Skip to main content

Medical Treatment and the Physician’s Legal Duties

  • Chapter
  • 232 Accesses

Abstract

In the course of obtaining medical care, the older patient enters into a relationship with one or more physicians, professional staff working under the physician’s control, and frequently health care entities through which or in which the health care is delivered. These relationships may be described as both contractual (i.e., based on a mutual exchange of promises) and fiduciary (i.e., based on the necessary trust that accompanies the patient’s reliance on the more knowledgeable and powerful health care provider). Under either of these characterizations, the relationships that are formed entail a variety of legal obligations on the part of the physician. These duties are enforceable, and their violation may lead to adverse legal and financial consequences for the physician.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kapp MB. The malpractice crisis: relevance for geriatrics. J Am Geriatr Soc. 1989; 37: 364–368.

    PubMed  CAS  Google Scholar 

  2. Kapp MB, Lo B. Legal perceptions and medical decisionmaking. Milbank Q. 1986; 64 (suppl 2): 162–202.

    Google Scholar 

  3. Kapp MB. Defensive medicine in geriatric practice. In: Homburger F, ed. The Rational Use of Advanced Medical Technology with the Elderly. New York: Springer; 1994: 67–74.

    Google Scholar 

  4. Sager M, Voeks S, Drinka P, et al. Do the elderly sue physicians? Arch Intern Med. 1990; 150: 1091–1093.

    Article  PubMed  CAS  Google Scholar 

  5. US General Accounting Office. Medical Malpractice: Medi-care/Medicaid Beneficiaries Account for a Relatively Small Percentage of Malpractice Losses. Washington, DC: US Government Printing Office; 1993.

    Google Scholar 

  6. Burstin H, Johnson W, Lipsitz, et al. Do the poor sue more? JAMA. 1993; 20: 775–795.

    Google Scholar 

  7. Weiler P, Hiatt H, Newhouse J, et al. A Measure of Malpractice: Medical Injury, Malpractice Litigation, and Patient Compensation. Cambridge, MA: Harvard University Press; 1993.

    Google Scholar 

  8. Kapp MB. Our hands are tied: legally induced moral tensions in health care delivery. J Gen Intern Med. 1991; 6: 345–348.

    Article  PubMed  CAS  Google Scholar 

  9. Making Health Care Decisions: The Ethical and Legal Implications of Informed Consent in the Patient-Practitioner Relationship. Washington, DC: President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research; 1982.

    Google Scholar 

  10. Keeler EB, Solomon DH, Beck JC, et al. Effect of patient age on duration of medical encounters on physicians. Med Care. 1982; 20: 1101–1108.

    Article  PubMed  CAS  Google Scholar 

  11. Levinson SA, ed. Medical Direction in Long-Term Care. 2nd ed. Owings Mills, MD: National Health Publishing; 1993.

    Google Scholar 

  12. Faden RR, Beauchamp TL. A History and Theory of Informed Consent. New York: Oxford University Press; 1986.

    Google Scholar 

  13. Marsh FH. Informed consent and the elderly patient. Clin Geriatr Med. 1986; 2: 501–510.

    PubMed  CAS  Google Scholar 

  14. Rozovsky FA. Consent to Treatment: A Practical Guide. 2nd ed. Boston, MA: Little, Brown; 1990.

    Google Scholar 

  15. Miller L. Informed consent. JAMA. 1980; 244: 2100–2103, 2347–2350, 2556–2558, 2661–2662.

    Google Scholar 

  16. Kapp MB. Evaluating decision making capacity in the elderly: a review of recent literature. J Elder Abuse Neglect. 1990; 2: 15–29.

    Article  Google Scholar 

  17. Kapp MB. Assessment of competence. In: Carstensen L, Dornbrand L, Edelstein BA, eds. Practical Handbook of Clinical Gerontology. Newbury Park, CA: Sage Publications; 1996.

    Google Scholar 

  18. Larson EB, Lo B, Williams ME. Evaluation and care of elderly patients with dementia. J Gen Intern Med. 1986; 1: 116–126.

    Article  PubMed  CAS  Google Scholar 

  19. Dubler NN. Coercive placement of elders: protection of choice? Generations. 1987; 11: 6–9.

    Google Scholar 

  20. Blank K. Depressive illness in the elderly: legal and ethical issues. In: Rosner R, Schwartz HI, eds. Geriatric Psychiatry and the Law. New York: Plenum; 1987: chap. 11.

    Google Scholar 

  21. Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state. Parts One and Two. N Engl J Med. 1994; 330: 1499–1508, 1572–1579.

