1. 1.04 Understand legal and ethical issues of the healthcare professional

2. Importance for the healthcare professional to understand legal and ethical issues
Knowledge of legal responsibilities
Limitations of practice
Implications of their actions
1.04 Understand legal and ethical issues

3. Importance for the healthcare professional to understand legal and ethical issues
Protection of
Healthcare professionals
Patients
Co-workers
Facility
1.04 Understand legal and ethical issues

4. Importance for the healthcare professional to understand legal and ethical issues
Ethical behavior ensures
Quality patient care
Positive work relationships
Well-managed workplace
1.04 Understand legal and ethical issues

5. Legal and ethical dilemmas encountered by healthcare professionals
1.04 Understand legal and ethical issues

6. Legal and Ethical Dilemmas Abortion
Termination of a pregnancy
Spontaneous
Induced
Abortion is legal.
What are the ethical issues?
Possible ethical issues/topics for discussion on abortion:
Comparative rights – does the fetus have the same rights to life as the mom has to determine her future?
Question of personhood – when does a baby’s personhood begin? At conception or the day of birth?
Sanctity of human life – do we believe that all human life is sacred, and, thus, that the direct and intentional taking of an innocent human life is a proper act?
Abortion from a utilitarian perspective: The question is not can the fetus reason or talk, but can they suffer?
1.04 Understand legal and ethical issues

7. Legal and Ethical Dilemmas End of life
1.04 Understand legal and ethical issues

8. Legal and Ethical Dilemmas Euthanasia
(mercy killing)
Assisted
The act of ending the life of an individual in a painless manner. Individual is usually suffering from a terminal illness.
Types of Euthanasia
Voluntary – by consent of the individual (patient)
Involuntary – another person makes a decision for the individual
Assisted – another person provides information, guidance, means to end life
Involuntary
Voluntary
1.04 Understand legal and ethical issues

9. Legal and Ethical Dilemmas Advanced Directives
Legal documents that allow the patient to state the end of life treatments they would or would not want, in the event that they become unable to make those decisions.
1.04 Understand legal and ethical issues

10. Legal and Ethical Dilemmas Living Will
Patient’s document that states specific measures to be taken or not taken to prolong life.
Do Not Resuscitate (DNR)
Hydration
Medication
1.04 Understand legal and ethical issues

11. Legal and Ethical Issues Power of Attorney
Document that names the person that will make healthcare decisions for the patient that is unable to do so.
1.04 Understand legal and ethical issues

12. Legal and Ethical Dilemmas Organ Donation
The removal of healthy tissues from one person for the purpose of transplanting them into another person.
Donor can be living or recently deceased.
The following organs/tissues can be donated/transplanted:
Heart Tendons
Intestines Corneas
Lungs Heart Valves
Liver Bone Marrow
Pancreas Veins
Bones Skin
1.04 Understand legal and ethical issues

13. Legal and Ethical Dilemmas Research and Experimental Treatment
Healthcare research seeks to develop treatments for a disease process, or to establish new knowledge for health and wellness maintenance.
AIDS
Stem Cell
Cancer Research
1.04 Understand legal and ethical issues

14. 1.04 Contracts

15. -Contract- Agreement between two or more people. Enforceable by law.
1.04 Understand legal and ethical issues

16. Elements of a Contract -Offer-
A proposal by one party to another indicating willingness to enter a contract.
1.04 Understand legal and ethical issues

17. Elements of a Contract -Offer-
In healthcare, an individual enters into a relationship with a healthcare provider and offers to be a patient
1.04 Understand legal and ethical issues

18. Elements of a Contract -Acceptance-
The willingness to go along with the offer.
1.04 Understand legal and ethical issues

19. Elements of a Contract -Acceptance-
Healthcare provider gives an appointment, examines, or treats the patient.
1.04 Understand legal and ethical issues

20. Elements of a Contract -Genuine Agreement-
Valid offer is met by a valid agreement
1.04 Understand legal and ethical issues

