Devry HSM320 2019 JULY Full Course Latest

HSM320 Health Rights & Responsibilities

Week 1 Discussion

DQ1 WHAT IS ETHICS?

Explain why ethics is not just about the sincerity of one’s beliefs, emotions, or religious viewpoints. Explain how medical ethics are described in the Hippocratic Oath, which is still taken by all medical graduates.

DQ2 CASE - STANDARDS OF CARE

THE CASE OF JACOB AND THE DISEASED LEG

Jacob is an outstanding quarterback on his high school football team who has been offered a college scholarship when he graduates. Unfortunately, Jacob was injured during a late summer practice just before his senior year. He suffered a compound fracture of the fibula bone in his lower leg. Since the fracture broke through his skin, he required a surgical repair to align or set the bone and close the skin. Dr. M., an orthopedic surgeon, kept Jacob in the hospital for three days and ordered intravenous antibiotics to be administered. When he was discharged from the hospital, Jacob was told to come in for an office visit once a week for six weeks.

At six weeks Jacob’s parents took him into the surgeon’s office for his cast removal, and except for a slightly inflamed and draining area around his stitches, Jacob’s broken bone seemed to be healing. After his cast was removed, Jacob was told to wait for a few minutes while the surgeon went across the hall to check on another patient. Dr. M. removed his gloves, washed his hands in Jacob’s exam room, and then went across the hall to examine another patient, Sarah K. The doors between the exam rooms were left open and Jacob’s parents could see and hear Dr. M. examine Sarah’s infected leg. They could tell that Dr. M. did not replace his gloves. He told Sarah that he was glad to see that her osteomyelitis (a serious bone infection) was almost better and he told her to come back in another week. Dr. M. then came back into Jacob’s room, still without gloves, and examined Jacob’s leg more carefully. He was concerned about the inflammation around the incision site and told the parents to keep the area clean and dry. He wrote Jacob a prescription for an oral antibiotic and said he could start to put a little weight on his leg. When Jacob came back the following week, his leg was grossly infected with a large abscess. Jacob had to have further surgery to drain the abscess. The pathology report of tissue specimens from Jacob’s leg determined that he had developed osteomyelitis. This infection took several months to heal. The delay in his recovery meant that Jacob was unable to play football that fall and lost his chance at a college scholarship. Jacob’s parents asked Dr. M. to provide them with the results of the tissue test. They then sued Dr. M. for negligence.

What obvious mistake did Dr. M. make?

Did Jacob or his parents contribute in any way to his condition?

What could all of the involved parties have done to prevent this situation from occurring?

Discuss what the term standard of care means for someone in your profession.

 

 

 

 

HSM320 Health Rights & Responsibilities

Week 2 Discussion

DQ1 AREAS AND ISSUES THAT MCOS TRY TO CONTROL

Managed care can be considered any system of delivering health services in which care is delivered by a specified network of doctors, hospitals, and clinics that all agree to comply with the care regimes established by a care-management process. Providers may receive a capitated payment for providing all medically necessary care to enrollees or may be paid on a fee-for-service basis. Managed care often involves a defined delivery system of providers with some form of contractual arrangement with a health plan.

What are some of the areas and issues that MCOs try to control? How effective do you feel the MCOs in your own area have been in these efforts?

DQ2 CASE - PREVENTING MALPRACTICE

THE CASE OF MARION AND THE PACEMAKER

Marion is a 92-year-old patient who weighs 78 pounds. She has had poor eating habits for at least twenty years and refused all attempts by her two daughters to improve her nutrition. In addition, Marion had been a heavy smoker all her life and suffered frequent respiratory problems. During the past two years she has become quite forgetful, has suffered a broken hip as a result of a fall out of bed, and has been treated for pneumonia. Her daughters, who have their own family responsibilities and cannot bring their mother to live with them, have found an excellent nursing home near them. In spite of Marion’s protests, she enters the nursing home. However, she quickly adjusts to her new home and likes the care and the attention that she receives.

