2. Legal Concepts, Risk Management, and Ethical Issues
CHAPTER 2
Legal Concepts, Risk Management, and Ethical Issues

3. CH. 2 DEFINE TERMS TORT LAW MALPRACTICE ASSAULT MORAL PRINCIPLES
BATTERY
CODE OF ETHICS
FALSE IMPRISONMENT
SCOPE OF PRACTICE
ABANDONMENT
CREDENTIALING
INFORMED CONSENT
ACCREDITATION
INCIDENT REPORTS
RISK MANAGEMENT
ADVANCE DIRECTIVES

4. Objectives After studying this chapter, you will be able to:
Analyze the concepts of law
Interpret the legal responsibilities of the surgical technologist and other surgical team members
Compare and contrast criminal and civil liabilities and the consequences for these acts 4

5. Objectives (cont’d.)
Analyze the American Hospital Association’s Patient Care Partnership
Describe the need for professional liability insurance policies
Analyze the key elements related to developing a surgical conscience
Assess the resources that aid the surgical technologist in interpreting and following professional standards of conduct 5

6. Objectives (cont’d.)
Develop an increased sensitivity to the influence of ethics in professional practice
Analyze the role of morality during ethical decision making
Cite examples of ethical situations and problems in the health professions
Analyze scope of practice issues as they relate to surgical technology 6

7. Objectives (cont’d.)
Interpret prevention, correction, and documentation techniques that may positively affect risk management issues
Analyze the recommended practices and legal elements of proper documentation
Apply principles of problem solving in ethical decision making
Assess errors that may occur in the operating room and devise a plan for investigation, correction, and notification 7

8. Legal Issues
Tort law
A tort is generally defined as a civil wrong which causes an injury, for which a victim may seek damages, typically in the form of money damages, against the alleged wrongdoer. 8

9. Intentional Torts Intentional acts
Willful and violate the civil rights of a patient
Assault and battery
Defamation
False imprisonment
Intentional infliction of emotional distress
Invasion of privacy 9

10. Unintentional Torts Negligence and malpractice
Patient misidentification
Performing an incorrect procedure
Foreign bodies left in patients and patient burns
Falls or positioning errors resulting in patient injury
Improper handling, identification, or loss of specimens 10

11. Unintentional Torts (cont’d.)
Incorrect drugs or incorrect administration
Harm secondary to use of defective equipment/instrument
Loss of or damage to patient’s property
Harm secondary to a major break in sterile technique
Abandonment of a patient 11

12. Consent for Surgery: A Basic Right
Refers to permission being given for an action
Proper consent
Requires the party granting permission has the capability and authority to do so
Presumes at least two individuals are involved: recipient and person performing the action
Expressed or implied 12

13. Informed Consent Protects the patient Categories of consent
Guarantees the patient is aware of his or her condition, the proposed intervention, risks, and variables
Categories of consent
General: admit to hospital, broadest form
Special: surgical procedure, fertility, sterilization, anesthesia, transfusions, chemotherapy… 13

14. Informed Consent (cont’d.)
Required conditions
Information must be understandable
There can be no coercion or intimidation
Proposed surgical procedure or treatment must be explained
Potential complications must be explained
Potential risks and benefits must be explained
Alternative therapies and their risks and benefits must be explained 14

15. Informed Consent (cont’d.)
Required patient conditions
Of legal age or a legally emancipated minor
Mentally alert
Not under the influence of alcohol or drugs 15

16. Incident Reports
Constitute much of the information used by the hospital in risk management
Effort to collect and use data to decrease the chance of harm to patients and staff or damage to property
Events that would require reporting
Falls, medication errors, intraoperative burns, and loss of specimens 16

17. Advance Directives Characteristics
Written instruction dealing with the right of an incapacitated patient to self-determination
Expresses a patient’s wishes about the kinds and amount of medical treatment that will be provided
Examples: living will and durable power of attorney 17

18. Risk Management and Liability
Developed for prevention and control of areas of potential liability
Objectives
Minimize risks
Avoid or control financial loss
Identify causes of accidents
Implement programs, policies, and procedures
Collect and use data to decrease harm 18

19. Medical Errors Prevention/reduction techniques Technology: best weapon
Examples: bar-coded medications, identification strips, handheld wireless devices, and computer drug order-entry systems
Written policies and procedures; standard precautions 19

20. Malpractice Insurance
Hospital employees who commit negligent acts
Typically covered by facility insurance polices
Professional liability insurance
Should be carried by all practicing surgical technologists and surgical assistants 20

21. Health Insurance Portability and Accountability Act (HIPAA)
Overview
Provides patients with easy access to their medical records and more control over how personal health information is disclosed
Objectives
Ensure health insurance portability
Guarantee privacy of health information
Decrease incidences of fraud and abuse 21

22. Ethical and Moral Issues
Ethics
What is good for the individual and for society
Establishes the nature of duties that people owe themselves and one another
System of moral principles and rules 22

23. Moral Principles Guides for ethical decision making
Examples: trustworthiness, and honesty
Include concern that we have for the well-being of others and respect for their autonomy/ independence
Include basic justice, prevention of harm, and refusal to take unfair advantage 23

24. Elements of Ethical Decision Making
Basic questions
What makes a “right act” right?
To whom is moral duty owed?
What “kinds” of acts are right?
What is the relationship between specific situations and ethical principles or guidelines?
What action is to be taken in the situation at hand? 24

25. Elements of Ethical Decision Making (cont’d.)
Factors in ethical decision
Personal values
Accountability for one’s actions
Responsibility for one’s actions
Religious beliefs
Cultural beliefs
Corporate integrity
Method(s) of problem solving 25

26. Professional Codes of Conduct
Most professions have adopted highly detailed codes of conduct and methods for enforcement of breaches of those codes
Known as professional ethics or legal ethics
AST has established a Code of Ethics
Provides guidelines for the surgical technologist
Refer to Table 2-2 26

27. Scope of Practice Legal term
Identifies knowledge and skills to provide effective and reliable services 27

28. Credentialing Establishes a minimum knowledge base Many types
For a given health care profession
Many types
Registration
Certification
Licensure 28

29. Accreditation and Core Curriculum
Contributes to protection of the public by assessing educational programs
Quality and effectiveness in educating and training students
Important indicator for employers who are evaluating credentials of a potential employee 29

30. Summary This chapter reviewed: Concepts of law Legal responsibilities
Criminal and civil liabilities
Insurance policies
Ethics in professional practice
Scope of practice issues
Principles of problem solving in ethical decision making 30