Month: June 2016

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In June 2009, a 22 year old Honolulu mother of three young children was sentenced to one year in prison for illegally accessing medical records and send another woman on MySpace page that she had HIV.

The State of Hawaii brought charges against a woman under state law punishable unauthorized access to computers; and classified policy implementation as a class B felony.

According to accounts of the incident that led to the conviction of the woman, it was a feud between the victim and the victim’s sister-in-law, a friend of the defendant. The defendant, who worked as a patient service representative at the hospital where the victim was a patient, access the computer for the victim’s sister-in-law.

During the approximately ten months, the defendant obtained medical records of the patient three times a computer. After she learned of the condition of the victim, the defendant posted on the MySpace page that the victim had HIV. In another post, she said the victim was dying of AIDS.

The victim complained to officials in the hospital unauthorized access. After an internal investigation at the hospital resigned accused.

conduct of the defendant is, of course, was egregious and inexcusable. The one-year jail term handed down by the Court beyond the term recommended by prosecutors. Nevertheless, beyond the issue of holding the defendant accountable for her actions some may ask to what extent the hospital to be responsible for breaches of confidentiality that occurred.

Federal law imposes a statutory burden on health care providers to protect against misuse or disclosure of personal health and reasonably restrict the use and delivery to the minimum necessary to achieve the purpose .

Specifically, the Health Insurance Portability and Accountability Act of ( “HIPAA”) privacy regulations 1996 came into force on 14 April 2003. HIPAA is designed to protect consumers’ health, allowing consumers greater access and control of such information, expand health care, and ultimately to create a national framework for the protection of health privacy. HIPAA covered health plans, health care clearinghouses, and those health care providers who conduct certain financial and administrative transactions electronically.

In addition to privacy regulations, HIPAA security rules that took effect on 21 April 2005. Together, privacy and security regulations are only a national set of rules governing the use and disclosure of private, confidential and sensitive information.

Under HIPAA Security Rule, are standards for the protection of electronic information covered by HIPAA divided into three groups: administrative safeguards, physical safeguards and technical safeguards.

A couple of the most important safeguards required under HIPAA Administration are “Sanctions Policy” and “Security Awareness Training” security.

The sanction policy standard requires a communication to all staff regarding penalties to be taken by the covered entities for violations of HIPAA. Sanctions policy should have notice of civil or criminal penalties for abuse or misuse of health information and make employees aware of the violations may result in notification to law enforcement officials and regulatory, accreditation and licensing bodies.

The security awareness training standard requires all employees, agents, and contractors to participate in information security awareness training. Based on the duties covered entity should require individuals to meet customized education programs that focus on issues concerning the use of healthcare and responsibility for confidentiality and security.

HIPAA privacy and security regulations require privacy officer and security officer to be appointed by the covered entity. The privacy and security officers should constantly analyze and manage risk by carefully assess potential risks and vulnerabilities, and implementing security-related.

The US Department of Justice ( “DOJ”) clarify the penalties that may be assessed against whom and for HIPAA violations. Covered entities and individuals who “knowingly” Obtainment or disclose individually identifiable health information in violation of HIPAA may be fined up to $ 50,000 plus imprisonment up to one year.

committed under false pretenses allow penalties to be increased – $ 100,000 fine, with up to five years in prison. Finally, offenses committed in order to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain or malicious harm permission fine of $ 250,000 and imprisonment for up to ten years.

Given a security breach that led to the tragic events, including a one-year prison term for the defendant, Hawaii employers, health care providers and health plans should review the privacy and HIPAA policies and perform their audit practices in order to protect against improper use and disclosure of personal health and to reduce the risk of fractures in the privacy of their own business.

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Source by Roman Amaguin

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This information is designed to help you better understand the HIPAA and to assist in the office to become HIPAA compliant. The information was obtained from various sources and is not intended to be legal advice. If you are having trouble understanding some part of the HIPAA regulations you should contact a lawyer.
First, there are no HIPAA police. No one is going to come into the office to check you to see if you are HIPAA compliant. The appeal shall be submitted to enable the take.

What is HIPAA?

HIPAA stands for Health Insurance Portability and Accountability Act. It was launched by the federal government in 1996 as part of healthcare reform effort. HIPAA is designed to ensure confidentiality of patient related health information. It will also simplify administrative procedures, health care process, thus reducing costs and administrative burdens of health care.

One thing to remember is that HIPAA law uses the word “reasonable” several times. You and office staff will do everything reasonable to protect the privacy of your patients. For example, not smaller medical offices do not have to do the same privacy measures as large hospitals do. It would not be fair.

There are also no “privacy police.” No one is going to come in and view random office. Someone must file a complaint first. Complaints will be handled by the Office of Civil Rights. If someone puts in an application, then it will be investigated. The fines are very high, so you will want to be sure that the office has good privacy and they are on all the time.

Another thing to keep in mind is the type of job may determine the level of privacy you need to buy. For example, a patient is in office in Optometrist might not be as concerned about the people know that they are there, as opposed to a patient in a mental health office.
There are several different aspects of HIPAA, which has its own implementation date her.

Section 2: The Privacy Component: Implementation Date: April 2002

1. You must do everything within reason to protect the privacy of your patients.

2. Patient records and information should be kept in a safe part of the office, part of which is not accessible by other patients.

