reviewing health status and granting waivers forthose individuals unable to safely participate inphysical fitness testing and training, andassisting in the development of exerciseprescriptions.LEGAL IMPLICATIONS IN MEDICALCARELEARNING OBJECTIVE: Recognize thepolicies and procedures pertaining toconsent for medical treatment, incidentreports, and release of medical information.There are few aspects of medical administration oftreatment that do not have some legal implications.Every time a patient comes into contact with a facilityor its staff members, either directly or indirectly,formally or informally, the potential for legalentanglement exists. Although the law has becomemore and more involved in the operation of hospitals,the exercise of common sense combined with aknowledge of those situations that require special carewill protect the hospital and its staff from mostdifficulties.This section addresses some of the situations thatregularly arise and have legal consequences, includingthe policy and instructions that apply to thosesituations. Keep in mind that the law is an inexactscience, subject to widely varying circumstances. Theinformation in this chapter cannot substitute for theadvice of an attorney. Hospital staff members areencouraged to consult with hospital or area JudgeAdvocate General (JAG) Corps officers on issues withwhich they are uncomfortable.CONSENT REQUIREMENTS FORMEDICAL TREATMENTWith limited exceptions, every person has the rightnot to be touched without his having first givenpermission. This right to be touched only when and inthe manner authorized is the foundation of therequirement that consent must be obtained beforemedical treatment is initiated. Failure to obtainconsent may result in the healthcare provider beingresponsible for an assault and battery upon the patient.Informed ConsentWhile the term “consent” in the medical settingrefers to a patient’s expressed or implied agreement tosubmit to an examination or treatment, the doctrine of“informed consent” requires that the healthcareprovider give the patient all the information necessaryfor a knowledgeable decision on the proposedprocedure. When courts say that a patient’s consentmust be informed, they are saying that a patient’sagreement to a medical procedure must be made withfull awareness of the consequences of the agreement.If there is no such awareness, there has been no lawfulconsent.The duty to inform and explain rests with theprovider. THIS RESPONSIBILITY CANNOT BEDELEGATED.The provider must describe the proposedprocedure in lay terms so the patient understands thenature of what is proposed. The risks of the treatmentmust be explained. If there are any alternative medicaloptions, they should be disclosed and discussed.For common medical procedures that areconsidered simple and essentially risk free, a provideris not required to explain consequences that aregenerally understood to be remote. A determination ofwhat is simple and common should be made from theperspective of appropriate medical standards. Wherethe harm that could result is serious or the risk or harmis high, the duty to disclose is greater.Methods should be developed within each hospitaldepartment to acquaint patients with the benefits,risks, and alternatives to the proposed treatment. Insome departments, prepared pamphlets or informations h e e t s m a y b e d e s i r a b l e . I n o t h e r s , o r a lcommunication may be the best method. Some states(e.g., Texas) have laws that are very specific aboutwhat is required.Emergency SituationsConsent before treatment is not necessary whentreatment appears to be immediately required toprevent deterioration or aggravation of a patient’scondition, especially in life-threatening situations, andit is not possible to obtain a valid consent from thepatient or a person authorized to consent for thepatient. The existence and scope of the emergencyshould be adequately documented.15-8
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