Practicing medicine across state lines An answer to a question on MedicalSciences.SE prompts my question. Suppose I live in Wisconsin and I fly to Texas to undergo a procedure with a specialist there (I chose the states arbitrarily; I'm not asking about state-specific laws). So I have my procedure and fly back home. This procedure requires medications and months of follow-up care, which means I'll be receiving instructions from the Texas doctor and his staff, refills on prescriptions, and so forth. These interactions are all via phone or email while I remain physically in the state of Wisconsin. I'm fairly sure all these interactions would be considered "practicing medicine" under the law. However, the Texas doctor is not licensed to practice medicine in the state of Wisconsin; and yet, that's exactly what he's doing. How does the law view this? Do state laws typically make a specific exception for an ongoing doctor/patient relationship or is this covered only by case law? If it's based on case law, a citation would be a nice addition to an answer. Bonus points for adding how it would work if the specialist was in Europe instead of Texas.
I think it really is a state-by-state answer. From a web site for doctors getting involved in Telemedicine. Some medical boards such as Alabama, Montana and Oregon offer a special purpose telemedicine license. Other states that regulate telepractice in medicine include Texas, Florida, California and Colorado. The levels of regulation vary greatly by state. For example, California and Florida, similar to New York, require full licensure to perform any function relating to patient care, with some exceptions for consultation in some instances. Other states are exploring the issue of telepractice and in general, how to regulate it. That site has a state-by-state break out of the rules. I see other things about reciprocity among some nearby states. Three states (MD, NY, VA) and Washington DC provide reciprocity to bordering states. Alabama and Pennsylvania have agreements with other states to grant licenses to out-of-state physicians who have licenses in states that reciprocally accept their home state licenses. In Connecticut, an out-of-state physician can obtain an in-state license based on his or her home state standards.
Expunction may be possible for instance if you are acquitted, later proven innocent, pardoned, and various other things that fall short of being convicted and doing the time. The entire law is here (Texas code of criminal procedure 55.01). There is also the option of an order of non-disclosure, overviewed here. A requirement for such an order is that you were placed on and completed deferred adjudication community supervision, which from what I can tell is not what happened. "Background check removal" may range between simply taking your money and doing nothing, to doing what you could do yourself to get free of traces via radaris, intelius, spokeo, and so on to "request removal" from that web site. This will not make your record unavailable, because these websites don't have any special powers to reach into and manipulate state records.
This is a close call, in the example that you suggest, because it won't have been executed with the proper formalities and it isn't clear that the content at a url would be fixed in its language at the time that the Will is executed. Subject to an exception for personal property memorandums (and a more subtle one for powers of appointment in trusts) you can't change the terms of a Will once it is signed except by a Codicil executed with the same formalities. Certainly, the best practice would be to assume that the answer is no. There are times when a reference to an external document in a will is allowed (e.g. a reference to real property by address rather than a full legal description found in a recorded deed), but a list of beneficiaries would ordinarily not be allowed unless it was effectively a reference to vital statistics records (e.g. "all children born to or adopted by me.") In general, references to external documents are not allowed when used to establish the nature of the testator's donative intent (a "testator" is someone who writes a will), unless it "describes the writing sufficiently to permit its identification" and can't be modified after the Will is signed, but can be used to establish general facts about reality. One exception in Colorado is that a "personal property memorandum" designating who will receive specific items of tangible personal property can be incorporated by reference and does not have to be executed with the same formalities as a will. It isn't clear to me if a url could be a valid personal property memorandum and that issue has never been tested in Colorado. Colorado's probate laws are based on the Uniform Probate Code and would be substantially identical to any other jurisdiction that adopted the Uniform Probate Code's substantive provisions. The primary statutes governing this (which aren't necessarily easy to understand without context) are: Colorado Revised Statutes § 15-11-502. Execution--witnessed or notarized wills--holographic wills (1) Except as otherwise provided in subsection (2) of this section and in sections 15-11-503, 15-11-506, and 15-11-513, a will shall be: (a) In writing; (b) Signed by the testator, or in the testator's name by some other individual in the testator's conscious presence and by the testator's direction; and (c) Either: (I) Signed by at least two individuals, either prior to or after the testator's death, each of whom signed within a reasonable time after he or she witnessed either the testator's signing of the will as described in paragraph (b) of this subsection (1) or the testator's acknowledgment of that signature or acknowledgment of the will; or (II) Acknowledged by the testator before a notary public or other individual authorized by law to take acknowledgments. (2) A will