LEGAL AND ETHICAL RESPONSIBILITIES

In Healthcare there are laws and legal responsibilities to protect you and society.- Being aware: protects you Protects your employer Protects patient

LEGAL RESPONSIBILITIES

Legal responsibilities are those authorized by on law.Can be Criminal or Civil Criminal – focuses on wrongs against

person, property or society Civil – focuses on legal relationship

between people and protection of person’s rights

CRIMINAL LAWS

Practicing without a license Misuse of narcotics (controlled

substances) Theft Murder Follow state regulations within

respective field

CIVIL LAW

Involving Contracts and Torts (Wrongful acts that do not involve contracts) Contract law involves wrongs against a breach

of contract – not doing what was agreed. A tort occurs when a person is harmed or

injured because injured because a healthcare worker did not meet a “standard of care”. Torts can be complex and up for different

interpretation. Tort – no contract

TORTS – SEVEN TYPES

1. Malpractice2. Negligence3. Assault and Battery4. Invasion of Privacy5. False Imprisonment6. Abuse7. Defamation

MALPRACTICE

Commonly known as BAD PRACTICE Failure of a professional to use the

degree of skill and learning commonly expected in the profession. Results in injury, loss or damage to

person receiving care Examples – nurse going beyond scope (doing

surgery) Doctor not giving a tetanus shot with puncture

wound

NEGLIGENCE

Failure to give care that is normally expected of a person in a particular position, resulting in injury. Examples

leaving bed side rails down Using defective equipment Using non sterile instruments Using equipment improperly

ASSAULT AND BATTERY

Assault - Threat or attempt to injureBattery – Unlawful touching without consent Closely related and often used together

Patients must give consent and have the right to refuse

Consent (Permission) - verbal, written and informed.

Informed consent – permission granted by a person of sound mind after the procedure and all risks are explained.

INVASION OF PRIVACY

Unnecessarily exposing an individual or revealing personal information about an individual without consent. Improper draping or covering a patient Giving out information on a patient

without permission (informing news, insurance, others)

FALSE IMPRISONMENT

Restraining or restricting an individuals freedoms Keeping patients hospitalized against

their will Applying restraints without justification

or authorization

ABUSE

Any care that results in physical harm, pain or mental anguish Physical Abuse – hitting, forcing against

will, restraining movement, depriving of food, water and not providing physical care

Verbal Abuse – speaking (written) harshly, swearing, shouting, using improper words to describe race or nationality or just abusive statements.

ABUSE - CONTINUED

Psychological Abuse – threatening to harm, denying rights, belittling, intimidating or ridiculing the person. Includes threatening to reveal information

about patient. Sexual Abuse – any unwanted sexual

touching or act, using sexual gestures and/or suggesting sexual behavior

ABUSE CONTINUED

Failure to Report Domestic Abuse Intimate partner uses violent behavior to

maintain power or control over another person.

Unexplained bruises, fractures, burns or injuries Signs of neglect – poor personal hygiene Irrational fears or a change in personality Aggressive or withdrawn behavior Patient statements that indicate abuse

DEFAMATION

False statement either causes a person to be ridiculed or damaged the person’s reputation. Incorrect information can given out in

error can be defamation. Slander – information that is spoken Libel – information that is writtenAny information that is about individuals, news or government

CONTRACT LAW

A contract is an agreement between two or more parties

Most contracts have three parts:1. Offer – competent person offers to be a

patient2. Acceptance – provider gives an

appointment, examines or treats a patient.3. Consideration – payment made more

services

CONTRACT LAW

Implied or Expressed Implied Contracts – obligations that are understood

without verbally expressed terms.

Expressed Contracts – Stated in distinct and clear language either orally or written.

All parties entering into a contract must be free of legal disability – must have legal capacity to make agreement (minors, mentally incompetent, under influence of drugs/alcohol , semi-conscious or unconscious.

CONTRACT LAW

Use of a translator A translator must be used when a contract is entered

with a non-English speaking patient Includes – Deaf or hard of hearing

Role of an AGENT – a person works under the direction of another person. Employer is called the Principal Worker is called the Agent Principal is responsible for the agent –

Dental assistant tells patient denture will be nicer than real teeth and they aren’t the dentist is responsible.

