The case of Jeannette M. (Fremgen, 2002) presents a problem with three actors: a patient, a physician, and a medical receptionist. The case will be analyzed by employing the CIRAC method of examining legal cases.
CIRAC is a variation of IRAC, a method of legal analysis. It consists of five steps: Conclusion (answer to the question or solution for a dilemma), Issue (what is under consideration in a given case), Rule (or Relevant law, a law or regulations appropriate in the case), Application (or Analysis, examining how the law should be applied to the case), and Conclusion (restating the answer or the solution based on the analysis) (Gopen, 2011). Although the approach has been criticized for oversimplifying the process of legal analysis, it is still used, especially to demonstrate a theoretical legal framework for real-life events.
In the case of Jeannette M., the conclusion is that the receptionists at the patient’s physician’s office is responsible for the fact that medical care had not been provided to Jeannette on time, which inadvertently caused her death. The issue, in this case, is the necessity and urgency of a physician’s staff to notify the physician about patients’ complaints, if any. The question is thus connected to the professional ethics and can be formulated as, “Is a physician’s staff member obliged to notify the physician immediately about patients’ complaints or can this staff member put it off because he or she is busy or considers a particular complaint to be not urgent or low priority?” The rule is observed in nursing codes of ethics, which state that such notifying should be immediate in order to avoid adverse effect for a patient (Butts & Rich, 2012). The physician’s receptionist is not necessarily a nurse, but since he or she professionally acts as a mediator between a doctor and a patient, the nursing ethics should apply to this case. Moreover, the studies have shown that patients often trust medical receptionists more than nurses or physicians (Akseer, 2014). The analysis suggests that the receptionist was responsible for communication between Jeannette and her physician. Therefore, if the message from the patient was not delivered to the doctor immediately but was put off, even though there was a reasonable excuse, the receptionist is responsible for the delay and, subsequently, for the patient’s death.
This case presents both a legal problem and an ethical problem. It deals with the receptionist’s job instructions: if it is stated in them that the receptionist is obliged to notify the physician immediately, his or her behavior in this case was a violation. The ethical component of it was whether or not the receptionists had a moral right to distract the doctor from giving flu shots. I believe that the receptionist is not to be blamed directly for Jeannette’s death, but a violation of an ethical code is clearly observed. The physician is not at fault either because she did not know about Jeannette’s state at the time when the patient had a heart failure. If the receptionist had notified the physician about the patient’s complaint, it could have helped to prevent Jeannette’s death.
The CIRAC analysis has shown that the receptionist bears indirect responsibility for the death of a patient. The reason is that delivering notifications on time is the responsibility of the receptionist, and the physician was notified about the patient’s complaint too late.
References
Akseer, R. (2014). A narrative study of patient encounter accounts of physicians, nurses, and medical receptionists after two decades of a paradigm of patient-centered care (Doctoral thesis, Brock University, St. Catharines, Canada). Web.
Butts, J. B., & Rich, K. L. (2012). Nursing ethics. Burlington, MA: Jones & Bartlett Publishers.
Fremgen, B. F. (2002). Medical law and ethics. Upper Saddle River, NJ: Prentice Hall.
Gopen, G. D. (2011). IRAC, REA, where we are now, and where we should be going in the teaching of legal writing. Legal Writing, 17(1), xvii-xxxv.