Legal and Ethical responsibility Chapter 4

Legal REsponsibility Legal responsibilities are based on law. Civil Law- legal relationships Criminal Law- wrong committed against a person, property or society. Healthcare is generally affected by civil law. Primarily TORTS

TORTS Torts- Wrongful acts that do not involve contracts. Failure to meet your legal responsibility. Doctor did not meet the established or expected standards. (reasonable standard)

Tort violations Malpractice Bad practice. More commonly thought of as PROFESSIONAL NEGLIGENCE. Ie. Dr. fails to give tetanus shot after a puncture wound Negligence- failure to give care normally expected, resulting in injury to another person.

Tort Violations Assault-Threat or attempt to injure Battery- unlawful touching without consent Patients have the right to refuse care. Sometimes verbal consent is allowed. Ie. Put the side rail down on the bed. Some MUST be signed ie. INFORMED CONSENT Permission granted after all risks have been explained. Patient must be of sound mind to be legally bound to the document. HOWEVER: Patient always retains the right to withdraw consent. A and B may be rough handling of a patient or procedure performed against the patient’s will.

Tort violations cont… Invasion of Privacy False imprisonment Revealing personal information without consent. Not properly covering a patient to maintain modesty False imprisonment Restraining or restricting and individual’s freedom (hospitalization against will) Abuse: Verbal, physical, psychological, sexual abuse, (ELDERLY)

Tort Violations Defamation of character- false statements that cause ridicule or damage to reputation Slander that is written as LIBEL

contracts Contracts: Agreement between 2 or more parties. Contains the following: Offer Acceptance Consideration (payment made) Implied Contract- understood without verbally stating. If nurse gives meds and patient voluntarily takes them, it is implied that the patient accepts treatment.

Contracts cont… Expressed contract- stated clearly and distinctly either orally or in writing. Legal disability- all parties in a contract must have the legal capability to enter the contract ie. Legal adult, sound mind, power of attorney. TRANSLATOR-must be present if person does not speak language or documents are not in their language.

Privileged communications Legal responsibility- information about their health can only be shared with other members of that patients healthcare team, must stay confidential (dr/pt confidentiality) Only shared by written consent UNLESS: Death, birth, battery, abuse, stabbing, drug abuse, disease communicable, STD, gun shot etc… Healthcare records- privileged information that belongs to the doctor. Patient has a right to obtain copy. May be used in a court of law.

ethics Ethics- set of principles relating to what is morally right or wrong. Standard of conduct or code of behavior. LOTS of dilemma’s arise due to ethics!!!!! Euthanasia If doctor has HIV should he have to disclose that to his patients? Page 93: Pick 2 and write answer

Basic Ethics principles Saving life and promotion of health Keep patient comfortable Respect patients choice to die peacefully with dignity Treat all patients equally regardless of race, etc… Provide care for all individuals to the best of your ability Maintain competent skill level Stay up to date through continuing education Maintain confidentiality Refrain from immoral unethical and illegal practices Loyalty to patients and employers Be sincere honest and caring

Patient rights Written rights and policies are federal and state law required. Pg 94 Patient Bill of Rights Resident bill of rights for long term care

Advance directives Legal directives- allow individuals to state what treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care. 1) LIVING WILL States what measures should be taken to prolong life when conditions are terminal Document must be signed when patient competent. DNR Do not resuscitate (extremely hard to determine.

Advanced directives 2)DURABLE POWER OF ATTORNEY Principal (pt)- appoints another person to make any decisions regarding health care if the principal should not be able to make those decisions. POA- must be signed by principal agent and 2 legal witnesses. 1990 Patient self determination act (PSDA). All healthcare agencies requiring federal aide must inform patients of their legal rights and directives. Page 97: Professional standards