3. Tables should not be left lying around, open where anyone can read it.

4. If you are making a call on a patient or a patient, you have to do it from the area where it can not be heard if you give out personal information. For example, if you call their insurance company, and you must tell the patient’s first and last name, date of birth, ID # and / or analysis, then you do not want to do it for others, perhaps in the waiting room, can hear you.

5. If the patient charts are always removed from the office you need to have a strategy in place. For example, you should have a sign out sheet that says the name of the patient is, Taken, by whom, and then signed back in when the chart is returned.

6. If tablets are removed, they should sue marked “Confidential -. Health records” If you were ever involved in an accident, or separated from the bag for any reason, either the authorities or medical personel would ensure information. Or you would have to at least do anything reasonable to protect the information.

7. If a computer screen in the position that patients can view them, you may want to move them, or get a screen cover. A screen cover makes it so that the computer screen is read-only when directly in front of her.
The above are just some things you need to consider when becoming HIPAA compliant. Each office will have its own area it is required to review. The above are many of the common areas.

Chapter 3: Administrative Simplification: go Date: October 2002

This section requires standardization of data transfers or EDI and procedure / diagnosis codes.

As for the standardization procedure / diagnosis codes, this means that you must use CPT-4 codes for procedure codes and ICD-9 codes for diagnosis codes.

As for the standardization of EDI, which refers to electronic billing. In order to submit your requirements electronically, you must do it in a HIPAA compliant format.

Part 4: Security Component: no execution date set yet

This section requires that health professionals, Billing Services, and clearing houses take appropriate security measures to ensure that health information pertaining to a person still safe and not accessible by others.

Things to consider:

Where is the fax machine? Is there a place where only office staff can access incoming faxes? Is it 24 hours a day? When you are not in the office (after office hours) can access any other fax machine?
Whenever you fax personal information about an individual, you should use the fax cover sheet with a confidentiality agreement. The statement must show the following fax contains personal medical information and if the fax is received by anyone other than the intended party, the fax should be destroyed and they should let you know that it was received in error.

Are you hire a cleaning person / crew? They are in the office when you are not? Do they have access to the personal information of the patient? You may want to ask them to sign a confidentiality agreement statement.

Are you renting office space? If yes, the landlord access to the office? Do they ever come into office without you be there? If they do, you may want to ask them to sign a confidentiality agreement statement.

By asking people who have access to the office to sign a confidentiality statement statement, you are making a good effort to protect the privacy of your patients. It is not fair to never allow anyone access to areas containing personal information. If these people sign a contract and then sitting an agreement, you would not be liable.

If you do any business with e-mail, you need to use encryption service. This will ensure that if someone were to get your email, they would not be able to read it.

Part 5 “. Privacy officer” Privacy Officer

All offices will appoint a proxy This person would be responsible for ensuring that all staff are HIPAA trained and that the privacy policy is typed up and followed . They would also be the employees or patients could go to with any concerns or questions about HIPAA compliance. Even if you have very little practice, you must have someone designated as privacy officer. It may even be Doctor themself.

Chapter 6: Disclosure Patient / Approval

You need the written consent of the patient in order to release any of their records / information.

(Exception :. If the request is due to the immediate / urgent care patient)

You should see the current development and licensing forms to make sure they are HIPAA compliant. HIPAA requires you to get approval for the use and dissemination of information from each of your patients. You can refuse to treat patients who do not sign the consent form.

Part 7: unique identifiers: No execution date set yet

HIPAA will mandate the use of unique identifiers. More to come on this part. Most likely you will have one national provider number, instead of the second provider number for each insurance company.

Section 8: Policies and Procedures required by HIPAA

1. Identify the people on staff who have access to protected health information.

2. Prevent access to protected health information irrelevant.

3. Ensure that the “minimum necessary” amount of information released is routine information (only the information relevant to the request, but not the entire file of the patient.)

4. Verify the identity the requested information.

5. Providing patients access to their data, the opportunity to request corrections, and access to accounting information.

6. Each office must have written policies about privacy practices.

Overview

Meta physical office for potential privacy and security risks. One of the best things you can do to be “ready” for HIPAA walk through (better yet – have someone else go through) office as if you are patient. Look around at everything. What do you see? Do you see any personal information of the patient, tablets before? Start right from the front door, and go through every room in the office, especially a room that patients have access to. Then proceed to carry out regular checks to ensure continued compliance.

Make sure you have a written policy on what the person as well as to remove tables from the office, fax patient information, review any complaints from patients, etc. Also make sure you designate a “privacy officer.”

Make sure all employees are trained on HIPAA policy. Remember to train any / all new employees on HIPAA policy. You should also periodically review your current rules HIPAA.

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Source by Michele Redmond

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Presbypopia literally means “old eye,” emphasize the fact that as we age, our eyes become less flexible, making it harder to focus. This usually happens between the ages of 40 and 50 and passes through the age of 65. Early symptoms are often difficult to read smaller print, leading to the use lesgleraugu, bifocals and trifocals.

The high cost of vision care and vision surgery in the United States has sent many people seeking treatment vision problems to cure travel agency representing the largest private hospital network in Mexico where prices for high-quality medical care is considerably more affordable for Americans.

