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LEGAL AND ETHICAL. ETHICS. Ethics. Set of principles relating to what is morally right or wrong Provide a standard of conduct or code of behavior Allows a health care provider to analyze information and make decisions based on what people believe is right and good conduct - PowerPoint PPT Presentation



  • EthicsSet of principles relating to what is morally right or wrongProvide a standard of conduct or code of behaviorAllows a health care provider to analyze information and make decisions based on what people believe is right and good conductModern health care advances have created many ethical dilemmas for health care providers

  • Some Dilemmas are.Group activity

  • Ethical CodesMost of the national organizations representing the different health care occupations have established ethical codesThe codes differ slightly, but contain the same basic principles:Put the saving of life and the promotion of health above all elseMake every effort to keep the patient as comfortable as possible and to preserve life whenever possible

  • Ethical Code PrinciplesRespect the patients choice to die peacefully and with dignity when all options have been discussed with the patient and family and/or predetermined by advance directivesTreat all patients equally, regardless of race, religion, social or economic status, sex, or nationality. Bias, prejudice, and discrimination have no place in health careProvide care for all individuals to the best of your abilityMaintain a competent level of skill consistent with your particular occupation

  • Principles continuedStay informed and up to date and pursue continuing education as necessaryMaintain confidentiality. Confidentiality means that information about the patient must remain private and can be shared only with other members of the patients health care team.A legal violation can occur if a patient suffers personal or financial damage when confidential info is shared with others, including family members. Info obtained from patients should not be repeated or used for personal gain. Gossiping about patients is ethically wrong.

  • And moreRefrain from immoral, unethical, and illegal practices. If you observe others taking part in illegal actions, report such actions to the proper authoritiesShow loyalty to patients, co-workers, and employers. Avoid negative or derogatory statements and always express a positive attitudeBe sincere, honest, and caring. Treat others as you would want to be treated. Show respect and concern for the feelings, dignity, and rights of others

  • Patients RightsFederal and state legislation requires health care agencies to have written policies concerning patients rights, or the factors of care that patients can expect to receiveAgencies expect all personnel to respect and honor these rightsThe American Hospital Association has adopted a Patients Bill of Rights that is recognized and honored by many health facilities.

  • Patients Bill of RightsStates, in part, that a patient has the right to:1. considerate and respectful care2. obtain complete, current info concerning diagnosis, treatment, and prognosis (expected outcome)3. receive info necessary to give informed consent prior to the start of any procedure or treatment4. have advance directives for health care and/or refuse treatment to the extent permitted under law5. privacy concerning a medical care program

  • Bill of Rights continued6. confidential treatment of all communications and records7. reasonable response to a request for service8. obtain info regarding any relationship of the hospital to other health care and educational institutions9. be advised of and have the right to refuse to participate in any research project10. expect reasonable continuity of care

  • Bill of Rights11. review medical records and examine bills and receive an explanation of all care and charges12. be informed of any hospital rules, regulations, and/or policies and the resources available to resolve disputes or grievances

  • OBRAResidents in a long-term care facilities are guaranteed certain rights under the Omnibus Budget Reconciliation Act of 1987Every long-term care facility must inform residents or their guardians of these rights, and a copy must be posted in each facility.Often called a Residents Bill of Rights

  • Residents Bill of RightsFree choice regarding physician, treatment, care, and participation in researchFreedom from abuse and chemical or physical restraintsPrivacy and confidentiality of personal and chemical recordsAccommodation of needs and choice regarding activities, schedules, and health careVoice grievances without fear of retaliation or discrimination

  • Residents Bill of Rights continuedOrganize and participate in family/resident groups and in social, religious, and community activitiesInformation on medical benefits, medical records, survey results, deficiencies of the facility, and advocacy groups including he ombudsman program (state representative who checks on resident care and violation of rights)Manage personal funds and use personal possessionsUnlimited access to immediate family or relatives and to share a room with his or her spouse, if both are residentsRemain in the facility and not be transferred or discharged except for medical reasons, the welfare of the resident or others, failure to pay, or if the facility either cannot meet the residents needs or ceases to operate

  • OBRAAll states have adopted these rights, and some have added additional rightsHealth care workers can face job loss, fines, and even imprisonment if they do not follow and grand established patients or residents rights

  • Advance Directives for Health CareAlso known as legal directivesLegal documents that allow individuals to state what medical treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical careTwo main directives are a living will and a Durable Power of Attorney (POA) for Health Care

  • Living WillsDocuments that allow individuals to state what measure should or should not be taken to prolong life when their conditions are terminalDocument must be signed when the individual is competent and witnessed by two adults who cannot benefit from the deathFrequently results in a DNRAllows the patient to die in peace and keep the belief that quality of life is more important than quantity

  • Durable Power of Attorney (POA)Document that permits an individual (known as a principal) to appoint another person (agent) to make any decisions regarding health care if the principal should become unable to make decisionsIncludes providing or withholding specific medical or surgical procedures, hiring or dismissing health care providers, spending or withholding funds for health care, and having access to medical recordsPOA must be signed by the principal, agent, and one or two adult witnesses

  • Patient Self-Determination Act (PSDA)1990Mandates that all health care facilities receiving any type of federal aid comply with the following requirements:Inform every adult, both orally and in writing, of their right under state law to make decisions concerning medical care, including the right to refuse treatment and right-to-die optionsProvide information and assistance in preparing advance directives

  • PSDADocument any advance directives on the patients recordHave written statements to implement the patients rights in the decision-making processAffirm that there will be no discrimination or effect on care because of advance directivesEducate the staff on the medical and legal issues of advance directives

  • PSDAPSDA ensures that patients are informed of their right and have the opportunity to determine the care they will receiveAll health care workers must be aware of and honor advance or legal directives

  • Professional StandardsBy following certain standards at all times, you can protect yourself, your employer, and the patientHere are some basic standards:

  • 1. Perform only those procedures for which you have been trained and are legally permitted to doNever perform a procedure unless you are qualifiedIf you are not legally permitted to either perform a procedure or to sign documents, it is your responsibility to refuse to do so because of legal limitations

  • 2. Use approved, correct methods while performing any procedureFollow specific methods taught to you by a qualified person or observe and learnMost health care agencies have an approved procedure manual that explains the step-by-step methods for performing tasks

  • 3. Obtain proper authorization before performing any procedureCan be directly from Dr., therapist, or individual in charge of patients careCan be in written ordersImmediate supervisor will interpret orders and then direct you to perform procedures if you are unable to access patients records

  • 4. Identify the patient and obtain patients consent before performing any procedureCheck the patients name bandIf a patient refuses to allow you to perform a procedure, check with you immediate supervisor b/c some require written consent

  • 5. Observe all safety precautionsHandle equipment carefullyBe alert to all aspects of safetyKnow and follow safety rules and regulationsMake an effort to eliminate any hazards as quickly as possible

  • 6. Keep all information confidentialThis includes oral and written informationDo NOT place patient records in any area where they can be seen by unauthorized individualsIf you are reporting specific information about a patient to a supervisor, make sure no one can hear you conversationAvoid discussing patients with others at home, in social situations, in public places, or anywhere outside the agency

  • 7. Think before you speak and carefully consider anything you say8. Treat all patients equally regardless or race, religion, social or economic status, sex, or nationalityProvide care for all individuals to the best of your ability