Introduction
Healthcare professionals operate within the dictates of various laws that impose certain obligations arising from their work and interactions. Doherty and Purtilo (2016) explain that regulations delineate the conditions under which hospitals, doctors, nurses, and administrators acquire the privilege to practice. Consequently, they are vulnerable to both personal and institutional liability based on any acts or decisions that contravene the standards established by the operative laws. For instance, a triage nurse would be personally liable for a discharge decision that they are not authorized to make. Although the hospital may also be responsible vicariously, it may invoke its policy to trigger an exception to this rule or obtain indemnity from the nurse. However, a doctor-patient relationship cannot arise by simply walking into a physician’s office because an affirmative act that manifests by, at least, agreeing to examine, diagnose, or treat the patient, must be apparent.
Liability for Unauthorized Acts or Decisions
Hospitals are typically responsible for their employees’ actions unless under specific exigent circumstances. This liability derives from the employer-employee dynamics that create a special relationship recognized in law and which constitutes an exception to the general rule on individual responsibility for one’s actions or decisions. Consequently, by virtue of this connection, one person or entity can be held accountable for the acts or decisions of another under the principle of vicarious liability. However, to invoke this doctrine, there must be an impugned deed or resolution which must have been executed or made within the scope of employment. The essence of this prerequisite is that an employer cannot be held liable for employees’ acts that they neither instructed nor controlled (Beatty et al., 2019). Therefore, employees’ behavior that is not within the ambit of employment qualifies as illegal. The employer cannot be, as an exemption to the rule on vicarious liability, held accountable for such conduct. Consequently, such an employee would be individually responsible for such unsanctioned acts.
The hospital and the triage nurse under the present circumstances have a special relationship as employer and employee respectively. Additionally, a wrongful decision is apparent since the triage nurse opted to discharge the patient regardless of the latter’s symptoms and history and the obvious lack of authority. Accordingly, the only other requirement is to establish whether the discharge was made within the scope of employment. It depends on whether the hospital has an explicit policy that delineates the competencies of every healthcare professional and if the staff has been informed of it. If a clear rule on triage nurses’ inability to make discharge decisions exists, such action would constitute a direct violation of the hospital policy and is therefore illicit due to being beyond the scope of employment. Therefore, the triage nurse would be individually culpable for the unauthorized determination to discharge the patient. However, in the unlikely event the hospital is held liable, it can pursue indemnification by the nurse or rely on insurance to offset the cost.
Inception of the Doctor-Patient Relationship that Gives Rise to Liability
The doctor-patient relationship is considered a sacred pact that is based on trust and guarantees confident interactions between the concerned parties. Notably, this affiliation cannot arise passively or by implication because the former must make an affirmative indication of the willingness or acquiescence to handle the latter’s case (“Establishing Doctor-Patient Relationship in Telemedicine,” 2019). Accordingly, without a positive indication by the doctor, the relationship cannot be established. Actions that suffice to create the requisite relations include consultations or advice, examination, diagnosis, or treatment of the patient by the physician or other approved personnel acting under the doctor’s directions. Being in a hospital or a clinician’s office, without the execution of any of these acts, does not suffice to create the doctor-patient relationship.
A doctor-patient relationship was never established under the circumstances because, first, the individual had never seen any particular doctor before. Second, when he walked into the office, he simply sat in the waiting room for several hours without any attempt to see the physician or make any inquiries. There is no evidence of any manifestation of an affirmative act by the doctor or any of their employees signifying the acknowledgement or willingness to handle the person’s case through consultation, examination, diagnosis, or treatment. Therefore, no legal duty on the part of the physician or her employees arises since the mere entry of the individual into the office did not create any legal obligation. However, it is not clear whether the individual simply went into the waiting room and sat without inquiry or communication with any one at the reception desk. Reporting at the receptionist and being invited to wait for the doctor would qualify as a positive act that is indicative of the willingness to handle the case. Nonetheless, the legal duty would still not arise until the doctor or some other personnel advise, examine, diagnose, or treat the person.
Conclusion
Accordingly, since triage nurses do not make discharge decisions, one who does so would be personally liable. If the hospital has a clear policy in that regard, the likelihood for being held responsible for the nurse’s decision diminishes. However, if the hospital is found vicariously culpable, the nurse can indemnify it. Remarkably, the inception of a doctor-patient relationship does not occur without the express indication by the former of the willingness to handle the latter’s case.
References
Beatty, J., Samuelson, S., & Sánchez Abril, P. (2019). Business law and the legal environment (8th ed.). Cengage.
Establishing doctor-patient relationship in telemedicine. (2019). OrthoLive. Web.
Doherty, R., & Purtilo, R., (2016). Ethical dimensions in the health professions (6th ed.). Elsevier.