In addition to wearing glasses, there are several treatments for Presbypopia, including mono vision LASIK (which leaves one eye suited for distance viewing and the other for close-up view); leading Keratolasty (used to help one eye see better up close while the other eye is still untouched by contact lens correcting distance vision); Surgical Reversal of Presbypopia (SRP) with white Expansion Bands (SEBS); and pH lens exchange (RLE), which consists replace the natural lens with an artificial lens.

New PresbyLASIK Method Adopted in the US 2010, Mexico NOW

One of the newest and most promising treatments for presbypopia is multifocal LASIK or PresbyLASIK. PresbyLASIK process is now in clinical trials in the United States, the method has been adopted in Mexico and Europe. With multifocal or PresbyLASIK, different ‘zones’ are created on the surface of the cornea to correct vision at near, intermediate, and long range. With mono vision LASIK correction presbypopia, patients use their eyes independently to see near or far; with PresbyLASIK, patients are able to focus naturally with both eyes on any object from any distance.

Although multifocal PresbyLASIK procedure is not yet FDA-approved in the United States, it is performed with state of the art VISX technology in hospital Angeles Tijuana, just 15 minutes across the border from San Diego. Hospital Angeles is one of 20 technical modern hospitals that form the largest private hospital network in Mexico, and often hosts the American Medical tourists looking for affordable, high quality medical and surgical equipment care.

Low Cost of Medical travel to Mexico Attracts Patients from the world

surgery and hospital stay in the most modern hospitals are available in Mexico for as little as one-third of the price paid in America. The US aid Medical Tourism Association reports in its examination of the American Medical travelers (estimated at over 500,000 a year) that the vast majority are enthusiastic repeat customer complaint and state-of-the-art private hospitals and clinics in Mexico where they got surgerical methods. But private Mexican hospitals are every bit as modern as the famous US hospitals, they usually cost less than half as much as their American counterparts do. Though Angeles Hospitals are identically advanced equipment and resources, the US health care system has higher costs associated with medical education, training, insurance and facility construction. Costs are driven up even further by the US health insurance industry. The net savings to Mexico medical travel patients work with medical travel, Mexico, the agency is often quite dramatically, from 50-75% less than in the US medical and hospital costs.

Convenience and Savings

With the help of medical travel, Mexico, organization, to get to the right hospital is easy. There are 20 hospitals in major areas of Metro throughout Mexico with direct flights from most major American cities. Most medical tourists have easy access to cheap flights in and out of Mexico on a daily basis, making affordability attractive option when a long delay times added to the sky-high price of medical and surgical equipment care in the United States

Because Presbypopia LASIK surgery can be performed on American medical travelers over the weekend period (flight procedures and Inclusive), savings are high for this type of medical tour packages for Americans. The innovative approach implemented in the latest VISX technology, costs less than $ 5,000 (both eyes), but the process is expected to debut in the US at $ 10,000- $ 15,000 or more. According to the Medical Tourism Association survey medical tourist patients involved in medical travel to Mexico often enjoy travel time, including fine dining, shopping and relaxing resort beaches; more than 8 in 10 said they would definitely choose medical travel, Mexico, as a solution in the future.

Mexico meets and exceeds current standards

While many know Mexico offers gorgeous beaches, delicious food, lively music, star golf and excellent deep-sea fishing, the the last decade, Mexico has rapidly become widely known for quality, affordable medical care. Even the most advanced medical and surgical care in Mexico is usually one-third the cost of the same medical care in the United States. After factoring in travel-related costs, to realize the American medical travel patients considerable savings by seeking treatment in Mexico.

But savings and quality are not the only attraction of medical travel, Mexico. In the 2009 survey, reported most medical tourists to the United States help Medical Tourism Association that they found the hospital and their surgical care in Mexico as good or better than any US healthcare experience they have had, and would not hesitate to recommend the experience to other American patients who need quality affordable medical care.

low cost Mexico of living and lower costs for the same medical technology found in the US and lower doctor, hospital, and charges Experts’ against the United States can all work together to provide American patients medical TRAVEL excellent care at a fraction of what they would pay for the same care in the United States.

Mexico hospital undergo rigorous credentialing process ensures the highest international standards of education, training, equipment and patient centric care. Mexico hospital patients do not experience the limitations and rationing health care through premiums, policies penalties for pre-existing conditions, but denial, and out of pocket expenses. This results in high levels of service and patient satisfaction with the overall experience.

Americans can save thousands of dollars by seeking medical care in Mexico receive the same high quality health care they would expect in the US at a fraction of the cost, and hospital a modern, beautiful and comfortable to fly from major US city airports.

In particular, the convergence of medical and tourism is a winning combination for patients looking Wavefront LASIK surgery Presbypopia.

Affordable and convenient Care

Medical travel, Mexico, 20 hospitals in major metropolitan areas throughout Mexico, including Tijuana, Juarez, Mexico City, Puebla, and Guadalajara. For most Americans, the Mexico hospital is just a quick direct flight to Mexico, San Diego or El Paso, where they enjoy the airport to the hospital pick-up service as part of medical travel package. In addition, nearly half the United States population lives within driving distance of Mexico, making it a convenient choice American health care.

