Legal and Ethical Responsibilities Principles of Health Science

Legal Responsibilities Legal Responsibilities - those that are authorized or based on law. Legal Responsibilities - those that are authorized or based on law. Civil Law – focuses on legal relationships between people and the protection of a person’s rights Civil Law – focuses on legal relationships between people and the protection of a person’s rights Criminal Law – focuses on wrongs against a person, property, or society Criminal Law – focuses on wrongs against a person, property, or society Torts – wrongful acts that do not involve contracts Torts – wrongful acts that do not involve contracts

Torts A tort occurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of care. A tort occurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of care. There are many types of torts: There are many types of torts: Malpractice - the failure of a professional to use the degree of skill and learning commonly expected in that person’s profession. Results in injury, loss or damage to person being cared for. Malpractice - the failure of a professional to use the degree of skill and learning commonly expected in that person’s profession. Results in injury, loss or damage to person being cared for.

Torts Negligence - failure to give care that is normally expected of a person in that position, results in injury. Negligence - failure to give care that is normally expected of a person in that position, results in injury. Assault - a threat or attempt to injure. Assault - a threat or attempt to injure. Battery - unlawful touching of another person without consent. Battery - unlawful touching of another person without consent. Informed Consent - permission granted voluntarily by a person of sound mind after being informed Informed Consent - permission granted voluntarily by a person of sound mind after being informed

Torts Invasion of Privacy - unnecessarily exposing an individual or revealing personal info without consent Invasion of Privacy - unnecessarily exposing an individual or revealing personal info without consent False Imprisonment - restraining an individual or restricting an individual’s freedom False Imprisonment - restraining an individual or restricting an individual’s freedom Abuse - any care that results in physical harm, pain, or mental anguish. Abuse - any care that results in physical harm, pain, or mental anguish.

Abuse Physical Abuse – hitting, forcing people against their will, restraining movement, depriving food or water, not providing physical care. Physical Abuse – hitting, forcing people against their will, restraining movement, depriving food or water, not providing physical care. Verbal Abuse – speaking harshly, swearing, shouting, threats, abusive statements Verbal Abuse – speaking harshly, swearing, shouting, threats, abusive statements Psychological Abuse – threatening harm, denying rights, belittling, intimidating, ridiculing, threatening to reveal confidential info Psychological Abuse – threatening harm, denying rights, belittling, intimidating, ridiculing, threatening to reveal confidential info Sexual Abuse – unwanted sexual touching or act, using sexual gestures or behaviors Sexual Abuse – unwanted sexual touching or act, using sexual gestures or behaviors

Abuse Domestic Abuse – when intimate partners use threats, aggressive, or violent behaviors to maintain power and control over the other Domestic Abuse – when intimate partners use threats, aggressive, or violent behaviors to maintain power and control over the other Child Abuse – abuse directed toward a child Child Abuse – abuse directed toward a child Elder Abuse – abuse directed toward an older person Elder Abuse – abuse directed toward an older person

Torts Defamation – when false statements either cause a person to be ridiculed or damage the person’s reputation (even in error) Defamation – when false statements either cause a person to be ridiculed or damage the person’s reputation (even in error) Slander – when the defamation is spoken Slander – when the defamation is spoken Libel – when the defamation is written Libel – when the defamation is written

Contracts Contract Contract An agreement between 2 or more parties. An agreement between 2 or more parties. Most contracts have 3 parts: Most contracts have 3 parts: Offer – competent person enters into relationship with a healthcare provider and offers to be a patient Offer – competent person enters into relationship with a healthcare provider and offers to be a patient Acceptance – Healthcare provider gives an appointment, or exam, or treatment to the patient Acceptance – Healthcare provider gives an appointment, or exam, or treatment to the patient Consideration – payment made by the patient for services provided Consideration – payment made by the patient for services provided

Contracts Implied Contracts – obligations that are understood without verbally expressed terms. Implied Contracts – obligations that are understood without verbally expressed terms. Expressed Contracts – stated in distinct and clear language, either orally or in writing. Expressed Contracts – stated in distinct and clear language, either orally or in writing. Legal Disability – minors, mental incompetent persons, under the influence of alcohol or drugs that alter mental status, semiconscious or unconscious. Legal Disability – minors, mental incompetent persons, under the influence of alcohol or drugs that alter mental status, semiconscious or unconscious. Agent – when a person works under the direct control of another person Agent – when a person works under the direct control of another person

