LEGAL AND ETHICAL ISSUES

INTRODUCTION
From we were very young we began to learn what was right and wrong behavior was. We
learned this from our parents, relatives, friends and teachers. By the time we be adults, we
had a personal set of ethics to guide our behavior in daily life we may believe for
examples, that honesty important and necessary and important.
We will try to be honest because we believe it is right to do so. Being dishonest would
then be wrong for us. This is ethical behavior.

ETHICS
DEFINITION
1. Ethics refer to the moral code for nursing and is based on obligation to service and
respect for human life.
a\c to Melanie and Evelyn.

2. Ethics are the rules or principles that govern right conduct and are designed to protect
the rights of human.
a/c to sister Nancy

NEEDS FOR NURSING ETHICS

1. Helps the students/ RN to practice ethically

2. Helps the nurse to identify the ethical issues in her work place
3. Protecting patients right and dignity
4. Providing care with possible risk to the nurses health
5. Staffing patterns that limit the patients access to nursing care.
6. Ethical reasoning
7. Helps the nurse to respond to ethical conflicts
8. Helps to differentiate right/wrong behavior
9. Guide for a professional behavior
10. Help teachers plan education.
11. Prevent below standard practice.
12. Protect a nurse if falsely accused and guide direction for legal action.

KEY PRINCIPLES OF ETHICS IN HEALTH CARE SYSTEM

1. Autonomy- The right of self determination , independence and freedom. Right to
health care decision.
2. Justice- Obligation to be fair with all people.
3. Fidelity- Obligation of an individual to be faithful to the commitment made to
himself, and to others. It is the main support of accountability.
4. Veracity- The duty to tell the truth.
5. Beneficence- Doing good for the client. What exactly is good for one person may
not be the same for others.
6. Malfeasance - Is the requirement that health care providers do no harm to their
client either intentionally or unintentionally
7. Deontological- Rule based ethics.
8. Situational: - What causes a good outcome is good action.

Thus a profession's ethical code is a collective statement about the group's

expectations and standards of behavior. The ANA and ICN have established widely
accepted codes that professional nurses attempt to follow.

CODE OF ETHICS
Code of ethics is the providing guidelines for safe and compassionate care. Nurse's
commitment to a code of ethics guarantees the public that nurses adhere to
professional practice standards.

I.C.N. CODE OF ETHICS FOR NURSES

Ethical concepts applied to nursing:-
The fundamental responsibility of the nurses is of four fold: to promote health. to
prevent illness, to restore health and to alleviate suffering.
Nurses and people
• The nurses primary responsibility is the those people who require nursing care
• The nurses provides care, promotes an environment in which the values customs and
spiritual beliefs of the individual are respected
• The nurses holds confidence, personal information and uses judgment in sharing their
information
Nurses and practice
• The nurse carries personal responsibility for nursing practice and for maintaining
competence by continuous learning
• The nurses maintains the higher standards of nursing care possible within the reality
of a specific situation.
• The nurses assess judgment in relation to individual competence when accepting and
delegating responsibilities.
• The nurse when acting in a professional capacity should at all times maintain
standards of personal conduct which reflect created upon the profession.
Nurses and Society
 • The nurses with other citizens the responsibility for initiating and supporting action to
in edit the health and social needs of the public

Nurses and Co-workers.

• The nurse sustains a co-operative relationship with co-workers in nursing practice and
nursing education.
• The nurse is active in developing a care of professional knowledge.
• The nurse acting through the professional organization, participants in establishing
and maintaining equitable social and economic working conditions in nursing.

TYPES OF ETHICAL THEORIES

1. Duty-oriented ethical theories
A duty oriented ethical theory is a system of ethical thinking having the concept of
duty or obligation as foundation. Duties are strict obligations that take primary over
rights and goals. Keep in mind however each duty has corresponding rights.
Duty Oriented Ethical Theories
Duties
Right
Goals

2. Rights-Oriented Ethical theories

A rights-oriented ethical theory is a system of ethical thinking having the concept of
rights as a foundation. Rights-oriented theories assign the highest value to rights, so
that duties and goals flow from rights, from right-oriented perspective, you would first
look to the clients right to privacy flowing from that right to privacy would be your
duty to keep care information confidential to achieve the goal of encouraging clients
to communicate information freely.

