Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 3 Laws and Ethics

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Rules of conduct established and enforced by government Intended to protect both the general public and each person Laws

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Constitutional laws –Founders of the United States wrote the first formal laws oDivided power among three branches of government oProtected the entire nation oIdentified rights and privileges of U.S. citizens Laws: Six Categories

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Statutory laws –Laws enacted by federal, state, or local legislatures: public acts, codes, or ordinances –Nurse practice acts: common elements oDefine scope of nursing practice; establish the limits to practice Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Statutory laws (cont’d) –Nurse practice acts (cont’d) oIdentify titles: licensed practical nurse (LPN); licensed vocational nurse (LVN); or registered nurse (RN) oAuthorize a board of nursing to oversee nursing practice oDetermine what constitutes grounds for disciplinary action Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Administrative laws –Legal provisions: federal, state, and local agencies maintain self-regulation –State boards of nursing –Nurse licensure compacts Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Common laws –Decisions based on prior similar cases: judicial law –Based on the principle of stare decisis –Refers to litigation: falls outside the realm of constitutional, statutory, and administrative laws Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Criminal laws –Penal codes: protect citizens from people who pose a threat to the public good –Used to prosecute those who commit crimes –Misdemeanors or felonies Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Civil laws –Statutes: protect personal freedoms and rights –Disputes between individual citizens –Civil cases: torts oIntentional oUnintentional Laws: Six Categories (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Intentional torts –Assault –Battery –False imprisonment –Invasion of privacy –Defamation Laws: Civil Law

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Unintentional torts –Negligence –Malpractice Laws: Civil Law (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following is an unintentional tort? a. Assault b. Battery c. False imprisonment d. Negligence

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer d. Negligence Negligence is an unintentional tort, whereas assault, battery, and false imprisonment are intentional torts.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Liability insurance –Contract between a person or corporation and a company willing to provide legal services and financial assistance: policyholder involved in malpractice lawsuit –Necessary for all nurses: accountable for their actions during clinical practice Professional Liability

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Liability insurance (cont’d) –Provides legal protection in the event of a lawsuit –Liability insurance available through: oPrivate insurance companies Professional Liability (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Mitigating liability –Good Samaritan laws –Statutes of limitations –Principles regarding assumption of risk –Appropriate documentation Professional Liability (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Reducing liability –Risk management –Incident reports –Anecdotal records Professional Liability (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Good Samaritan laws protect health care workers against being sued.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. Good Samaritan Laws protect health care workers against being sued. They provide legal immunity to passersby who provide emergency first aid to victims of accidents.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Malpractice litigation –Successful outcome in a malpractice lawsuit depends on physical evidence and attorney expertise –Appearance, demeanor, and conduct of the nurse defendant can help or damage the case Professional Liability (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Moral or philosophical principles: direct actions as being either right or wrong Codes of ethics –List of written statements describing ideal behavior Ethics

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethics (cont’d) Ethical dilemmas –Choice between two undesirable alternatives –Occur when individual values and laws conflict –Nurses actions may be legal but personally unethical; or ethical but illegal

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethical theories –Nurses use one of two ethical problem- solving theories to solve ethical dilemmas oTeleology oDeontology Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethical principles –Beneficence –Nonmaleficence –Autonomy –Veracity –Fidelity –Justice Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Nonmaleficence means “doing good” or acting for another’s benefit.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Nonmaleficence means “doing no harm” or avoiding an action that deliberately harms a person.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Values and ethical decision-making –Values: person’s most meaningful beliefs o Basis: decisions about right or wrong –Guidelines to ethical decision making Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethics committees –Ethical decisions are complex and can affect the lives of clients –Cross-section of professionals and nonprofessionals debate about ethical issues –Called on to offer advice to protect clients’ best interests and to avoid legal battles Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Common ethical issues –Truth telling –Confidentiality –Withholding or withdrawing treatment –Code status –Allocation of scarce resources –Whistle-blowing Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Truth telling –All clients have the right to complete and accurate information –Physicians’ and nurses’ duty to report truth regarding client health matters Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Confidentiality –Safeguarding a person’s health information from public disclosure –Must not divulge health information to unauthorized people without client’s written permission Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Withholding/withdrawing treatment –Advance directives oTwo types  Living will  Durable power of attorney Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Code status –During cardiac or respiratory arrest, refers to how health care personnel are required to manage care Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Allocation of scarce resources –Process of deciding how to distribute limited life-saving equipment or procedures oFirst come, first served oIntent to produce most good to most people Ethics (cont’d)

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Whistle blowing –Reporting incompetent or unethical practices and unsafe or potentially harmful situations oInvolves personal risks oEthical priority: protecting clients Ethics (cont’d)