Legal and Ethical Responsibilities

Unit-D

2H04. Apply appropriate legal & ethical behaviors.

• Specific Objectives:

2H04.01 Analyze legal roles and

responsibilities.

2H04.02 Evaluate ethical behavior in a health care setting.

2H04.03 Explore legal and ethical issues related to death and dying.

2H04.01: Analyze legal roles & responsibilities.

• Torts• Malpractice• Negligence• Assault and battery• Invasion of privacy• False imprisonment• Abuse• Defamation

TORTSFrom the French word “wrong.”

A civil wrongful act

causing harm or injury

due to the healthcare

worker not performing

the standard of care.

MalpracticeInterpreted as “bad practice”

Includes providing improper or unprofessional treatment or care that results in injury/harm to the patient.

Performing a procedureon a patient that that the health care worker is not trained to perform is malpractice.

Negligence

A person at fault failed to do what a reasonable &

Careful person would DO. Also can be defined as

failure to take reasonable precautions to protect

others from the risk of harm.

NO, NO! How many times do I Have to tell you, nurse? The appendix is a small pink thing about this big…

Battery

The unlawful touching of another that results in injury. Battery, which is theclaim that the patient did not give his/her consent prior to initiating the treatment orprocedure (surgery) or treatment in question.

Assault

Verbal aggravation meant to cause harm or offense.

False Imprisonment

• Restraining an individual or restriction and individual’s freedom.

Invasion of Privacy

• Unnecessary exposure of an individual or revealing personal information about an individual without consent.

Abuse

Abuse- any care that results in physicalharm, pain, or medical anguish.

Abuse can be classified as:

Sexual - any form of sexual contact with a patient.Physical -unwanted touching, restraining & withholding food/ water.Verbal- talking harshly, swearing of shouting, teasing, ridiculing, intimidating a person.

It is required that any type of abuse must be reported

Defamation of Character

• Any information that damages a person’s name and reputation by making public statements that are false and malicious.

There are 2 types:

Libel-It is written about

Someone.

Slander-It is spoken about

someone.

B. Contracts-Agreement between to parties.

• Parts of a contract

• 1. Offer - competent individual enters

• into a relationship with health care providers and offers to be a patient.

• 2. Acceptance - health care provider gives an appointment or examines or treats a patient.

• • 3. Consideration - payment

made by patient for services provided.

Types of Contracts:

1. Expressed Contract -

a contract are specifically

stated (offer, acceptance,

consideration), & the

terms are stated.

Types of Contracts:

• 2. Implied Contract - is a contract that is implied (indirectly) when a party knowingly accepts a benefit from another party, in circumstances where the benefit cannot be considered a gift. Therefore, the party accepting the benefit is under a legal obligation to give fair value for the benefit received.

Contract Obligations

Agency an organization or company that provides some service for another.

Agent (employee)

Principal (employer) wherein the employee acts on behalf of the principal while supervised by the principal.

PRIVILEGEDCOMMUNICATION

Covers all information given to health personnel by a patient.

• Physician - Patient Information cannot be told to anyone else without the written consent of the patient.

• Written consent should state:

1. What information can be released.

2. Who can get the information.

3. Any time limits related to the release of information.

Medical Information Exempt by Law

1. Births and Deaths.

2. Injuries caused by

Violence. (abuse, etc.)

3. Drug Abuse.

4. Communicable Diseases.

5. Sexually Transmitted Diseases.

Legal Disabilities1. Mentally incompetent

persons

2. Individuals under the influence of drugs that alter the mental state

3. Semi- or unconscious people.

4. Minors- anyone under 18 or the age of majority, is called “an infant” under law.

Health Care Records

• Contains information on the care that has been provided to the patient.

• Medical records belong to the health care provider but the patient has the right to obtain a copy.

• The medical record is a legal document and may be subpoenaed as evidence in court.

Health Care Records (continued)

Records must be kept as

required by state law

(2-7 years).