During her third week in the nursing home, Marion develops a cough, high temperature, and respiratory problems. She is hospitalized with a diagnosis of pneumonia. Marion immediately becomes disoriented and attempts to remove her intravenous and oxygen tubing. Because she tried to climb out of bed, her daughters must remain at her side. The attending physician tells the daughters that in addition to treatment for pneumonia, Marion will also need to have a pacemaker inserted to regulate her heartbeat. Marion would then be unable to return to the nursing home, as the facility is not equipped to care for someone recovering from surgery.

One of Marion’s daughters has been granted a medical power of attorney for her mother. Before Marion became confused, she clearly explained to her daughters her wishes not to receive extraordinary measures to prolong her life. She also signed a living will indicating her wishes. After thoughtful discussions with other family members, Marion’s daughters tell the physician that they do not want to put their confused mother through the surgical procedure. They state that they want to spare her the pain of recovery from a surgical procedure because she is quite confused and elderly. Further, they are concerned that their mother will not survive an anesthetic and surgical procedure in her frail condition.

The physician seems to be understanding of this decision. He says that he will place into Marion’s chart their request not to have the pacemaker inserted. However, the floor nurses take the daughters aside on several occasions to tell them that this is not a dangerous procedure and that they need to sign a permit for surgery. In fact, the nurses make the daughters feel that they are not acting in their mother’s best interests by not signing the surgical permit. Marion returns to the nursing home without a pacemaker. She lives another four years without any cardiac problems.

Were the nurses carrying out their responsibility as licensed healthcare professionals or were they overstepping their role?

Were Marion’s daughters acting in the best interests of their mother because they knew that if she had the surgery she could not return to the nursing home where she was receiving good care?

What should happen when a physician agrees with the family members and the nursing staff does not?

What are some ways in which physicians and healthcare organizations can prevent malpractice?

 

HSM320 Health Rights & Responsibilities

Week 3 Discussion

DQ1 PHYSICIAN-PATIENT RELATIONSHIP

How has the physician-patient relationship changed over the past century? Are the changes good or bad for the delivery of quality healthcare?

DQ2 CASE - FAMILY PRACTICE MEDICAL GROUP

Following Mrs. Cary’s admission to the hospital, she has initiated a lawsuit against Family Practice Medical Group (FPMG) and Community Hospital. Her suit claims that Dr. Smith failed to properly supervise his employees and as a result, she received the wrong medication which caused her hospitalization for hypotension (low blood pressure) and delayed treatment for her infection which then became life-threatening.

She is also suing Community Hospital because the office staff members are hospital employees. In the lawsuit, is there likely to be a judgment against the hospital? Or FPMG? Why?

 

HSM320 Health Rights & Responsibilities

Week 4 Discussion

DQ1 HIPAA COMPLIANCE

The staff of any medical office comes into contact with a variety of PHI. As the office manager of FPMG, what practices would you put in place to ensure compliance with HIPAA?

DQ2 CASE - HANDLING MEDICAL WASTE

As the new office manager for the Family Practice Medical Group, you are responsible for establishing policies and procedures for maintaining a safe environment for both the staff and patients. Medical waste is an important area that you will be legally responsible for, making sure it is handled safely and appropriately. The four categories of medical waste are: solid waste, chemical waste, radioactive waste, and infectious waste. Pick one of the categories and post your plan for safe handling of the waste. What types of items would be included in the category? What would your policy say about proper disposal?

 

 

 

HSM320 Health Rights & Responsibilities

Week 5 Discussion

DQ1 PATIENT CONFIDENTIALITY

Why has patient confidentiality become a more difficult issue to deal with in the present healthcare environment?

DQ2 CASE - TUSKEGEE SYPHILIS STUDY

THE CASE OF THE TUSKEGEE SYPHILIS RESEARCH STUDY: HISTORICAL CASE

In 1929, the United States Health Service worked with state and local departments of health in six states to find a method to control venereal disease. The statistical reports that were conducted between 1930 and 1932 demonstrated a high rate of syphilis in Macon County, Alabama, where over 84 percent of the population were black and 40 percent of the men were infected with syphilis. The methods used for treating this disease consisted of the injection of mercury and other toxic chemicals. Some men recovered with this treatment; others were made even more ill; and in some cases in which no treatment was given, the patient was able to live for several decades.

