Legal and Ethical Issues and professional role

related to emergency and critical care

 Jizan university

Nursing college

Legal and Ethical Issues and professional role

related to emergency and critical care

By

Emergency and critical care team

 To identify and describe the nurses duty of care
in the emergency and Critical care settings.

 Toapply ethical principles and rules using case-

studies, and to test ethical decision-making
processes.
 Ethics Versus Morals The terms ethics and morality are
used to describe beliefs about right and wrong and to
suggest appropriate guidelines for action.
 ethics is the formal, systematic study of moral beliefs to
understand, analyze, and evaluate matters of right and
wrong; whereas, morality includes specific values,
characters, or actions whose outcomes are often examined
through systematic ethical analysis.
 Because the distinction between ethics and morality is
slight, the terms are often used interchangeably
 Nurses have a duty to practice ethically and morally
 As a profession, nursing is accountable to
society. Nursing has identified its standards
of accountability through formal codes of
ethics. The International Council of Nurses
(ICN) has endorsed a globally applicable Code
of Ethics for Nurses.
 The American Nurses Association (ANA)
established a Code of Ethics for Nurses that
includes ethical standards provide guidance
to address and resolve ethical dilemmas by
incorporating universal moral principles.
 CODE OF ETHICS For Emergency
Nurse
1. The nurse practices with compassion and respect for the
inherent dignity, worth, and unique attributes of every
person.

2. The nurse’s primary commitment is to the patient,

whether an individual, family, group, community, or
population.

3. The nurse promotes, advocates for, and strives to protect

the rights, health, and safety of the patient

CODE OF ETHICS For Emergency Nurse
4.The Emergency Nurse has authority, accountability,
and responsibility for nursing practice; makes decisions;
and takes action consistent with the obligation to
promote health and to provide optimal care.
5. The Emergency Nurse owes the same duties to self as
to others, including the responsibility to preserve
health and safety, maintain competence, and continue
personal and professional growth.
6.The Emergency Nurse,
Nurse through individual and
collective effort, establishes, maintains, and
improves the ethical environment of the work
setting.
7. The Emergency Nurse,
Nurse advances the profession
through research and scholarly inquiry
8. The nurse collaborates with other health
professionals and the public to promote human
rights.
9. The Emergency Nurse,
Nurse , collectively through
its professional, and integrate principles of social
justice
 Moral Situations Many situations exist in which ethical
analysis is needed.
 1/moral dilemmas, or situations in which a clear conflict
exists between two or more moral principles, and
nurses must choose the lesser of two evils.
 2/moral problems, in which there may be competing
moral claims or principles, although one claim or
principle is clearly dominant.
 3/moral uncertainty, when one cannot
accurately define what the moral situation
is or what moral principles apply but has a
strong feeling that something is not right.
 4/moral distress, in which one is aware of
the correct course of action but
institutional constraints stand in the way of
pursuing the correct action
 In order to prevent potential legal problems, it is
essential that the nurse know what functions are
within the bounds of the practice of professional
nursing as defined by the Nurse Practice Act. In
addition, the nurse must have the education and
experience to competently perform those functions
and must perform them in congruence with the
policies of the employing institution
There are two major areas of law: criminal law
and civil law. Criminal law. The most
common types of criminal cases are criminal
assault and battery, criminal negligence, and
murder.
The most common types of suits filed against
nurses are civil suits involving tort law.
Tort law concerns a wrong committed against
a person or the person’s property..
 Negligence and assault and battery are
examples of torts.
 When nurses obtain consents from patients
or proxies appropriately, before providing
care or treatments, they protect themselves
against charges of assault and battery
You are personally accountable for your practice.
In caring for patients or clients, you must;

 Respect the patient or client as an individual

 Obtain consent before you give any treatment or
care
 Protect confidential information
 Cooperate with others in the team
 Maintain your professional knowledge and
competence
 Be trustworthy
 Act to identify and minimise risk to patients and
clients.
“ a formal obligation to disclose, what you have done,

why you did it and what the results of your action

were”.
  Civil law
 The patient (and
family)
 Criminal law
 The public
 Disciplinary
process
 The employer
 Remove from
register
 And Oneself
 Informed consent of a competent adult must be
obtained before any intervention

 Groups who may be unable to give informed

consent:
 Infants
 Some mentally ill patients
 Some elderly patients
 Unconscious
 A patient is admitted to the Accident and
Emergency Department. He is unconscious and
requires an emergency operation. How will
consent for this intervention be obtained?
 Consists of planned, organized learning
experiences designed to augment(increase)
the knowledge, skills, and attitudes.

