Legal Aspects of Nursing Practice- 2.6.

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- Nursing practice is governed by many legal concepts

- Important for nurses to know the basics of legal concepts because nurses are accountable
for their professional judgemental actions

Accountability

- Essential concept of professional nursing practice and law

Knowledge of Laws that Regulate and Affect Nursing Practice is Needed for:

1. Ensure that nurses’ decisions and actions are consistent with current legal principles
2. Protect nurse from liability

Law

- Sum total of rules and regulations by which a society is governed as such, law is created by
people and exists to regulate all persons

Function of Law in Nursing

1. Provides framework for establishing which nursing actions in the care of clients are legal
2. Differentiates the nurses’ response from those of the other health professionals
3. Helps establish the boundaries of independent nursing actions
4. Assists in maintaining a standard of nursing practice by making nurses accountable under
law

Informed Consent

- Agreement by a client to accept a course of treatment or a procedure after being provided

with complete information including; benefits and risks of treatment, alternatives to
treatment and prognosis if not treated by a health care provider
- Usually clients signs a form provided by agency or institution. The form is the record of the
informed consent not the informed consent itself
- Right of consent are also involved in the right of referral

3 Major Elements

1. Consent must be given voluntarily

2. Consent must be given by a client or individual with the capacity and competency to
understand
3. The client or individual must be given enough information to be the ultimate decision maker

General Guidelines:

1. The diagnosis or condition that requires treatment

2. The purpose of the treatment
3. What the client can expect to feel or experience
4. The intended benefits of treatment
5. Possible risks or negative outcomes of the treatment
6. Advantages and disadvantages of possible alternatives to the treatment
Two Types of Consent

1. Express Consent
o Either an oral or written agreement usually more invasive a procedure and/or the
greater the potential for risk to the client, the greater the need for written
permission
2. Implied Consent
o Exists when the individual’s nonverbal behaviour indicates agreement
o Ex. Client who positions their body for an injection or cooperate with the taking of
vital signs infer implied content
o Consent also implied by medical emergency when an individual cannot provide or
express consent because of physical condition

*Note:

- obtaining informed consent for specific medical and physical treatment is the responsibility of the
person who is going to perform the procedure

- generally it is the physician ; however, it could also be the nurse practitioner, clinical nurse
specialist, or physician’s assistant who is going to perform procedures in their advanced practices

- cultural perspectives also needs to be considered when clients are asked to make decisions about a
particular treatment

- the nurse can provide culturally competent care by asking client if there is someone they would like
to be present when information or discussion of their healthcare occurs

Ethical Principle of Authority (US Based)

- Patient’s rights to self determination

- Cultural Perspective; Other members of the family are the decision makers
- it is important that the client understands
- if client cannot read, consent form must be read to client and the client must state
understanding before the form is signed
- if the client does not speak the same language as the healthcare provider, who is providing
the information, an interpreter must be present
- if given sufficient information, a competent adult can make decisions regarding health
- a client who is confused, disoriented, or fractured is not considered functionally competent
- a legal guardian or representative must provide or refuse consent for incompetent adult

Three Groups of People who CANNOT provide Consent

1. Minors
o Parent or guardian must give consent before minors can obtain treatment. Same is
true for an adult who has the mental capacity of a child and who has appointed
guardian
o Some states, minors are allowed to give consent for such procedures such as blood
donations, treatment for substance overdose, treatment for mental health problems
and treatment for reproductive health concerns such as STD or pregnancy
o Certain groups of minors are often legally permitted to provide own consent
 2. Unconscious or injured
o Consent is obtained from the closest adult relative if existing statutes permit
o In life threatening emergencies, if consent cannot be obtained from client a relative,
then the law generally agrees that consent is implied to provide necessary care for
the client’s emergency condition
3. Mentally ill persons
o Judged by professionals to be incompetent
o State and provincial mental health acts or similar statutes generally provide
definitions of mental illness and specify the right of mentally ill under the law as well
as the right of the staff caring for such clients

Nurses’ Role

- Nurse is responsible for explaining and is a witness

- Writes signature