After funding to treat the disease ran out during the Depression, the researchers conducting the Tuskegee Study attempted to discover how severe this disease was if left untreated. For this study, the U.S. Public Health Service selected 600 men. Of these 600 research subjects, 400 of the men had syphilis and the other 200 nonsyphilitic men became the control group of research subjects who received no treatment. The infected patients were not told about the purpose or nature of the research. In fact, the researchers would refer to procedures such as spinal taps as “treatments” to induce patient participation. When some of the men in the control group developed syphilis over the course of the study, they were transferred into the research group without ever being told they had the disease. No treatment was ever given to any of the men to fight the disease.

In the early 1940s, penicillin was found to be effective against syphilis. The Tuskegee Project could have been discontinued at this time, as there was no longer any need to study the course of this disease without treatment. However, the research project did continue. The researchers were able to track the men and make sure they did not receive antibiotics for any condition including syphilis. In the 1960s, a researcher working for the U.S. Public Health Service tried to put an end to the project, which was now being conducted by the Centers for Disease Control (CDC) in Atlanta. When he was unsuccessful, he notified the press and ultimately the project was stopped. The public was outraged that poor black men had been subjected to a research project without their consent and denied treatment for a treatable disease in an attempt to gain what was seen as useless information. In 1973, the surviving patients received an out-of-court settlement of $37,500 for the infected men and $16,000 for the men in the control group. The families of men who had died also received compensation of $15,000 for the infected men and $5,000 for the uninfected men.

In 1997, President Clinton offered a public apology to the men, including one 100-year-old survivor, who were involved in this study. The last remaining survivor of this study died in 2004.

This was never a secret project. This project had been well publicized in medical journals. The people who read about the study did nothing to stop it.

Identify ethical issues pertaining to this scenario.

What is a control group and are control groups still used in today's medical research?

What ethical measures and requirements are in place to guide human subject research nowadays?

HSM320 Health Rights & Responsibilities

Week 6 Discussion

DQ1 VIEWS ON ABORTION

What do you say to a coworker who does not share your moral or religious views concerning abortion?

DQ2 CASE - VIEWS ON STERILIZATION

In an Oklahoma case, Goforth v. Porter Med. Assoc., Inc., 755 P.2d 678, Okla. in 1988, a physician assured his patient that she was sterile after he performed a sterilization procedure in August 1980. The patient subsequently became pregnant and delivered a baby in October 1981.

What are the ethical and legal issues pertaining to this case?

What was the outcome of the legal battle between Goforth and Porter Medical Association?

Do you agree with the final court's decision? Explain your answer.

 

HSM320 Health Rights & Responsibilities

Week 7 Discussion

DQ1 INCREASING HEALTHCARE COSTS

What is at the heart of the increasing healthcare costs in America? Is it possible to reduce the cost of healthcare so that everyone can have access to affordable healthcare services? Do you feel that the Patient Protection and Affordable Care Act is a good step toward reducing healthcare costs in our nation? Why or why not?

DQ2 CASE - DETERMINING HEALTH SERVICES AND DEATH

CASE OF MARGUERITE M. AND THE ANGIOGRAM

Marguerite M., an 89-year-old widow, is admitted into the cardiac intensive care unit in Chicago’s Memorial Hospital at 3:00 A.M. on a Sunday morning with a massive heart attack (myocardial infarction). Her internist, Dr. K., who is also a close family friend, has ordered an angiogram to determine the status of Marguerite’s infarction (heart attack). Dr. K. knows that the angiogram and resulting treatment need to be done within the first six hours after an infarction in order to be effective. Therefore, the procedure is going to be done as soon as the on-call surgical team can set up the angiography room. The radiologist, who lives thirty minutes from the hospital, must also be in the hospital before the procedure can begin. At 4:30 A.M. the team is ready to have Marguerite, who is barely conscious, transferred from the intensive care unit (ICU) to the surgical suite.

Coincidentally, at 4:30 A.M. Sarah W., an unconscious 45-year-old woman, is brought in by ambulance with a massive heart attack. The emergency room (ER) physicians, after conferring with her physician by phone, conclude that she will need a balloon angiography (dilating an obstructed blood vessel by threading a balloon-tipped catheter into the vessel) to save her life. When they call the surgical department to have the on-call angiography team brought in, they are told that the room is already set up for Dr. K.’s patient. They do not have another team or surgical room for Sarah. A decision is made that because Sarah needs the balloon angiography in order to survive, they will use the angiography team for her.

