What Can Be Done About A Disruptive Physician? A Legal Analysis

House, a medical drama about an infectious disease specialist, entertained television audiences for years as the irascible and pill-popping physician solved medical mysteries with the zeal of a modern-day Sherlock Holmes while playing mind games with his coworkers. Uncanny intuition and eccentric thinking earned the physician great respect but his bullish behavior and antisocial tendencies were a distraction at the hospital. Not only did Dr. House clash with his fellow physicians but he also insulted patients, flouted hospital rules and caused great conflict with the hospital administrators. In fact, his actions often crossed the line into obnoxiousness and rage causing the hospital staff to tiptoe around his dysfunctional behavior. In the real world, Dr. House would be labeled a “disruptive physician” and would be subjected to disciplinary action including the loss of his hospital privileges. This article will explore the problems caused by being labeled a disruptive physician in a legal context with a focus on the peer review process and the relevant court cases

The Ever-Changing Landscape of Informed Consent and Whether the Obligation to Explain a Procedure to the Patient May Be Delegated

Informed consent is an integral part of the shared decision making process and requires a patient be informed of the benefits, risks and alternatives to a medical procedure. This information, which requirement has been codified into the law and practice of every healthcare provider, helps a patient decide whether to proceed with the recommended treatment plan. Informed consent has its foundation in the ethical notion of patient autonomy and fundamental human rights. After all, it is the patient’s decision to determine what may be done to his or her body and to ascertain the risks and benefits before undertaking a procedure. On the other hand, a physician’s role is to act as a facilitator in the patient’s decision making process by providing information about the planned treatment and to answer questions. While the roles of the patient and physician seem clearly defined, a number of barriers present challenges in creating a process that guarantees a patient understands a test or procedure. This includes ineffective communication between the doctor and patient. The first part of this article will explore the liability of various health care providers who participate in the informed consent process, such as the physician, nurse, physician assistant and hospital. The second section will examine whether the treating physician may delegate the duty to explain the risks and alternatives of a procedure to another. The controversial decision of Shinal v. Toms, which mandates that the doctor must have a one-on–one exchange with the patient in order to secure a valid informed consent, will also be explored. This recent ruling has sent shock waves throughout the medical community causing a reexamination of their informed consent policies

Uranium and Associated Heavy Metals in Ovis aries in a Mining Impacted Area in Northwestern New Mexico.

The objective of this study was to determine uranium (U) and other heavy metal (HM) concentrations (As, Cd, Pb, Mo, and Se) in tissue samples collected from sheep (Ovis aries), the primary meat staple on the Navajo reservation in northwestern New Mexico. The study setting was a prime target of U mining, where more than 1100 unreclaimed abandoned U mines and structures remain. The forage and water sources for the sheep in this study were located within 3.2 km of abandoned U mines and structures. Tissue samples from sheep (n = 3), their local forage grasses (n = 24), soil (n = 24), and drinking water (n = 14) sources were collected. The samples were analyzed using Inductively Coupled Plasma-Mass Spectrometry. Results: In general, HMs concentrated more in the roots of forage compared to the above ground parts. The sheep forage samples fell below the National Research Council maximum tolerable concentration (5 mg/kg). The bioaccumulation factor ratio was >1 in several forage samples, ranging from 1.12 to 16.86 for Mo, Cd, and Se. The study findings showed that the concentrations of HMs were greatest in the liver and kidneys. Of the calculated human intake, Se Reference Dietary Intake and Mo Recommended Dietary Allowance were exceeded, but the tolerable upper limits for both were not exceeded. Food intake recommendations informed by research are needed for individuals especially those that may be more sensitive to HMs. Further study with larger sample sizes is needed to explore other impacted communities across the reservation

Is the Use of Artificial Intelligence in Alternative Dispute Resolution a Viable Option or Wishful Thinking?