that does not comply with subsection (1) of this section is valid as a holographic will, whether or not witnessed, if the signature and material portions of the document are in the testator's handwriting. (3) Intent that the document constitute the testator's will can be established by extrinsic evidence, including, for holographic wills, portions of the document that are not in the testator's handwriting. (4) For purposes of this section, “conscious presence” requires physical proximity to the testator but not necessarily within testator's line of sight. (5) For purposes of this part 5, “will” does not include a designated beneficiary agreement that is executed pursuant to article 22 of this title. and Colorado Revised Statutes § 15-11-503. Writings intended as wills (1) Although a document, or writing added upon a document, was not executed in compliance with section 15-11-502, the document or writing is treated as if it had been executed in compliance with that section if the proponent of the document or writing establishes by clear and convincing evidence that the decedent intended the document or writing to constitute: (a) The decedent's will; (b) A partial or complete revocation of the will; (c) An addition to or an alteration of the will; or (d) A partial or complete revival of the decedent's formerly revoked will or a formerly revoked portion of the will. (2) Subsection (1) of this section shall apply only if the document is signed or acknowledged by the decedent as his or her will or if it is established by clear and convincing evidence that the decedent erroneously signed a document intended to be the will of the decedent's spouse. (3) Whether a document or writing is treated under this section as if it had been executed in compliance with section 15-11-502 is a question of law to be decided by the court, in formal proceedings, and is not a question of fact for a jury to decide. (4) Subsection (1) of this section shall not apply to a designated beneficiary agreement under article 22 of this title. and Colorado Revised Statutes § 15-11-510. Incorporation by reference A writing in existence when a will is executed may be incorporated by reference if the language of the will manifests this intent and describes the writing sufficiently to permit its identification. and Colorado Revised Statutes § 15-11-511. Testamentary additions to trusts (1) A will may validly devise property to the trustee of a trust established or to be established (i) during the testator's lifetime by the testator, by the testator and some other person, or by some other person, including a funded or unfunded life insurance trust, although the settlor has reserved any or all rights of ownership of the insurance contracts, or (ii) at the testator's death by the testator's devise to the trustee, if the trust is identified in the testator's will and its terms are set forth in a written instrument, other than a will, executed before, concurrently with, or after the execution of the testator's will or in another individual's will if that other individual has predeceased the testator, regardless of the existence, size, or character of the corpus of the trust. The devise is not invalid because the trust is amendable or revocable, or because the trust was amended after the execution of the will or the testator's death. (2) Unless the testator's will provides otherwise, property devised to a trust described in subsection (1) of this section is not held under a testamentary trust of the testator, but it becomes a part of the trust to which it is devised, and is administered and disposed of in accordance with the provisions of the governing instrument setting forth the terms of the trust, including any amendments thereto made before or after the testator's death. (3) A revocation or termination of the trust before the death of the testator causes the devise to lapse, but exhaustion of trust corpus between the time of execution of the testator's will and the testator's death shall not constitute a lapse; a revocation or termination of the trust before the death of the testator shall not cause the devise to lapse, if the testator provides that, in such event, the devise shall constitute a devise to the trustee of the trust identified in the testator's will, and on the terms thereof, as they existed at the time of the execution of testator's will, or as they existed at the time of the revocation or termination of the trust, as the testator's will provides. and Colorado Revised Statutes § 15-11-512. Events of independent significance A will may dispose of property by reference to acts and events that have significance apart from their effect upon the dispositions made by the will, whether they occur before or after the execution of the will or before or after the testator's death. The execution or revocation of another individual's will is such an event. and Colorado Revised Statutes § 15-11-513. Separate writing or memorandum identifying devise of certain types of tangible personal property Whether or not the provisions relating to holographic wills apply, a will may refer to a written statement or list to dispose of items of tangible personal property not otherwise specifically disposed of by the will, other than money. To be admissible under this section as evidence of the intended disposition, the writing shall be either in the handwriting of the testator or be signed by the testator and shall describe the items and the devisees with reasonable certainty. The writing may be referred to as one to be in existence at the time of the testator's death; it may be prepared before or after the execution of the will; it may be altered by the testator after its preparation; and it may be a writing that has no significance apart from its effect on the dispositions made by the will. There is not a statutory definition of a "document" or a "writing" in the Colorado Probate Code.