Privileged Communications Privileged Communications – comprise all info given to Healthcare personnel by a patient; by law, this info must be confidential and shared ONLY with other member of the pt’s health care team. Privileged Communications – comprise all info given to Healthcare personnel by a patient; by law, this info must be confidential and shared ONLY with other member of the pt’s health care team. Health Care Records – contain info about the care provided to the patient. Health Care Records – contain info about the care provided to the patient.

HIPAA PRIVACY Health Insurance Portability and Accountability Act of 1996, It’s a federal law Health Insurance Portability and Accountability Act of 1996, It’s a federal law HIPAA is mandatory, penalties for failure to comply HIPAA is mandatory, penalties for failure to comply Establishes federal regulations regarding the privacy of patient information Establishes federal regulations regarding the privacy of patient information Patient Privacy is EVERYONE’s responsibility Patient Privacy is EVERYONE’s responsibility Government fines imposed for privacy violations Government fines imposed for privacy violations

Ethics Ethics – set of principles relating to what is morally right or wrong. Ethics – set of principles relating to what is morally right or wrong. Ethical Dilemmas – a necessary choice between equally undesirable ethical alternatives Ethical Dilemmas – a necessary choice between equally undesirable ethical alternatives

Ethical Dilemmas Euthanasia (assisted death) Euthanasia (assisted death) AIDS AIDS Aborted fetuses for research Aborted fetuses for research Discontinue life support Discontinue life support Religious rights Religious rights Financial issues Financial issues Transplant recipients Transplant recipients

Ethical Dilemmas Selling organs Selling organs Use of illegal substances Use of illegal substances Animals in research Animals in research Cloning Cloning Stem cell research Stem cell research

Ethical Code Guidelines National Organizations vary National Organizations vary All have the same basic principles: All have the same basic principles: Put saving of life and the promotion of health above all else. Put saving of life and the promotion of health above all else. Keep patient as comfortable as possible and preserve life. Keep patient as comfortable as possible and preserve life. Respect patient’s choice to die peacefully and with dignity. Respect patient’s choice to die peacefully and with dignity.

Ethical Code Guidelines Treat all patients equally regardless of race, religion, social or economic status, sex, or nationality. Treat all patients equally regardless of race, religion, social or economic status, sex, or nationality. Provide care for all individuals to the best of your ability. Provide care for all individuals to the best of your ability. Maintain competency. Maintain competency. Stay informed and continue education. Stay informed and continue education.

Ethics Confidentiality – info about the pt must remain private and can be shared ONLY with other members of the pt’s HC team. Confidentiality – info about the pt must remain private and can be shared ONLY with other members of the pt’s HC team. Refrain from immoral, unethical, and illegal practices. Refrain from immoral, unethical, and illegal practices.

Patient’s Rights Federal and state legislation requires health care agencies to have a written policy concerning PATIENT’S RIGHTS. Federal and state legislation requires health care agencies to have a written policy concerning PATIENT’S RIGHTS. The AHA has affirmed a “PATIENT’S BILL OF RIGHTS” that is recognized and honored by most health care facilities. The AHA has affirmed a “PATIENT’S BILL OF RIGHTS” that is recognized and honored by most health care facilities.

PATIENT’S BILL OF RIGHTS Considerate & respectful care Considerate & respectful care Obtain complete, current info concerning diagnosis (dx), treatment (tx), & prognosis Obtain complete, current info concerning diagnosis (dx), treatment (tx), & prognosis Receive info necessary to give informed consent Receive info necessary to give informed consent Have advance directives for Healthcare and/or refuse treatment to the extent permitted under law Have advance directives for Healthcare and/or refuse treatment to the extent permitted under law

PATIENT’S BILL OF RIGHTS Privacy concerning a medical care program Privacy concerning a medical care program Confidential tx of all communications and records Confidential tx of all communications and records Reasonable response to a request for services Reasonable response to a request for services Obtain info regarding any relationship of the hospital to other healthcare and educational institutions Obtain info regarding any relationship of the hospital to other healthcare and educational institutions

