What laws would prevent the creation of an international telemedicine service? Clearly, every country has its own medical system. I do not know what the single source of legality tends to be, but I assume the government appoints a minister of health, and the minister of health somehow oversees who is allowed to practice medicine, how, and where, and who will be in charge of important topics like drug legality and medical ethics. Apparently, the World Health Organization has an international health standard that is “legally binding in 196 countries”. (here) Does that mean it is legally possible to create an international telemedicine product (as in, as much of health services as possible, like talking to a doctor, or getting medicine delivered, fast through an app)? The company would provide the same service but adapt it to any medical regulations of each country. In fact, the company would mainly be a vendor of a medium between doctors and patients already existing and practicing, in each country. However, I guess my point was precisely that - internationalizing health care. In theory, in the global, digital times, it does not make that much sense that an American living in Germany could not get telemedicine from America with the same level of convenience - for example, German insurance covering it, and the American prescription being somewhat valid. Maybe that is how things already are. People do sometimes have to travel for medical treatment and country’s medical systems do have to permit a degree of interoperability. I guess the bottom line is that medicine is like any other sector, every country is its own authority and creates its own system, including law, business, education, etc. What I’m trying to figure out is if that means it is already totally possible for an international telemedicine service which can connect you with a doctor in any country and give a prescription; but you would just need to figure out how to use that diagnosis in your country. My conclusion is I think this is legal. Is there some aspect of this I don’t know about?
The WHO regulations (according to that page; I haven't seen them) &quot;provide an overarching legal framework that defines countries’ rights and obligations in handling public health events and emergencies that have the potential to cross borders.&quot; They don't dictate the conditions for practicing medicine. it does not make that much sense that an American living in Germany could not get telemedicine from America with the same level of convenience - for example, German insurance covering it, and the American prescription being somewhat valid. This would result in a geometric increase in the administrative burden. You need a system for the American prescriber to know what medicines are approved in both countries (and in every other covered country). You need some way for the German health authorities and the insurers to trust that prescribers in the United States are not endangering the health of people in Germany, which means that they need to evaluate the education and certification systems in place in the US (and every other covered country). You need to consider the legal recourse in cases of malpractice: if the prescriber makes a mistake, does the case go to the US courts or German? If German, will the US state that licensed the prescriber honor a judgment revoking the prescriber's medical license? And more. There are simply too many elements that need to be coordinated. With two countries, you have to reconcile one pair of systems. With three countries, three pairs. With four countries, six pairs. With N countries, it's N(N-1)/2, so even with a modest number of countries such as 20, you have 190 pairs of systems to consider. With 196, the number is 19,110.
Your basic regulatory umbrella for anything that stores, transmits or interacts with any private health information or health IT systems is Health Information Privacy | HHS.gov, as well as state authorities. There are severe penalties at the federal and state level for non-compliance and privacy breaches, and many other agencies - such as the DEA, state health departments, insurance companies - would have to be involved in testing and certification of such a App. You will simply not be able to distribute the App on Google or iTunes without their approval, and those distributors will not approve a App that has not been strictly vetted for privacy and HIPAA compliance. In order to distribute such as App - with a TOS that assures personal privacy and shields you from liability (if possible) - you will need to spend hundreds of thousands of dollars on legal representation for compliance. As an example, see ohwilleke's answer to What kind of lawyer should I seek to understand compliance requirements for processing credit cards?
47 USC 227 forbids anyone to make any call (other than a call made for emergency purposes or made with the prior express consent of the called party) using any automatic telephone dialing system or an artificial or prerecorded voice...to any telephone number assigned to a paging service, cellular telephone service, specialized mobile radio service, or other radio common carrier service, or any service for which the called party is charged for the call, unless such call is made solely to collect a debt owed to or guaranteed by the United States where an automatic dialing system is equipment which has the capacity— (A) to store or produce telephone numbers to be called, using a random or sequential number generator; and (B) to dial such numbers. This prohibition covers voice calls, SMS and MMS, see Satterfield v. Simon &amp; Schuster, Van Patten v. Vertical Fitness and Facebook v. Duguid. I assume that the messages are send automatically, not by hiring hundreds of people to enter numbers and send individual texts. Since businesses have been sued for doing this, a lawsuit is one of the consequences.
A doctor can choose their patients A doctor has a professional duty to render aid in an emergency. However, apart from this and assuming the decision is not made for a prohibited or unlawfully discriminatory reason, they can refuse to see whoever they want. What you have here is poor customer relations, not illegally. Find a better doctor.
