Over the past decade, science and technology have advanced the field of oncology. In the era of precision medicine, treatments that were not otherwise readily available are now accessible to patients. Molecular testing coupled with the advent of immunotherapy, radiation therapy, chemotherapy, and surgery brings new hope for the cure of cancer.
In the meantime, the health care delivery system has gone through an enormous amount of transformation, making the delivery of cancer care complex; in addition, cancer care represents a significant portion of total US health care spending. Approximately $183 billion was spent in the United States on cancer-related health care in 2015, and this amount is projected to grow to $246 billion by 2030—an increase of 34%. Cost containment while maintaining a high level of quality care is of paramount importance.
In this high-stakes system, it is easy for a clinician, such as a radiation oncologist, medical oncologist, surgeon, primary care physician, pharmacist, social worker, nurse, or other specialist involved in cancer care, to make mistakes. Such mistakes come at great costs not only to individual clinicians and patients but also to the entire system; in addition, it is distressing when a clinician is named in a lawsuit or when a patient is harmed as a result of medical malpractice, resulting in pain and suffering. Therefore, it behooves a clinician to have basic familiarity with the legal aspects of clinical medicine. It is no longer adequate for clinicians just to know medicine. They must be versed in the various issues in the interface of law and medicine so that they have a road map to practice medicine effectively, economically, and safely. As a specialty, oncology pervades all medical specialties, and understanding law and medicine through the lens of cancer care is a provocative and prudent proposition.
Furthermore, just as clinicians should learn about law and medicine, other stakeholders such as health care attorneys, hospital CEOs, office managers, public health officials, social workers, entrepreneurs, and those who work in health care should also find the various topics invaluable to their understanding of the complexity of health care administration. In fact, there is no better time to start to learn than when they are students. Therefore, medical students, residents, MHA students, MPA students, law students, and MBA students would greatly benefit from reading this treatise as they progress into their careers and leadership positions.
This textbook explores the intersection of law and medicine, focusing on an array of topics specific to the field of oncology and its nexus to other specialties. It is divided into 3 sections: Section I (Chapters 1, 2, 3, 4, 5) dives into the fundamentals of law with respect to how the legal system operates on cancer care. Section II (Chapters 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16) speaks to the different specialties where law and medicine manifest most prominently in cancer care. Section III (Chapters 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30) explores cogent topics that are relevant to cancer care. Illustrative examples via clinical vignettes in Sections II and III reinforce the legal relevance to the clinician's day-to-day practice. Case laws alert the reader to mistakes that have been made and how these mistakes have been borne out in the legal system. The reader should use them as learning tools. Key points are practical recommendations at the end of the chapter for the reader as take-away pearls.
Each chapter is authored by expert specialists, almost all of whom have both a medical or dental and legal background, in particular fields of law and medicine. Their treatise reflects their own research, experience, and professional opinions. While each chapter provides a general discussion of its intended topic, laws and regulations vary by jurisdiction. The reader is therefore encouraged to review the laws, regulations, and standards of care specific to the reader's jurisdiction and field of practice as they relate to the issues discussed in these chapters.
We hope you enjoy this first-of-its-kind textbook for the understanding of the principles and practice of legal oncology.
Tony S. Quang, MD, JD, FCLM
Michelle S. Taft, JD
Sushil Beriwal, MD, MBA, FASTRO, FABS