Licensure The Act speci es many details regarding medical licensure, including: • Requirements for medical education and tness for licensure; • The term of each license and conditions for renewal; • Continuing medical education requirements; • Licensure fees and the purposes for which they may be used; and • General terms under which medical students, residents, and visiting physicians may practice. Discipline The Act also speci es many details regarding medical discipline, including: • Penalties for practicing medicine without a license or beyond the scope of one’s license; • What disciplinary actions may be taken by IDFPR, including restriction, suspension, or revocation of licenses; • 43 speci c grounds for discipline, ranging from gross negligence to record-keeping failures; • Fines that may be levied by IDFPR in addition to any disciplinary action; and • Requirements for con dentiality of all materials related to disciplinary proceedings.
The Illinois Medical Practice Act is an essential state law that governs the practice of medicine in our state; without it, any person regardless of quali cation could practice medicine in Illinois without restriction or penalty. Because medicine is an ever-changing eld, the Act is set to expire on a regular basis, enabling the legislature to ensure that the law keeps pace with the current state of medical practice. Unfortunately, this regular expiration has also allowed politicians and interest groups to use this indispensable piece of legislation as a tool for exercising political in uence.
(410 ILCS 130/) Compassionate Use of Medical Cannabis Pilot Program Act.
(410 ILCS 130/1)
(410 ILCS 130/5)
(Section scheduled to be repealed on July 1, 2020)
Sec. 5. Findings.
(a) The recorded use of cannabis as a medicine goes back nearly 5,000 years. Modern medical research has confirmed the beneficial uses of cannabis in treating or alleviating the pain, nausea, and other symptoms associated with a variety of debilitating medical conditions, including cancer, multiple sclerosis, and HIV/AIDS, as found by the National Academy of Sciences’ Institute of Medicine in March 1999.
(b) Studies published since the 1999 Institute of Medicine report continue to show the therapeutic value of cannabis in treating a wide array of debilitating medical conditions. These include relief of the neuropathic pain caused by multiple sclerosis, HIV/AIDS, and other illnesses that often fail to respond to conventional treatments and relief of nausea, vomiting, and other side effects of drugs used to treat HIV/AIDS and hepatitis C, increasing the chances of patients continuing on life-saving treatment regimens.
(c) Cannabis has many currently accepted medical uses in the United States, having been recommended by thousands of licensed physicians to at least 600,000 patients in states with medical cannabis laws. The medical utility of cannabis is recognized by a wide range of medical and public health organizations, including the American Academy of HIV Medicine, the American College of Physicians, the American Nurses Association, the American Public Health Association, the Leukemia & Lymphoma Society, and many others.
(d) Data from the Federal Bureau of Investigation’s Uniform Crime Reports and the Compendium of Federal Justice Statistics show that approximately 99 out of every 100 cannabis arrests in the U.S. are made under state law, rather than under federal law. Consequently, changing State law will have the practical effect of protecting from arrest the vast majority of seriously ill patients who have a medical need to use cannabis.
(d-5) In 2014, the Task Force on Veterans’ Suicide was created by the Illinois General Assembly to gather data on veterans’ suicide prevention. Data from a U.S. Department of Veterans Affairs study indicates that 22 veterans commit suicide each day.
(e) Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, and Washington, D.C. have removed state-level criminal penalties from the medical use and cultivation of cannabis. Illinois joins in this effort for the health and welfare of its citizens.
(f) States are not required to enforce federal law or prosecute people for engaging in activities prohibited by federal law. Therefore, compliance with this Act does not put the State of Illinois in violation of federal law.
(g) State law should make a distinction between the medical and non-medical uses of cannabis. Hence, the purpose of this Act is to protect patients with debilitating medical conditions, as well as their physicians and providers, from arrest and prosecution, criminal and other penalties, and property forfeiture if the patients engage in the medical use of cannabis.
(Source: P.A. 98-122, eff. 1-1-14; 99-519, eff. 6-30-16.)
Many doctors have licenses in more than one state. Whether you have actively use your license or just have it just in case, a discipline in one state is likely to lead to a discipline in another. The Illinois Department of Financial and Professional Regulation will often mirror the discipline of another state. There is no hard and fast rule in the Illinois Medical Practice Act that Illinois MUST follow the discipline of another state. Some states are harder on doctors than others. Illinois is harder than some and more lenient than others. Just becuase a state has disciplined you does not mean that you MUST get the same punishment in Illinois. A doctor disciplined in one state has the right to a hearing in Illinois, not to dispute the fact that the doctor was disciplined (unless that is actually the case) but to show that the discipline in Illinois should be less restrictive.
