Healthcare professionals must have a good understanding of the legal system for a variety of reasons. The advanced state of medical technology creates new legal, ethical, moral, and financial problems for the consumer and the healthcare practitioner. Today’s healthcare consumer demands more of a partnership with the physician and the rest of the healthcare team. Patients have become more aware of their legal rights. Court cases and decisions have had a greater impact than ever on the way healthcare professionals practice business in the medical field. It’s important to remember that while laws do protect an individual’s rights, they are made for the protection of society as a whole. Laws tell us how we must conduct ourselves during interactions with other people as well as in business transactions, such as in providing healthcare services.
Every effort should be made to provide a quality of care for patients that will not only help them recover their health but will also avoid lawsuits.
THE LEGAL SYSTEM
To understand the American legal system, it is important to first understand the two fundamental principles on which the U.S. system of government was founded—federalism and checks and balances. A federal form of government is one in which power is divided between a central government and smaller regional governments. The Constitution of the United States, which was drafted in Philadelphia in 1787, established a federal form of government, giving a limited and enumerated power to the central government (i.e., the federal government). All powers that have not been specifically delegated to the federal government by the Constitution are retained by the states.
The U.S. legal system has one federal legal system and fifty separate and unique state systems. For example, the federal government administers the U.S. Tax Court and the U.S. Bankruptcy Court. The state governments administer such courts as traffic and small claims courts. State governments also administer medical licensing acts. The majority of criminal cases originate in state courts. Most states have at least three court levels: trial, appellate, and supreme. The jurisdiction of a particular court refers to the subject matter of a particular case, territory the case occurred in, or people that a court has lawful authority over. An appellate court has the authority to review a decision made by a lower court, such as the trial court.
The court system is only one part of the government, however. In establishing a federal government, the U.S. Constitution separated the government’s power into three branches: legislative, executive, and judicial. Each branch complements the others but does not take on the power of the other branches. The separation between the three branches created a system of checks and balances and was designed by the framers of the Constitution so that no one branch could have more power than another branch. See Figure 2.1 for an illustration of the branches of the U.S. government.
Figure 2.1 Branches of U.S. Government
The legislative branch, referred to as Congress, is the lawmaking body. It is composed of members of the Senate and House of Representatives and is responsible for passing legislation into law. The executive branch (consisting of the President of the United States, his or her cabinet, and various advisers) administers and enforces the law. The judicial branch (consisting of judges and the federal courts, including the Supreme Court) interprets the laws. Congress has the power to make laws, but the President has the power to veto these laws, although Congress can then override the veto with a two-thirds majority vote. The President can appoint all federal and Supreme Court judges, but Congress must confirm appointments. The judicial branch can review legislation and interpret the laws passed by Congress and the President, but the President must enforce the law. Congress can, in many instances, pass new laws to replace laws that are deemed unconstitutional by a judicial decision. See Figure 2.2 for an illustration of the separation of powers.
The states all have their own constitutions, which in many respects mirror the U.S. Constitution. The state constitutions likewise establish legislative, executive, and judicial branches within each state. See Figure 2.3 for an illustration of the federal court system.