Hurley vs. Eddingfield. In 1901, the Indiana Supreme Court heard the tragic case of Charlotte Burk [1]. Dr. Eddingfield was Burk`s local general practitioner and family physician, but when Burk suffered complications during childbirth, her husband sent a messenger to Dr. Eddingfield, and Dr. Eddingfield refused to treat Burk [1]. She and her unborn child died. Dr.
Eddingfield was not considered obligated to care for Ms. Burk because „the state does not require and the [medical] licensee does not undertake to practise at all or on terms other than those he can accept“ [1]. The court distinguishes doctors from innkeepers, who are obliged to serve anyone who comes to their door. There is little case law, literature, and legislation on a physician`s legal duty of care during a pandemic.5 Physicians can better understand their duties by becoming familiar with the general legal doctrines and laws developed in non-pandemic cases. For example, physicians working during a pandemic may consider ending their relationship with certain patients. However, an abrupt separation of the doctor-patient relationship could lead to a claim for negligence if it causes harm to the patient that would have been foreseeable by a reasonable physician.3 Courts may be willing to depart from this traditional position. Physicians who work in emergency departments or provide regular emergency services may have a duty of care to people who are not their patients because the public relies on these physicians to provide emergency treatment.7 These physicians may be held liable if they carelessly refuse people who need emergency care during a pandemic. What is considered reckless depends on the circumstances; In assessing liability, the courts will consider what a reasonable physician would have done in these circumstances. If there is a relationship between the patient and the physician, the physician has an ethical and legal obligation to continue care and not to abandon the patient. A summary of abandonment lawsuits postulates that a waiver generally exists when the physician-patient relationship is either (1) terminated at an inappropriate time or (2) without giving the patient time to find a qualified replacement [16].
„Without good reason. If the physician knows, or ought to know, that there is a condition that requires additional medical attention to prevent adverse consequences, the physician must pay attention or arrange for another competent person to do so“ [16]. A doctor should advise the patient and give them time to seek alternative treatment. A physician who fails to do so may be ethically and legally responsible for letting the patient down. In 1990, Nancy Cruzan`s tormented life came to an end. In a persistent vegetative state of a car accident seven years earlier, Cruzan was allowed to die when the U.S. Supreme Court ruled that her parents could order doctors to remove the feeding tube that had kept her alive. The case established a constitutional right to terminate life-sustaining treatment when it was clear that the patient would have wanted such action. From day one, medical students learn that their primary obligation is to patients. But defining who their patients are is another matter. Who qualifies as a patient is a complex legal issue that has major implications for when a physician has a duty to treat, when a physician can be sued for malpractice, when a physician has „left“ a patient, and other serious matters.
The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for more than a century, and many aspects of the issue are still being clarified. This article will examine a number of important legal cases that have helped define the patient-physician relationship in general, as well as some important exceptions to the general rule. The continuing power of attorney for health care (CDP) is designed to take effect immediately, but the officer is not authorized to make decisions on behalf of the patient unless the patient is usually judged by his or her physician to be incapable of knowingly consenting or refusing. In this case, the officer has access to confidential medical records and can make decisions regarding treatment forgiveness, anatomical donations, autopsy and disposal of the patient`s remains. Physicians are required by law to respect the wishes of an officer. Bush S. Doctor-patient relationship formation: The Oregon Court of Appeals clarifies, but questions remain. Medical organizations. 2010;13(2):11-13. www.healthlawyers.org/Members/PracticeGroups/PO/Documents/ Simon RI, Shuman DW.
The doctor-patient relationship. Focus.2007;5:423-431. The physician must disclose all conflicts of interest to all affected individuals and, in the case of a patient with a conflict of interest, refer them to an impartial colleague if possible. A physician serving a rural or isolated community could also be legally prevented from refusing a person who is not his or her patient, at least if the person`s condition is serious and it is impractical to go to another medical facility.3 Physicians in Canada have a legal duty of care to their current patients and, in certain circumstances, towards those who: who are not their patients. The obligation to treat patients in non-emergency situations is ambiguous. Principle VI of the American Medical Association (AMA) Principles of Medical Ethics states that „in providing appropriate patient care, except in emergencies, a physician is free to choose with whom to serve, with whom to work, and in which environment to provide medical care“ [1]. Therefore, outside of EMTALA or a patient-physician relationship, there is no customary duty or ethical imperative that obliges a physician to treat every patient. Although AMA`s Council on Ethics and Judicial Affairs has found it unethical to deny treatment to patients for certain diseases, such as HIV, this decision does not indicate whether physicians are wrong to reject patients without certain conditions or disabilities [2]. Unlike the public defender, the physician faces a moral dilemma: conscience drives him to treat all patients, no matter what, but a convergence of factors in the health care system such as rising medical liability premiums, stagnant reimbursement by commercial insurers, escalating overhead costs, and personal moral beliefs can make it costly to follow one`s conscience. The relationship between patient and physician is different from the relationship between client and public defender. The doctor must receive a huge amount of information about a patient`s personal life and history to ensure effective care.
Trust and honesty are at the heart of the relationship. The public defender does not ask and, in all likelihood, does not care whether his client is guilty or not.
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