Dr. K. is called at home and told that his patient, Marguerite, will not be able to have the angiogram. The hospital is going to use the angiography team for Sarah, because she is younger than Marguerite and has a greater chance for recovery. Unfortunately, it took longer than expected to stabilize Sarah before and after the procedure and the six-hour “window” when the procedure could be performed on Marguerite passed. Marguerite expired (died) the following morning.

Do you believe that this case presents a legal or an ethical problem, or both?

What do you believe should be the criteria for a physician to use when having to choose a solution that will benefit one patient at the expense of another?

How can Dr. K. justify this decision when speaking to the family of Marguerite M.?

What options does a member of the angiography team or a caregiver for Marguerite have if he or she disagrees with this decision?

Why is the ability to determine when death has occurred so critical in today’s healthcare environment?

 

HSM320 Health Rights & Responsibilities

Week 3 Assignment  

COLLABORATIVE ACTIVITIES

Relating course content to the current healthcare environment is an integral part of your learning; this also helps develop your awareness of the critical importance of legal and ethical issues. Two (2) collaborative activities are required in this course. These activities will give you the opportunity to apply course content. Specific instructions for each of these activities are provided each week they are assigned. The first collaboration activity on professional liability is to be completed in two parts. Part one is due week 3 and part two is due week 4.

Collaborative Activity 1: Professional Liability—select an allied health (nonphysician) profession; this can be your own profession or another profession that interests you. Some examples of allied health professions include physical therapy, respiratory therapy, pharmacy, nursing, physician assisting, radiography, ultrasonography, nuclear medicine, medical laboratory, medical assisting, phlebotomy, and many others. Research the topic of professional liability, including negligence and malpractice. Identify the most common form of litigation in this profession. Describe a situation in which an individual in this profession might be held liable for negligence and ways to proactively avoid or prevent negligence in the profession that you selected.

Week 3, each team member will complete the research on the selected allied health profession. The group will then schedule a live meeting using interactive online meeting tools, or alternatively an asynchronous meeting using a multimedia video, to discuss their individual findings and share the commonalities of the risks in these health care professions. Document the participation in this meeting by taking and saving a screen shot of the meeting or saving the multimedia video. Submit the documentation. The week 3 collaborative activity is worth 50 points.

 

 

 

HSM320 Health Rights & Responsibilities

Week 4 Assignment  

COLLABORATIVE ACTIVITIES

Relating course content to the current healthcare environment is an integral part of your learning; this also helps develop your awareness of the critical importance of legal and ethical issues. Two (2) collaborative activities are required in this course. These activities will give you the opportunity to apply course content. Specific instructions for each activity are provided in the week they are assigned. The second part of the first collaboration activity on Professional Liability is due this week.

Collaborative Activity 1: Professional Liability—select an allied health (nonphysician) profession; this can be your own profession or another profession that interests you. Some examples of allied health professions include physical therapy, respiratory therapy, pharmacy, nursing, physician assisting, radiography, ultrasonography, nuclear medicine, medical laboratory, medical assisting, phlebotomy, and many others. Research the topic of professional liability including negligence and malpractice, Identify the most common form of litigation in this profession. Describe a situation in which an individual in this profession has been or might be held liable for negligence. Identify ways to proactively avoid or prevent negligence in the profession that you selected. Week 3 each group met and discussed the most common forms of liability in each profession. Discuss as a group the commonalities of the risks in these health care professions. Week 4 the group will develop a list of recommendations for practitioners to limit risk in these professions, there may be some overlap. Using a presentation tool with audio, such as Power Point, summarize the group findings and recommendations.  The week 4 document is worth 100 points.