Medical travel, Mexico, organizations working with hotels and airlines offering patients special discounted price. Instead of waiting months for a three-minute date with Wavefront LASIK doctor in the United States, American patients medical travel choose Presbypopia LASIK surgery in Mexico can save thousands by driving or flying to Mexico for the same care and prescription drugs at a fraction what it would cost in the United States and enjoy more innovative, effective treatment for presbypopia who may not receive FDA approval in the US for years to come.

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Source by Paulo Yberri

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A California employee may be exempt or nonexempt. An exempt employee maintains administrative, executive, professional or outside sales position, and is not entitled to pay for standby or on call time.

Every other employee is nonexempt and is appropriate to increase the reward for waiting times, perhaps negotiated above the minimum wage of $ 8.00 per hour.

If a nonexempt employee must be in place employer’s business and respond to requests for assistance or emergency, he or she must pay for all hours of the premises, including waiting time.

If a nonexempt employee does not need to be in place employer’s business, but it is necessary to respond to the request of the employer to return to work for the emergency, he or she must pay for waiting time when the time is controlled, rather than uncontrolled.

working hours Under federal and state Standards:

“hours” under the Federal Fair Labor Standards Act and the Implementing Regulation (29 CFR 778.223) that employee should be paid, are: ((a) all the time that the employee must be on duty or to be on the premises of the employer or the required work and (b) all the time where the employee is suffered or permitted to work whether is obliged to do so. “

definition of” hours of work “adopted California division Standards Enforcement in 1wc wage orders, departments 2 (K), however, broadly includes: (a) the whole time employee is subject to the supervision of the employer, and all the time the employee is suffered or permitted to work

.

It should be noted, however, that workers in the health care industry to provide patient care may work 12 hour shifts straight time pay. And employees need to live in housing employer are exempt from overtime pay, not minimum wage.

Controlled Standby Time paid by the employer

Whether waiting time is considered “controlled” by the employer and shall be paid depends on the restrictions placed on the use of time for personal purposes of the employee.

If the waiting time is completely unrestrained or free for use for personal purposes, it is out of control and need not be paid. This waiting period will not be considered compensable hours. But if the employer so wishes uncontrolled waiting period may be paid less than the minimum wage or a lump sum.

As early as July 9, 1984, California Supreme Court, through Mr Justice Reynoso, adopted a two-step analysis of the type of significant restrictions on time (Code 7) of the officers, sergeants and transport of Madera Police Department changed the time during working hours. See Madera Police Officers Assn. v. City of Madera (1984), 36 Cal.3d 403; 204 Cal.Rptr. 422; 682 P.2d 1087th

two-step analysis consists of: first, see “whether restrictions on off-duty time are primarily directed to meet the requirements and direction of the employer;” and second, analyzing “whether employees’ off-duty time is so significantly reduced that they are not engaging in personal pursuits.”

Both questions, according to the California Supreme Court in Madera, s Uprava must answer yes.

In 1992, the Ninth Circuit looked at the two dominant factors in determining whether the waiting time is spent primarily for the benefit of the employer, to wit: (1) the extent to which employees are free to participate in personal activities; and (2) the agreements between the parties, in Owens v. Local No. 169, Ass’n. Western Pulp and Paper Workers, 975 F. 2d 347 (9 Cir. 1992).

The Owens, supra, the Ninth Circuit concluded that no compensation was required for the call time because employees enjoy a variety of personal activities on on-call hours ; and they agreed to call the system by continuing to operate under its terms.

Call-Back travel time and pay

A nonexempt employee of untreated standby can be called back by the employer to perform extra work for emergencies after termination scheduled work hours.

Such an employee has to pay for all travel time to respond to emergency calling customer employer in place of the client business, the salaries California and Hour Division.

But if the travel time for the employee to call back to and from the regular place of business of the employer is compensable is unclear. Because California Wage and Hour Division has no official position on it, many California employers do not pay for the call back time travel.

The working part of the call back is “hours” and shall be supplemented with methods approved California’s wage and hour division, to wit: (1) at the rate of one and a half times the regular hourly rate or higher for real time call-back; or (2) with a guaranteed number of hours of work or pay at the rate of one and a half times the regular hourly rate or higher, for each call-back in accordance with federal regulations. See Wages and while Manual Richard J. Simmons, Castle Publications Limited, pp 234-235 0.321 in 322.

Conclusion :.

Compensation for standby (on -call) time nonexempt employee depends on whether it is regulated or unregulated by the employer.

If the Board, it must be paid; if Uncontrolled, it need not be paid. The unsettled issues include the payment of travel time dial back and manner of payment time to call back.

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Source by Roman Mosqueda, SJD

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The Health Insurance Portability and Accountability Act (HIPAA) is a federal issue and was signed by President Clinton in 1996. This Act ensures that individuals would be able to renew or obtain health insurance in the event of a job loss or change of jobs. This ensures portability of settings employment and would reduce and hopefully eliminate discrimination against those persons with underlying disease. This legislation was expanded to include administrative simplification and health care fraud and abuse as the most part, focused on issues with regard to privacy of patient health information.

The administrative simplification is divided into two categories, standards common electronic information and protect the privacy and security of patient information stored in electronic medical record. The privacy of patient information prompted the drafting of the privacy rule. The US Department of Health and Human Services (HHS) issued the Privacy Rule which was to be implemented as a requirement of the Health Insurance Portability and Accountability Act of 1996. The requirements are described in the Summary HIPAA Privacy Rule.

