3. Legal Responsibilities Health care professionals/Health care professionals/ workers must know and follow the state laws that regulate their licenses or registrations or set standards for their professions.

4. Legal and Ethical Practices Law – a rule that must be followed Laws are created and enforced by federal, state, or local governments Two main types: criminal and civil

5. deals with offenses against all persons, property, and society Examples of Criminal Law *Practicing in a health care profession without a license. *Misuse of narcotics. *Theft. *Murder Criminal Law: AKA Crime

6. An example of criminal law is: A. A.[A divorce] B. B.[Practicing Medicine without a license] C. C.[Child custody and child support] D. D.[Breech of contract]

7. Private Law is Civil Law! (This primarily affects health care) Civil Law - deals with the legal relationships between people and the protection of a person’s rights Two Main Types of Civil Law: Torts Contracts

8. Torts Tort - from the French word “wrong.” It can be defined as a wrongful act that does not involve a contract Occurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of careOccurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of care

9. Malpractice Failure of a professional to use the degree of skill and learning commonly expected in that individual’s profession called “professional negligence”.called “professional negligence”. Causes injury, loss, or damage to the person receiving careCauses injury, loss, or damage to the person receiving care Ex: physician not administering a tetanus shot when pt. has a puncture woundEx: physician not administering a tetanus shot when pt. has a puncture wound

10. [Which situation is malpractice if the patient is injured as a result of a health care workers actions?] A.[A health care worker fails to wipe up some water that he/she spilled on the floor.] B.[A health care worker forgets to put up the patient’s bedside rail.] C.[A health care worker performs a special procedure on a patient that he/she is not instructed to perform.] D.[A heating pad with a defective cord is used on a patient even though the health care worker knows it is defective.]

11. Negligence Failure to give care that is normally expected of a person in a particular position. Results in injuryResults in injury Ex: patient falls out of bed when bedrails are down, using defective equipment,Ex: patient falls out of bed when bedrails are down, using defective equipment,

12. Assault any willful attempt or threat to injure another person with the apparent ability to do so.

13. unlawful touching of another person without their consent. Battery

14. [Dr. Williams is charged with assault and battery. What situation might have caused this charge?] A.[A patient’s bandage will not stay on] B.[The patient leaves the hospital without being discharged] C.[Dr. Williams operates on a patient without consent] D.[Dr. Williams accidentally removes the wrong body part.]

15. Informed Consent Permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand.Permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand.

16. Informed Consent The person has the right to withdraw consent at any timeThe person has the right to withdraw consent at any time All procedures must be explained to the patient, and no procedure should be performed if the patient does not give consentAll procedures must be explained to the patient, and no procedure should be performed if the patient does not give consent

18. Invasion of Privacy Unnecessary exposure of an individual, or revealing personal information about an individual without their consent. Ex: improperly draping a patient

19. [Two health care workers were overheard discussing a co-worker who was admitted to the hospital drunk and violent. What legal standard was violated by the two workers?] A.[Libel] B.[Malpractice] C.[Assault and battery] D.[Invasion of privacy]

20. False Imprisonment Restraining an individual, or restricting an individual’s freedom. Ex: holding someone in a facility against their will or physically restraining them. Sometimes treated as a crime.

21. [Chelsia charges a hospital with false imprisonment. What might have happened?] A.[A doctor would not write an order for Mrs. Daniel to be discharged] B.[A nurse applied physical restraints on Mrs. Daniel without justification] C.[A nursing assistant put up the bedside rails while Mrs. Daniel was sleeping] D.[A ward secretary sent Mrs. Daniel’s chart to her insurance company without her permission]

22. Abuse Any care that results in physical harm, pain, or Mental anguish. Abuse can be classified as: Physical - hitting, forcing persons against their will, restraining movements, depriving of food or H2O, or not providing physical care.

23. Abuse Verbal Abuse – talking harshly, swearing or shouting, teasing, ridiculing, intimidating a person, using inappropriate words to describe a person's race or nationality, and/ or writing threats or abusive statements

24. Abuse Psychological -threating harm; denying rights; belittling, intimidating. Or ridiculing the person; and/or threatening to reveal information about the person

25. Abuse Sexual Abuse – any unwanted sexual touching or act, using sexual gestures, and/or suggesting sexual behavior

26. Abuse ** Laws in all states require reporting of any form of abuse to proper authorities. **

27. Defamation damaging a person’s name and reputation by making public statements that are false and malicious

28. [An RN who has been fired from a medical practice has been making negative, untrue statements about her boss. What could he/she be charged with?] A.[Immorality] B.[Defamation] C.[Invasion of Privacy] D.[Negligence]

29. Defamation There are 2 types: Libel - if the information released is written. Slander - if the information released is spoken.

30. [Grant is angry at a physical therapist who will not date him. He starts spreading ugly rumors around town about her. What is this?] A. A.[Libel] B. B.[Malpractice] C. C.[Invasion of privacy] D. D.[Slander]

31. Contracts A contract is a voluntary agreement between two parties

32. Contracts 3 parts to most contracts:3 parts to most contracts: Offer: a competent individual offers to be a patientOffer: a competent individual offers to be a patient Acceptance: Health care provider gives an appointment to or examines a patientAcceptance: Health care provider gives an appointment to or examines a patient Consideration: payment is made for the services providedConsideration: payment is made for the services provided

33. Types of Contracts Implied – contractual obligations by some action or inaction without verbally expressed terms. Ex: when a qualified health worker prepares a medication and the patient takes it-it is implied that the patient accepts treatment

34. Types of Contracts Expressed - actual agreement between the parties, the terms are stated in distinct and explicit language, either orally or in writing. Ex: surgical consent

35. Rules of a contract All parties in a contract must be free of legal disabilities.All parties in a contract must be free of legal disabilities. A person with legal disabilities does not have the legal capacity A person with legal disabilities does not have the legal capacity to form a contract. to form a contract.

