Are hospitals required to provide language interpreters to patients? California, USA. The hospital is on COVID lockdown, no visitors allowed. The patient had a stroke, lost her English, but seem to understand her native language; she slowly and barely coherently speaks a few words, but only in her native language. Is the hospital required to provide an interpreter to help communicating with the doctors and the therapists?
Hospitals in the US that receive federal funding (e.g., Medicare, Medicade, FCHIP, etc.) are required to provide language services under Title VI of the Civil Rights Act of 1964, 52 U.S.C. §2000d et seq to those persons of limited English proficiency who receive services. This US Government Department of Health &amp; Human Services page notes: Persons with limited English proficiency must be afforded a meaningful opportunity to participate in programs that receive Federal funds. Policies and practices may not deny or have the effect of denying persons with limited English proficiency equal access to Federally-funded programs for which such persons qualify. Many HHS documents address this requirement. An overview can be found in the HHS Language Plan (2013), which contains sections requiring translation of oral communications as well as written documents when the patient has limited English proficiency. Given the pervasive presence of these federal programs in the provision of health care in the US, most (if not all) US hospitals will be required to comply and provide translation services.
Your interpretation seems to be correct. A furloughed employee is defined by Acas to be one who is "temporarily sent home because there's no work". This could in principle be through unpaid leave. The Coronavirus Job Retention Scheme is a government scheme to compensate employers for the wage bills of their staff during the furlough, so that the furloughed staff can continue to receive some income. An employee would have no direct dealings with the scheme and would continue to be paid via their employer. Your company seems to be offering to match the terms offered to employees under the Coronavirus Job Retention Scheme of 80% of salary, presumably out of their own funds. A kind gesture, it seems!
http://www.healthinfoprivacybc.ca/confidentiality/when-can-and-cant-they-tell-others is a pretty good summary. Different rules apply to private practices than public clinics and hospitals. I will assume that the clinic on campus is private. This is a summary of the summary about who your information can be shared with: Health care professionals can share information within your "circle of care". Specifically, they are allowed to assume your consent to this but you can explicitly withdraw that consent. This would include doctors within the same practice. Admin staff can access your information for administrative purposes. Anyone you have authorised them to share it with e.g. relatives, friends etc. The Medical Services Plan for billing and admin If you are unable to drive If there is suspected of child abuse If you are wounded by a gun or a knife If you are a danger to others For your specific questions: I asked about it and they said it's confidential, but confidential to the clinic. Correct, unless you explicitly revoke this. the counselling department can share information with the doctors This is tricker, these people may be either within your "circle of care" or they may be part of the same organisation. Notwithstanding, councillors are not doctors and are governed by the everyday laws related to confidentiality i.e. information given in confidence is confidential and everything else isn't. If you are told the limits of the confidentiality i.e. they tell the doctor, then those are the limits unless you renegotiate them. he would know I only have one kidney? Well you said "the counselling department can share information with the doctors" and this would require the information going the other way i.e. the doctor sharing with the councillor. Even if this type of sharing was OK in general (and I'm not sure it is, see above); the information shared should only be what is required for the councillor to do their job - the number of kidneys you have is probably irrelevant to this. What laws apply to situations like this where confidential information in one entity (medical office) decides to share it without the consent of the patients to another entity (the counselling dept.)? Well, we are not sure there are 2 entities: legally there may only be 1 - the university. Anyway, the laws are the Personal Information Protection Act and common law (Smith v. Jones, [1999] 1 SCR 455)
This is not a HIPAA violation. HIPAA requires that personal information not be revealed to people lacking a statutorily-defined interest, without the patient's consent. A password itself is not "personal information", though having it could lead to such information. An example of personal information would be the fact that you personally had a certain tooth filled (not that "somebody had a tooth filled"). Protected information can be revealed to certain people, such as the lab that they send samples to, or your insurance company. This is covered by what is known as "The Privacy Rule". There is a related rule, the Security Rule, which essentially says "you need to keep information safe". An example of a required security rule standard is that the provider must Implement policies and procedures to address the final disposition of electronic protected health information, and/or the hardware or electronic media on which it is stored HHS recommends degaussing, but other means of satisfying the rule exist (burning, dissolving in acid). Tossing in the trash would not satisfy the rule. Password management falls under the weaker category of "addressable", that is, a provider needs to think about how they will manage passwords, but there is no specific requirement regarding what you have to do (unlike the requirements of Data Backup, Written Contract. Incident Reporting or Media Disposal). Printing and distributing to customers your account and password would, on the other hand, be a reportable incident. Information about your name, the dental procedure done, and the cost of the procedure, is probably also on the paperwork that they give you, and that even more than your password is protected information. A provider is allowed, indeed required, to disclose protected information to the patient. The assumption is that once you have processed that information, you will destroy or protect the paperwork, as you see fit.
