Transcript Legal and Ethical Responsibilities

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.
2.
3.
4.
5.
6.
7.
Malpractice
Negligence
Assault and Battery
Invasion of Privacy
False Imprisonment
Abuse
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 injure
Battery – 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 written
Any 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 patient
2. 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 care
2. Obtain complete , current info on diagnosis,
treatment and prognosis.
3. Receive necessary information to give consent
4. Have advance directives – DNR
5. Privacy concerning medical care
6. Confidentiality of all communications and records
PATIENTS RIGHTS
Bill of Rights – Continued
7. Reasonable response time to requests
8. Obtain info on relationship between hospital and
other healthcare facilities
9. Be advised and right to refuse being part of
research study
10. Reasonable continuity of care
11. Review medical records and examine bills
12. Informed of any/all hospital rules, regulations
policies and resources to resolve disputes
PATIENTS RIGHTS
Long Term Care Facilities – Residents bill of Rights
1.
2.
3.
4.
5.
6.
Free choice regarding physician, treatment and
participation in research
Freedom from abuse, chemical or physical restraints
Confidentiality of records
Accommodations and choice regarding activities,
schedules and healthcare
Voice grievances without fear of retaliation
Organize and participate in family/resident socials,
religious and community activities
PATIENTS RIGHTS
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
7.
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
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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
