Stark Law Case Study

This case is extremely relevant to what is known as the four D’s of negligence; duty, dereliction, direct cause and damages. Duty is when a doctor and a patient have formed a relationship and said doctor has taken on the responsibility of taking care of the patient. Dereliction or failure to perform a duty, there must be some kind of proof that the doctor somehow neglected the doctor neglected the patient. Direct cause, there must be some kind of proof that what happened to the patient was a direct cause of how the doctor conducted himself or his failure to act which resulted in injury. Damages a patient must prove that harm was incurred by the direct result of the physicians actions.

This research paper is being submitted on December 8, 2011, for Mara Pehkonen’s M230 Medical Law and Ethics Course.

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

The two provisions from the Nursing Code of Ethics that were violated are Provision 2 and 3. Provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population” (Brown, Lachman & Swanson, 2015). Provision 2 focuses on “the nurse’s obligation to assure the primacy of the patient’s interests regardless of conflicts that arise between clinicians or patient and family”(Brown, Lachman & Swanson, 2015). Provision 2 was violated because the nurses

The physicians instead of making the call to the cardiology team sent the nurse to do so (Violation).

Not only did the dentist have possible legal violations, but there is evident failure to follow ethical principles. One of the applications of the

In this assignment you will practice what you have learned in chapters 5 and 7 in the Medical Law and Ethics textbook:

Considering the provisions of the Stark law, it is clear that Congress enacted the law to curb the self-referrals that were prevalent among medical practitioners due to the sprawling specialty hospitals and health facilities (Choudhry, Choudhry, and Brennan 2005). Furthermore, Congress saw the need to prevent a physician’s referral decision that is dependent on a selfish, financial gain. The idea was to preclude “overutilization” of certain health care facilities that may arise from objectionable referrals and the resultant increase in health care cost (Staman 2010).

The Stark Law, “the federal Stark law, which prohibits physician referrals of designated health services for Medicare and Medicaid patients if the physician (or an immediate family member) has a financial relationship with that entity” (Hill, 2002).

Stark II and Medicare and Medicaid Program Protection Act of 1987 should be very familiar and important to any healthcare professional or institution. Any healthcare professional and or institution should always operate with the patient’s wellbeing and what decisions are best for the patient at all times. Stark II or Stark Law is violated when a healthcare professional refers a patient to an institution where he or she owns or has a financial interest in the referred medical establishment. Violation of Stark law happens when the medical professional knowingly refers the patient to the facility knowing that there is be a better facility available to treat the patient’s said condition. Stark Law has been violated because the patient’s wellbeing

Stark Law is actually three separate provisions that govern physicians’ self-referrals, mostly for payment by Medicare patients; it is also known as “the self-referral law.” “The law is named for United States Congressman Pete Stark, who sponsored the initial bill (“STARK LAW,” n.d., para. 1). The first phase became effective on January 1, 1992 (Taromina, 2013, p. 83). It prohibited a physician from referring a patient to a clinical laboratory with which they, or an immediate family member, had a financial relationship.

The American College of Healthcare Executives (ACHE), has a strong impact on ethical decision making because they focus on the “entire being” of the healthcare professional. For example, in ACHE’s preamble of The Code of Ethics it states, “In fulfilling their commitments and obligations to patients or others served, healthcare executives function as moral advocates and models.” Imagine, when a healthcare administrator recites these few words, he cannot help but acknowledge the depth of his commitment and the high level of morality that is expected from him. Because of the vast number of complex ethical dilemmas that arise, ACHE further promotes the value and importance of strong ethical decision making in ACHE’s Ethics Toolkit. “When the ethical guidelines are not enough, when there is uncertainty about the proper ethical approach, and when there is a need to develop additional

Medical ethics and legal issues have been a key topic in medical field for many years now. It is important for medical professionals to understand the importance of the way we care for patients, it is therefore important to be knowledgeable and aware of the medical ethics and legal issues that govern good patient care. Health care professionals must make decisions based on ethical and legal issues to performance their regular duties. However, Medical ethics is not only about avoiding harm to patients. It is rather a norms, values and principles (Ethical theories 2015). Therefore norms, values and principles are intended to govern medical ethical conduct. Ethics is defined as “a standard of behaviour and a concept of right and wrong beyond what the legal consideration is in any given situation”. In another words medical ethics is a discipline that used to handle moral problems coming out the care of patients. Law is another important discipline that often comes together with medical ethics. Law defined as a “rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority”. Government imply law to keep the society running smoothly and to control behaviour that could threaten public safety. Medical professionals have to often prioritise these terms before making any clinical decision. The following findings will constructively emphasise on medical ethics, its

The Reagan Administration disagreed and argued that, “If a physician or parent chooses to withhold full treatment when the exceptions are not met, they are liable for medical neglect”, (Resnick, 2011). The Baby Doe Rules mandate followed and stated that hospitals that have access or are federally funded, the physicians have the

Other concerns are conversations within the hospital cafeterias/lobbies about patients and their families, and employees sharing information throughout the hallways without a “need to know.” Once employees discover their colleagues looking at patient information without a “need to know basis,” and, other wrong doings according to the agency’s standards, their own sense of what is right and wrong instantly comes into question. Reporting the unethical behavior, the employee who had discovered the violations of patient rights is presented with a number of difficult choices. The legal basis for imposing liability for a breach of confidentiality is more extensive than ethical guidelines, which dictate the morally right thing to do.