Clinical guidelines can enter the legal arena in two ways. Legislators can use them to help regulate clinical activities, and courts can use them to resolve civil disputes alleging medical negligence. This chapter examines how clinical codes and guidelines interact with legislation (legal law). In Europe and the United States, legislative law has played an important role in these developments. In the United Kingdom, the increased use of professional self-regulatory mechanisms has meant that legislation in this area is still relatively scarce, although the situation is beginning to change. The formulation and implementation of law-based clinical guidelines has probably reached a higher level of development and maturity in the United States than in Europe. The breadth of U.S. legislation in this area is illustrated by three different initiatives. The three separate initiatives are the peer review bodies, the Agency for Health Policy and Research, and the Maine 5-Year Medical Demonstration Project. Public laws may enact new powers or amend existing laws. If you want to see all the powers enacted or changed by law, look at public law. If you want to see the most recent version of a particular legal authority, including changes made by subsequent public laws, you should consult the United States Code for that topic. The many types of legal instruments in the United States are a product of this three-sectoral system.
The types of legal and policy instruments discussed on this website generally originate from the legislative and executive branches. Learn more about specific guidelines for these organizations: The proliferation of clinical guidelines has raised a number of concerns about the status of clinical advice statements. Are the guidelines advisory or mandatory? What regulatory functions do the guidelines fulfil? Do they allow clinical discretion to play a sufficiently important role? It explains the relationship between legislation and guidelines, as well as how courts determine the legal status of guidelines. The following issues are addressed in the context of negligence law. Are physicians who deviate from the guidelines at increased risk of liability for negligence if patients are injured as a result? Could compliance protect health workers from liability in such circumstances? What is the legal liability of guideline developers and publishers if their guidelines turn out to be wrong? Common law cases with clinical guidelines or protocols were identified from the Lexis database, which searches for the full text of protocols and reports from court cases in the United Kingdom, Commonwealth and United States. Secondary literature from the University of Aberdeen Department of Health Services Research Clinical Guidelines Bibliography (compiled by DHSS-DATA, Embase, Grateful Med, Medline and SIGLE) was also searched. The legal status of a guideline depends on whether its development and application are enshrined in law and whether the guideline embodies clinical practices that are accepted as appropriate by a responsible medical panel. The mandatory impact of the guidelines can be measured to some extent by the penalties imposed for non-compliance. U.S. courts have ruled that guideline developers can be held liable for erroneous guidelines and that physicians cannot absolve themselves of responsibility by claiming that adherence to the guidelines impaired clinical judgment.
Protocols and guidelines provide courts with examples of clinical standards in a wide range of medical practices. As policies multiply, they are increasingly being used in court. However, adherence to the guidelines has not automatically been equated with reasonable practice, and it is unlikely that courts will follow the standards set out in clinical guidelines without critically assessing their authority, flexibility and scope. The most discussed types of legal instruments are laws and regulations. Laws are passed by both branches of Congress and signed by the president. Laws set requirements or prohibitions. Regulations are published by executive authorities to clarify their interpretation of a law and the implementation of a law. Regulations also contain requirements or prohibitions. One way to learn about federal laws and regulations is through the federal agencies responsible for administering them. In the following list, you will find links to agency pages on popular legal topics. When there is no federal law, websites offer compilations of state laws on a topic. [1] To be clear, the term “practice statement” does not include decisions, orders or other documents issued in the course of legal proceedings that do not purport to bind anyone beyond the parties to the decision.
Nor does it contain documents informing the public about the Authority`s enforcement priorities or the factors that the Authority takes into account in exercising its discretion with respect to the Crown. It also does not include internal guidelines, memoranda, legal and policy monographs, or training materials for agency employees to inform them of the performance of their duties, positions taken by an agency in litigation, or departmental legal advice. The Occupational Safety and Health Administration (OSHA) is part of the U.S. Department of Labor. It deals with environmental issues in the workplace. This includes the presence or handling of toxic chemicals and fumes. Research recent Supreme Court decisions. Or learn about landmark Supreme Court decisions by topic. A state legislature may remove its governor and other state officials.
Many local governments also have impeachment proceedings. Agencies generally consolidate their offices under the Privacy Act and the Access to Information Act (FOIA). If you are writing, direct your request to the agency or program`s FOIA/Privacy Act officer and indicate in your letter that it is a request under the Privacy Act. If you are a U.S. citizen or permanent resident, the Privacy Act gives you the right to inspect and correct the information the government holds about you. There are many other types of policy documents issued by the U.S. government, from presidential memorandums to agency guides and policy statements.