PATIENT’S BILL OF RIGHTS Be advised of and have the right to refuse to participate in any research project Be advised of and have the right to refuse to participate in any research project Expect reasonable continuity of care Expect reasonable continuity of care Review medical records, examine bills, and receive an explanation of all care/charges Review medical records, examine bills, and receive an explanation of all care/charges Be informed of hospital rules, regulations, and/or policies & resources available to resolve disputes or grievances Be informed of hospital rules, regulations, and/or policies & resources available to resolve disputes or grievances

RESIDENT’S BILL OF RIGHTS Residents in Long Term Care Facilities (LTCF’s) are guaranteed certain rights under the Omnibus Budget Reconciliation Act (OBRA) of Residents in Long Term Care Facilities (LTCF’s) are guaranteed certain rights under the Omnibus Budget Reconciliation Act (OBRA) of These rights known as the ‘Resident’s Bill of Rights’ These rights known as the ‘Resident’s Bill of Rights’

RESIDENT’S BILL OF RIGHTS Free choice regarding Dr, treatment, care, and participation in research Free choice regarding Dr, treatment, care, and participation in research Freedom from abuse and chemical or physical restraints Freedom from abuse and chemical or physical restraints Privacy and confidentiality of records Privacy and confidentiality of records Accommodation of needs and choice regarding activities, schedules, and healthcare Accommodation of needs and choice regarding activities, schedules, and healthcare

RESIDENT’S BILL OF RIGHTS Voice grievances without fear of retaliation or discrimination Voice grievances without fear of retaliation or discrimination Organize and participate in groups, social, religious, and community activities Organize and participate in groups, social, religious, and community activities Info on medical benefits, records, and advocacy groups Info on medical benefits, records, and advocacy groups Manage personal funds & use personal possessions Manage personal funds & use personal possessions

RESIDENT’S BILL OF RIGHTS Unlimited access to immediate family or relatives and to share a room with his/her spouse (if both are residents) Unlimited access to immediate family or relatives and to share a room with his/her spouse (if both are residents) Remain in the facility and not be transferred or discharged except for medical reasons; the welfare of the resident or others; failure to pay; or if the facility either cannot meet the resident’s needs or ceases to operate. Remain in the facility and not be transferred or discharged except for medical reasons; the welfare of the resident or others; failure to pay; or if the facility either cannot meet the resident’s needs or ceases to operate.

Professional Standards Legal responsibilities Legal responsibilities Ethical responsibilities Ethical responsibilities Patients/Residents Rights Patients/Residents Rights Advance Directives Advance Directives There are certain standards of behavior/care required by health care providers to carry out their duties There are certain standards of behavior/care required by health care providers to carry out their duties

Professional Standards Perform only those procedures for which you have been trained and are legally permitted to do Perform only those procedures for which you have been trained and are legally permitted to do Use approved, correct methods while performing any procedure Use approved, correct methods while performing any procedure Obtain proper authorization before performing any procedure Obtain proper authorization before performing any procedure Identify the patient and obtain the patients consent before performing any procedure Identify the patient and obtain the patients consent before performing any procedure

Professional Standards Observe all safety precautions Observe all safety precautions Keep all info confidential Keep all info confidential Think before you speak and carefully consider everything you say Think before you speak and carefully consider everything you say Treat all patients equally regardless of race, religion, social or economic status, sex, or nationality Treat all patients equally regardless of race, religion, social or economic status, sex, or nationality

Professional Standards Accept no tips or bribes for the care you provide Accept no tips or bribes for the care you provide If any error occurs or you make a mistake, report it immediately to your supervisor If any error occurs or you make a mistake, report it immediately to your supervisor Behave professionally in dress, language, manners, and actions Behave professionally in dress, language, manners, and actions

REMEMBER!!! It is your responsibility to understand the legal and ethical implications of your particular health care field. Ethical responsibilities are based not on law, but rather, on what is morally right or wrong. Healthcare workers must respect the patient’s rights.