All doctors want to avoid the National Practitioner Data Bank, becuase it is routinely monitored by hospitals, state licensing boards, Medicare and Medicaid and insurance companies. A discipline in the Data Bank can be fatal to a doctors career. According to the Data Bank, a doctor must be reported for certain disciplines that last longer than 30 days, or for resigning from a Medical Staff to avoid an ongoing investigation of that doctors medical staff privileges. Many doctors, when confronted by the hospital CEO or the Chair of their Department feel pressured to leave a medical staff without any written agreement. Many times the CEO or Chair mean the doctor no harm. Sometimes they do. But even when no harm is intended, the CEO or Chair are not familiar with the reporting requirements of the Data Bank, and once the matter is brought the the hospital’s attorney, it is determined that a report must be made. At that point it is too late. Doctors must protect against such a report by getting an agreement in writing that there will be no report, BEFORE they resign.
Illinois grandparents win appeal of their case in Springfield. Maternal grandparents of 4 children are now able to have visitation with their grandchildren.
This week the Supreme Court of the State of Washington heard arguments in a case that has profound implications for the doctor-patient relationship.
In the case, Volk v. DeMeerleer, a psychiatrist, Howard Ashby, was sued after a patient of his, Jan DeMeerleer, shot and killed an ex-girlfriend and her 9-year-old son before killing himself. (Mr. DeMeerleer also stabbed another son, who survived.) The estate of the victims, Rebecca and Phillip Schiering, took legal action, arguing that Dr. Ashby was liable because he had not warned the Schierings. A lower court ruled in Dr. Ashby’s favor on the grounds that Mr. DeMeerleer, who had occasionally voiced homicidal fantasies, had made no specific threats toward the Schierings during his treatment.
Throughout history, doctor-patient confidentiality has been a cornerstone of Western medical practice. The duty to keep patients’ information private is written into the codes of ethics of medical organizations, and is even in the Hippocratic oath: “What I may see or hear in the course of treatment,” it says, “I will keep to myself.”
Patients allow physicians into their private lives on the condition that the information we learn will not be used against them. I once took care of a business executive in the emergency room who had hired call girls during a weekend drug binge. When he saw a police officer outside his room, he quietly handed me an envelope containing a large amount of white powder. I wasn’t sure what to do with it, so I discarded it. For the next several hours the patient eyed me suspiciously, probably wondering whether I had ratted him out. But it never occurred to me to do so.
Of course, like all ethical imperatives, doctor-patient confidentiality is not absolute. Doctors have to disclose private information when it is clearly in the patient’s interest (documenting a drug allergy in the medical record, for example) or when it comes to complying with a court order (as in cases of child abuse). We must also betray confidentiality when it is in the “public interest” (reporting infectious diseases, for example).
The duty to warn third parties in danger is also an important exception to confidentiality. We publicly disclose the identities of sex offenders. We alert family members when hereditary diseases in our patients come to light. A colleague of mine once took care of a patient, a school bus driver, who received an implantable defibrillator after suffering cardiac arrhythmias. When my colleague advised the man to quit his job because of the potential risk to young children, the man refused, so my colleague reported him to the Department of Motor Vehicles. It was an action that my colleague felt very comfortable taking, even though it created an irreparable rift in that relationship.
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In the same vein, doctors have a duty to warn individuals who are threatened by their patients with bodily harm. This obligation was largely shaped by the seminal 1976 case of Tarasoff v. Regents of the University of California, in which the Supreme Court of California ruled that mental health professionals had a responsibility to protect the intended victims of their violent patients through direct warning or by notifying the police. As Justice Matthew Tobriner famously wrote in the majority opinion, “The protective privilege ends where the public peril begins.” The case has served as a basis for law in 33 states obligating physicians to warn or protect third parties.
However, the Tarasoff case has generally been interpreted to confer an obligation to warn individuals who are specifically targeted by psychiatric patients. The lower court in Washington observed that Jan DeMeerleer communicated no threats toward the Schierings during his treatment. Predicting when violence will occur or where it will be directed is difficult under the most straightforward of circumstances. When the threat is not articulated, it is next to impossible.
The World Medical Association states that confidentiality may be breached when the expected harm of maintaining privacy is believed to be “imminent, serious” and “unavoidable.” This standard does not appear to have been met in the case before the Washington Supreme Court.
Breaching doctor-patient confidentiality in such situations will likely be self-defeating. Mentally ill patients may not seek treatment, and psychiatrists, saddled with new legal liabilities, may decline to treat them. We are more likely to minimize harm if the confidence of patients at the greatest risk for violence is maintained.