chapter 5 ethical and legal issues
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Chapter 5 Ethical and Legal Issues. Along with the privilege of providing professional health care services to consumers, the professional nurse has a commensurate degree of responsibility and accountability to follow ethical principles and standards of care integral to the profession. - PowerPoint PPT PresentationTRANSCRIPT
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 5Ethical and Legal Issues
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Along with the privilege of providing professional health care services to consumers, the professional nurse has a commensurate degree of responsibility and accountability to follow ethical principles and standards of care integral to the profession.
Sheehy, 2006
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Learning ObjectivesAfter studying this chapter, you should be able to
• Explain the relationship between state Nurse Practice acts and the concepts of risk management and quality assurance
• Construct the six-step model of ethical nursing care designed by Chally and Loriz
• Articulate why nurses must become knowledgeable about genetics and the issues surrounding this topic
• Recognize five forms of nursing malpractice
• Discuss implications for psychiatric care related to the Tarasoff ruling of duty to warn
• Compare the criteria for voluntary and involuntary admission to a psychiatric facility
• Interpret the concept of competency
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Learning Objectives (cont.)
• Compare the legal rights of adults and minors admitted to psychiatric facilities
• Discuss the impact of the Omnibus Reconciliation Act (OBRA) on the placement of clients with psychiatric disorders in long-term care facilities
• Distinguish the legal phrases: diminished capacity, not guilty by reason of insanity, and guilty but mentally ill
• Explain forensic psychiatry and the role of the forensic nurse
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ethics in Nursing
• Model of ethical nursing care
• Ethics in pain management
• Ethics in genetic testing and clinical research
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Ethical Decision-Making Model
• Clarify the ethical dilemma
• Gather additional data
• Identify options
• Make a decision
• Act or carry out the decision
• Evaluate the impact of the decision
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Ethical Dilemmas in Clinical Research
• Informed consent
• Documentation of research protocols
• The client’s right to full disclosure
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Legal Issues in Nursing
• Nurses, now more than ever, are subject to the scrutiny of federal and state regulations as well as the legal system.
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Bill of Rights for Registered Nurses
Nurses have the right to
• A safe environment
• Practice in a manner that ensures the provision of safe care through adherence to professional standards and ethical practice
• Advocate freely on behalf of themselves and their clients
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Four Elements Required for Nursing Malpractice• Failure to exercise reasonable care or act in an
acceptable way when undertaking and providing care to a client
• Breach of duty or failure to conform to the required standard of care in treating the client’s condition
• Approximate cause, which requires that there be a reasonably close connection between the defendant’s conduct and the resultant injury (ie, the performance of the health care provider caused the injury to the client)
• The occurrence of actual damage to the client as a result of malpractice
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Other Forms of Malpractice
• Intentional torts
• Assault
• Battery
• Defamation
• False imprisonment
• Failure of duty to warn
• Breach of confidentiality and privacy
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Bill of Rights for Psychiatric–Mental Health Clients
• Receive treatment
• Refuse treatment
• Have a probable cause hearing
• Maintain client privacy and confidentiality
• Communicate freely with others
• Have personal privileges
• Maintain one’s civil rights
• Engage in religious freedom and education
• Maintain respect, dignity, and personal identity
• Maintain personal safety and assert grievances
• Be transferred and receive continuity of care
• Access own records
• Obtain an explanation of cost of services
• Obtain aftercare
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Psychiatric Hospitalization
• Involuntary admission or civil commitment
• Voluntary admission
• Hospitalization of minors
• Long-term care facilities
Omnibus Reconciliation Act (OBRA) of 1987
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Forensic Psychiatry
• Evaluation of an individual’s competency
• Diminished capacity
• Not guilty by reason of insanity
• Guilty but mentally ill
• Role of the forensic nurse
• The forensic nurse as a legal nurse consultant and expert witness
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Key Terms• Advance psychiatric directives
• Assault
• Battery
• Bill of Rights for Registered Nurses
• Civil commitment
• Client confidentiality
• Client privacy
• Code of Ethics for Nurses
• Defamation
• Diminished capacity
• Doctrine of Charitable Immunity
• Ethics
• Failure of duty to warn
• False imprisonment
• Forensic psychiatry
• Genetic testing
• Guilty but mentally ill
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Key Terms (cont.)
• Incompetent
• Informed consent
• Intentional tort
• Involuntary admission
• Libel
• Malpractice
• Miranda warning
• Negligence
• Not guilty by reason of insanity
• Nurse Practice Act
• Omnibus Reconciliation Act
• Paternalism
• Quality assurance
• Risk management
• Sentinel event
• Slander
• Tarasoff decision
• Voluntariness hearing
• Writ of habeas corpus
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Reflection
Imagine that you are providing care for a client undergoing a clinical research drug study. The client informs you that she suspects that she is pregnant but has not seen a doctor to confirm the pregnancy.
??• What informed and effective
care decisions do you need to make before taking action?