Hardly ever While all doctors in private practice has a contract with each of their patients: For most practical purposes clinical negligence lawyers can forget about these. It is not that contractual duties do not exist – all private medicine and surgery is performed pursuant to such duties – but that they rarely add anything to the parallel duty owed in tort. The courts have been very reluctant to imply a duty in contract which goes beyond the duty imposed by the common law of negligence. While tort damages aim to restore the plaintiff to the position they were in before the tort and contractural damages aim to place them in the position they would have been in had there been no breach, for medical malpractice there is no practical difference.
The vaccine card doesn't have a specific legal status under US law. There are federal laws against fraud which would encompass vaccine card fraud, but tidying up disparate notices into a single notice is not fraudulent (there is no attempt to deceive), as long as you don't falsify signatures, seals, or specific information. From a practical perspective, though, the official vaccination record from your state is a better and more official way to have a single proof of vaccination. There is probably no practical way to transport vaccinations from a foreign country into the US system, but that is a question best asked on Travel, since it's not about the law, it's about quasi-legal mandates authorized under broad laws that say &quot;in an emergency, the government can stipulate necessary rules&quot;.
There is a potentially infinite regress of questions regarding the constitutionality of restrictions imposed under these "emergency" circumstances. The basic legal principle is clearly established: laws restricting fundamental rights are subject to strict scrutiny. The specific details of a particular law and surrounding circumstances have yet to be discovered by the courts. If it is necessary to the purpose of saving lives that meetings of more than 10 people be prohibited, then the "compelling interest" test probably has been satisfied. That is basically a medical question, and the courts have a limited interest in scientific controversies, instead they are interested in whether people who make legal decisions do so rationally (is it reasonable to think that such limits would accomplish that compelling government end). Is it reasonable to think that restrictions lasting two months are necessary? The Black Death lasted at least 4 years. In the current circumstances (very limited hard knowledge this disease), it's hard to say what government actions could not be excused based on necessity. Summary execution is, at least in the current knowledge context, probably not going to pass strict scrutiny. As already explained in other thread on the topic, there is no "churches are above the law" constitutional provision. The appropriate question in the Florida case is not about the First Amendment, it is about the Due Process clauses – is the arrest lawful? We will, no doubt, see. On the face of it, he violated the law, so he can be arrested. I understand that there is a team poking holes in the order.
As a preface, while the best course of action isn't always clear and the reality of implementing some solution is often rocky, the bipolar diagnosis situation you describe is probably the single most common situation in which legal arrangements must be made for an adult child, and is almost as common as the need for children to make legal arrangements for the care of their declining parents. You aren't the only one going through situations like these. Probably 0.5%-2% of people in any given area experience bipolar, usually starting in adolescence or young adulthood, and difficulties managing it of the kind that you describe are the rule and not the exception. Also, just ignoring the problems you describe is a very bad idea. Premature death either from suicide or bad judgment related to the bipolar diagnosis is all too common in these situations. It is serious business, not something that should be thought of as bad character, or futile to do anything about, or blameworthy. It just is, and if someone doesn't do something when the plan gets off course, serious consequences often follow. There are really several intertwined issues present here. Realistically, given the nature of the concerns expressed, a limited guardianship may be necessary to accomplish the goals expressed. What Are Medical Powers Of Attorney? A healthcare or medical power of attorney gives the person who holds it (who is called an "agent" or "proxy") the authority to make medical decisions for someone called the principal (i.e. John Smith) when the principal lacks the capacity to give informed consent at that very moment to do so. This is because a power of attorney is an inherently revocable document expressing the wishes of the person writing it. You generally can't bind yourself in the future without court approval or a contractual relationship with a third party which a power of attorney is not. It isn't uncommon for medical personnel to decide on the spot when to and not to listen to someone with a medical power of attorney based upon how mentally competent the patient seems at the time on a decision-by-decision basis. For example, they might defer to the medical power of attorney agent when the patient is unconscious or heavily drugged, and listen to the patient when the patient is conscious, not drugged, and not acting erratically. Parents, incidentally, do not automatically have this authority, nor do spouses. A medical POA is a document that allows the agent to say "yes" when the patient (i.e. John Smith) cannot. Another name for a document that is very similar and sometimes used is a "health care proxy." It would typically cost a few hundred dollars to $1,000 to have a medical power of attorney drawn up after discussing the situation and the principal's needs in a meeting with a lawyer and might take an initial meeting and then a second one at which the document is signed after it is prepared following the initial