The HHS published the proposed rule defining privacy standards for personal information for health on November 3, 1999. The rule was available to the public for review and comments resulting form of the public in excess of 52,000. These comments were organized and generated in response to the proposed rule. HHS took the comments in question and gave the final order December 28, 2000, formally established standards for privacy of individually identifiable Health Information more commonly known as the Privacy Rule.

The Privacy Rule standards address the use and disclosure of individuals called protected health information. Organizations that are necessary to demonstrate compliance with privacy standards for the privacy rights of individuals must understand and control how the information health of their patient’s use. The Privacy Rule describes the regulations governing the access, use and disclosure of personal health.

The O’Neill Institute (2009) composed Summary defining ulti Privacy Rule: to ensure that health information is easily accessible to individual healthcare providers who are authorized to access the information and the individual health information is also kept secret and protected from inappropriate use.

The phrase Privacy Rule has been much confusion and misunderstanding about how the Privacy Rule is applied to various situations. Final Privacy Rule was set in 2001 and specific guidelines were drawn up to deal with concerns regarding the application of privacy principles to individual health-care system. Within HHS’s Office for Civil Rights (OCR). This office is responsible for the implementation and enforcement of the Privacy Rule to compliance activities. Money penalties are enforced for non-compliance by parties healthcare.

Notice of privacy practices shall be in writing and should be advised of their rights according to their personal health information. These rights are access medical records for changes to information contained personal medical records of those accounts of individuals who have had access to their medical information and special requests to limit the disclosure of sensitive information. When electronic medical records began to be more concerned about protecting health information had to be treated with a different level.

The American Recovery and Reinvestment Act (ARRA) passed in 2009. The Health Information Technology for Economic and Clinical Health (HITECH) was adopted as part of the ARRA. The goal of funding this initiative was to develop advanced health information technology that would be used nationally and institutions would be incentivized to participate and take a culture representative of advanced health organizations. Healthcare is expected to have in place a certified electronic medical complying with HIPAA, privacy rule, HITECH and ARRA. If this is accomplished, a health care institution would be allocated additional funding to assist with the provision of patient care. It is expected for the full implementation of an electronic system to be in place by the end of 2013.

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Source by Rachel C Cartwright-Vanzant

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Doctors and doctors are people we trust as they try their best to save and heal lives by implementing their knowledge and practice euthanasia, but gives doctors the opportunity to play against the decision God, in fact the voice of euthanasia raises the patient is in trouble with no signs of life, but nothing is perfect in God, whether one agrees or not, past and present experience shows that euthanasia promotes abuse. Dr. J Forest Witten warned that euthanasia will give doctors “power of life and death of individuals who have committed no crime without becoming ill or being born, and could lead to tyranny and totalitarian state.”

Examples of this very statement Dr. J Forest Witten was seen in Pennsylvania, in 1947 after 47 years Ellen Haug admitted killing ailing seventy year old mother with an overdose of sleeping pills. Her request was that she could not bear her crying and misery and her excuse was that “if something had happened to her, what had become of her mother?”. Ellen said her mother had been too far and actually Ellen herself was on the brink of the end, but euthanasia is not only nothing of the problem her Ellen was not to put his mother out of misery but she was getting rid of the responsibility. Euthanasia interferes not only alive but also changes in the pattern of a perfect life.

Likewise, Dutch government research euthanasia came up with some alarming results. In 1990, 1,030 patients Dutch killed without their consent. Twenty-two thousand five hundred deaths were caused by the withdrawal of support, 63% (14.175 patients) was denied medical treatment without their consent and twelve percent (1,701 patients) were mentally competent but were not consulted. These results were widely publicized for the November 1991 referendum in Washington state and these results contribute much to defeat the proposal of those in favor to legalize euthanasia and lethal injection. Euthanasia, at the moment is illegal in most parts of the world. In Europe it is only legal in the Netherlands and Belgium, provided certain conditions are met (Irish lawyer).

The role of the actual doctor is trying his / her best to secure even life than to prescribe death for someone to free him / herself from pain , it is not fair and it should not be legal. The American Medical Association (AMA) is well known for its pro-abortion campaigns and funding. Now, AMA has begun Institute for Ethics, designed to trained doctors of other medical procedures rather than euthanasia. This shows that the AMA realized baloney on euthanasia and ironically they are trying their best to reduce the use of euthanasia.

