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 Confidentiality of Health InformationPart A: Answer each of the following questions in one or two paragraphs. Each answer is worth 20 points.Essay #1Dr. Bob is preparing to operate on Sally for an immediately life-threatening condition.

Just before he begins the operation, he discovers that she is 17 years old. Her parents, with whom Dr. Bob has never discuss `informed consent` and describe what Dr.

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Bob should do in this situation and how his obligations might be different if Sallys parents were unavailable.            Sally is 17 years old and is suffering from a life-threatening condition.  She requires undergoing immediate surgery and Dr. Bob is to perform the surgery.  According to the law, the need for such surgeries has been identified and the process of informed consent is not necessary.  The parents have to actually give consent for the procedure, but in the absence of their consent, Dr. Bob can demonstrate the need to perform immediate surgery in order to prevent loss of limb or life.  It would be reasonable justified if the Doctor takes measures without the consent.

  Consent in such a situation is implied, as it is assumed that the parents want the life of their child to be saved at any cost.  The extent to which such implied consent would go is not defined by the law.  If the parent or legal guardian of the child can be found easily, it would be preferable to inform them and take consent.Essay #2Paula Patient doesnt want her violent boyfriend to know shes getting an abortion, so she asks Dr.

Bob to send all communications to her to a post office box and to phone her only at work. What should Dr. Bob do, and what is the legal basis for your advice? If she tells Dr. Bob that not doing this will endanger her, would your answer be different?            In case a woman requires undergoing abortion she has to fulfill certain with relation to the duration of the pregnancy.  Within this period, the woman has full autonomy to undergo abortion.  Following the cases Parenthood of Central Missouri, et al.

v. Danforth, 44 L.W. 5197 and Bellotti, et al. v. Baird, et al (1976), the restrictions of taking the consent of the husband was deemed as unconstitutional.  Even for unmarried minor women, the consent of the parents was not needed to undergo abortion.

Essay #3Paula Patients attorney asks Dr. Bob for medical records about Paulas car accident and promises to provide a written authorization from Paula later. Dr.

Bob gives the attorney Paulas entire file, including her records about treatment for HIV. Discuss any violations of HIPAA privacy rule that may have occurred.            Under the HIPAA rules regarding privacy and security of medical information of the patient, the physician can give the medical records to the attorney only if prior authorization is taken from the patient to seek the medical records from the physician.  There may be certain instances in which the attorney representing the opposing party or the state may seek the medical records of the patient.  In such a circumstance, the physician can also give the medical information to the attorney provided the attorney is bound to maintain the information as confidential and protect it to the same extent as the physician would be doing.  In such circumstances, the physician has to provide only the relevant portions of the medical records that would be applicable to the particular case.

  HIPAA in general would be applying to all patients also including those who suffer from HIV/AIDS.  The same level of protection is to be maintained.  However, by practice, may physicians and attorney would like to be extra cautions whilst handling the medical records of the patients that suffer from HIV/AIDS as this is a sensitive issue and the rules of HIPAA would strictly apply.

Part B: Answer each of the following questions in 2 to 5 sentences. Each answer is worth 4 points.1. Compare and contrast contributory negligence with comparative negligence.            In contributory negligence, the fault of negligence caused by the involved party is determined and depending on the amount of negligence caused, they would be made to pay for damages.  In comparative negligence, the involved party who is injured may be able to obtain some of the cost of damages even though they were partially responsible for causing the accident (which has resulted in damages and loses).

2. If HIPAA rules are stricter than state law, which standard should you follow and why? What if the state law was stricter?The federal government sets certain minimum standards which the states need to follow.  The states can select stricter laws requiring maintenance of higher standards depending on the standards or conditions that are existent in the states.  The states are left with the option of maintaining higher standards that may be stricter.  In such a case, the state laws would apply.

  On the other hand, if the state laws are less strict than HIPAA, then HIPAA would apply.3. What is res ipsa losquitur and what does it do?            Res ipsa losquitur is a legal doctrine that means ‘things that speak for itself’.

  The proof of evidence would be clearly speaking for itself.  Res ipsa losquitor is usually utilized in tort case to demonstrate negligence, and further does not need more evidence to be provided.4. Explain the subject matter jurisdiction of federal courts.

            In the US, the subject matter of the federal courts is restricted.  Some of the issues where the federal courts would be hearing include:-Involvements of ambassadors and consulsMilitary or maritime casesCase involving the United StatesAntitrust casesSecurities casesBankruptcy casesPatent and copyright infringementsCases in which the Constitution of the US is at questionAmounts involving damage claims of more than 10000 dollars5. At what point during the course of treatment of a new patient should notice of use and disclosure of health information, required under HIPAA, be given and why?            The patient should be informed of any treatment procedure well in advance so that they can make a decision and give consent for the treatment.  Before starting any treatment, the health professional needs to give the patient information of the risks, benefits, details, and viable options available that could be utilized to treat a particular patient.

  The patient should be able to make a valid decision.  This process is based on the need to provide greater amount of autonomy to the patients. 

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