Legal, Ethical, and Professional Standards
Rights, Duties, and Boundaries
Legal and ethical practice rests on confidentiality, consent, competence, and scope of practice. HIPAA governs protected health information: use and disclose only as permitted, apply the minimum-necessary standard, and report breaches. Informed consent requires capacity, disclosure, understanding, and voluntariness; the provider obtains it, while the assistant may witness and document. Negligence requires duty, breach, causation, and damages; malpractice is professional negligence.
Concepts to Master
- Scope of practice: perform only what your training, state law, and employer policy allow.
- Mandatory reporting: suspected abuse, certain communicable diseases, and unsafe conditions per law.
- Advance directives and patient rights, including refusal of treatment.
- Fraud and abuse: false claims, kickbacks, and improper billing are prohibited.
- Professional boundaries: no personal relationships, no social media disclosure, no accepting inappropriate gifts.
Traps
The exam tests who may disclose information and under what authority. A subpoena is not automatically sufficient; verify with the provider or legal counsel. Minors and emancipated minors have specific rules. Do not discuss patients in public areas or online. Never sign a provider’s name or alter a record. When an action is outside your scope, stop and refer.
Worked Example
A caller identifying as a spouse demands a patient’s test results. Without the patient’s authorization or a legal exception, do not disclose. Verify identity, explain the policy, and offer to obtain authorization. Rule of thumb: “when in doubt, protect the record - verify authority, disclose the minimum, and document.”