On the other hand, permits euthanasia brought mass murder that took place in Germany in the Second World War and left everlasting stain on society and all these murders were the result of euthanasia. In this war were over 100,000 people killed in the Nazi euthanasia program is. During the war physicians were responsible for two things in the first place, it had to euthanize patients, and second, they had to write a strong reason why they euthanized these patients to provide evidence of his family. Surprisingly, organizations such as General Ambulance Service, Charitable medical transports, and charitable foundation for Institutional Care transported patients to six killing centers, where euthanasia was established by poisonous injection or slow starvation if the children (Humphrey & Wicket, 1986). This incident shows how badly euthanasia was treated in the past and how people

Other than the facts and figures clearly indicate that euthanasia create abuse, various religions also prohibit euthanasia as this is against God’s will. For example, the Catholic Church has its own opinion on euthanasia. The Vatican’s 1980 Declaration on Euthanasia said that “No one can make an attempt on the life of an innocent person without opposing God’s love for that person, without violating a fundamental right and therefore without committing a crime of utmost sin.” It also says that “intentionally causing the death of their own, or suicide is as wrong as murder, such action by a person is considered rejection of God’s sovereignty and loving plan.” In Islam euthanasia is immoral and against the teachings of God. Basically, In Islam, this life gives you the opportunity to spend your life in God will not reward him, but only for his will and in fact this philosophy if someone suffers a lot because of the disease the more he will take patience and bear all this difficulty here then he / she will get great esteem that patience and endurance are highly regarded and award value in Islam. Some verses from the Holy Quran euthanasia Quran says: “Those who patiently preserve will truly receive a reward without measure” (Quran 39:10) and “and bear in patience whatever (ill) may befall you: this, behold, is something to put one’s heart over “(Quran 31:17). As, Prophet Mohammad (PBUH) taught that “When religion is afflicted with pain, even the prick of a thorn or more, God will forgive their sins, and wrong his actions are discarded as a tree sheds of the branches.” Once way to prevent or reduce pain fall short, this spiritual dimension can be called very effectively to support patient who believes that accepting and standing unavoidable pain will be to his / her credit in here, real and enduring life.

This religious believes shows that euthanasia should be legal and that all the opinions regarding euthanasia should be allowed Conflicting most religious and against God will and sanctity of life.

Conclusion:
Kant argued that people who commit suicide destroy their sense of service to something else – pain. So suicide and ask for euthanasia do not show respect for our own common sense. In terms of relief and patient care we should not participate in the decision and will of God, that no one knows the reason behind the long and painful suffering for someone. Euthanasia should not be legalized because it gives the right to terminate another life as in the case of non-voluntary euthanasia, if any patient is unable to speak and can not express his / her feelings and it is quite possible that he or do not want to end his / her own life. So, it is not a solution to human suffering and human rationality. While euthanasia is a controversial subject, it is clear that it does not interfere just a normal human life, incorporate human life as well as it is the act of playing against the decision and the will of God, which is even contrary to various religious believes.

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Source by Sajjad Rasool

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The purpose of medical malpractice insurance is to cover doctors and other health care professionals for any liability arising from their treatment of patients.

If a doctor or health professional found guilty of medical malpractice, damages awarded often reach millions, and may be even larger if punitive damages are awarded. Malpractice insurance shields him or her from liability in case of malpractice verdict.

However, just like auto insurance rates go up with each ticket you get, been found guilty of medical malpractice can drive a doctor’s insurance rates for years. In addition, recent years have seen a steep rise in the cost of medical malpractice coverage. This has in many cases, cause great difficulties for those in the medical community, and some are pushing the limits on certain types of damage in order to bear the cost.

Despite these concerns, many lawyers for malpractice victims disagree with such restrictions. Specifically, they blame high premiums on poor investment choices than large plaintiff rewards simply reflect inadequate patient care and medical practice.

This crisis has been particularly prevalent in Pennsylvania. Doctors and hospitals are citing a lack of supply and affordability for malpractice insurance, so much so that it is driving many professionals right out of business.

High-risk specialty areas have been hit the hardest, as they face the greatest opportunity for malpractice claims, and therefore carry the highest price. General malpractice payouts have been increasing in recent years and the fallout for healthcare have been serious.

Despite the difficulties, some experts may be experiencing in regards paying their malpractice insurance premiums, it is a problem that is not likely to go away. Since it is really only shield doctors have from financial ruin that could cause a huge damage award, health workers should include these rates to stay in business.

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Source by Richard Romando

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The pain to a minimum back drops you to your knees again. All you did was bend over to pick up the pen you dropped on the floor. This time is different, though. It is worse than it has been in the past. This time you feel pain shooting down the back of the leg. A white-hot dagger is stabbing you in the back end and you feel numbness and tingling in the leg, perhaps all the way down to your foot. You can not correct a walk and you are limping along like you’ve been shot. You stand still and pray the pain persists … but it does not go away. In fact, it is getting worse. Your thoughts come in rapid-fire order, “what is happening to me, what should I do, that I do not call, I should go to the emergency room, I need surgery?” Good questions.

If you are experiencing any combination of these symptoms, chances are you have a herniated disc in the lower back, one of the causes of mechanical back pain. Swelling of inflammation or disk itself can cause impingement or “pinch” in the spinal nerve root. The lower lumbar nerve roots eventually form the sciatic nerve in the leg. Inflammation of this nerve is commonly known as sciatica. “Mechanical low back pain is one of the most common patient complaints made to doctors emergency in the United States accounted for more than 6 million cases per year. Approximately two-thirds of adults are affected by mechanical low back pain at some point in their lives, making it the second most common complaint in outpatient medical and third most expensive disorder in terms of health care dollars spent, carry only cancer and heart disease. “1

But just because you have these symptoms, not necessarily that you have to rush to the surgeon. According to a landmark study published in the medical journal Spine, “action should not be performed if another treatment will give equivalent results within an acceptable time … the patient with low back pain and sciatica should not automatically referred to a surgeon.” 2 If this is the case, what are the some of your other options? If you are like most people, the first place you think will be visiting your family doctor’s office (or the emergency room, if you are really in a panic). Traditionally, doctors prescribe drugs such as pain killers, muscle relaxers, anti-inflammatory or a combination thereof. There are three problems with taking medicines, if this is all that is done.

