NHA Unit 13 | Medical Law & Ethics
Bell Work 1:
Scenario: The Concerned Husband
You are working at the front desk of a medical clinic. A patient's husband calls and asks for the results of his wife's recent blood tests. He tells you, "I'm her husband. I have a right to know what's going on with her health!"
You check the patient's chart and find no documentation authorizing you to release information to him.
Questions:
1. Which healthcare law applies to this situation?
2. Should you provide the husband with the test results? Explain your answer.
3. What would be an appropriate response to the husband?
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NHA Unit 13 | Medical Law & Ethics
Bell Work 2:
Scenario: The Confused Patient
A 67-year-old patient is scheduled for a minor surgical procedure. The provider has explained the procedure, but the patient tells you, "I don't really understand what they're going to do, but I guess I'll sign the paperwork."
The provider has already left the examination room.
Questions:
1. What type of consent is required before the procedure?
2. Has the patient demonstrated informed consent? Why or why not?
3. What should the medical assistant do before allowing the procedure to continue?
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NHA Unit 13 | Medical Law & Ethics
Bell Work 3:
Scenario: The Patient Who Refuses Treatment
A 45-year-old patient has been diagnosed with a serious infection. The provider recommends treatment, but the patient refuses because of personal beliefs.
A medical assistant tells the patient, "You're making a terrible decision. You need to do what the doctor says!"
Questions:
1.Which ethical principle gives the patient the right to refuse treatment?
2.Was the medical assistant's response appropriate? Explain.
3.How can healthcare professionals respect the patient's decision while still promoting their health and safety?
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NHA Unit 13 | Medical Law & Ethics
Theory of Action: NHA Unit 13 – Medical Law & Ethics
If students receive direct instruction on medical laws, patient rights, informed consent, professional responsibilities, and ethical principles, and participate in structured Think-Pair-Share activities using realistic healthcare scenarios, then students will develop the critical-thinking and decision-making skills necessary to recognize legal and ethical issues, protect patient rights, and respond appropriately in clinical situations.
This will lead to improved student understanding of medical law and ethics, increased classroom engagement, and greater readiness to apply professional standards in healthcare settings and on the NHA CCMA certification exam.
Instructional Strategies
Direct Instruction: Teacher-led slides and answers to student note-catcher questions.
Active Learning: Three Think-Pair-Share scenarios encourage discussion, collaboration, and clinical reasoning.
Formative Assessment: Student responses and class discussions
Real-World Application: Students connect healthcare laws and ethical principles to situations they may encounter
Measurable Student Outcome
By the end of the lesson, at least 80% of students will demonstrate proficiency in identifying medical laws, explaining ethical principles, and selecting appropriate actions in patient-care scenarios, as measured through completed note catchers, scenario responses, and an exit ticket.
Instructional Focus: Moving students beyond memorizing healthcare laws to applying those laws when making safe, ethical, patient-centered decisions.
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Patient's Bill of Rights
The American Hospital Association introduced A Patient's Bill of Rights in 1973; it was revised in 1992 and replaced by The Patient Care Partnership in 2003.
The historic AHA bill of rights is commonly presented as 12 patient rights, though counts differ among versions and organizations.
Core ideas: respectful care, information about care, informed decisions, privacy, confidentiality, access to records, continuity of care, and a process for concerns.
The note catcher does not identify a particular version; verify the expected count against the assigned NHA lesson.
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Laws & Regulations • Part 1
Patient Protection & Affordable Care Act (ACA): expanded health coverage and consumer protections.
HIPAA: privacy, security, and permissible use/disclosure of protected health information.
HITECH: promotes electronic health records and strengthens health information privacy/security enforcement.
OSHA: workplace health and safety requirements, including bloodborne-pathogen protections.
Controlled Substances Act (CSA): regulates manufacture, distribution, and dispensing of controlled substances.
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Laws & Regulations • Part 2
EMTALA: requires emergency screening and stabilizing care or appropriate transfer at covered hospitals.
CLIA: federal quality standards for laboratory testing on human specimens.
Title VII of the Civil Rights Act of 1964: prohibits employment discrimination based on protected characteristics.
ADA: prohibits disability discrimination and requires reasonable accommodations/access where applicable.
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Laws & Regulations • Part 3
HERCA: abbreviation is not defined in the uploaded notes; confirm the intended law before teaching.
Good Samaritan laws: provide limited legal protection for qualifying good-faith emergency assistance; specifics vary by state.
GINA: prohibits certain genetic-information discrimination in health insurance and employment.
PSQIA (Patient Safety and Quality Improvement Act): supports confidential patient-safety reporting and improvement.
AKBS: likely refers to the Anti-Kickback Statute (AKS), which prohibits certain payments for referrals involving federal health programs.
NSA (No Surprises Act): protects many patients from specified unexpected out-of-network bills.
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Why These Laws Matter
Protect patient safety, privacy, access, and informed decision-making.
Reduce discrimination, fraud, improper referrals, and preventable harm.
Set standards for healthcare workers, facilities, laboratories, and insurers.
Provide mechanisms for accountability, reporting, and enforcement.
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PAUSE • THINK–PAIR–SHARE: Privacy at the Front Desk - 1
SCENARIO: A caller says they are a patient's spouse and demands the patient's test results. The chart does not show permission to disclose.
THINK (1 min): What privacy concern exists?
PAIR (2 min): What should the medical assistant say or do?
SHARE (2 min): What is the safest response and why?
If students receive direct instruction and participate in structured Think-Pair-Share activities, then students will develop the critical-thinking and decision-making skills.
This will lead to improved student understanding of medical law.
