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            When operating on a minor, it is the responsibility of the doctor to inform the parents and secure a signed written consent permitting the operation. This is the dilemma being faced by Dr. Bob. Upon discovering that the patient to be operated on is minor, it is a pre-requisite for him to call on the parents at once and explain the situation. The dialogue should contain that the operation is underway and is an important part in trying to save the patient from his life-threatening condition. If the parents sign on the consent form, then the operation should push through.

If the parents cannot be immediately present, the operation should be deferred until consent can be secured. However, the operation can still be continued depending on the rules and regulations of the hospital and with consideration of the state laws if the condition is severe and the operation is of urgent need. This is also the case when the parents are not around to speak with and to sign the consent form. However, if the patient has an appointed guardian, the guardian may consent the operation in the parents’ behalf. Full accountability on the outcome of the operation will then be entrusted to the guardian.

            Getting an abortion requires the father of the child to consent the operation. This is because the law enacts both parents of an unborn child to share the responsibility of planning the family, or at least to make conjugal decisions. Thus, Dr. Bob should advice Paula Patient that what she is requesting him to do is against the law. He should also advice Paula Patient to talk to her boyfriend about the impending abortion.

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            If Paula Patient claims that not pushing through as she requested will endanger her life, Dr. Bob should stand by his decision yet offer alternative solutions to ensure that Paula Patient will be safe. He can offer her connection to woman’s rights groups or, if things are worse and may be more violent than expected, she may also seek federal protection.

            Under the HIPAA, all medical records of any patient may only be secured by a person upon presentation of a written authorization letter signed by the patient unless the purpose of the copy is to carry out an operative procedure, treatment, or for payment purposes. When Dr. Bob gave Paula Patient’s attorney her medical history files without this authorization, Dr. Bob committed a sin against the law and against Paula Patient. In addition to this, most state laws are stricter, allowing release of medical records only with consent. Thus, even for the purposes stated above, when the patient did not consent the release of records especially when the records were released in full, Dr. Bob will have accountability to the law.

            Considering that Dr. Bob has given the attorney all medical files, including confidential ones such as HIV treatment history, reveals an even bigger accountability in the medical confidentiality laws. Dr. Bob should have secured an authorization from Paula Patient as well with regard to the release of HIV-related records.

Part B.

1.                  Contributory negligence is a defense used in a case where the plaintiff has committed a deed that contributed to the damages that the defendant has incurred to him. This happens, for example, when the plaintiff was also negligent in the point when the defendant was negligent. Thus, when the issue in contention such as an accident has occurred, both the defendant and the plaintiff are accountable. On the other hand, comparative negligence is a defense where the negligence of the plaintiff is compared to the negligence of the defendant or a group of defendants. This is a variation of contributory negligence where the defendant and the plaintiff both is accountable for the case in sue, but where there is a possibility that one of them has bigger responsibility or deeper negligence.

2.                  If HIPAA rules were stricter than the laws of the state, HIPAA rules should be primary. This will ensure that the welfare of the patient and all the others concerned is protected at the largest extent. However if the state laws were stricter then the law should prevail. Again, following the stricter regulation will ensure the safety of the patient. However, in all cases the patient’s needs should be considered and both regulations should be weighed.

3.                  Res ipsa loquitur literally translates to the thing speaks for itself. The term denotes that a defendant on a case is fully responsible for the case, and that the plaintiff did not contribute to the occurrence of negligence. This puts full responsibility of the case on the defendant.

4.                  Jurisdiction of federal courts is a term that refers to items that are under the authority of the federal courts, and thus other organizations, groups, or entities cannot rule over them. When a case is identified as being under the jurisdiction of the federal court, secondary guidelines such as the HIPAA cannot prevail against the state law.

5.                  According to HIPAA, notice of use and disclosure of patient information may be given to proper authorities such as another doctor when the treatment is on the stage of an impending operation, treatment, or to secure payment for treatments made. The patient can also consent or deny disclosure of his information as he deems necessary.

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