21. Elements of a Contract -Genuine Agreement-
Fraud, misrepresentation or undue influence can destroy the genuine agreement.
1.04 Understand legal and ethical issues

22. Elements of a Contract -Capacity-
The legal ability to
enter a contract.
1.04 Understand legal and ethical issues

23. Elements of a Contract -Capacity-
Legal Disability
Individual who can
not legally enter
into a contract
1.04 Understand legal and ethical issues

24. Elements of a Contract -Capacity-
Legal Disability
Minors - younger than
18 years of age unless
married
Mentally incompetent
Under the influence of
drugs/alcohol
Semi-conscious/unconscious
1.04 Understand legal and ethical issues 24

25. Elements of a Contract -Consideration-
The thing of value promised in exchange for something else of value.
Payment is made by the patient for the services received.
1.04 Understand legal and ethical issues

26. Elements of a Contract -Legality-
Persons entering a contract cannot agree to do something that is illegal or forbidden by law.
Ex: cannot agree to sell a kidney
1.04 Understand legal and ethical issues

27. Types of Contracts
Implied contracts – non-verbal agreement of understanding
Expressed contracts – state the terms of the agreement in distinct and clear language, either oral or written
Implied contract – May be difficult to prove that the contract was formed.
Ex. Visit to the doctor with understanding that the patient will pay for services.
Expressed contract – easier to hold the parties accountable if the contract is written.
1.04 Understand legal and ethical issues

28. Healthcare Contract -Informed Consent-
The patient or their healthcare power of attorney gives written permission for a treatment or procedure, based on a clear understanding of desired outcomes and possible complications.
Informed consent is an essential component of a healthcare contract.
Permission can be withdrawn at any time. No procedure should be done without consent.
1.04 Understand legal and ethical issues

29. 1.04 Patient Rights Legislation

30. Patient Rights Legislation
Patient’s Bill of Rights
The Health Care Consumer
Consumer Bill of Rights
Consumer Responsibilities
Omnibus Budget Reconciliation Act
Patient Self-Determination Act
Health Insurance Portability and Accountability Act (HIPAA)
1.04 Understand legal and ethical issues

31. Patient Rights Legislation
Patient’s Bill of Rights (1973, revised 1992)
Statement of rights that patients are entitled to while in the care of a physician or in the hospital
Includes:
Choice of providers
Confidentiality
Information disclosure
Participation in treatment decisions
Respect
1.04 Understand legal and ethical issues

32. Patient Rights Legislation
The Healthcare Consumer
March 1998, the Advisory Commission on Consumer Protection and Quality in the Health Care Industry outlined the Consumer Bill of Rights and Responsibilities.
Purpose
Build consumer confidence
Support the healthcare provider and patient-provider relationship
Emphasize the role of the consumer with regard to health improvement
1.04 Understand legal and ethical issues

33. Patient Rights Legislation
Consumer Bill of Rights
Information disclosure
Choice of providers
Access to emergency services
Participation in treatment decisions
Respect and nondiscrimination
Confidentiality of health information
Complaints and appeals
1.04 Understand legal and ethical issues

34. Patient Rights Legislation
Consumer Responsibilities
Healthy habits
Participate in healthcare decisions
Communicate relevant information to healthcare provider
Avoid knowingly spreading disease
Recognize the risks and limits of medical care
Know about healthcare insurance plan
Show respect
Make effort to pay your bills
Report fraud or wrongdoing
1.04 Understand legal and ethical issues

35. Patient Rights Legislation
The Health Care Consumer Bill of Rights is used to develop healthcare insurance plans.
The Health Care Consumer must be familiar with their rights and responsibilities.
1.04 Understand legal and ethical issues

36. Patient Rights Legislation
Omnibus Budget Reconciliation Act (1987)
Regulates long term care and home health
Requires nurse aide training/certification for nursing and geriatric assistants
States specific skills to be mastered
Requires continuing education, and work evaluations
Requires retraining and/or testing if unemployed for 2 or more years
Limits use of restraints
1.04 Understand legal and ethical issues