3. Goal-oriented ethical theories

A goal-oriented ethical theory is a system of ethical thinking having the concept of
maximizing the overall goal as its foundation- goal-related theories suggest that good
choices result from concern with the consequences of actions
In today's environment of health care reform nurses might choose to support changes
that will provide basic preventive and treatment services for all. Providing both
prevention and treatment could be viewed as maximizing the welfare of society.

4. Intuitionist ethical theory

An ethical theory is a system of ethical thinking that balances goals, rights and duties
according to the situation. Philosophers espousing this theory
5. Utilitarian ethical theories
Utilitarian ethical theories Utilitarian ethical theories are based on one's ability 1. Re
to predict the consequences of an action. To a 2 Re utilitarian, the choice that yields
the greatest benefit to the most people is the one that is ethically correct. There are
two types of utilitarianism, act utilitarianism and rule utilitarianism.
Act utilitarianism subscribes-a person performs the acts that benefit the most people,
regardless of personal feelings or the societal constraints such as laws. Rule
utilitarianism takes into account the law and is concerned with fairness. A rule
utilitarian seeks to benefit the most people but through the fairest and most just means
available. Therefore, added benefits of rule utilitarianism are that it values justice and
includes beneficence at the same time.

6. Virtue ethical theories

The virtue ethical theory judges a person by his/her character rather than by an action
that may deviate from his/her normal behavior. It takes the person's morals,
reputation, and motivation into account when rating an unusual and irregular behavior
that is considered unethical. For instance, if a person plagiarized a passage that was
later detected by a peer, the peer who knows the person well will understand the
person's character and will judge the friend accordingly. If the plagiarizer normally
follows the rules and has good standing amongst his colleagues, the peer who
encounters the plagiarized passage may be able to judge his friend more leniently.

ETHICAL PRINCIPLES
Ethical principles actually control professionalism nursing practice much more than to
ethical theories. Principles are the moral norms that nursing, as a profession, both
demands and strives to implement to every day clinical practice. Ethical principles
that the nurses should consider when making decisions are as follows
1. Respect for persons
2. Respect for autonomy
3. Respect for freedom
4. Respect for beneficence (doing good)
5. Respect for non-malfeasance(avoiding harm to others)
6. Respect for veracity (truth telling)
7. Respect for justice (fair and equal treatment)
8. Respect for rights
9. Respect for fidelity (fulfilling promises)
10. .Confidentiality (protecting privileged information)

1. Respect for persons

This principle not only applied to clinical situation, but it applies to all life
situations it directs individuals to treat themselves and other with a respect
inherent to main humans. The respect to person's a need to be simplified as not
affects nursing practice.
2. Autonomy
Autonomy means that individuals are able to act for themselves to the level of
their capacity. It is the rights of individuals, governing their actions according to
their own purpose and reason.

3. Freedom
Nurses a group believes that patient should be observed freedom of choice within
the nation's health care system. This principle should be observed by staff nurses
when planning patient care. by nurse's manager when leading subordinates.

4. Beneficence: (the ethical principles of upholding doing good)

The beneficence principles states that the actions one takes should promote good.
It requires the. balancing the harms and benefits. Benefits promote the clients
welfare and health whereas harms or risks detract from the client's health and
welfare. In other words, providing benefits that enhance the other welfare.
Whereas balancing the benefits and harms of intervention made on the others half.

5. Non – malfeasance
The principle of non- malfeasance states that one should do no harm. The nurses
should interpret the term harm to mean emotional and social as well as quality
physical injury. Harm is threading, defeating or setting back one person's interest
through invasive action by another.

6. Veracity
Veracity concerns truth talking and incorporates the is a prob concept that
individuals should always tell the truth. It requires professional care givers to
provide with accurate, reality based information about their health status and care
or treatment prospective

7. Justice
Justice concerns the issue that persons should be treated equally and fairly. This
principle of justice requires treating others fairly and giving persons their due.