meeting. Other lawyers might manage this in a single meeting and draft it while you wait. If all you need is a power of attorney, don't be penny wise and pound foolish by doing it yourself, unless the form is provided to you by the health care provider you will spend most of your time dealing with and they prefer their own form. Otherwise, the likelihood that you will have to pay more to a lawyer later cleaning up your own mistakes probably exceeds any money that you will save. Other Kinds Of Authorizations Many medical providers will allow someone to act on behalf of a patient in matters other than matters that call for the kind of medical decision that would normally require the informed consent of the patient, even when the patient is not manifestly incapable of making medical decisions at that very moment. This could simply be a note in the file that the patient has given that person authority to do so, it could be a written authorization to access HIPAA protected personal health information of the patient, and it could be a variety of other things (e.g., authority to make financial arrangements). Some of this is often incorporated in the same document as a medical POA. Picking Up Controlled Substances A Medical POA may, or may not, necessarily be sufficient to authorize someone to pick up a controlled substance on behalf of a patient if the patient is physically able to do so, without the presence of the patient. I don't know what the true rule of law under the controlled substances acts and pharmacy regulation is, but I do know that practice in real life varies quite a bit. The best practical solution to the issue of picking up controlled substances would be to ask the usual pharmacist what they require and to comply. (A legal guardian would generally have the power to pick up controlled substances for a ward.) Guardianships and Limited Guardianships What Is a Guardianship? A guardian of the person is someone appointed by a court who has the authority to make medical decisions and other personal life decisions for their ward (i.e. John Smith), even contrary to their apparent stated wishes. A guardian has the authority to say "yes" and also to say "no" to the expressed wishes of the ward, overruling the ward. A guardianship of an adult can be general, or can be limited on a customized basis. A guardian must be appointed by a court with jurisdiction over these cases, usually in the county where the ward resides. But, a guardianship can be requested by the ward as opposed to contested. Realistically, a court would be unlikely to grant a full guardianship or a contested guardianship in these circumstances, but might grant a limited guardianship with the consent of the ward in these circumstances. The parents and possibly any siblings, would have a right to notice of the proceedings and to object or to seek to be appointed instead. What Process Is Involved In Having a Guardian Appointed? This would realistically be a proceeding that should ideally involve a specialist lawyer (with experience in mental health or elder law and guardianships) and at least one medical professional's statement (probably a treating psychiatrist or psychologist). There would also probably be a court investigator or guardian ad litem appointed at the ward's expense, to confirm that the facts represented in the petition to have a guardian appointed really reflect the ward's intent. Usually, a proposed guardian selected by the adult ward during a lucid interval would have priority for appointment. The medical professional and lawyer should be able to provide good suggestions regarding what the scope of the limited guardianship needs to be, although don't ignore or fail to give full credit to your own layperson's practical understanding of the situation either. The guardian would have to provide information to the court in connection with the petition showing eligibility to serve (e.g. criminal record check, credit check, CV, nomination by ward). Often the guardian would have to demonstrate good intentions towards the ward in some way, especially if the guardian is a third party and not someone who serves as a guardian as a livelihood. Some courts would require the guardian to have insurance for liability in connection with the task or a surety bond up to some dollar amount. The final decision would usually be made in an in-person hearing at which the ward, the proposed guardian, the proposed guardian's lawyer, the medical professional, the guardian ad litem or investigator, the judge, a court clerk, a court reporter, and any family members who chose to appear (with their lawyers, if any), were present. If the guardianship was granted, perhaps with modifications requested by the judge to the terms of the guardianship, then the Court would issue what are called "Letters" that formally appoint the guardian to the post. Once appointed, the guardian would have to file periodic status reports with the court and would also be subject to the court's jurisdiction in the event of any future dispute regarding the guardianship, or any allegations of misconduct by the guardian, or any circumstance that requires court approval such as a change in the terms of the guardianship or in the person serving as guardian. The procedural details I am describing are approximate and aren't necessarily up-to-the minute correct, and might vary somewhat even from court to court within California under local rules and customs of practice; but they give you a gist of what the process would be like if it is working properly and with best practices. Typically, this might cost $3,000 to $10,000 all in for an uncontested proceeding, and many times that much in the event of a contested attempt to have a guardian appointed. Health Insurance Eligibility I'll defer to someone else's answer regarding health insurance eligibility, as I don't have time to look into that at the moment. My instinct is that this wouldn't be a problem in any case except a guardianship and probably wouldn't be a problem even in a case with a third party guardian, but I can't confirm that without doing research.