Examples of Unethical Medical Practices

Medical care is often received at the most vulnerable times in a person’s life, and everyone should reasonably be able to expect to receive ethical treatment. However, healthcare professionals and medical institutions do not always act ethically, which is where medical malpractice lawsuits are created.

Let’s identify some common examples of unethical medical practices.

Identifying Unethical Medical Practices

Unethical conduct refers to a behavior that violates established principles or standards of behavior in an unacceptable, wrong, or unfair manner. When this happens within a medical situation, this can refer to a medical practice or practitioner who acts with dishonesty, deception, discrimination, exploitation, fraud, or harassment towards a patient.

From a legal perspective, an unethical medical practice would be defined as a medical professional who owed a duty of care to the patient and breached that care with their intentional actions or omissions that were unfair or harmful. Some examples of unethical medical practices could include:

• Treating patients with discrimination
• Hiding mistakes that were made
• Taking money fraudulently or “upcoding” insurance
• Working under the influence of drugs or alcohol
• Violating patient confidentiality (HIPAA regulations)
• Joking or acting inappropriately around patients
• Failing to provide informed consent

Unethical conduct from a medical practice or staff member is often cited as a reason for filing a malpractice lawsuit. Pursuing compensation from those who harmed you is your right, but the process can be complicated and frustrating without experienced guidance from a skilled attorney.

The Importance of Informed Consent

Informed consent is one of the most important ethical duties a medical practice or professional owes to every patient. Before any treatment or testing, each medical provider is ethically and legally required to confirm the patient’s understanding and agreement to treatment protocols, alternative treatment options, benefits, and risks of proceeding. The American Medical Association’s Code of Medical Ethics prioritizes informed consent as one of its nine core principles.

Medical procedures that require informed consent are typically ones where the patient is accepting known risks or has an expectation of protected privacy. There are four components of informed consent: a patient’s capacity to make a decision, documentation of the consent, disclosing information, and competency.

Examples of treatments that require informed consent include:

• Being treated with high-risk medication like an opioid
• Most surgeries or biopsies, even when they are not in-patient or done at a hospital
• Use of anesthesia or some other types of sedation
• Some vaccines and blood tests, such as HIV testing
• Treatment with radiation or chemotherapy
• Clinical trials on human patients
• Any invasive procedure such as endoscopy
• Transferring or sharing your personal information

If you or a loved one was injured due to unethical medical practices, our experienced Philadelphia medical malpractice attorneys at Lopez McHugh LLP are here to help you with your claim.

Unethical Medical Discrimination

Discrimination can happen consciously or unconsciously, and medical professionals should work to treat all patients with the same care in diagnosis and treatment. However, discrimination against certain groups sometimes occurs in the medical realm, whether due to gendered, cultural, religious, or ethnic biases. Healthcare professionals have been known to misinterpret or dismiss patient symptoms, leading to withheld treatment and misdiagnosis.

Discrimination is often cited as a cause of medical negligence. The Center for Justice and Democracy found that racial and ethnic minorities face a reduced standard of health services when accessing regular medical care. When facing treatment in a medical practice, minority patients may experience disproportionately more medical errors causing harm than other patients at the same medical facility.

There are several legal safeguards in place that address discrimination in healthcare, including provisions made in the Affordable Care Act. In addition, the Civil Rights Act is a federal statute that bars discrimination in healthcare based on race, color, national origin, sex, age, or disability. If you or a loved one has experienced harm due to discrimination, you may be able to file a civil lawsuit to pursue a settlement for medical bills, lost wages, and possibly even punitive damages, depending on the severity of the ethical misconduct.

What Is Upcoding?

Upcoding is a type of insurance fraud that causes billions of dollars of overpaid claims every year. According to PubMed, Medicare fraud alone caused $60 billion in overpaid claims in the last reporting year. Upcoding occurs when a healthcare provider submits codes to Medicare, Medicaid, or a private insurer for a pricier treatment or care plan than the provider actually carried out.

Healthcare procedures and services are all identified in medical billing by extremely specific codes that are called Current Procedural Terminology (CPT) codes. There are over 7,800 CPT codes that are used in the medical billing field. Upcoding can refer to either willful, fraudulent misuse of these billing codes or accidental use of the codes when billing a patient’s insurance.

Upcoding harms our whole economy by inflating rates in insurance coverage, leading to an increase in private insurance costs. This activity also takes money from government programs like Medicare and Medicaid, resulting in a loss of taxpayer funds. However, the more harmful problem with upcoding can be the fraudulent impact it has on the patient’s medical records. If a patient has an upcoded procedure on their record, even an ethical healthcare professional might misdiagnose them or provide the wrong treatment based on the misinformation on the charts.

When to Report Unethical Behavior in Medical Practices

Unethical behavior does not need to cause physical harm to the patient to be important enough to report. Unethical behavior can be reported within the hospital or medical practice to a supervisor, or the patient can file a complaint with the state’s Department of Health. More specifically, upcoding can be reported through the False Claims Act, which gives employees and other witnesses a safe and anonymous way to report any fraudulent practices.

Not every instance of unethical behavior causes physical, emotional, or other harm to a patient. In these situations, the person may feel they should just “get over it” and not pursue legal action. However, inappropriate or negligent actions can lead to harm later on, and failing to report them could mean others suffer the same poor treatment, potentially with damaging effects.

An example of an unharmful act ending in a case of medical malpractice may include a doctor utilizing upcoding to fraudulently bill insurance or medical staff making jokes about a patient who is under anesthesia. These unethical behaviors show a breach of established care, even if the patient suffered no direct harm. Patients deserve to be treated with respect and care while under the supervision of a medical professional and these acts are an example that breaks that deserved trust.

What to Do if You Have Suffered from Unethical Medical Practices

If you have been harmed, whether directly from an unethical medical practice or as a result of the longer-term repercussions, you should speak with a qualified medical malpractice lawyer to determine if you are eligible to recover compensation. Patients should be able to trust that their medical professionals are following the rules and ethical standards that our civilization lives by. Holding unethical medical professionals accountable through a claim can help regain justice.

Determining whether behavior crossed the line into unethical territory will require proof to establish a case, but a Philadelphia medical malpractice attorney can help. Contact Lopez McHugh LLP to get started on your claim and take the first step toward justice.