Unit 4 Legal and Ethical Responsibilities

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4:1 Legal Responsibilities

Legal responsibilities are based on law– Civil law – legal relationships btw people

• Protection of person’s rights• Main type of law affecting health care

– Tort – wrongful act that does not involve a contract

– Criminal law – wrongs against a person, property or society

• Can also affect health care– Ex: Practicing without a license, misuse of narcotics, murder

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4:1 Legal Responsibilities - Torts Many offenses qualify as a tort (civil wrong)

– Malpractice – aka “bad practice”, “prof negligence”• Failure to use proper skill and techniques• Results in injury, loss or damage to patient

– Negligence – failure to give care normally expected• Results in injury of patient

– Assault and battery• Assault – threat or attempt to injure• Battery – unlawful touching of another person• All patients must give informed consent for treatment

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4:1 Legal Responsibilities - Torts(continued)

Invasion of privacy – unnecessarily exposing patient

– Also includes revealing personal info without patient’s consent

False imprisonment – restraining an individual

Abuse – any care resulting in physical or mental harm

– Physical, verbal, psychological and/or sexual

– All health care workers are required to report all types of abuse, even if it occurred before the patient arrived

• Domestic, child, elder

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4:1 Legal Responsibilities - Torts(continued)

Defamation – false statement damaging person’s reputation– Slander (spoken) or Libel (written)

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Contracts

Contract law is another aspect of civil law Def: Agreement between two or more parties Components of contract

– Offer – competent individual offers to be a patient

– Acceptance – health care provider treats patient

– Consideration – payment for services Implied contract – obligations understood without

verbally expressed terms Expressed contract – stated in distinct, clear language

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Contracts (continued)

Legal disability – if a person is legally disabled, cannot enter a contract

– Need parent, guardian, spouse Breach of contract – if contract not performed

according to agreement

– May be cause for legal action Non-English speaking party – need interpreter Agent – works under the direction of another person

– Principal – employs the agent, may be held accountable for actions of the agent

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Privileged Communications Privileged communications

– Encompass all info given to health care personnel by patient

– Info must be kept confidential • Shared only with members of patient’s health care team

– Exempt info: births, deaths, injuries due to violence, drug abuse, STD, communicable diseases

Health Care Records– Considered privileged communications

• Only kept for a certain amount of time, then destroyed

– Patient has right to obtain a copy

– Can be used in court as legal records, nothing can be erased

• Corrected info should be initialed and dated, wrong info crossed out

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Summary

Important aspect of health care All states have set rules and regulations Most health care agencies have specific

rules, regulations, and standards Standards vary from state to state and

agency to agency Health care worker must know all legalities

of what is expected of them

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4:2 Ethics

Def: Set principles, deals w/ what is morally right or wrong Provide a standard of conduct or code of behavior Help health care worker analyze information and make

decisions Ethical Dilemmas:

– Euthanasia

– Health care workers with HIV

– Aborted fetuses – use for research?

– Life support – when to discontinue?

– Religion v. medical treatments

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Basic Rules of Ethics

Save lives and promote health Patient comfort Respect the patient’s right to die peacefully Treat all patients equally Provide the best care possible Maintain competency and level of skill needed Stay informed and up to date

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Basic Rules of Ethics (continued)

Maintain confidentiality – No Gossiping! Refrain from immoral, unethical, illegal actions Report others taking part in illegal actions Show loyalty to patients, co-workers,

and employers Be sincere, honest, and caring Treat others the way you would like to be treated

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Summary

Study the code of ethics for the occupation you enter

Abide by the code Become a competent and ethical health

care worker Earns you the respect and confidence of

patients, co-workers, and employers

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4:3 Patients’ Rights

Def: factors of care that patients can expect to recieve Agencies must have written policies for patients’ rights All personnel must respect and honor these rights American Hospital Association has affirmed a

“Patient’s Bill of Rights” Long-term care facilities has affirmed a “Resident’s

Bill of Rights”

Patient’s Bill of RightsPatient has the right to: Considerate and respectful care Obtain complete, current info concerning diagnosis, treatment and

prognosis Receive info needed to give informed consent Refuse treatment Privacy and confidential treatment Reasonable response to a request for services Obtain info about relationship btw hospital & other institutions Be advised of right to participate in any research project Expect continuity of care Review medical records & examine bills, get explanation of care Be informed of any hospital rules or regulations

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Resident’s Bill of RightsResident has the right to: Free choice on physician, treatment, care, research participation Freedom from abuse and chemical/physical restraints Privacy and confidentiality of records Accommodation of needs and choice regarding activities,

schedules, heath care Voice grievances without fear of retaliation Organize in social, religious and community activities Info on medical benefits, medical records, survey results,

deficiencies in facility Manage personal funds and use personal possessions Unlimited access to family/relatives, to share a room w/ spouse Remain in facility and not be discharged, with some exceptions

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4:4 Advance Directives Def: legal documents that allow individuals to state what

medical treatment they want in the event they become unable to express wishes

– Also known as legal directives Two main directives

– Living wills – documents that allow individual to state what measures should be taken if in terminal condition

• Must be signed with witnesses when individual is competent

– Durable Power of Attorney (POA) – document that permits an individual to appoint another person to make health care decisions

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Advance Directives (continued)

Patient Self-Determination Act (PSDA)

– Law requiring health care facilities receiving federal aid comply with certain requirements

Ensures patients are informed of their rights Health care workers must be aware of the act and

honor it Health care workers should give serious

consideration to preparing their own advance directives

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Summary

Agencies, states, and organizations have created statements on patient’s rights

By observing rights, health care workers assure patient’s safety, privacy, and well-being, and provide quality care

Advance directives must be recognized and respected by health care workers

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4:5 Professional Standards

Perform only those procedures for which you have been trained and are legally permitted to do.

Use approved, correct methods while performing any procedure.

Obtain correct authorization before performing any procedure.

Identify the patient and obtain patient’s consent before performing any procedures.

Observe all safety precautions. Keep all information confidential.

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Professional Standards (continued)

Think before you speak and watch everything you say.

Treat all patients equally. Don’t accept tips or bribes. If any error occurs or you make a mistake,

report it immediately to your supervisor. Behave professionally in dress, language,

manners and actions. Always carry liability insurance.

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Summary

Know the legal and ethical implications for your particular health career

Ask questions or request written policies Contact state board of health or education

to obtain regulations and guidelines Follow the basic standards listed Protect yourself, your employer, and your

patient for whom you provide health care