The courts of Washington will not apply the law of Tennessee in an action somehow involving something about Tennessee, they will apply the laws of Washington. If neither end of the conversation is in an all-party state, no party has standing to sue under the laws of some other state. If a person in Idaho calls a person in Oregon and the call is routed through Washington state, neither party can sue under Washington law. In all 50 states, there is an &quot;exception&quot; to the consent requirement when the &quot;interception&quot; is due to routing / switching, otherwise it would be illegal to call from house to house if you don't have a single wire between the houses (never the case). No state has a law that imposes two-party state law in calls that pass through a two-party state. The federal wiretapping law say you may not intercept any wire, oral, or electronic communications without consent, then sets up the definitions to encode the exceptions. For example, &quot;aural transfer&quot; is a transfer containing the human voice at any point between and including the point of origin and the point of reception (anticipating the need for connections), and &quot;intercept&quot; means &quot;acquisition of the contents of any wire, electronic, or oral communication through the use of any electronic, mechanical, or other device&quot; (a hearing aid is a device). But then &quot;electronic, mechanical, or other device&quot; is further defined to exclude a hearing aid, or also they exclude any telephone or telegraph instrument, equipment or facility, or any component thereof, (i) furnished to the subscriber or user by a provider of wire or electronic communication service in the ordinary course of its business and being used by the subscriber or user in the ordinary course of its business or furnished by such subscriber or user for connection to the facilities of such service and used in the ordinary course of its business; or (ii) being used by a provider of wire or electronic communication service in the ordinary course of its business, or by an investigative or law enforcement officer in the ordinary course of his duties which is a good thing since the telephone is a device, and the switching system is a system used to make a phone call possible, but it intercepts under the ordinary meaning of intercept. Intercept has a specific, narrow meaning. The law of Florida is very similar
A variant of this question is addressed in Kearney v. Salomon Smith Barney, with recording taking place in a call between a 1-party and an all-party jurisdiction (California and Georgia). The CA Supreme court ruled in favor of California as the &quot;most-interested&quot; jurisdiction, which if applied to your hypothetical would favor Florida as the most-interested jurisdiction. There would be a true conflict in the law of the two jurisdictions, and (with substitution of names of jurisdictions) as a general matter, the failure to apply California→Florida law in this context would impair California's→Florida's interest in protecting the degree of privacy afforded to California→Florida residents by California→Florida law more severely than the application of California law would impair any interests of the State of Georgia→Nation of Canada The thing is, the person in Florida is violating Florida law by recording, so the cross-jurisdictional issue would only favor the person being recorded in Florida. The Florida statute makes no mention of where the person being recorded is, so there exception to the effect that the law does not apply when the person being recorded is outside of Florida. The Florida person broke Florida law.
I'm not a lawyer or a medical professional, but on Wikipedia's page about DNR, we see the following quote: In the United States the documentation is especially complicated in that each state accepts different forms, and advance directives and living wills are not accepted by EMS as legally valid forms. If a patient has a living will that states the patient wishes to be DNR but does not have an appropriately filled out state sponsored form that is co-signed by a physician, EMS will attempt resuscitation. Based on this, I would hazard the guess that you can't treat anything other than those forms as legally binding, as they even ignore a living will without that state's form.
Because the prohibition of selling to a resident of another state isn't a state law, but rather a Federal law. ATF explains May a licensee sell a firearm to a nonlicensee who is a resident of another State? Generally, a firearm may not lawfully be sold by a licensee to a nonlicensee who resides in a State other than the State in which the seller’s licensed premises is located... In addition, a licensee may sell a rifle or shotgun to a person who is not a resident of the State where the licensee’s business premises is located in an over–the–counter transaction, provided the transaction complies with State law in the State where the licensee is located and in the State where the purchaser resides. [18 U.S.C. 922(b)(3); 27 CFR 478.99(a)]
It depends highly on which jurisdiction you're referring to. This is one of the areas where it varies state to state. &quot;Practicing law&quot; is not generally defined in statute, but the Wikipedia definition defines it as (emphasis mine): giving legal advice to clients, drafting legal documents for clients, and representing clients in legal negotiations and court proceedings such as lawsuits, and is applied to the professional services of a lawyer or attorney at law, barrister, solicitor, or civil law notary. Wikipedia defines Legal advice as the giving of a professional or formal opinion regarding the substance or procedure of the law in relation to a particular factual situation. and displays the following enforcement provision (emphasis mine): Criminal laws and enforcement of &quot;Unauthorized Practice of Law (UPL)&quot; statutes is the organized bar's preferred method. Thus, New Jersey has a law which makes it a “disorderly persons offense” to knowingly to engage in the unauthorized practice of law, and a “crime in the fourth degree” to commit UPL if one (a) creates a false impression that one is a lawyer; (b) derives a benefit from UPL, or (c) causes an injury by UPL. See also IANAL, which has some information about usage on the Internet: The case law standard for determining what comments cross the line is generally &quot;the application of law to facts specific to an individual seeking legal advice&quot;.