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Foreword

Publication of this manual on “Legal Aspects of PHS Medical Care” comes at a particularly appropriate moment in the history of the Public Health Service. We are in the process of reorienting our mission to meet the dominant health need of the American people the delivery of the best in health services. Our own medical care activities can perform a vitally important function by serving as models of excellence and as demonstration centers for promising innovations in the field of patient care.

The heightened tempo of medical research and discovery has made it increasingly difficult for medical practitioners to keep abreast of the latest developments in the field. As medical science progresses, established concepts of medical care undergo a process of reappraisal and change. Many of these changes have a significant effect on the physician's legal obligations to his patient. Thus, law and medicine work together to define appropriate ways of meeting the patient's health needs.

This manual contains fundamental information designed to encourage and facilitate understanding of the legal problems associated with the provision of medical care by the Public Health Service. Its use by Public Health Service medical personnel will materially assist them in meeting their legal and medical obligations to the patients entrusted to their care. I am happy to commend its frequent consultation and use.

WILLIAM H. STEWART, M.D.,
Surgeon General,
U.S. Public Health Service.

Introduction

The legal restraints placed upon the practice of any profession are intended not to inhibit the full and resourceful application of the art and science, but rather, to place into proper balance the individuality of the practitioner and the personal rights of the individual. A full knowledge, therefore, of the legal aspects governing the provision of health care permits the physician and other members of the health team to recognize his obligations to his patient as defined by his peers and community and defines the parameters within which he can exercise and express his own individual creativity and capability. .

This manual, developed by Eli P. Bernzweig, Esq., Office of the General Counsel, Department of Health, Education, and Welfare, with professional medical review by the Public Health Service, is written in the framework of the Public Health Service's health care program. While its primary benefit will be to Service physicians and allied health workers, it is hoped that it will prove equally valuable to other practitioners of medicine and their colleagues. As a supplement to this publication, the Public Health Service is developing a programed instruction training manual on providing health services within the Public Health Service. This manual will permit the instruction of each health worker in the pertinent legal guidelines in this field in the shortest possible time and at the least possible cost.

CARRUTH J. WAGNER, M.D.,
Assistant Surgeon General,
Chief, Bureau of Medical Services.

IV

Preface

In preparing this manual for Public Health Service medical, paramedical, and administrative personnel, the objective has been to set forth the basic principles of professional liability and the practical rules of malpractice claim prevention as applied to the Public Health Service's medical care responsibilities. No attempt has been made to discuss criminal laws relating to medical practice, or the legal aspects of narcotic addiction, sterilization, abortion, artificial insemination, or other similar subjects. Legal problems relating to the mentally ill have been included only insofar as they involve potential liability in connection with the treatment of mentally ill patients.

It should be emphasized that this manual is not intended as an encyclopedic review of the subject of medical malpractice, but merely as an introduction to the fundamental principles involved. The text and cited court decisions are authoritative, but not exhaustive, and should not be relied upon as the sole basis for resolving specific legal problems. Extensive footnotes have been included as guideposts to additional reference materials for those who wish to delve more deeply into the subject.

Eli P. BERNZWEIG, LL.B.,
Public Health Division,
Office of the General Counsel.

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