1. Drugs acting only symptoms.
2. Drugs is only temporary relief.
3. Drugs are many unhealthy side effects. Take time to read the warning insert with any of these agents and you’ll know what I’m talking about.

By contrast has shown chiropractic care have to be effective in treating chronic low back pain than traditional treatment. In one study published in the Journal of manipulative Physiological Therapeutics (JMPT), concluded that it “… to compensate for chiropractic patients were five times more [than for medical patients] Patients with chronic low back pain. Treated with chiropractors show more improvement and satisfaction at one month than patients treated by family physicians. “3

are times when surgery is necessary? The answer is, most definitely, yes. Absolute signal for surgery are patients with cauda equina syndrome (which is rare), in the presence of severe motor deficits due to large extruded disk or transferred fraction, and in patients with intractable pain. Unless one of these conditions is present, chiropractic care for the treatment of discogenic or mild to moderate pain set of intervertebral disc herniation has been proven to be safe and effective. One study shows that chiropractic treatment (in this case in the cervical spine) is 100 times safer than using non-steroidal anti-inflammatory drugs such as Asprin, ibuprofen, naproxen, etc. 4. Another study shows patients showed a 86% increase in chronic low back pain after each chiropractic care. 5

As a side note, let me also say that medical and chiropractic care are not mutually exclusive ways to treat mechanical low back pain and sciatica. In my experience, I have seen great results with the most serious cases when the manager that conditions in cooperation with the patient’s primary care physician or pain management specialist. In these cases, the drug is useful or necessary for the patient to endure conservative thinking; for example, when it is extremely difficult for the patient to move or be moved.

Finally, not every case of sciatica is caused by a herniated disc. A condition known as piriformis syndrome can cause impingement of the sciatic nerve as it exits the pelvis. Basically, the piriformis muscle attaches the sacrum, passes through the greater sciatic notch in the pelvis and attaches to the top of the femur (upper leg bone). Athelete involved in sports where they sit, such as rowing or cycling are particularly sensitive strains piriformis. Runners who overpronate are also susceptible to piriformis injury. When a muscle is injured, it causes swelling due to inflammation, which can then irritate or compress the sciatic nerve as it exits the pelvis. Is important’s to rule out spinal cord injury color: the cause of sciatica, the video will display Following oral administration of stretching the Piriformis muscle . If symptoms resolve after the return stretch for a week or two, he had probably piriformis syndrome and should continue this stretch as part of daily life to prevent future injury. However, if you are still experiencing the same symptoms or if they promote, seek help as soon as possible.

1. Kinkade S. Evaluation and treatment of acute low back pain. Am Fam Physician. April 15, 2007; 74 (8): 1181-8.
2. Weber H. Lumbar disc herniation: a controlled prospective study with ten years of observation. Spine 1983; 8: 131-40.
3. Nyiendo J, Haas M, Goodwin P. patient symptoms, exercise activities, and once a month the results for chronic recurrent low back pain treated by chiropractors and Family Medicine doctors: A practice-based feasibility study. JMPT 2000 May; 23 (4): 239-245.
4. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine 1996 August 1/21 (15): 1746-59.
5. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Netherlands B. Changes in sagittal lumbar settings with a new method of extension grip: nonrandomized clinical placebo. Archives of Physical Medicine and Rehabilitation 2002 November; 83 (11): 1585-1591.

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Source by Dana C Williamson, DC

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The idea of ​​web-based decision-making seems to be basic to the practice of medicine, especially emergency medicine and disaster medicine. Unfortunately, the reality is that the US and, in fact, in most industrialized countries, medical decisions are not based resources, they are emotionally based. This works in all but the most dire circumstances.

More and more of the world now waking up to the dual threats of terrorism and natural resource-based decision-making, ie Triage, is becoming a skill not only necessary but often lacking.

Now for a short time this article that there is no way I can describe fully integrated process Triage. Suffice to say that Triage is an ongoing event. It happens repeatedly throughout the patient encounter; all the time that one is seeking and receiving medical care since their first approach to the moment they finally understand the care environment.

There is also an integrated starting with gross notes:

Can the patient walk?

Do they follow orders?

Do they know who they are, where they are and why they are here?

Proceeding to the basic physiology:

Are they breathing?

Do they have a pulse?

Can they follow orders?

And finally among the details:

Why was the patient actually brought about care?

What happened?

What are their expectations?

Unfortunately most Triage ends the first time last question is asked. In daily activities Triage in the emergency room and medical practice, the process stops here. No going back to ask questions again. For Triage to work the way it is intended, we must incorporate it in our minds and in the moment-to-moment our medical practice.

At first glance, this seems to be a minor problem; something that is easily corrected with a small amount of work. Unfortunately, far from the truth. In fact, as an integrated Triage is blamed for the nation that we are discovering a disturbing trend.

