Advisory opinions: Pronouncement of death
Q. Who can pronounce death? A. Only a physician is legally authorized to pronounce death. see RS 9:111 A. A physicians' pronouncement of death must be preceded by the physician's personal evaluation and examination of the individual, therefore this duty cannot be delegated to another licensed health care provider. This requirement is not altered by the clinical setting in which the death occurred, i.e., in a hospital setting or if the patient is in hospice care.
Advisory opinion: medication administration by unlicensed individuals
Q. Who can administer medications? A. Administration of medications may be undertaken only by a person who is licensed to do so such as a nurse, physicians' assistant or physician. A physician may authorize an unlicensed individual to administer medications to his patients, under a physician's direction and immediate personal supervision, i.e., where the physician is physically present at all times that the unlicensed individual provides medical services. The physician retains full responsibility to patients for the training, delivery and results of all services provided by unlicensed individuals.
Q. Can an unlicensed individual carry out a physician's order to administer controlled substances to his patients? A. Only certain licensed health care providers (RN's, PA's) are authorized to administer controlled substances to patients under a physician's order. An unlicensed individual is not legally authorized to handle controlled substances, and could not prepare or "draw up" syringes of controlled substances or fill pain pumps. An unlicensed individual could administer medications to a patient, under a physician's immediate personal supervision, i.e., at the bedside, however, the physician retains full responsibility for the training and delivery of any medical service provided by an unlicensed individual.
Advisory opinion: self-referral for laboratory or diagnostic studies
Q. Can radiologic testing be performed on a patient who presents without a physician's prescription or referral? A. Under Louisiana law, the ability of a licensed radiology technologist or private radiologic technologist to perform radiologic procedures on patients requires the order of an authorized practitioner. It is the position of the Board that the ordering of, or prescription for any diagnostic study necessarily encompasses an evaluation of a specific patient, and the decided medical judgment that such study will be beneficial in the diagnosis and/or treatment of a medical condition, injury or disease. Legal authority to order the performance of diagnostic testing is not delegable.
Q. Can radiologic testing be performed on "self-referred" patients under a physician's "blanket prescription"? A. Under LA law, the legal capacity to administer diagnostic radiography is contingent upon the specific order of a physician given with respect to a specified patient and that a general or "blanket prescription" for diagnostic radiography do not suffice as the "prescription of a licensed practitioner" required by state law to authorize performance of such procedures. It would be improper for a physician to order diagnostic testing on patients without first establishing a patient physician relationship and making a determination that such testing is indicated.