8. Rights
Rights is an entitlement to behave in a certain way under circumstances, such as
nurses entitlement to freely express personal beliefs and preferences by voting in a
political election.
Right is also used to mean agreement with justice, law and morality. So right may
be mental rights or legal rights to respective profession.

9. Fidelity
Fidelity is keeping one's promises or commitment's. The principles of fidelity hold
that a person should faithfully fulfil his duties and obligations.
10. Confidentiality
 Confidentiality is the duty to respect privileged information. The principle of
confidentiality provides that care-givers should respect a patient need for privacy
and by personal information about him or her only to improve care.

LEGAL SYSTEM
LEGAL
Established by or founded upon law or official or accepted rules.
LAW
The term law is derived from its tentoric root lag witch means something witch lies fixed o
events
Law means a body of rules to guide human action
Law means that witch is laid down or fixed.

DEFINITION
1. The law us a system of rights and obligations which the state enforces. By Green

2. The law constitutes body of principles fecognized or enforced by public and regular
tribunals has the administration of justice.

3. The law is the body of principles recognized and applied by the state and the
administration of justice by salmaind.

4. Law is a rule or standard of human conducta established & enforced by authority,

society or custom.

SOURCES OF LAW
1. Constitutional law- it is a judgmental law. Law that governs the state. It determines
structure of state, power and duties.
2. Common law - it is a body of legal principles that evolved from court decisions
3. Administrative law - rules and regulations estabtished by administrative agencies
made by executives of government.

PURPOSES
1. To help the nurse to understand that they do have legal responsibilities in nursing
practice.
2. To make them understand by which authority these legal responsibilities can be
enforced.
 3. To make them understand what areas of nursing practice can mostly create legal
problems.
4. To describe and protect the rights of clients and
5. To describe and protect the rights of clients and
6. Law is there for the protection of nursing practice Law is there for the identification
of the risk of liability
7. Law is there to assist in the decision-making process involved in nursing practice
8. Nurses have more responsibility
9. Another important purposes are
Safeguarding the public
Safeguarding the nurse.

LEGAL ISSUES IN NURSING

:Some legal issues recur frequently in nursing practice. It is wise for the nurse to try to
understand these particular issues as they relate to individual practice.
DO'S AND DON'TS FOR SAFE PRACTICE
1. Do document all unusual incidences.
2. Do report all unusual incidences
3. Do follow policies and procedures as established by your employing agency.
4. Do keep current year to practice.
5. Do perform procedures that you have been thought and that are within the standard scope
of your practice.
6. Do not work as a nurse in state in which you are not licensed.
7. Do protect the patient from injury.
8. Do not advice that is contrary to the doctor's order or nursing care plan.

LEGAL RESPONSIBILITIES OF NURSE

1. Responsibility of appointing and assigning.
2. Responsibility in quality control
3. Responsibility for equipment
4. Responsibility for observation and reporting
5. Responsibility to protect public
6. Responsibility for record keeping and reporting
7. Responsibility for death and dying.

ROLE AND FUNCTIONS OF NURSE MAN AGER IN LEGAL ISSUES

1. Serves as a role model by providing nursing care that meets or exceeds accepted
standards of care.
2. Reports substandard nursing care to appropriate authorities.
3. Fosters nurse-patient relationships that are respectful, caring and honest thus
reducing the possibility of future lawsuits
4. Joint and actively supports professional organizations to strengthen the
lobbying efforts of nurses in health care legislation
5. Practices nursing within the area of individual competence
6. Prioritizes patients right and welfare first in decision making
7. Prioritizes patients right and welfare first in decision making
8. Delegates to subordinates wisely, looking at the managers scope of practice and
that of those they supervise.
9. Increases staff awareness of intentional torts and assist them in developing
strategies to reduce the liability in these areas.
10. Provides educational and training opportunities for staff on legal issues
affecting nursing practice.