Legal and Ethical Context of Practice

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Morals-standard’s of conduct; values-ideals, beliefs, and patterns of behavior that are prized and chosen by a person, group, or society, and ;ethics-branch of philosophy that systematically examines behavior to determine what constitutes good, bad, right, and wrong in human behavior

Ethical principles-autonomy-individual choices; beneficence-promotion of good; nonmaleficence-requires practitioner to do no harm; right to privacy-safeguarding information; fidelity-honoring agreements; justice-moral rightness,fairness, of equity; veracity-adhering to the truth

Common ethical problems-p. 18 Ethics in nursing-ANA code of ethics p.19

Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.

Sources of law Statutory law-healthcare, nurse practice acts, Medicare,

Medicaid Types of laws

Civil law-disputes between individuals, and individuals and groups

Tort-civil wrong committed by one person against another person or that person’s property

Understanding the law Understand ongoing legal changes that affect your practice

Understanding your legal and professional obligations Illegal or incompetent practice = BAD OUTCOME!!!

Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.

Definition: civil wrong committed by one person against another person or that person’s property

May be intentional or unintentionalIntentional tort: Unintentional tort: – Fraud – Negligence – Defamation – Malpractice – Assault and battery – False imprisonment – Invasion of privacy

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Legal obligation or responsibility to provide care to a client that meets accepted standards of care

Liability in malpractice or negligence is determined by: Duty

▪ Nurse is responsible for accurate assessment and timely report of changes in client’s condition

Breach of duty▪ Nurse fails to note a client’s thumb is warm to touch, red, swollen, and

painful

Causation▪ Failure to note the signs and symptoms of an infection leads to amputation

of the thumb

Damages▪ Loss of the thumb seriously limits the client’s use of the hand

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Table 2-3 Failure to monitor and assess

Failure to ensure safety-faulty equipment, failure to follow policy and procedure

Medication errors

Improper implementation of skills or procedures-improper training for assignment

Documentation errors

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Single most important law affecting nursing practice

Each state has a Nurse Practice Act Defines the practice of nursing in that state Establishes the requirements for obtaining a

license to practice nursing

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Credentialing: methods by which the nursing professional attempts to ensure and maintain the competency of its practitioners Accreditation Licensure Certification

Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.

Occupational Safety and Health Act Controlled Substance Acts Health Care Quality Improvement Act Americans with Disabilities Act Good Samaritan Laws Mandatory Reporting Laws Health Insurance Portability and

Accountability Act (HIPAA)

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Informed consent Legal right of clients to receive adequate and accurate

information about their medical condition and treatment Advance directives

Living will Durable power of attorney for health care Organ transplants Do-not-resuscitate orders

Confidentiality

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Know your obligations and responsibilities Practice competently Know your strengths and limitations Keep current Document your care Purchase professional liability insuranceOnly you can protect your licensure. Don’t

second guess information; don’t be swayed if you know what is right; and always go with your 6th sense if something doesn’t feel right, it probably isn’t right…. This will come with experience. Use common sense!!!

Elsevier items and derived items © 2007 by Saunders, an imprint of Elsevier Inc.