CLASSROOM DISCUSSION • 5 MINUTES | 7
Sharing Information & Release of Information
Protected health information is shared only as HIPAA permits or with a valid authorization when required.
HIPAA generally permits disclosures for treatment, payment, and healthcare operations without patient authorization, subject to applicable rules.
Other permitted/required disclosures may include public-health reporting, reporting certain abuse, court/legal processes, and serious-threat situations, when legal conditions are met.
Use minimum necessary information where that standard applies; verify identity and follow facility policy.
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Consent: Informed, Implied & Expressed
Informed consent: a patient receives and understands relevant risks, benefits, alternatives, and can voluntarily decide.
Implied consent: inferred from a patient's actions or the circumstances, such as extending an arm for routine blood pressure measurement.
Expressed (express) consent: clearly stated orally or in writing.
Consent must come from a person legally authorized to give it; the MA supports the process but does not independently obtain procedural consent outside policy/scope.
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Advance Directives, Minors & Living Wills
Advance directives: documents stating healthcare wishes or identifying a decision-maker if the patient loses decision-making capacity.
Living will: describes preferences for certain medical treatments in specified circumstances.
Minors: consent is usually provided by a parent/guardian, but exceptions may apply for emergencies, emancipation, and certain confidential services.
Minor's age: generally under 18 in many states, including Tennessee; specific consent exceptions depend on state law and service.
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Healthcare Power of Attorney, DNR & POLST
Healthcare power of attorney: appoints an agent to make healthcare decisions when authorized by the document and applicable law.
Without a named agent, state surrogate laws may prioritize spouse, adult children, parents, siblings, or other qualified persons; exact order varies.
DNR (Do Not Resuscitate): medical order not to perform CPR when breathing or heartbeat stops; it does not mean 'do not treat.'
POLST: portable medical orders documenting treatment preferences for eligible seriously ill/frail patients; naming and availability vary by state.
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Criminal Law, Civil Law & Torts
Criminal law: addresses offenses against society prosecuted by government (e.g., theft or assault).
Civil law: resolves disputes involving rights, duties, and compensation.
Tort: civil wrong that causes injury or loss.
Intentional tort: deliberate wrongful act, such as assault, battery, or false imprisonment.
Malpractice: professional negligence by a healthcare professional.
Negligence: failure to use reasonable care, resulting in legally recognized harm when required elements are met.
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PAUSE • THINK–PAIR–SHARE: Consent and Professional Boundaries - 2
SCENARIO: A 16-year-old arrives alone requesting care. The medical assistant assumes every minor needs a parent to consent.
THINK (1 min): What information is missing?
PAIR (2 min): How should the MA handle consent without guessing the law?
SHARE (2 min): What can the MA do immediately while protecting the patient's privacy?
If students receive direct instruction and participate in structured Think-Pair-Share activities, then students will develop the critical-thinking and decision-making skills.
This will lead to improved student understanding of medical law.
CLASSROOM DISCUSSION • 5 MINUTES | 13
Mandated Reporting & Abuse
Mandated reporting: legal duty for designated people to report suspected abuse, neglect, or other specified events to the proper authority.
Examples may include suspected child abuse, abuse of vulnerable adults, and certain injuries or communicable diseases, depending on jurisdiction.
Physical abuse: bodily harm or injury.
Verbal/emotional abuse: insults, threats, humiliation, or intimidation.
Psychological abuse: coercive behavior that harms mental well-being.
Sexual abuse: nonconsensual sexual contact or exploitation.
Economic abuse: misuse or control of another person's financial resources.
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Recognizing & Reporting Abuse
Children: unexplained injuries, injuries inconsistent with history, fearful behavior, poor hygiene, or concerning caregiver interactions.
Older adults: unexplained bruises, neglect, sudden financial changes, withdrawal, fear of caregiver, or unsafe living conditions.
Reporting duties vary by state and professional role; clinicians, teachers, social workers, and other designated reporters may be included.
Document objective observations, follow reporting laws/policy, and do not investigate independently or promise secrecy.
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Four Ethical Principles
Autonomy: respect a capable patient's right to make informed decisions.
Justice: treat people fairly and distribute care/resources equitably.
Beneficence: act to benefit the patient.
Nonmaleficence: avoid causing harm; 'Do No Harm' refers to nonmaleficence.
Ethical decisions may require balancing several principles at once.
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PAUSE • THINK–PAIR–SHARE: Ethics Under Pressure - 3
SCENARIO: A patient declines a recommended procedure after the provider explains its benefits and risks. A staff member says the patient must be forced to comply.
THINK (1 min): Which ethical principles apply?
PAIR (2 min): What should the medical assistant do and avoid?
SHARE (2 min): How can the team respect autonomy while promoting patient safety?
If students receive direct instruction and participate in structured Think-Pair-Share activities, then students will develop the critical-thinking and decision-making skills.
This will lead to improved student understanding of medical law.
CLASSROOM DISCUSSION • 5 MINUTES | 17
Bias, Cultural Competence & Culture
Bias: a conscious or unconscious preference or prejudice that can affect judgment or treatment.
Cultural competence: ongoing development of skills to communicate and provide respectful care across diverse backgrounds.
Build it through self-reflection, respectful questions, qualified interpreters, and adapting care to individual needs.
Culture includes shared or learned values, customs, language, beliefs, traditions, and behaviors; individuals within a culture are not all alike.
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Unit 13 • Quick Review
1. What does HIPAA protect, and when may information be disclosed?
2. How is informed consent different from implied consent?
3. What is the difference between negligence and malpractice?
4. Which ethical principle means 'Do No Harm'?
5. What should an MA do when abuse is suspected?
6. Why must consent and surrogate rules be checked by state?
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