TL;DR: Most likely, for certain drugs. Self-prescribing was never illegal under Federal Law; it is regulated to varying degrees by the states, and discouraged by professional organizations like the American Medical Association. Pharmacists can refuse to fill prescriptions they are uncomfortable filling, and many will not fill self-prescriptions. It's not clear if, as originally written, this question is referring to the FDA's Expanded Access Program, which was created under FDA's regulatory authority (ergo it is not a law) and is colloquially called compassionate use; or the Right to Try Act, which was signed into law by President Trump in 2018. I am going to take a few moments to give an overview of both and then get to the question of self-prescribing. Expanded Access has been around for about 30 years, when it began as a way to make experimental HIV drugs available to patients during the HIV/AIDS epidemic. It has been used since them to make drugs available for a variety of diseases (like cancer), and most recently for COVID-19. The Right to Try Act is similar in that it makes experimental drugs available to patients before they have received full regulatory approval. The mechanism for that availability is a different, and it has since it is a law it has the explicit approval of Congress. Here are a journal article and a very good table breaking down the differences between Right to Try and Expanded Access. Neither of these modify the patient/doctor relationship, so they do not effect whether a prescriber can write their own prescriptions either way. A doctor could probably prescribe COVID-19-related treatments for themselves approved for widespread use under Expanded Access; they would likely be unable to self-prescribe other more medically-complex, higher-risk treatments like chemotherapy. See below. Self-prescribing is legal under federal law. As noted by the Emergency Care Research Institute: Under federal law, physicians in the United States are not prohibited from self-prescribing medications. State laws governing physicians, however, vary greatly, and some may prohibit physicians from prescribing, dispensing, or administering certain medications to themselves or family members. Restrictions vary by state. Most (perhaps all) states prohibit a prescriber from self-prescribing Schedule II controlled substances, with some providing an exception for an emergency. Many prohibit prescribing of Schedule II drugs to family members. I have found several sources that claim some states outright prohibit self-prescribing, but whenever I follow those back to the actual statute they only apply to Schedule II drugs. Professional organizations like the American Medical Association strongly discourage their members self-prescribing, stating in their Code of Ethics that &quot;treating oneself or a member of one's own family poses several challenges for physicians, including concerns about professional objectivity, patient autonomy, and informed consent.&quot; The greatest barrier to self-prescribing lies at the pharmacy, where pharmacists are able to refuse prescriptions when they question the medical necessity or standard of care that lead to the prescription.
What should and shouldn't happen isn't going to do a damn thing about your passport situation. Your passport isn't being 'held', it's in processing at a place that is currently not operational due to an unprecedented virus outbreak. No one is acting like a criminal or treating you like one, you are just unlucky. If your situation is that dire, you have no choice but to get a temporary passport. I seriously doubt an Indian court is going to side with you on this one. Just because the passport office is legally allowed to operate, doesn't mean that they are actually able to. If, for example, COVID-19 hit enough of their workforce, they won't have enough people to operate properly and they'll have no choice but to close. And no, '2 or 3 people' is not enough to operate such a large scale, sensitive operation with high security requirements, even just to return passports .
Merely encouraging people not to vaccinate via educational and political communication without purporting to provide individualized medical advice is probably not the practice of medicine and protected by the First Amendment's protections for freedom of speech, rather than constituting medical malpractice. Also, many anti-vax individuals (I couldn't quote a percentage) do so out of religious conviction and are protected not just by the freedom of speech in the First Amendment, but also by the free exercise component of the freedom of religion under the First Amendment. Generally speaking, it is harder to find a legal grounds for disregarding the free exercise of religion than it is to find a legal basis to regulate otherwise free speech. For example, commercial speech is subject to more rigorous regulation than private political and educational speech, which is why there are no private businesses taking anti-vax positions in their advertising. The theory is that courts are not in a good position to make general determinations of the truth of policy positions or statements about general truths as opposed to what happened in a particular transaction or occurrence. This is in part because a ruling by the right court at the right time can preclude the correctness of its determination from being revisited indefinitely and from time to time, accepted conventional wisdom and scientific consensus at one time are revealed later on to have been wrong with more discussion and investigation. I think that this is unlikely to be the case in the vaccination area, but the whole point of the First Amendment's protection of these kinds of issues is that we can't know in advance what will continue to be widely accepted and what will turn out to be mistaken. But, if someone in a medical diagnosis and treatment profession (e.g. M.D., D.O., physician's assistant, or nurse), were to advise a patient in a capacity as a medical care provider not to vaccinate, and as a result that person's child got sick from a disease that vaccination could have prevented, there probably would be medical malpractice liability. A somewhat similar issue arises when health insurance companies or government agencies set rules on providing care. In those cases, it isn't uncommon to have a physician or other medical professional placed on a committee or in an office such as medical director, with that person making the call and exposed to liability although not in the same way as a treating medical professional. A case about a month ago found malpractice by an insurance company's medical director (the company was United Health) to be a huge liability for both the medical director and the insurance company.