    Google Scholar 

  22. Munetz M, Lidz C, Meisel A. Informed consent and incompetent medical patients. J Fam Pract. 1985; 20: 273–279.

    PubMed  CAS  Google Scholar 

  23. Goldstein RL. Non compos mentis: the psychiatrist’s role in guardianship and conservatorship proceedings involving the elderly. In: Rosner R, Schwartz HI, eds. Geriatric Psychiatry and the Law. New York: Plenum; 1987: chap. 16.

    Google Scholar 

  24. Strain JJ, Fulop G. Screening devices for cognitive capacity. Ann Intern Med. 1987; 107: 583–585.

    PubMed  CAS  Google Scholar 

  25. Meisel A, Roth L, Lidz C. Toward a model of the legal doctrine of informed consent. Am J Psychiatry. 1977; 134: 285–289.

    PubMed  CAS  Google Scholar 

  26. Grisso T, Appelbaum PS. Mentally ill and nonmentally ill patients’ abilities to understand informed consent disclosures for medication. Law Human Behav. 1991; 15: 377–388.

    Article  Google Scholar 

  27. Roth L, Meisel A, Lidz C. Tests of competency to consent to treatment. Am J Psychiatry. 1977: 134: 279–284.

    PubMed  CAS  Google Scholar 

  28. Culver C. The clinical determination of competence. In: Kapp MB, Pies H, Doudera AE, eds. Legal and Ethical Aspects of Health Care for the Elderly. Ann Arbor, MI: Health Administration Press; 1985: chap. 24.

    Google Scholar 

  29. Harris S. Protecting the rights of questionably competent long-term care facility residents. In: Kapp MB, Pies H, Doudera AE, eds. Legal and Ethical Aspects of Health Care for the Elderly. Ann Arbor, MI: Health Administration Press; 1985: chap. 17.

    Google Scholar 

  30. Heikoff LE. Practical management of the demented elderly. West J Med. 1986; 145: 397–399.

    PubMed  CAS  Google Scholar 

  31. Caplan A. Let wisdom find a way. Generations. 1985; 10: 10–14.

    Google Scholar 

  32. Sachs GA, Rhymes J, Cassel CK. Biomedical and behavioral research in nursing homes: guidelines for ethical investigations. J Am Geriatr Soc. 1993; 41: 771–777.

    PubMed  CAS  Google Scholar 

  33. Sachs GA, Cassel CK. Biomedical research involving older human subjects. Law Med Health Care. 1990; 18: 234–243.

    PubMed  CAS  Google Scholar 

  34. Levine RJ. Ethics and Regulation of Clinical Research. 2nd ed. Baltimore: Urban & Schwarzenberg; 1986.

    Google Scholar 

  35. Ratzan RM. Being old makes you different: the ethics of research with elderly subjects. Hastings Cent Rep. 1980; 10: 32–42.

    PubMed  CAS  Google Scholar 

  36. Annas GJ, Glantz LH. Rules for research in nursing homes. N Engl J Med. 1986; 315: 1157–1158.

    Article  PubMed  CAS  Google Scholar 

  37. American College of Physicians. Cognitively impaired subjects. Ann Intern Med. 1989; 111: 843–848.

    Google Scholar 

  38. Warren JW, Sobal J, Tenney JH, et al. Informed consent by proxy: an issue in research with elderly patients. N Engl J Med. 1986; 315: 1124–1128.

    Article  PubMed  CAS  Google Scholar 

  39. Melnick VL, Dubler NN, Weisbard A, et al. Clinical research in senile dementia of the Alzheimer’s type: suggested guidelines addressing the ethical and legal issues. J Am Geriatr Soc. 1984; 32: 531–536.

    PubMed  CAS  Google Scholar 

  40. Dubler NN. Legal judgments and informed consent in geriatric research./Am Geriatr Soc. 1987; 35: 545–549.

    CAS  Google Scholar 

  41. Kapp MB. Proxy decision making in Alzheimer’s disease research: durable powers of attorney, guardianship, and other alternatives. Alzheimer’s Dis Assoc Disord. 1994; 8 (suppl 4): 28–37.

    Article  Google Scholar 

  42. Dickens BM. Substitute consent to participation of persons with Alzheimer’s disease in medical research: legal issues. In: Berg J, Karlinsky H, Lowy F, eds. Alzheimer’s Disease Research: Ethical and Legal Issues. Toronto: Carswell Publishers; 1991: 60–75.