This article delves into the evolving relationship between artificial intelligence (AI) and the legal profession, particularly in the context of alternative dispute resolution (ADR). The introduction sets the stage by highlighting AI\u27s transformative potential in reshaping legal practice through automation, efficiency, and data-driven insights. While acknowledging the uncertainty surrounding AI\u27s long-term impact on the legal landscape, it emphasizes the need for investigation and adaptation as the technology evolves. Key considerations, such as AI technology\u27s limitations, regulatory challenges, and ethical implications, are also addressed. Despite the promises of efficiency and accessibility, questions remain about AI\u27s ability to replicate human reasoning and navigate complex legal nuances. Moreover, legal and ethical concerns, such as privacy, confidentiality, and liability, underscore the need for careful evaluation and oversight in AI-driven dispute resolution

Should a Physician Apologize for a Medical Mistake? – The Controversy Over the Effectiveness of Apology Law Statutes

There are two approaches that health care providers can pursue in handling a medical error. Is it better for a physician not to admit a mistake and aggressively defend the claim or apologize and try to amicably resolve the matter? There has been a growing movement for physicians to offer words of sympathy or to apologize for a medical mistake as a way of minimizing the impact of a medical error and reducing the chances of a malpractice claim. There are a number of benefits to this approach but critics maintain that an apology is a useless gesture with an unproven track record and merely a way of obtaining tort reform in disguise. This Article explores this controversy, the enactment and criticisms of apology laws designed to encourage physicians to talk to patients about medical mistakes, and examines how the courts have responded to whether expressions of sympathy and fault are admissible in court without constituting an admission of liability

The Liability of Health Care Providers to Third Parties Injured by a Patient

Duty of care is a critical component of any negligence claim necessary to establish liability. It is well recognized at common law that a physician owes a duty to advise a patient but is not mandated to take affirmative measures outside the physician-patient relationship to protect a third-party. Health care providers may also be responsible for oversight, or the failure to safeguard a patient, due to a special relationship they undertake, such as failing to properly diagnose or recommend an appropriate treatment plan. Recently, the courts have struggled over whether public policy and fairness require the expansion of the law to impose liability upon health care providers for injuries sustained by third parties caused by patients in motor vehicle accidents. Various theories are advanced to establish liability, such as the physician being negligent by violating a statute created to protect the public through negligence per se, establishing prima facie negligence, or offering evidence of carelessness. A clear court consensus has failed to emerge whether the common law should be expanded in favor of responsibility. This article will provide a brief history of the efforts to enlarge physician liability to third parties. It will then focus on the cases that have arisen against physicians by a third party injured in a motor vehicle accident related to a patient’s medical condition or medication side-effects. This is a dilemma confronting the courts on a regular basis

Revolutionizing Justice: Unleashing the Power of Artificial Intelligence

The practice of law is changing, and most lawyers are unprepared for this metamorphosis. This statement is not an exaggeration but the acknowledgment that artificial intelligence (“AI”) has altered the way lawyers do business. Instead of having a “battle of forms,” attorneys will now be confronted with the “battle of computers.” Linking artificial intelligence and the law, however, is a natural progression. Both operate in similar fashions: each examines and applies “historical examples in order to infer rules to apply to new situations.” While many attorneys are unsure how to integrate this new technology into their practices, they already use some form of AI without knowing it. Conducting a Google search for opposing counsel or experts are examples of the use of artificial intelligence. The same is true for using Westlaw or Lexis to retrieve a case on a particular point of law. Similarly, accessing a court’s website to look up a docket requires the use of computer learning. These examples are simple applications, but artificial intelligence continues to evolve. New uses allow attorneys to employ AI to write contracts and to use natural language to obtain answers about a point of law. This evolution makes it essential for attorneys to ascertain what data is obtainable and how to utilize that material in representing a client. This article will provide a primer on how AI transforms the legal arena. Following an explanation of how the technology operates, various examples will be provided on how machine learning can benefit attorneys, from contract drafting to improving client relations. The ethical and legal issues presented by AI will also be explored