37. Patient Rights Legislation
Nursing Home Reform Act (1990)
Patient must be fully evaluated upon admission to a nursing home
Health
Memories
Habits
Hobbies
A plan of care must be written and maintained
Must have annual re-evaluation
1.04 Understand legal and ethical issues

38. Patient Rights Legislation
Patient Self-Determination Act (1990)
Healthcare agency receiving Federal Aid must inform a patient about advanced directives at the time of admission
Healthcare agency must provide education for staff
1.04 Understand legal and ethical issues

39. Patient Rights Legislation
Health Insurance Portability and Accountability Act (HIPAA) (1996)
Protects the individual medical information of a patient and includes:
Name
Address
Diagnosis billing information
Provides for security of that
information
1.04 Understand legal and ethical issues

40. Patient Rights Legislation
Health Insurance Portability and Accountability Act (HIPAA)
Gives patient more control over their
health information
Sets boundaries on the use and release
of health records
Establishes safeguards to protect records
Punishes violators
Enables patients to make choices
Gives patients the right to obtain a copy of their records
1.04 Understand legal and ethical issues

41. Patient Rights Legislation
Health Insurance Portability and Accountability Act (HIPAA)
Permits release of information
needed to protect public health
Prevent disease
Protect from injury or
disability
1.04 Understand legal and ethical issues

42. Patient Rights Legislation
Health Insurance Portability and Accountability Act (HIPAA)
Exempt information:
Births
Deaths
Injuries caused by violence
Communicable diseases
Sexually transmitted diseases
1.04 Understand legal and ethical issues

43. Patient Rights Legislation
Patient’s Bill of Rights
The Healthcare Consumer
Consumer Bill of Rights
Consumer Responsibilities
Omnibus Budget Reconciliation Act
Patient Self-Determination Act
Health Insurance Portability and Accountability Act (HIPAA)
1.04 Understand legal and ethical issues

44. 1.04 -THE LAW- System of Rules
1.04 Understand legal and ethical issues

45. -Criminal Law-
1.04 Understand legal and ethical issues 45

46. Criminal Law Protects all people from those who:
pose a threat to society.
are a danger to the public.
Can result in being arrested.
Could prevent a person from being employed.
A felony is a serious crime punishable by imprisonment or death.
1.04 Understand legal and ethical issues

47. Criminal Law Assault
Any threat or attempt to injure another person with the apparent ability to do so
1.04 Understand legal and ethical issues 47

48. Criminal Law Battery
Unlawful touching of another person without consent
1.04 Understand legal and ethical issues 48

49. Criminal Law Misuse of Narcotics
May relate to:
Personal use by healthcare professionals
Patient use of prescribed dosage
1.04 Understand legal and ethical issues

50. Criminal Law Murder Taking another person’s life
1.04 Understand legal and ethical issues

51. Criminal Law Practicing Without a License
Individual providing healthcare services without a license
Required
It’s the law.
1.04 Understand legal and ethical issues

52. Criminal Law Sexual Assault
Rape
Forced sexual act by a male against a female
Statutory rape: the victim is under age.
The consent of the under age person does not matter.
The age of the offender does not matter. A minor can be charged with statutory rape.
Date rape
1.04 Understand legal and ethical issues 52

53. Criminal Law Theft Taking another person’s possessions
1.04 Understand legal and ethical issues 53

54. -Civil Law-
1.04 Understand legal and ethical issues 54

55. -Civil Law-
Involves disputes between people or organizations and protection of people’s rights.
1.04 Understand legal and ethical issues

56. Civil Law -Torts-
Wrongful acts, not involving a contract, that result in physical injury, property damages, or damages to a person’s reputation for which the injured person is entitled to compensation for damages done.
1.04 Understand legal and ethical issues 56

57. Civil Law -Torts- Physical Abuse
Depriving of nutrition
Hitting
Restraining a patient
1.04 Understand legal and ethical issues