20
 Legal Documentation
• In all records the documentation required
by federal ,laws and regulations and
accepted standards of nursing practice.The
documentation must be:
• Must be accurate, complete, legible
(readable)
• Sign name and initials as they appear on
your license

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1.Provider of Service
The nurse is expected to provide safe and
competent care so that harm (physical, psychologic
or material) to the recipient of the service is
prevented.
2. Liability (responsibility)
It is the quality or state of being legally
responsible for one’s obligations and actions and to
make financial restitution for wrongful acts.
3. Standards of Care
It is by which the nurse acts or fails to act are
legally defined by nurse practice acts and by rule of
prudent professional that they acts with similar
experience.
4. Employee or Contractor for Service
A nurse who is employed by a hospital work as an
agent of the hospital.
5. Citizen
The rights and responsibilities of the nurse in the
role of a citizen are the same as those individual under
the legal system.
Rights are privileges or fundamental powers to
which an individual is entitled unless they are revoked by
law or given up voluntarily. e.g. right to physical safety.
 Ethics guide the profession in self-regulation. It

remind nurses of the special responsibility they

assume when caring for the sick, especially the

critically ill patients admitted in Emergency Room

or Critical Care Unit.

1. Autonomy: This word autonomy is derived from
the Greek words autos (“self”) and nomos
(“rule” or “law”) and therefore refers to self-
determination. The principle of autonomy
entails the right of patients to receive adequate
and accurate information so that they have the
ability to make a choice free from external
constraints
 Beneficence and Nonmaleficence 2.Beneficence
is the duty to “perform deeds of mercy,
kindness, friendship, charity, and the like to
benefit others. It also entails taking positive
action to prevent patients from harming
themselves or others.
 3. Non maleficence is the duty to not inflict
harm. The only time when it is considered
morally permissible to exercise power over a
competent person against their will is when by
doing so, harm to others is prevented.
4.Veracity: telling the truth and incorporates the
concept that individuals should always tell the truth.
5.Double Effect
The double effect is a principle that may morally
justify some actions that produce both good and evil
effects.
6.Distributive Justice
justice states that like cases should be treated alike.
More specifically, distributive justice is an ethical
principle commonly applicable to clinical situations.
This principle is upheld when benefits and burdens are
distributed equitably and fairly without consideration of
age, gender, socioeconomic status, religion, ethnicity.
 VERACITY: It means telling the truth, which is
essential to the integrity of the client- provider
relationship.
 FIDELITY: Means being faithful to one’s
commitments and promises. Nurses’ commitments
to client include providing safe care and
maintaining competence in nursing practice.
 PRIVACY
It is important to most people. A loss of privacy
occurs if others inappropriately use their access to a
person. Nurses protect patient privacy by ensuring
that the patient’s body is appropriately covered, by
not discussing medically irrelevant physical features
and by not engaging in discussion of intimate details
about the patient unless necessary for the provision
of good care.
 CONFIDENTIALITY
1-The principle of confidentiality requires that
information about a client be kept private.
2-What is documented in the client’s record is
accessible only to those providing care to the
client.
3- No one else is entitled to that information unless
the client had signed consent for Release of
Information that identifies with whom information
may be shared and for what purpose.
 BENEFICENCE
The principle of beneficence promotes doing acts of
kindness and mercy that directly benefit the
patient. These acts promote the health of the
patient, prevent illness or complications, alleviate
suffering and assist towards peaceful death if
inevitable comes.