I guess it depends on what courts decide is the &quot;standard of care&quot; in prisons against transmissible diseases. This has been litigated in various way recently, not just following deaths: From a legal standpoint, many the cases center upon: due process claims under the Fourteenth Amendment, particularly related to pre-trial detainees; Eighth Amendment protections against cruel and unusual punishment; Americans with Disabilities Act violations; and discrimination claims under the Rehabilitation Act. Plaintiffs are often asking judges to intervene to force immediate changes at prisons and jails, while litigation is pending. The approach has yielded mixed results thus far. Some judges have moved aggressively, ordering institutions to improve conditions and to do more to adhere to CDC guides. Yet those decisions have met with continued appeals and resistance from corrections officials, and the U.S. Supreme Court has twice overturned efforts by federal judges to intervene forcefully in coronavirus-related matters. In May, the high court rejected on procedural grounds a request by inmates to increase cleaning and COVID-19-related education efforts at their Texas-based geriatric correctional facility. The court upheld the U.S. Court of Appeals for the 5th Circuit, which had overturned a Houston-based federal judge’s ruling supporting the prisoners. A few days later, however, the court appeared to switched course, letting stand a federal judge’s order requiring that prison officials move hundreds of inmates from an Ohio institution where nine people had died from COVID-19. Then, on Aug. 3, justices, in a 5-4 decision, overturned a lower-court injunction requiring stricter health and safety measures at the jail in Orange County in Southern California. The Orange County case, Barnes v. Ahlman, is instructive in terms of the arguments being made on both sides and the response by the courts. The jail’s leadership was accused by prisoners of ignoring Centers for Disease Control and Prevention recommendations by failing to enforce social distancing measures and declining to isolate inmates with COVID-19 symptoms. A federal judge in California had issued a preliminary injunction that required the jail to take stronger measures, and the U.S. Court of Appeals for the Ninth Circuit declined a request by the jail to halt the injunction. Jail officials argued that, prior to the injunction, CDC guidelines had been “largely implemented” and said the injunction’s requirements far exceeded the scope of the CDC’s recommendations. They also cited their efforts to voluntarily release half of the jail’s inmates to help with social distancing and said they had all but eliminated “COVID within the jail population.” The Supreme Court majority voted to stay the injunction while litigation continues. As is custom, the justices did not explain their reasoning in the order. Justice Sonia Sotomayor dissented, saying the stay was premature and that jail had placed inmates at significant risk. Earlier in the Texas case, Sotomayor encouraged lower courts to ensure “that prisons are not deliberately indifferent in the face of danger and death.” I guess some Supreme Justices might not say it but probably think it that it's not cruel and unusual to (catch and) die of transmissible diseases in prison since it happens all the time. E.g. according to one study 97% of infected inmates don't get Hep C treatment. At the other end of the spectrum: a former jail administrator in Oklahoma was sentenced to more than 4 years in prison following his decision not to take an inmate with diabetes to hospital, resulting in his death in 2013. The administrator &quot;pleaded guilty to one count of deprivation of rights under color of law.&quot; The inmate in question died of ketoacidosis. So the standard of care in prisons is somewhere in between these extremes. Most litigation regarding Covid-19 seems to center on whether CDC guidelines have been followed or not. I see that the CDC does have some specific guidelines for correctional facilities in this regard. I'm not sure of negligence case law in prison, but regarding the 8th Amendment violations, Helling v. McKinney is probably relevant to preventative measures: In Helling v. McKinney, the Court considered the case of a Nevada prisoner, &quot;the cellmate of a five-pack-a-day smoker,&quot; who sought to be housed in an environment free of second-hand smoke. McKinney suffered from no ailment and sought no medical treatment. Justice Byron White wrote for a 7-2 majority of the Court that McKinney's claim that prison officials &quot;have, with deliberate indifference, exposed him to levels of ETS [second hand smoke] that pose an unreasonable risk of serious damage to his future health&quot; raised a valid claim under the Eighth Amendment. He wrote that McKinney would have to prove both the scientific facts of the dangers of exposure to second-hand smoke and prove that community standards supported him, that &quot;it violates contemporary standards of decency to expose anyone unwillingly to such a risk. In other words, the prisoner must show that the risk of which he complains is not one that today's society chooses to tolerate.&quot; He would also have to prove that prison officials acted with deliberate indifference. Also following Ashcroft v. Iqbal government officials could not be held liable for the unconstitutional conduct of their subordinates so each official would have to be proved liable individually for involvement in such a (faulty) decision.