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The Effect of the Treatment Setting on the Decision-Making Process: Acute Care Hospitals and Emergency Services

Published online by Cambridge University Press:  29 April 2021

Extract

This paper discusses the obligation of acute care hospitals and emergency services to treat patients. Since care rendered in these settings is, of necessity, provided by health care professionals, not buildings or programs, the obligation may be twofold. First, are there obligations for hospitals and emergency services to offer treatment? Second, do health care professionals practicing in these settings have an independent obligation to treat? How has the Supreme Court decision in Cruzan affected these obligations?

The tradition in this country has been that private hospitals had no obligation to treat patients, as opposed to public hospitals which were frequently set up for the very purpose of treating patients who had no other access to care. Over the years, statutes and case law have limited the rights of private hospitals and physicians to refuse to treat patients.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1991

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References

Cruzan v. Missouri Dept. of Public Health, 110 S. Ct. 2841 (1990).Google Scholar
Section 1317 of the Health and Safety Code of the State of California: Chapter 111, Section 70 (e), Massachusetts Patients and Residents Rights.Google Scholar
For example, Title VII of the Civil Rights Act or 1964 (42 U.S.C. Section 2000(e), et.seq.), the Federal Rehabilitation Act of 1973 (U.S.C. Section 7990, et seq.), the Confidentiality of HIV-related Information Act (Pennsylvania Act 148, 11/29/90, and the Required Policy for Employers Within the City of Philadelphia Regarding Aspects of Transmission of Human Immunodeficiency Virus (Title 9 of Philadelphia Code, Ch. 9–1700).Google Scholar
Omnibus Budget Reconciliation Act of 1990, P.L. 101–508 (November 5, 1990).Google Scholar
Cruzan v. Harmon, 760 S.W. 2d 408 (Mo. en banc 1988).Google Scholar
Id. at 424.Google Scholar
For a competent patient who was able to consent and refused, a subsequent emergency does require consent or court order before the previously refused treatment may be rendered.Google Scholar
The Patient Self Determination Act, which takes effect in December, 1991, requires hospitals that receive Medicare and Medicaid funds to inform all patients of their rights to make health care decisions and of applicable state law, e.g. advance directives living wills, etc.Google Scholar