 

HSM320 Health Rights & Responsibilities

Week 6 Assignment  

 COLLABORATIVE ASSIGNMENT

Collaborative Project: Advance Directives In teams, -research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? The deliverable for this assignment is to develop an informational/educational brochure about advance directives for the general public. The brochure should include a description of advance directives, emphasizing their importance in ensuring patient autonomy in health care decisions. The brochure will also include a scenario in which a Living Will or Durable Power of Attorney for health care were helpful to the patient, family and health care team. Examples of forms for Living Will and Durable Power of Attorney will be included as examples. Week 6, the team will gather information, share this information and plan the brochure. Group collaboration may be via an organized meeting, multimedia recording, or other collaborative live or asynchronous tool. Each team member will submit a screen shot or other evidence of participation in the collaboration submission area.

The topic for your brochure is noted below. Refer to at least one outside source, in addition to your text, as you prepare your brochure.

Activity 2: Advance Directives-research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? Briefly discuss a situation in which a Living Will might apply and would be of benefit to those involved. Once you have researched and discussed Advance Directives, draft a sample Living Will, indicating the type of content that should be found in such a document. Some students take this opportunity to prepare their own actual Living Will, and that certainly is encouraged.

 

HSM320 Health Rights & Responsibilities

Week 7 Assignment  

COLLABORATIVE ACTIVITIES 2: ADVANCE DIRECTIVES

Collaborative Activities 2: Advance Directives In teams, research and discuss the legal and ethical basis for Advance Directives such as the Living Will and Durable Power of Attorney for healthcare. Why are these documents so valuable in healthcare situations? What legal authority do these documents provide for decision making by family and/or healthcare providers? The deliverable for this assignment is to develop an informational/educational brochure about advance directives for the general public. The brochure should include a description of advance directives, emphasizing their importance in ensuring patient autonomy in health care decisions. Include a scenario describing a situation in which a Living Will or Durable Power of Attorney for Health Care were helpful to the patient, family and health care team. Provide examples of forms for Durable Power of Attorney for Health Care and Living Wills.

Using the information gathered and discussed week 6, the week 7 collaborative assignment is to complete the brochure and add a section for Frequently Asked Questions, including at least four FAQ's. Use Microsoft Word Brochure templates or other publishing software to develop the brochure. Each team will submit a copy to the Week 7 Collaborative Activity for grading. The Week 7 Collaborative Activity is worth 100 points.

 

HSM320 Health Rights & Responsibilities

Week 8 Final Exam   

Question 1 (CO 1) The three-step approach to solving ethical dilemmas is based on

  asking ourselves how our decision would make us feel if we had to explain our actions to a loved one.

  asking ourselves if the intended action is legal.

  asking ourselves if the intended action results in a balanced decision.

  A and B only

  A, B, and C

Question 2 (CO 2) Three or more physicians who share the same facility and practice medicine together are known as

  a group practice.

  an associate practice.

  a solo practice.

  an exclusive provider organization.

  a sole proprietorship.

Question 3 (CO 3) In order to obtain a judgment for negligence, the patient must show

  direct or proximate cause.

  duty.

  damages.

  dereliction, or neglect, of duty.

  All of the above

Question 4 (CO 4) The patient

  has the legal right of "privileged communication."

  owns the medical record.

  cannot have any portion of the medical record.

  A and B

  A, B, and C

Question 5 (CO 4) Medical records

  provide a record from birth to death.

  provide statistics on health matters.

  are legal documents.

  A and C only

  A, B, and C

Question 6 (CO 2) What specialist uses inaudible sound waves to outline shapes of tissues and organs?

  Electrocardiograph technologist

  X-ray technologist

  Phlebotomist

  Ultrasound technologist

  Social worker

Question 7 (CO 5) A disease that could cause serious birth defects for an unborn child if the pregnant mother is exposed to it during her pregnancy is

  Down syndrome.

  Huntington's disease.

  cystic fibrosis.

  rubella.

  retinoblastoma. 

Question 8 (CO 3) An electroencephalogram is used to

  reverse a coma patient's condition.

  measure cardiopulmonary function.

  measure brain function.

  reverse the condition of hypothermia.

  reverse the condition of rigor mortis.

Question 9 (CO 7) What is the ethical term that is used to morally justify the removal of a cancerous uterus from a pregnant patient?

