Health Ethics 2021

LEGAL AND ETHICAL RESPONSIBILITIES IN HEALTH CARE

Nsg 106 Health ethics
Legal Responsibilities
Civil Law

Legal relationships between people and the protection of a person’s rights

Torts- wrongful acts that do not involve contracts

Health care mainly affected by civil law:

both contractual and torts

Criminal Law

Wrongs against a person, property or society

Examples of criminal law in health care- practicing without license, use of narcotics, theft,
murder
Tort

a wrongful act or an infringement of a right (other than under contract) leading to civil legal
liability.
TORTS

Malpractice- “bad practice”

◦ Ex: a physician not administering a tetanus injection when a patient has a puncture
wound

Negligence- failure to give care that is normally expected

◦ Ex: Falls & injuries that occur when side rails are left down

Assault-threat or attempt to injure

Battery-unlawful touching of another person without their consent

◦ Ex: Surgery of treatment to minors

Invasion of Privacy- includes unneccessary exposure of an individual or revealing personal

information

◦ Ex: Improperly draping or covering a patient

Torts (cont.)

False imprisonment-Restraining an individual or restricting their freedom.

◦ Applying physical restraints

Abuse-Any care that results in physical pain or mental anguish

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◦ Ex: Physical,verbal, psychological, or sexual abuse

Defamation: occurs when false statements either cause a person to be ridiculed or damage the
person’s reputation

◦ Slander: spoken defamation

◦ Libel: written defamation

Forms of Abuse

Physical- hitting, restraining, depriving of food water or physical needs

Verbal- can be spoken or written – swearing, shouting, ethnic slurs

Psychological-threatening harm, denying rights, intimidating, belittling

Sexual touching, gestures, or suggestions that are unwanted

Torts (cont.)

Defammation- false statements which cause a person to be ridiculed or ruin their reputation

1) Slander-spoken

2) Libel-written

Informed Consent

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

Contracts

Expressed Contracts

Stated in distinct and clear language either orally or in writing.

Ex. Surgical permit

Implied Contracts

Obligations understood without verbally expressed terms

Ex. Giving medication to a patient

Legal Disability

A person who does not have the legal capacity to form a contract.

Minors

Mentally incompetent individuals

Someone under the influence of drugs

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Someone who does not understand the language

EMPLOYER

Principal

EMPLOYEE

Agent

Privileged Communications

All information given to health care personnel by a patient

Must be kept confidential and shared only by members of patient’s health care team

Must receive written release to give information to others (exceptions: births and deaths, injuries
caused by violence, drug abuse, communicable diseases and sexually transmitted diseases.

Health Care Records

An example of privileged communications

Patient may obtain a copy

Can be used as legal records

Errors crossed out with a single line and initialed, and dated

Must be kept for amount of time required by law then burned or shredded

Ethics

Set of principles relating to what is morally right or wrong.

Provide a standard of conduct or code of behavior.

Issues: Euthansia, Stem Cell Research, marijuana legalization, animal in research, denying
treatment on religious grounds etc..

Code of Ethics by the HC Worker

The Health Care Worker’s Primary Goals:

◦ To promote optimal wellness, preserve life, & provide for a peaceful death

◦ To respect religious beliefs & cultural values of client

◦ To provide adequate & continuous care for all clients despite differences (age, race,
gender, etc)

◦ To know limits of practice for which he/she is competent

◦ To maintain competence & current knowledge

◦ To practice jurisprudent behavior at all times

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Code of Ethics Cont.

To respect dignity & rights of each client by maintaining confidentiality & a professional attitude
regarding info

To ask for clarification & ask when unsure

To participate in professional activities & organizations to provide better health care

To maintain high standards of ethical & legal behavior, and to state current on all certifications,
licenses, etc

Confidentiality

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

Patients’ Rights

Patient’s Bill of Rights by AHA

Considerate respectful care

Obtain complete current info about diagnosis etc…

Receive info to give informed consent

Have advanced directives- can refuse treatment

Patients’ Rights

Privacy

Confidentialty - HIPPA

Reasonable response to a request for services

Receive info about relationships between doctors and medical facilities etc…

Be informed of right to refuse being involved in research

Patients’ Rights

Reasonable continuity of care

Right to review medical records and examine bills

Be informed of hospital rules, regulations, and resources to settle grievances

Advanced Directives

Grey’s Anatomy – DNR – “Do Not Resuscitate”

◦ https://www.youtube.com/watch?v=xEhKy3dhQec
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◦ Legal doc that states that a person should NOT be revived if he/she suffers from cardiac
or resp arrest.

Living Wills-

◦ Documents that allow individuals to state what measures should or should not be taken to
prolong life when their conditions are terminal

General or Specific Power of Attorney-

◦ Authorizes your Agent to act on your behalf in a variety of general or specific situations.

Durable Power of Attorney-

◦ Document which allows another individual to make their medical decisions for them if
they become unable to

Advanced Directives Cont.

Patient Self-Determination Act

Inform every adult verbally and in writing of their right to make decisions about their care
including right to refuse treatment and right to die

Professional Standards

Only perform procedures you have been trained and are legally permitted to do.

Use only approved, correct procedures

Obtain proper authorization before performing any procedure

Identify patient and receive their consent before performing procedure

Professional Standards

Observe all Safety Precautions

Keep all information confidential

Think before you speak

Treat all patients equally

Accept no tips or bribes

If any mistakes or errors occur report them immediately to your supervisor

Behave professionally in dress, language, manners and actions