PRIVILEGED COMMUNICATION

Composed of all information given to healthcare personnel by a patient. By law this information this information must be

kept confidential Shared with only members of patients healthcare

team. Can only be shared with written consent and has

time limits Certain circumstances are exempt: births, deaths,

injuries caused by violence, abuse, stabbings, communicable diseases and sexually transmitted diseases.

PRIVILEGED COMMUNICATIONS

Healthcare Records All records about care of patient are to be

kept private. Shared only with healthcare team Patient has legal right to all records. Must be maintained a certain time limit.

7 years Till 18 for minors Burned or shredded to maintain confidentiality

ETHICS

Legal responsibilities are determined by law – Ethics are a set of principles morality of right and wrong Provide a standard of conduct Code of Behavior

ETHICS

Modern healthcare has created dilemmas: Euthanasia? HIV Status? When should life support be

terminated? Refuse treatment due to cost? Sell Organs? Genetic research, gene transplants,

cloning?

ETHICS

Use ethical guidelines or codes: Saving a life and promotion of health above all Keep every effort to keep patient comfortable Respect’s patient choice to die with dignity Treat all patients equally Provide care to the best of your ability Stay competent in skills and knowledge Maintain confidentiality Refrain from illegal or immoral behavior-report others Show loyalty to patient, co-workers and employers Be sincere, honest and caring

PATIENT’S RIGHTS

Federal and State Law – written Patient Rights“Patient’s Bill of Rights” – AHA (American Hospital Association)

Patient has the right to:1. Considerate and respectful care2. Obtain complete , current info on diagnosis,

treatment and prognosis.3. Receive necessary information to give consent4. Have advance directives – DNR5. Privacy concerning medical care6. Confidentiality of all communications and

records

PATIENTS RIGHTS

Bill of Rights – Continued7. Reasonable response time to requests8. Obtain info on relationship between hospital

and other healthcare facilities9. Be advised and right to refuse being part of

research study10. Reasonable continuity of care11. Review medical records and examine bills12. Informed of any/all hospital rules, regulations

policies and resources to resolve disputes

PATIENTS RIGHTS

Long Term Care Facilities – Residents bill of Rights1. Free choice regarding physician, treatment and

participation in research2. Freedom from abuse, chemical or physical restraints3. Confidentiality of records4. Accommodations and choice regarding activities,

schedules and healthcare5. Voice grievances without fear of retaliation6. Organize and participate in family/resident socials,

religious and community activities

PATIENTS RIGHTS

7. Information on medical benefits, survey results, deficiency of facilities and advocacy groups.

8. Manage personal funds and use personal possessions

9. Unlimited access to immediate family or relatives

10. Remain in facility and not be transferred unless for medical reasons

ADVANCE DIRECTIVES

Also known as legal directives – legal documents that allow patients to state what medical treatment they want and don’t want. Living Wills – what measures should or

should not be done to prolong life (includes DNR)

Durable Power of Attorney- document that permits an individual (principal) to appoint another person (agent) to make decisions regarding healthcare

ADVANCED DIRECTIVES

Patient Self Determination Act - 1990 federal law requiring healthcare facilities that receive federal aid do the following: Inform every patient both orally and written they have the

right to make decisions about medical care including refusal. Provide information and assistance about advance directive Document any advance directives on chart Have written statements to implement patients rights in

decision making process Affirm there will be no discrimination or effect on care

because of advance directives Educate the staff on medical and legal issues of advance

directives

PROFESSIONAL STANDARDS

Legal responsibilities, ethics, patient rights and advance directives protect the patient:

Following Professional Standards protects:

Healthcare worker (YOU)Employer

PROFESSIONAL STANDARDS

Perform only those procedures for which you have been trained and are legally permitted to do.

Use approved methods while performing any procedure

Obtain proper authorization before performing a procedure

Identify the patient and obtain patient consent before performing procedure

Observe all safety prcautions

PROFESSIONAL STANDARDS

Keep all information confidential Think before you speak. Treat all patients equally Accept no tips or bribes for your care If an error or mistake is made - report

immediately Behave professional in dress, language,

manner and actions

LEGAL AND ETHICAL RESPONSIBILITIES

Even when all is followed errors leading to legal action occur. Have and maintain liability insurance

Insurance companies specializing in liability

Professional Organization Homeowners or Business Insurance