Reporting health care professionals to state licensing boards--VA. Final rule

It continues to be the policy of the Department of Veterans Affairs (VA) to report to State Licensing Boards any separated physician, dentist, or other licensed health care professional whose clinical practice so significantly failed to meet generally accepted standards of clinical practice as to raise reasonable concern for the safety of patients. This document provides that, in addition, VA will report to State Licensing Boards any currently employed physician, dentist, or other licensed health care professional (one who is on VA rolls) whose clinical practice so significantly failed to meet generally accepted standards of clinical practice during VA employment as to raise reasonable concern for the safety of patients. Some health care professionals who are VA employees also provide health care outside VA's jurisdiction. Accordingly, the reporting of currently employed licensed health care professionals who meet the standard for reporting is necessary so that State Licensing Boards can take action as appropriate to protect the public. Examples of actions that meet the criteria for reporting are set forth in the text portion of this rulemaking. Also, nonsubstantive changes are made for purposes of clarity.     

个人健康医疗信息和隐私权保护

Personal health care and medical treatment information are both personal information which can be used as a sign to identify each individual. Such information shall be under the control of the owner. The comprehensiveness of personal health care and medical treatment information makes it more valuable than the simplex personal information. The controlling right of personal health care and medical treatment information is irretrievable once deprived. The rights of controlling, managing and using regarding personal health care and medical treatment information can be separated appropriately. The right of privacy is an independent personality right. For the protection of public interests, the right of personal privacy shall be appropriately limited. Meanwhile, the government shall be responsible for the protection of personal health care and medical treatment information. Tang Xiaotian is a professor and supervisor in charge of the development and planning division of Shanghai University of Political Science and Law, and deputy General Secretary-in-chief of the Society of Law of Shanghai, whose main studies is focused on victim science, criminal law and criminology. Till now, he has 8 monographs and over 90 articles published in academic journals.     

Stress,coping, and psychological well‐being among forensic health care professionals

Purpose. Although forensic services are often regarded as highly stressful environments, there has been a surprising lack of research into the phenomena of occupational stress among forensic health care professionals (FHCP) in the United Kingdom. This study investigated stress, coping, and psychological well‐being among FHCP employed within inpatient settings. Methods. One hundred and thirty‐five FHCP were recruited from four Medium Secure Units in the United Kingdom. A postal research pack was used to collect background information and measures of psychological well‐being, burnout, occupational stress, work satisfaction, and coping. Results. The study found that a substantial proportion of FHCP experienced elevated levels of occupational stress and psychological distress, while moderate levels of burnout were demonstrated in terms of emotional exhaustion, depersonalization, and reduced personal accomplishment. The findings confirmed that FHCP utilized a range of problem‐focused (e.g., positive), emotion‐focused (e.g., religious, negative, and supported), and palliative coping strategies (e.g., excessive smoking and drinking). Conclusions. The results appeared to support the commonly held assertion that forensic services are an inherently stressful and dangerous working environment, which can cause FHCP to experience marked levels of psychological distress, burnout, and occupational stress.     

Special report on medical staff relationships. Handling "impaired" health care professionals

Applying the doctrine of corporate negligence, courts will, in appropriate circumstances, deem hospitals and other institutional health care providers responsible for the quality of patient care in their institutions and for the consequences of negligent physician performance that could have been discovered and prevented. See, e.g., Darling v. Charleston Community Memorial Hosp., 33 Ill. 2d 326 (1965), cert, denied, 383 U.S. 946 (1966); Johnson v. Misericordia Community Hosp., 99 Wis. 2d 709 (1981); Elam v. College Park Hosp., 132 Cal. App. 3d 332 (1982). In such a climate, and with Data Bank reporting now a reality, neither institutional providers nor health care professionals on their medical staffs can afford to ignore problems of practitioner impairment. Recognizing this reality, some state laws now mandate an organized approach--such as the establishment of an impaired practitioners committee--to problems of professional impairment. However, whether state-mandated or not, providers must have policies and procedures in place to insure not only that impaired professionals are referred to available treatment programs, but that they fully participate in and complete such programs, and achieve rehabilitation, before they return to practice at the institution. The earlier detection and treatment are initiated, preferably before peer review action becomes necessary, the better for patients, institutions, and practitioners themselves.     

Medical: informed consent--designate health care professionals to obtain informed consent. Final rule

This document amends U.S. Department of Veterans Affairs (VA) medical regulations on informed consent. The final rule authorizes VA to designate additional categories of health care professionals to obtain the informed consent of patients or their surrogates for clinical treatment and procedures and to sign the consent form.     

Mental health professionals in forensic arenas

The authors discuss a variety of forensic matters using cases in which they have been involved as experts. Pertinent issues are illustrated in cases in which the offender is charged with homicide. The need for a comprehensive evaluation, the importance of corroboration of the offender's statements, and the value of preparing a thorough report are discussed.     

Regulation for the enforcement of federal health care provider conscience protection laws. Final rule

The Department of Health and Human Services issues this final rule which provides that enforcement of the federal statutory health care provider conscience protections will be handled by the Department's Office for Civil Rights, in conjunction with the Department's funding components. This Final Rule rescinds, in part, and revises, the December 19, 2008 Final Rule entitled "Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law" (the "2008 Final Rule"). Neither the 2008 final rule, nor this final rule, alters the statutory protections for individuals and health care entities under the federal health care provider conscience protection statutes, including the Church Amendments, Section 245 of the Public Health Service Act, and the Weldon Amendment. These federal statutory health care provider conscience protections remain in effect.     

Application of the strict liability doctrine to hospitals and other health care providers

The legislation and cases discussed above reflect the fact that if hospitals and other health care providers were not excluded from application of the doctrine of strict liability in connection with the equipment and supplies they furnished to physicians and patients, they would be forced to perform what is in essence an insurance function for patients and physicians. This would ultimately serve to increase health care delivery costs and potentially discourage the use of innovative drugs and equipment that carry with them inherent, but tolerable risks.     

Access to health care and equal protection of the law: the need for a new heightened scrutiny

Proposals to reduce national expenditures for health care under Medicare and other programs raise questions about the limits on legislative power to distribute health care benefits. The constitutional guarantee of equal protection has been a weak source of protection for the sick, largely because they fail to qualify for special scrutiny under traditional equal protection analysis. Recent decisions of the United States Supreme Court suggest that the Justices seek a newer, more flexible approach to reviewing claims of unequal protection. This Article examines the application of the equal protection guarantee to health-related claims. It argues that traditional equal protection analysis is too rigid and newer rationality review too imprecise to provide just eligibility determinations. The Article concludes that courts should subject claims of unequal protection in the health care context to heightened scrutiny, as health care plays a special role in assuring equality of opportunity.