d. Values in an Age of Litigation. Values take on added importance in an age
when lawsuits for incompetence and malpractice are more and more frequent. There
was a time when health care professionals were considered ethical by the very nature
of their station and duty. Now the ethical (and technical) appropriateness of your health
care actions can more easily have legal consequences. In the civilian world,
radiographers can be named in lawsuits (along with other health care providers and the
hospital itself) if their actions contribute to injuries suffered by a patient. It is, generally,
the malpractice insurance of the responsible party (physician, nurse, and/or hospital)
that ends up paying if damages are awarded by the court. There is, however, a trend
toward increased direct responsibility for the x-ray technologist. In New York State, for
example, radiographers are now required to carry malpractice insurance.
e. Gonzales Act. The legal situation for military health providers is slightly
different than that of their civilian counterparts. The Gonzales Act (10 USC 1089-1976)
protects military health care professionals performing their duties in a Federal medical
treatment facility (MTF) in the Continental United States (CONUS) from being sued
directly. The exclusive remedy for damages from negligent acts of military health care
providers (acting within the scope of duty or employment) is against the United States
(US). Government. This means that the US Government is named in the suit and the
individual health provider does not suffer individual pecuniary liability.
(1) However, military health providers working overseas can be sued; in
which case, the Department of Justice defends them and/or provides suitable
insurance. So, even military radiographers may be named in a lawsuit, in some
settings.
(2) Health care providers must be cognizant of the fact that their health care
decisions may have legal repercussions, which can result a range of adverse actions.
Even if a provider is not named in a suit and is not required to pay damages, providers
can be subject to administrative sanctions, depending on the nature of the misaction.
The US Government can, for example, issue a report to the state licensing board
recommending removal of a license. Sanctions may include: adverse comments on an
officer evaluation report (OER), a Noncommissioned Officer Evaluation Report
(NCOER), a military occupational specialty (MOS) reclassification (enlisted), or a report
to the accrediting or licensing agency (with possible loss of license). So, health care
actions can have administrative and/or legal implications for the health care provider,
the rest of the health care team, the hospital, and/or the US Government.
f. The Importance of Values in Health Care.
(1) Ultimately, what you do as a health care provider reflects your basic
ideas of right and wrong, your personal and professional values. We tend to think that
the technology component (the sophistication of the machines and technical expertise
of the health care providers) plays the greatest role in health care. (Interestingly
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