Lessons Learned (eBook)

Susan Schmerler is a genetic counselor and supervisor in the Section of Genetics at the Children’s Hospital of St. Joseph's Regional Medical Center, Paterson, New Jersey. Her academic post is as Associate in Pediatrics at the University of Medicine and Dentistry-New Jersey Medical School. She is on the Board of Directors of the National Society of Genetic Counselors, where she serves as Chair of the Education Committee. From 1999 through 2003, she was the Chair of the Credentials Committee of the American board of Genetic Counseling.

Acknowledgements 11
Contents 12
1 Introduction 16
2 Sources of Liability 19
Forms of Legal Complaints 19
Tort Law 19
Fraud 25
Contract Law 26
Legal Initiatives 27
Federal Regulations 28
State Regulations 31
Criminal Complaints 32
Organizational Requirements 34
Private Practice 35
Partnerships 36
Billing 36
Industry/Technology 37
Reproductive Technology 38
Research 38
Human Subjects 39
Gene Transfer 40
Clinical Testing on Research Samples 41
Institutional Review Boards 41
Epidemiology 42
Trainees 42
3 Duty as an Element of a Lawsuit: 45
Duty Element 45
Establishing a Professional Relationship 46
Abandonment 48
Obligations and Duties 48
Standard of Care 49
Specialty Practitioners 50
Good Practice 50
Nongeneticists Providing Genetic Services 56
4 Duty as an Element of a Lawsuit: 60
Test for a Standard 60
Sources for Standards 60
Scope of Practice163 61
Code of Ethics166 61
Professional Organizations 62
Professional Literature 62
Professional Guidelines 63
Credentials 63
Expert Testimony 65
5 Duty as an Element of a Lawsuit: 68
Medical Records 68
Chart Contents 69
Ownership 72
Storage of Medical Records 72
Shadow Charts 73
Failure to Follow Policies and Procedures 73
Informed Consent 74
Confidentiality 81
Improper Techniques 90
Nondirective 90
Nonjudgmental/Value Neutral 91
Transcultural Competency 92
Defenses for the Duty Element 93
6 Breach, Causation and Damages as Elements of a Lawsuit 95
Breach 95
Decision Makers 95
Defense to Breach Element 97
Causation 97
Remote Causation 98
Proximate Cause 98
Informed Consent Cases 99
Defense to the Causation Element 100
Damages 101
General Damages 101
Compensatory Damages 102
Noneconomic Damages 102
Punitive Damages 103
Assessing Damages 103
Defense to the Damage Element 103
7 Defenses to a Lawsuit 104
Helping Yourself 104
Affirmative Defenses to Malpractice Lawsuits 104
Statute of Limitations 105
Contributory Negligence 105
Comparative Negligence 105
Assumption of the Risks 105
Good Samaritan Statute 106
Indemnity or Release 106
Countersuits 106
Malicious Prosecution 106
Abuse of Process 107
Defamation 107
Negligence 107
Intentional Torts 108
8 Communication 110
Face-to-Face 110
Electronic Communication 111
Internet 111
Privacy 114
Transmission of Information 115
Managing Your Malpractice Exposure in Cyberspace 121
9 Conclusions: Lessons Learned 124
Defensive Practice 124
Advice from Experience 125
Appendix 127
Definition of Genetic Counseling 127
1975 127
2006† 127
Scope of Practice 128
The Code of Ethics of the National Society of Genetic Counselors 130
A.4 Suggested Readings 133
Notes 135
Glossary 144
Index 148