StMU Research Scholars

Featuring Scholarly Research, Writing, and Media at St. Mary's University
May 14, 2023

The Physical and Legal Ramifications of Combatting Liver Disease

 

Diagram of Liver
Diagram of Liver http://creativecommons.org/licenses/by/3.0/us/

The Functions of the Liver

The liver plays a huge role in the process of digestion in the body. The functions of the liver include the following: filtration, digestion, metabolism, detoxification, protein synthesis and storage of vitamins and minerals. These functions are what the liver does every time we consume food. If the liver is not functioning as it should, there can be a variety of problems that can occur impacting other major organs in the body. Filtration is when the liver removes what is good or bad as particles continue through the rest of the digestion process. Digestion is how foods that we consume are dissolved and processed through the rest of the digestive tract. Metabolism is when the liver breaks down certain nutrients and sends them to where they need to go in the body. Detoxification is when the liver detoxifies things that do not belong in the liver and will try to remove them. Protein synthesis is the breakdown of proteins in the liver. The storage of vitamins and minerals makes sure that the body gets enough of these maintains the balance of all vitamins and minerals which is provided from the foods that we eat or through supplementation. 2

According to Eric Loewy, “Unfortunately, just because something new has been discovered, tested, and found to work well does not mean that it is correct”. This is an important concept to understand because a lot of physicians may assume things before actually making sure that there is evidence behind the given research, but more importantly because every body functions differently than others. There are other factors that need to be included other than ethics and evidence based medicine. This resource could be beneficial to the public to recognize the cause of their symptoms and seek medical help before it is too late to reverse the damage to the liver. Many people do not rely on visiting their primary doctors because of the lack of communication about specific health related topics, like issues with the liver. 3

Patients may feel as if the doctor is not listening to their responses and as a result begin to search elsewhere to figure out the cause of their symptoms. It is of crucial importance to have enough evidence based research before recommending any kind of medication to a patient.

Legal Aspects in Health Care Related Topics

There are certain laws and regulations that limit the amount of information a healthcare facility can tell the public about liver disease. This is one of the reasons that many people don’t understand that they are experiencing problems with their liver. According to Mary Bobinski, “There is a dramatic difference between law and medicine.” 4 It’s very important for the public to be aware of the laws governing communication about their illness to understand the way the physician must legally communicate to them about their disease. The patient must be able to ask questions to their diagnosis, and what lifestyle changes can be made to improve their health. If these laws are in place, how will a patient be able to receive the proper care that they need in regards to their health? 

The laws that regulate the healthcare industry are Health Insurance Portability and Accountability Act (HIPAA), The HITECH Act, EMTALA, Anti-Kickback and Stark Laws, PSQIA, Fraud and Abuse Laws. Additional laws and regulations include but are not limited to Americans with Disabilities Act, Family and Medical Leave Act, and Medicaid. These laws are very different from each other, and are of crucial importance to understand their terms and definitions. HIPAA is an important law that is in place in the healthcare system. It is important for consumers of any healthcare facility to understand their rights as a citizen to these laws that are in place. HIPPA protects the consumers medical history and any other confidential information that can be used in any healthcare facility. Some of the information that is protected by HIPAA also includes conversations with doctors, billing information, and information put into your medical record.  5 In regards to HIPPA, there is of crucial importance to protect and keep patient information confidential.

The HITECH Act is something that is put into place to ensure that employees for health care facility are in compliance with HIPAA privacy and security requirements. The EMTALA stands for the Emergency Medical Treatment and Labor Act is required for hospitals to provide stabilization and treatment for those that come to the Emergency department despite not having any kind of payment or insurance. The Anti-Kickback and Stark laws are those that include any kind of abuse of the healthcare system for financial gain. The Stark Law is a set of laws to prohibit physicians from referring patients to designated health services. The PSQIA is an act that is in place to protect any of the healthcare workers who feel unsafe while at their work facilities. The Fraud and Abuse Laws are in place to ensure that the healthcare providers do not commit fraud or abuse in any facility. 6

According to Tanya Stivers, “We believe that to improve physician-patient communication about treatment and maintain and improve quality of care, physicians need more communication strategies for working with engaged patients.” 7  It is extremely important for there to be a sense of clarity of their diagnosis or any related health information. My family members felt as if their physicians did not explain the diagnosis. They felt as if they were just being told that they were heavy drinkers-alcoholics and did not give them any nutrition related information. After receiving my Bachelor of Science with a focus on nutrition, it became apparent to me that the illness experienced within my family is actually directly related to nutrition. The liver has a lot of important functions that are not generally talked about in our healthcare system. There was an automatic assumption that my family members were heavy alcohol drinkers, and that was not the case. Alcohol played little to no role with  their diagnosis. When my family members visit their doctor, the doctor typically provides them with information about alcohol related cirrhosis. Two of my family members were diagnosed with Primary Biliary Cholangitis which is an autoimmune disease. The doctors know their diagnosis but are not providing information and research about what this disease is and how it can affect a person’s overall health. There are many potential reasons families aren’t provided research about other less common liver conditions, as as the expense and time it takes to publish this content for only a few patients. It’s a complicated condition, and legally it can be tough to create the content in a way the patient can understand and still be accurate. This is one of the reason’s I’ve become very determined to help my family members and others facing similar conditions understand the impact nutrition has on their symptoms.

The health care system has certain laws and aspects in place to protect their employees and their patients. Since these laws such as HIPPA are in place may make it difficult for consumers wanting to receive more information to better their health may not be able to receive any more information because of the law that is in place of the healthcare system. There are even more reasons why communication during a health care visit is so important to patients to be able to lessen the severity of any kind of symptoms they may be experiencing related to their liver health.  I am still continuing to do my research to help them understand the symptoms that they experience.