58. Civil Law -Torts- Sexual Abuse
Sexual harassment
Any unwanted sexual touching or act
1.04 Understand legal and ethical issues

59. Civil Law -Torts- Verbal Abuse
Swearing
Talking harshly
Teasing
1.04 Understand legal and ethical issues

60. Civil Law -Torts- Defamation of Character
A statement that causes injury to a person’s reputation
Libel
Slander
Slander
Libel
1.04 Understand legal and ethical issues

61. Defamation of Character
Civil Law -Torts-
Defamation of Character
Libel
Untrue written statements that cause injury to a person’s reputation
1.04 Understand legal and ethical issues

62. Defamation of Character
Civil Law -Torts-
Defamation of Character
Slander
Untrue spoken statements that cause injury to a person’s reputation
1.04 Understand legal and ethical issues

63. Civil Law -Torts- False Imprisonment
Examples:
Doctor refuses to let patient leave the hospital
Restrain a patient without a doctors order
Pharmaceutical restraints
A person is confined or retained against his/her will
1.04 Understand legal and ethical issues

64. Civil Law -Torts- Invasion of Privacy
Make personal information public without the consent of the patient
Unnecessary physical exposure of a patient
1.04 Understand legal and ethical issues

65. Civil Law -Torts- Malpractice
Providing bad care,
resulting in injury.
Act of Commission
For example:
Medical errors
Inaccurate diagnosis
Failure to diagnose a condition
Lack of informed consent
Mistakes during surgery
Medical instruments left inside patients during surgery
1.04 Understand legal and ethical issues

66. Civil Law -Torts- Negligence
Failure to provide care that is normally expected, resulting injury to the patient.
Act of Omission
Examples:
Health Care worker forgets to lock the brakes on a wheelchair and patient is injured
1.04 Understand legal and ethical issues

67. -Civil Law- Involves relationships between people Torts
1.04 Understand legal and ethical issues 67

68. Reasonable Care
The legal obligation of healthcare professionals to provide care according to the standards of practice expected within their community for healthcare professionals.
Ex. all physical therapists follow the same guidelines for ROM exercises
1.04 Understand legal and ethical issues

69. Ethics in healthcare

70. Healthcare professionals’ ethical obligations
Ethics
Standard of conduct or code of behavior for a person or group of people
Involves:
Personal values
Professional standards expected of a healthcare professional
Organizational standards expected of an employee
1.04 Understand legal and ethical issues

71. Aspects of Ethics Ability to determine “right” from “wrong”
Commitment to do what is right
1.04 Understand legal and ethical issues

72. Personal Ethics Ethical Foundations: Personal values Dependable Honest
Responsible
Trustworthy
1.04 Understand legal and ethical issues

73. Professional Ethics Code of Ethics Specific for each healthcare career
Two components
1. Principles of Ethics
Standards of exemplary professional behavior for all members of the association
2. Rules of Ethics
Mandatory, direct standards of minimally acceptable professional conduct
1.04 Understand legal and ethical issues

74. Organizational Ethics
Moral values that guide the way corporations make decisions
Governed by
Legislation/laws
Professional codes
Individual values
Never compromise your ability to perform in the best interest of the organization
1.04 Understand legal and ethical issues

75. Healthcare professionals’ ethical obligations
Recognize Illegal and Unethical Behavior
Report any event that has adverse affects on the health, safety or welfare of any person within the healthcare agency
Healthcare professional must
Obey the law
Follow code of ethics for his/her job description
Treat everyone with respect
1.04 Understand legal and ethical issues

76. Healthcare professionals’ ethical obligations
Report Illegal and Unethical Behavior
Ensures health, safety and welfare of any person within the healthcare agency
Follow employee handbook for reporting procedures
Consult manager/supervisor
Contact human resources supervisor
1.04 Understand legal and ethical issues

77. 1.04 Understand legal and ethical issues in healthcare
THE END