When records are

destroyed, they should be

shredded or burned.

A. Ethical/Professional Standards - are a set of principles of : Right or Good Conduct.

1.Competent care, with compassion & respect for human dignity, & the 7 rights.

2. Professionalism, be honest.

3. Respect the law

I.e. Ethical or unethicalSelling organs for money.Promoting health above all else. Keeping views about religion, politics, or abortion to ones self.Gossiping or talking about others.

2H04.02 Evaluate ethical behavior in a health care setting.

B. Confidentiality

Always keep what a

patient tells you in

Confidence unless it is

medical information

exempt by law.

C. Patient’s Bill of Rights

A patient has the right to:• Considerate and respectful care.• Obtain complete, current

information concerning diagnosis, treatment, and prognosis.

• Receive information necessary to give informed consent prior to the start of any procedure or treatment.

• Refuse treatment to the extent permitted under law.

• Privacy concerning a medical-care program.

• Confidential treatment of all communications and records.

Patient’s Bill of Rights (continued)

• Reasonable response to a request for services.

• Obtain information regarding any relationship of the hospital to other health care and educational institutions.

• Be advised of and have the right to refuse to participate in any research project.

• Expect reasonable continuity of care.

• Examine bills and receive an explanation of all charges.

• Be informed of any hospital rules of regulations.

D. OBRA- Omnibus Budget Reconciliation

The Federal Nursing Home Reform was created in 1987. It set standards for

care and the Patients Bill of Rights. It is provided for people in long term

facilities for the right to freedom from abuse and chemical or physical restraints.

2H04.03 Explore legal and ethical issues related to death

and dying.A. Legal directives:

1. Living wills

2. Durable Power of

Attorney (POA)

3. Patient Self-

Determination Act (PSDA)

Living Will

• Document that allow individuals to state what measures should or should not be taken to prolong life when their condition is terminal.

• Most states not have laws that allow the withholding of life-sustaining procedures and honor living wills.

• Frequently result in DNR (do not resuscitate) orders for terminally ill individuals. No CPR!

Durable Power of Attorney for Health Care (POA)

• Document that

permits an individual to

appoint another person

to make any decision

regarding health care if

the patient is unable to

make the decisions.

(POA) cont…..

• Includes providing or withholding specific medical or surgical procedures, hiring or dismissing health care providers, spending or withholding specific medical or surgical procedure, hiring or dismissing health care providers, spending or withholding funds for health care, and having access to medical records.

PSDA-Patient Self Determination Act

• A federal law requires that all health care facilities receiving any type of federal aid provide patents with information about advanced directives.

B. Euthanasia

• The act or practice of killing somebody who has an incurable illness or injury, or of assisting that person to die. Euthanasia is illegal in most countries.

C. 5 Stages of Death & Dying

• Denial-you are in disbelief that its happening to you.• Anger-you start blaming your loved ones for your

situation.• Bargaining-many people turn to God for help or the

doctors to have more time.• Depression- you become withdrawn, quiet and an

extreme sadness.• Acceptance- you begin to put your affairs in order

and you spend the last part of your life with your loved ones and help them cope with the upcoming death.

Dr. Elizabeth Kubler-Ross

D. Organ Procurement

Removal of the tissues of The human body from a person who has recently died, or from a living donor, for the purpose of transplanting. Organs &tissues are removed in procedures similar to surgery. People of all agesmay be organ & tissuedonors.

Should people be allowed to sell organs for money?

HOSPICEHospice care is end –of-life careprovided by health professionals & volunteers, with the goal of allowing the patient to die with dignity. They give medical, psychological and spiritual support. Hospice volunteers can stay with patients while the familyleaves for short periods of time. Patients are referred to hospicewhen life expectancy is approximately six months or less.

Terminal illness is non-curable and results in death.

Informed Consent

The patient/client

understands the reason

for treatment.

They understand:1) What will be done.

2) Who will do it.

3) How it will be done.

4) Expected outcomes