Foods that make the liver work harder

The diet plays an important role in the health of the liver. Foods that contain high sodium, high fat content, and less nutrient dense. Foods that are high in sodium are highly processed foods such as sandwich meats. Foods that are of high fat content are for example cooking oils or butter. Foods that are less nutrient dense are those that do not contain much energy content these are foods that are considered to be “junk food”. Focus on eating healthier foods to take better care of your liver

Look at the healthy plate, with vegetables and fruits making up half, and protein and grains the other.
Ideal meal plate courtesy of US Government

Some patients are unable to even with a healthy diet to control their liver disease, and the must take medication to help their condition. The disclaimers included in advertisements for specific brand-name prescriptions come with so many required legal disclaimers making the required pages of disclaimers larger than the printed advertisement. Viewers watching media often make fun of the disclaimers, and they have even joked about them on Saturday Night Live! The purpose of the use of disclaimers is to educate the public about the side effects of specific drugs, and to provide a legal safety net for the pharmaceutical industry, as well as protect the patient. When looking at liver disease and other conditions that can be helped by improved nutrition, there should also be information about the impact of fatty foods can healthy recommendations legally required in the disclaimer. These disclaimers need to be designed for the patient to read and understand.

The purpose of this plate visual is to show the balance of food groups. These food groups include dairy, protein, fruit, vegetable, and grains. It is of crucial importance to understand the food plate and how it needs to have balance of each of these food groups in the diet. A balance of these foods groups can help everyone live a healthier lifestyle, especially those individuals struggling with liver disease.

Cover of the book called The Amazing Liver and Gallbladder Flush
Book cover of recommended book.

One of the best tools to learn about diseases can be found in books. Books aren’t typically held to advertising standards and are generally protected by the First Amendment, freedom speech. I’ve found several books that helped me understand what is going on with my family members. Books take time to read, often aren’t offered in the language necessary for the reader and may take a while to locate through a local library system. That being said they tend to be comprehensive and help encourage patient doctor communication thanks to an in depth explanation of problems.  For example the book Skinny Liver goes into great detail about the liver, and provides helpful recipes, The book called the Amazing Liver and Gallbladder Flush, is also a good reference for anyone wanting to look at different ways to help their liver. Another tool to use if someone is struggling to find information about the liver or any disease is to locate articles through  scholarly sources, like the public library and google scholar. University libraries are generally open for the public which allows free access to extensive databases. There is a lot of information that can be misleading and can cause misunderstandings if not received from a scholarly source. 

Throughout this document I have quoted from credible sources that are both related to my topic of the liver and the healthcare system. These sources have crucial information that can be of great importance when researching about topics that are related to the liver and the healthcare system. These authors have an expertise with information related to diseases of the liver, and related information to the healthcare system. 

The community will benefit from this crucial information related to the liver. Many people are not able to distinguish credible sources to sources that are not credible. The information that I have researched can help those families that are not receiving the answers that they need from their doctors. Nutrition is a crucial aspect for any person to consider when combatting diseases especially those related to the liver. The liver has a lot of major processes in the body that many people may not be familiar with. Nutrition is constantly evolving, and our community needs to be given this viable information that can possibly save their life.  

  1. Cutler, Jennifer. “Hepatic Anatomy,” January 12, 2023.https://www.openanesthesia.org/keywords/hepatic-anatomy/.
  2. Kalra, Arjun. National Library of Medicine, n.d. https://www.ncbi.nlm.nih.gov/books/NBK535438/#:~:text=The%20liver%20is%20the%20storage,unconjugated%20bilirubin%20and%20conjugates%20it.
  3. Agrawal, Karoon. “Ethics and Evidence Based Research: Is There a Conflict?,” April 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745128/.
  4. Bobinski, Mary Anne. “Health Care-Associated Hepatitis B and C Viruses: Legal Aspects,” February 14, 2010.https://www.sciencedirect.com/science/article/abs/pii/S108932610900083X?via%3Dihub.
  5. “United States Department of Health and Human Services,” January 19, 2022. https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html.
  6. “Law Offices of Art Kalantar,” n.d. https://www.kalantar.law/laws-that-regulate-healthcare-industry/.
  7. Stivers, Tanya. “The Role of Health Care Communication in Treatment Outcomes,” January 2023. https://www.annualreviews.org/doi/abs/10.1146/annurev-linguistics-030521-054400.

Amanda Hinojosa

I am very passionate about Health and Nutrition. I received my Bachelors of Science from Abilene Christian University. I aspire to become a Registered Dietitian in the near future to be able to educate the community about the importance of Nutrition.

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Recent Comments

3 comments

  • Lauren Sahadi

    I loved the picture of the 10 foods with highest sodium. It was a great was to grab the readers attention. Health is a great topic and things that everyone should know. I was a biology major for a few years and I was shocked at some of the information presented. Great subject matter and great presentation and information in the article.

  • Daniel Gutierrez

    Nutrition is always something that I love learning more and more about. Firstly I would like to start by stating that the inclusion of the top 10 food with the highest amount of sodium is a great hook in and a great graphic in general. though I think the core of your work in the great amount of research that you have Brought together that allows for people to better understand the Liver. Furthermore I feel like the concept of degrees was such a great choice stating that some foods the body has to work harder to handle. Though I wonder how you feel about people eating for training rather than just everyday life and what their difficult for their liver might be.

  • Andrew Ponce

    Hello Amanda. I want to start by saying the photo choice for this article is great. It captures the reader’s eye and entices them to continue scrolling to see what it is. Secondly, the way this article was subdivided into groups, truly helps the better understand what each main paragraph is intending to talk about. The information aspect of this publication is also truly incredible. There are so many concepts about this liver that are covered in this article that I never would have known before reading. Great topic, and great article!

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