36. Legal Disability Minors- under 18 Mentally incompetent persons Individuals under the influence of drugs that alter the mental state Semi- or unconscious people

37. Law of Agency Agency is a personal relationship, created by mutual consent: – – Principal-an employer who has employees. Responsible for the actions of the employees – –Agent-the employee who acts on behalf of the employer

38. Privileged Communication Patient information cannot be told to anyone else without the written consent of the patient. Written consent should state:Written consent should state: 1. What information can be released.1. What information can be released. 2. Who can get the information.2. Who can get the information. 3. Any time limits related to the release of3. Any time limits related to the release of information.information.

39. Privileged Communication Medical Information Exempt by law Births and Deaths Injuries caused by Violence Drug Abuse Communicable Diseases Sexually Transmitted Diseases

40. Health Care Records Considered privileged communication because the record contains information on the care that has been provided to the patient.

41. Health Care Records Medical records belongs to the health care provider but the patient has the right to obtain a copy. The medical record is a legal document and may be subpoenaed as evidence in court

42. Health Care Records Erasures are not allowed. Errors should be crosses out with a single line, correct the information, initial, and date.

43. Health Care Records Records must be kept until the statues of limitations has passed (2-7 years.) When records are destroyed, they should be shredded or burned.

44. Health Care Records Computer Confidentiality:Computer Confidentiality: Limit personnel who have accessLimit personnel who have access Use codes to prevent access to certain informationUse codes to prevent access to certain information Requiring passwords in order to access specific informationRequiring passwords in order to access specific information

45. [Meredith is moving to Cleveland and needs to take her medical records. She is aware that patients’ medical record are the property of the:] A.[State] B.[Patient and his or her family ] C.[Owners of the facility where they were created]

46. HIPAA Standards used to protect informationStandards used to protect information Patients must be:Patients must be: Able to see and obtain copies of their recordsAble to see and obtain copies of their records Given medical information by health care providers about how they use medical informationGiven medical information by health care providers about how they use medical information Allowed to set limits on how personal health information is usedAllowed to set limits on how personal health information is used

47. HIPAA Permitted to request that health care providers take responsible care to keep communication confidentialPermitted to request that health care providers take responsible care to keep communication confidential Given the right to state who has access to their information and even to limit providing information to their familyGiven the right to state who has access to their information and even to limit providing information to their family Provided with information on how to file a complaint against a health care provider who violates the privacy actProvided with information on how to file a complaint against a health care provider who violates the privacy act

48. Ethics A set of principles relating to what is morally right or wrong.A set of principles relating to what is morally right or wrong. Provide a standard of conduct or code of behaviorProvide a standard of conduct or code of behavior

49. Confidentiality Information about the patient must remain private and can be shared only with other members of the patient’s health care team.Information about the patient must remain private and can be shared only with other members of the patient’s health care team.

50. Patient Rights Factors of care a patient can expect to receive.Factors of care a patient can expect to receive. –Patient Bill of Rights Considerate careConsiderate care Obtain current informationObtain current information Informed consentInformed consent Advance directivesAdvance directives PrivacyPrivacy

51. Patient Rights ConfidentialityConfidentiality Reasonable response for a requestReasonable response for a request Obtains information about the facilituObtains information about the facilitu Right to refuse to participate in researchRight to refuse to participate in research Be able to review medical records and billing.Be able to review medical records and billing. Be informed of disputes against the facilityBe informed of disputes against the facility

52. Advance Directives Legal documents that allow individuals to state what medical treatment they want or do not want in the event they become incapacitated and are unable to express their wishes regarding health care.Legal documents that allow individuals to state what medical treatment they want or do not want in the event they become incapacitated and are unable to express their wishes regarding health care.

53. Discussion 1. The patient is restrained in a wheelchair without a physician’s order. 2. Jarrod operates on a patient and a surgical consent was never signed. 3. Madison reports on the news that the football players at Butler High School all have AIDs but it is not true. 4. Lindsey leaves the door open while bathing Grant and everyone walking down the hall can see his naked body. 5. Morgan sends information to an insurance company without the patient’s permission.

54. Living Will Document that allows individual to state what measures should or should not be taken to prolong life when their conditions are terminal.Document that allows individual to state what measures should or should not be taken to prolong life when their conditions are terminal. –Must be signed when the person in competent and by witnessed by 2 people

56. Do Not Resuscitate (DNR) CPR is not performed when the patient stops breathing, so the patient is allowed to die with peace and dignityCPR is not performed when the patient stops breathing, so the patient is allowed to die with peace and dignity

58. Durable Power of Attorney (POA) Permits an individual (principal) to appoint another person (agent) to make any decisions regarding health care if the principal should become unable to make decisions.Permits an individual (principal) to appoint another person (agent) to make any decisions regarding health care if the principal should become unable to make decisions.

60. Patient Self-Determination Act (PSDA) 1990 law that mandates all health care facilities that receive any federal aid must:1990 law that mandates all health care facilities that receive any federal aid must: –Inform every adult (orally and written) of their right to make decisions concerning medical care –Provide assistance in preparing advance directives

61. Patient Self-Determination Act (PSDA) Have written statements detailing the Patient RightsHave written statements detailing the Patient Rights Affirm that there will be no discrimination or effect on care because of advance directivesAffirm that there will be no discrimination or effect on care because of advance directives Educate the staff on medical and legal issues concerning advance directivesEducate the staff on medical and legal issues concerning advance directives

62. The End