Although medical staff readily embrace the idea of ​​continuous reassessment of their patients (actually nurses have done this for decades) idea of ​​patients classification, especially in the most dire need, is still very emotional charge.

There are now reports service facilities refuse to classify all patients anything less than absolutely critical, until a full physical examination, measurement of liver enzymes and even scans have been done. In these structures the entire concept of Triage, classification masses such that the good can be done for the people, has been lost. They are not performing triage. They are jumping directly into treatment.

Of even greater concern are some individual cases, refuse to allow facilities to bypass patients where there are no resources immediately available. It is always emotionally difficult for healthcare professionals to recognize that under different circumstances they could save. A life that today can be lost simply because there are too many to handle. This person is too injured to save when compared to the good that can be done for so much more. Unfortunately, when the victim count soar, deaths soar as well. This is really a decision that disaster medicine professional must do. This is a decision that falls to the professional handling Triage.

Most commonly referred to as “black tag” patients “buddies”, as they require more resources than are available and sensible to utilize for one person at this time. These prospective patients often heartrending and more unfortunately for both patient and provider under different conditions are usually people who can be treated and saved. But on this day in these conditions, they must be “set aside”.

The problem comes in that health professionals today do not understand, however, set aside these patients are not abandoned. A “black tag” is not a death sentence. It is not “Do not resuscitate” order. It is not to abandon all care. Pregnant patients still receive comfort care, compassion and human dignity. They are still constantly re-classified and that resources are available. They are returned to the treatment mix.

The Louis Armstrong International Airport in New Orleans after Hurricane Katrina first five horrendous days Triage and treatment of tens of thousands of patients and evacuees, only 38 people were put in budding category. Of these 38, 36 were eventually re-classified, handled, balanced and sent to hospitals outside the state Louisiana. All 36 of these individuals survived the harrowing days at the airport. Two men died. In both cases these persons had already known terminal disease. They were actually in hospice care before the hurricane. One of these brave souls even refused transport to allow someone who had “better chance” to go ahead of them. These two “patient” died at the airport. At the time they died, they were only two people left in the expectant treatment areas. They each had their own nurse their response provided by the facility. Each of them had family members at the bedside and their local volunteers to sit with them.

In the case of each of these individuals, after they died, their families said they had received better care at Louis Armstrong International Airport after a hurricane, but they had received at home; Not because lodging was somehow incapable but at the airport they each had their own nurse them. Doctors came and saw them four times a day. They each had their own volunteer their and their family crowded around them.

The dreaded “black tag” given patient is not a death sentence. It is an opportunity for health professionals and patients to make the most of the persons that can already part of the overwhelming situation, it is an opportunity to think of others first.

(A flow chart of consecutive Integrated Triage is available by vBulletin mail the author at: Renaissancedoc@mauricearamirez.com )

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Source by Maurice Ramirez

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Chiropractic care is sometimes associated with some risks and benefits. The fact is, it is proven to be effective by thousands of people abroad. Doctors actually recommend this alternative treatment before patients take greater measures like surgery or long-term drug use. Here are some of the known risks and benefits.

Chiropractic is a Science-Based

Chiropractors are actually highly qualified specialists who have undergone both undergraduate and graduate programs to achieve the title. There are National and State Board Test as well, to make sure that the experts only ever use the highest levels of technology and applications that ensure the well-being of patients. Science Chiropractic enhances the relationship between the spine and nervous system, such physical processes are improved significantly.

Chiropractors are several methods to correct unusually vertebral. The process will be very safe and effective because the specialists are able to find, start, control and manage various functions cells and body fluids system by improving the flow of energy. Chiropractic care is viewed holistic approach, but science-based.

safer than other resources

The holistic therapies, chiropractic care is in large safer than other treatments because patients need not to undergo surgery or be placed in a sedated state to get results. The choice of measures, most doctors suggest that people try methods first before resorting to surgery or long-term use of drugs. You can expect to pay less when investing in chiropractic.

The type of remedy is also comfortable with low risk of complications when used by qualified professionals. Chiropractic are non-surgical, natural and drug-free method to increase natural energy body’s recovery and improve. Treatment courses can be very short if the patient responds positively. You can see that chiropractic can continue to maintain the maximum level of health in the long term. Patients who have fully recovered, may continue to visit the clinic Chiropractor for relaxation.

Knowing the risks

The risks mainly start if you rely on someone who does not really have a background in chiropractic. Make sure you do a background check first of which will be rendering services by checking the license, ask for patient referrals and determine whether a person truly is registered in your state. Check price as well, so that you avoid paying exorbitant fees. You can avail of packages, depending on your condition to make sure that you will simply pay the amount that was originally given to you.

Some Problems

In some cases, are also possible complications such as neck or spinal injuries due to incorrect maneuvering the joints. Some patients find the treatment very painful at the beginning, while others may not receive any benefits at all of the methods.

risk of injury from treatment decreases. Before any procedure is done, medical diagnosis is almost always required by qualified professionals, so that they can accurately determine the origin of the problem and correct joints efficiently.

Some doctors may even refuse to treat you if they realize that the patient is very prone to develop problems during or after treatment. Some patients may not respond to remedy the problem suddenly develop hours or days.

Correct application of force is very important, especially when a system of the elderly, children, babies and pregnant women.

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Source by Geoffrey Wagner