1.04 Understand legal and ethical issues of the healthcare professional

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

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

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

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

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

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

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

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

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

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

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

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

1.04 Contracts

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1.04 Patient Rights Legislation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

-Criminal Law- 1.04 Understand legal and ethical issues 45

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

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

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

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

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

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

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

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

-Civil Law- 1.04 Understand legal and ethical issues 54

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1.04 Ethics in healthcare

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

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

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

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

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

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

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

1.04 Understand legal and ethical issues in healthcare THE END