hhs.gov/hipaa/forindividuals/court-orders-subpoenas/index.html HIPAA and your medical records https://www.hhs.gov/hipaa/forindividuals/medical-records/index.html HIPAA Patient Rights to Access information https://www.hhs.gov/hipaa/forindividuals/guidance-materials-for-consumers/index.html Hospital Emergency Room and EMTALA • • • • • • • ACEP EMTALA Fact Sheet https://www.acep.org/life-as-a-physician/ethics-legal/emtala/emtala-factsheet/#:~:text=The%20Emergency%20Medical%20Treatment%20and,has%20re mained%20an%20unfunded%20mandate. EMTALA Law https://www.law.cornell.edu/uscode/text/42/1395dd Medicare Conditions of Participation Hospitals Patient Rights 42 C.F.R. 482.13 https://www.law.cornell.edu/cfr/text/42/482.13 ACEP EMTALA Fact Sheet https://www.acep.org/life-as-a-physician/ethics-legal/emtala/emtala-fact-sheet/ CMS State Operations Manual Appendix V – Interpretive Guidelines – Responsibilities of Participating Hospitals in Emergency cases https://www.cms.gov/Regulations-andGuidance/Guidance/Manuals/downloads/som107ap_v_emerg.pdf CMS S & C-02-34 On-Call Requirements EMTALA https://www.cms.gov/regulations-andguidance/legislation/emtala/downloads/sc0234pdf Derlet, R. and Richards, J. Ten Solutions to Emergency Department Crowding. West. J. Emerg. Med. 2008 Jan, 9(1): 24-27 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672221/ Patient Safety, Quality Improvement and Risk Management • • • • Joint Commission Patient Safety Resources https://www.jointcommission.org/resources/patient-safety-topics/patient-safety/ Hughes, R. Tools and Strategies for Quality Improvement and Patient Safety. https://www.ncbi.nlm.nih.gov/books/NBK2682/ FMP Care Management Tools (Includes checklists, letters, forms, for office use) https://www.aafp.org/fpm/toolBox/viewToolType.htm?toolTypeId=2 Management of Non-Complaint Patients. Medical Protective: Clinical Risk Management Department. (Oct. 2013) https://www.server5.medpro.com/documents/11006/16738/Management+of+Non compliant+Patients+Guideline_10-2013.pdf • KootenaiHealth Involuntary Detention, Leaving Against Medical Device https://www.kh.org/involuntary-detention-discharge-against-medical-advicemandatory-reporter/ Advanced Directives • • • • • Maryland Health Care Decisions Act https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/hcda.aspx Maryland Advanced Directives https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/AdvanceDirectives .aspx POLST Orders https://polst.org/ COMAR 10.01.21.04 Use of the MOLST Form (Maryland) http://mdrules.elaws.us/comar/10.01.21.04 Maryland Medical Orders for Life Sustaining Treatment (MOLST) Maryland's Medical Orders for Life-Sustaining Treatment (MOLST) Form | Nolo • • Maryland State Advisory Council on Quality Care at the End of Life https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/sac.aspx Maryland Health Decisions Policy https://www.marylandattorneygeneral.gov/Pages/HealthPolicy/eolcare.aspx Beginning and End of Life Decision Making • Elson, N., et. al. Getting Real: The Maryland Heatlhcare Ethics Committee Network’s COVID-19 working group debriefs lessons learned. HEC Forum. 2021 June 33 (1-2):91-107 doi: 10.1007/s10730-021-09442-y https://pubmed.ncbi.nlm.nih.gov/33582886/ • • Ethics Consultations: AMA Code of Medical Ethics Opinion 10.7.1 https://www.ama-assn.org/delivering-care/ethics/ethicsconsultations#:~:text=The%20goal%20of%20ethics%20consultation,and%20the %20health%20care%20team.&text=Seek%20to%20balance%20the%20concern s,the%20patient's%20needs%20and%20values. Howe, E. Mediation Approaches at the Beginning or End of Life. The Journal of Clinical Ethics. 26(4) (Winter 2015): pp. 275-85. Mediation Approaches at the Beginning or End of Life - PubMed (nih.gov) • Sanderson, C. et. al. Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at end of life. Ann. Palliat. Med. (2017) Dec 6 (suppl 2):S195-S205, doi: doi: 10.21037/apm.2017.08.11 https://pubmed.ncbi.nlm.nih.gov/29156901/ Futile Care • • • Clark, P. Medical Futility: Legal and Ethical Analysis. AMA Journal Of Ethics (May 2007) https://journalofethics.ama-assn.org/article/medical-futility-legal-andethical-analysis/2007-05 Baby K Case https://casetext.com/case/matter-of-baby-k Futile Care https://www.patientsrightscouncil.org/site/futile-care/ Abortion Law • • Maryland Abortion Laws https://statelaws.findlaw.com/maryland-law/marylandabortion-laws.html Whole Woman’s Health v. Hellerstedt, (U.S. Supreme Court, 2016) https://www.oyez.org/cases/2015/15-274 Stem Cell Laws • • • • • NIH Guidelines for Human Stem Cell Research https://stemcells.nih.gov/policy/2009-guidelines.htm NIH Stem Cell Basics Stem Cell Basics | STEM Cell Information (nih.gov) NIH Human Subjects Research Overview https://www.nidcr.nih.gov/research/human-subjects-research NIH Human Subjects Research Policies and Policy Notices https://grants.nih.gov/policy/humansubjects/policies-and-regulations/researchguide-notice.htm Institutional Review Board (IRB) Written Procedures: Guidance for Institutions and IRBs https://www.hhs.gov/ohrp/regulations-and-policy/requests-forcomments/guidance-for-institutions-and-irbs/index.html Ethical Codes • • • • • • AMA Code of Ethics Overview https://www.ama-assn.org/deliveringcare/ethics/code-medical-ethics-overview American College of Healthcare Executives (ACHE) Code of Ethics https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-codeof-ethics AMA code of Medical Ethics Opinion 7 .3.8 Research with stem cells https://www.ama-assn.org/delivering-care/ethics/research-stem-cells Health Care Compliance Association (HCCA) Code of Ethics for Health Care Compliance Professionals https://www.hcca-info.org/code-ethics-health-carecompliance-professionals American Health Information Management Association (AHIMA) Code of Ethics http://bok.ahima.org/doc?oid=105098#.YJmhrLVKiUl American College of Emergency Room Physicians (ACEP) Code of Ethics ACEP // Code of Ethics for Emergency Physicians