  Mercy killing

  Extraordinary means

  Ordinary means

  Doctrine of double effect

  Advance directive

Question 10 (CO 7) A hospice provides for

  palliative care.

  pain medications.

  in-patient care.

  home care.

  All of the above

Question 11 (CO 7) A person appointed by the court to defend a lawsuit on behalf of an incapacitated person is a(n)

  conscience clause.

  surrogate.

  AID.

  AIH.

  guardian ad litum.

 

Question 12 (CO 7) When caring for a comatose patient, one should include

  CPR and mechanical breathing.

  chemotherapy.

  turning and hydration.

  A and B only

  A and C only

Question 13 (CO 7) Medicare covers the health benefits for

  persons who are elderly.

  persons who are disabled.

  end-staged patients.

  All of the above

Question 14 (CO 1) Laws that affect the medical profession

  often overlap with ethics.

  have a binding force.

  are always fair to all persons.

  are determined by a governmental authority.

  A, B, and D

Question 15 (CO 1) Utilitarianism is an ethical theory based on the principle of

  performing one's duty to various persons and institutions.

  the greatest good for the greatest number of people.

  adhering to laws enforced by government authorities.

  a person's individual rights.

  None of the above

Question 16 (CO 1) The ethical theory that places the primary emphasis on a person’s individual rights is

  utilitarianism.

  rights-based.

  duty-based.

  philosophy.

  None of the above

Question 17 (CO 1) Common law is established by

  statutes.

  a judge.

  the Constitution.

  a previous court decision.

  B and D

Question 18 (CO 1) In order to obtain a judgment for negligence, the patient must show

  direct or proximate cause.

  duty.

  damages.

  dereliction, or neglect of duty.

  All of the above

Question 19 (CO 3) Signs of abuse include

  poor growth.

  lack of hygiene.

  malnutrition.

  bite marks.

  All of the above

Question 20 (CO 4) The records of all adult patients should be kept a minimum of

  2 years.

  5 years.

  10 years.

  None of the above

Question 21 (CO 4) The federal agency responsible for investigating HIPAA complaints is the

  Office of Civil Rights.

  Federal Marshall's Office.

  JCAHO.

  USPHS.

  HHS.

Question 22 (CO 5) The Privacy Rule is meant to ensure

  standardization of health data.

  standardization of financial data.

  standardization of medical care.

  a and b only.

  a, b, and c.

Question 23 (CO 6) Ethical issue(s) relating to contraception is/are

  dispensing contraceptives in schools receiving federal funds.

  requiring sex offenders to undergo sterilization.

  providing contraceptives for women on Medicaid.

  sterilization of mentally incompetent women.

  all of the above.

Question 24 (CO 6) Genetic testing of the newborn is required by law for

  Tay-Sachs disease.

  phenylketonuria.

  retinoblastoma.

  Down syndrome.

  Cooley’s anemia.

Question 25 (CO 6) Withdrawing a small amount of amniotic fluid from the uterus for genetic testing is called

  induced abortion.

  eugenics.

  amniocentesis.

  spontaneous abortion.

  drug-induced abortion.

Question 26 (CO 3) In most cases, federal laws

  are better than state laws.

  are not followed as closely as state laws.

  preempt state laws.

  are used when state laws are not effective.

  none of the above.

Question 27 (CO 2) A condition in which a patient understands the risks involved by not having a surgical procedure or treatment performed is known as

  standard of care.

  informed consent.

  implied consent.

  advance directive.

  agent.

Question 28 (CO 5) Nontherapeutic research

  will always benefit the research subject.

  does not directly benefit the research subject.

  should be justified with the benefits outweighing the risks.

  b and d only.

Question 29 (CO 5) The Summary of Opinions of the Council on Ethical and Judicial Affairs of the AMA

  describes fee splitting as an acceptable practice.

  admonishes the surgeon against “ghost surgery.”

  admonishes the physician to be sensitive to the need to assist patients in suicide.

  describes gene therapy as acceptable as long as it is for the purpose of altering human traits.

  all of the above.

Question 30 (CO 5) Conflicts of interest occur

  when there are financial interests present.

  if stock is owned by the physician in the company that sponsors the research.

  if the researcher can control the results of the research.

  if the patient’s needs are not considered.

  all of the above.