Key Takeaways
- Medical assistants work under the direct supervision of a licensed physician and must stay within their scope of practice
- Informed consent requires explaining the procedure, risks, benefits, alternatives, and right to refuse before treatment
- The four Ds of medical malpractice are: Duty, Dereliction (breach), Direct cause, and Damages
- Respondeat superior ("let the master answer") means the employer is legally responsible for employees' actions within their scope
- OSHA sets workplace safety standards; non-compliance can result in fines and legal action
- The Patient Bill of Rights includes the right to informed consent, privacy, refusal of treatment, and access to medical records
- Advance directives include living wills and durable power of attorney for healthcare (DPOA-HC)
- Mandatory reporting requirements include suspected child/elder abuse, communicable diseases, and certain injuries (gunshot wounds, stab wounds)
- The AMA Code of Ethics and AMT Standards of Practice guide professional conduct for medical assistants
Medical Law & Ethics
Medical law and ethics questions on the RMA exam test your understanding of legal principles, scope of practice, patient rights, and ethical standards that govern medical assistant practice.
Scope of Practice
Medical assistants perform tasks under the direct supervision of a licensed physician. Understanding what you CAN and CANNOT do is critical:
Medical Assistants CAN:
- Take vital signs and patient histories
- Perform clinical procedures as directed (injections, phlebotomy, ECGs)
- Prepare patients for examinations
- Administer medications as ordered by the physician
- Process insurance claims and medical records
- Educate patients using physician-approved materials
- Perform CLIA-waived laboratory tests
Medical Assistants CANNOT:
- Diagnose conditions or diseases
- Prescribe medications or treatments
- Interpret test results for patients (relay results as directed by physician)
- Practice independently without physician supervision
- Perform procedures outside of training and state regulations
Medical Malpractice: The 4 Ds
For a malpractice claim to succeed, ALL FOUR elements must be proven:
| Element | Definition | Example |
|---|---|---|
| Duty | A physician-patient relationship existed | Patient had an appointment at the practice |
| Dereliction (Breach) | The standard of care was violated | MA administered wrong dose of medication |
| Direct Cause | The breach directly caused the injury | The wrong dose caused an adverse reaction |
| Damages | The patient suffered actual harm | Patient required hospitalization due to the reaction |
Key Legal Concepts
| Concept | Definition |
|---|---|
| Respondeat superior | "Let the master answer" -- employer is liable for employee's actions within scope of employment |
| Res ipsa loquitur | "The thing speaks for itself" -- negligence is obvious (e.g., surgical sponge left in patient) |
| Standard of care | The level of care a reasonably competent healthcare provider would deliver in similar circumstances |
| Statute of limitations | Time limit for filing a malpractice lawsuit (varies by state, typically 1-3 years) |
| Informed consent | Legal requirement to explain procedure, risks, benefits, alternatives, and right to refuse |
| Implied consent | Patient's actions indicate consent (e.g., rolling up sleeve for blood draw) |
| Express consent | Written or verbal agreement to treatment |
| Assault | Threatening to harm a patient (verbal or physical threat) |
| Battery | Touching a patient without consent or exceeding the scope of consent |
| Abandonment | Terminating the physician-patient relationship without proper notice and transfer of care |
Informed Consent Requirements
For consent to be legally valid, the patient must be informed of:
- Nature of the procedure: What will be done
- Risks: Potential complications and side effects
- Benefits: Expected outcomes
- Alternatives: Other treatment options available (including no treatment)
- Right to refuse: Patient can decline without penalty
- Opportunity for questions: Patient must have time to ask questions
Who obtains informed consent? The physician obtains informed consent, NOT the medical assistant. The MA may witness the signature and verify the form is completed, but the physician is responsible for the discussion with the patient.
Advance Directives
| Type | Description |
|---|---|
| Living will | Written document stating the patient's wishes for medical treatment if they become incapacitated |
| Durable Power of Attorney for Healthcare (DPOA-HC) | Designates another person to make medical decisions if the patient cannot |
| Do Not Resuscitate (DNR) | Orders that CPR should NOT be performed if the patient's heart stops |
| POLST/MOLST | Physician/Medical Orders for Life-Sustaining Treatment; specific medical orders |
Mandatory Reporting
Medical assistants and other healthcare workers are mandated reporters required by law to report:
- Suspected child abuse or neglect
- Suspected elder abuse or neglect
- Communicable/infectious diseases (HIV, TB, hepatitis, STIs -- varies by state)
- Gunshot wounds and stab wounds
- Dog bites and animal bites
- Births and deaths
- Workplace injuries (workers' compensation)
The legal doctrine of respondeat superior means:
Who is legally responsible for obtaining informed consent from a patient before a procedure?
Which of the following would a medical assistant be required to report as a mandated reporter?
The four elements required to prove medical malpractice (the "4 Ds") are:
Which of the following are components of legally valid informed consent? (Select all that apply)
Select all that apply
Match each legal term with its correct definition.
Match each item on the left with the correct item on the right