    Google Scholar 

  43. Cassel CK. Ethical issues in the conduct of research in long term care. Gerontologist. 1988; 28 (suppl): 90–96.

    Article  PubMed  Google Scholar 

  44. Cantor NL. Advance Directives and the Pursuit of Death with Dignity. Bloomington, IN: Indiana University Press; 1993.

    Google Scholar 

  45. Kapp MB, ed. Patient Self-Determination in Long-Term Care. New York: Springer; 1994.

    Google Scholar 

  46. Areen J. Advance directives under state law and judicial decisions. Law Med Health Care. 1991; 19: 91–100.

    PubMed  CAS  Google Scholar 

  47. Menikoff JA, Sachs GA, Siegler M. Beyond advance directives: health care surrogate laws. N Engl J Med. 1992; 327: 1165–1169.

    Article  PubMed  CAS  Google Scholar 

  48. In re Storar, 52 NY2d 363, 420 NE2d 64 (1981).

    Google Scholar 

  49. US House of Representatives, Subcommittee on Health and Long-term Care of the Select Committee on Aging. Abuses in Guardianship of the Elderly and Infirm: A National Disgrace. 100th Congress, 1st Session; 1987. Committee Publication 100–641.

    Google Scholar 

  50. Applebaum PS. Limitations on guardianship of the mentally disabled. Hosp Community Psychiatry. 1982; 33: 183–184.

    Google Scholar 

  51. American Medical Association Judicial Council. Guidelines for ethics committees in health care institutions. JAMA. 1985; 253: 2698–2699.

    Article  Google Scholar 

  52. Brown BA, Miles SH, Aroskar MA. The prevalence and design of ethics committees in nursing homes. J Am Geriatr Soc. 1987; 35: 1028–1033.

    PubMed  CAS  Google Scholar 

  53. Fost N, Cranford RE. Hospital ethics committees: administrative aspects. JAMA. 1985; 253: 2687–2692.

    Article  PubMed  CAS  Google Scholar 

  54. Wood JS. Nursing home care. Clin Geriatr Med. 1986; 2: 601–615.

    PubMed  CAS  Google Scholar 

  55. Kapp MB. Legal and ethical aspects of resuscitation: an annotated bibliography of recent literature. Resuscitation. 1987; 15: 289–297.

    Article  PubMed  CAS  Google Scholar 

  56. US Congress, Office of Technology Assessment. Life- Sustaining Technologies and the Elderly. 100th Congress, 1st Session; 1987. Publication OTA-BA-306.

    Google Scholar 

  57. Miles SH, Ryden M. Limited-treatment policies in long-term care facilities. J Am Geriatr Soc. 1985; 33: 707–711.

    PubMed  CAS  Google Scholar 

  58. Stephens R. Do not resuscitate orders: ensuring the patient’s participation. JAMA. 1986; 255: 240–241.

    Article  PubMed  CAS  Google Scholar 

  59. Kapp MB. Futile medical treatment: a review of the ethical arguments and legal holdings. J Gen Intern Med. 1994; 9: 170–177.

    Article  PubMed  CAS  Google Scholar 

  60. Miles SH. Advanced directives to limit treatment: the need for portability. J Am Geriatr Soc. 1987; 35: 74–76.

    PubMed  CAS  Google Scholar 

  61. Farber N, Weiner J, Boyer G, et al. Cardiopulmonary resuscitation: values and decisions—a comparison of health care professionals. Med Care. 1985; 23: 1391–1398.

    Article  PubMed  CAS  Google Scholar 

  62. Rango N. The nursing home resident with dementia: clinical care, ethics, and policy implications. Ann Intern Med. 1985; 102: 835–841.

    PubMed  CAS  Google Scholar 

  63. Kapp MB. Adult protective services: convincing the patient to consent. Law Med Health Care. 1983; 11: 163–167.

    PubMed  CAS  Google Scholar 

  64. American Medical Association Council on Scientific Affairs. Elder abuse and neglect. JAMA. 1987; 257: 966–971.

    Article  Google Scholar 

  65. Kantor JE. Ethical considerations in geriatric forensic psychiatry. In: Rosner R, Schwartz HI, eds. Geriatric Psychiatry and the Law. New York: Plenum; 1987: chap. 19.

    Google Scholar 

  66. Quinn MJ, Tomita SK. Elder Abuse and Neglect: Causes, Diagnosis, and Intervention Strategies. New York: Springer; 1986.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kapp, M.B. (1997). Medical Treatment and the Physician’s Legal Duties. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_66

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-2705-0_66

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2707-4

  • Online ISBN: 978-1-4757-2705-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics