Transcript LEGAL / ETHICAL TERMINOLOGY

Legal Terminology
Biomedical Technology
Curriculum/ 2004
 Civil law: a legal relationship between
individuals.
 Criminal law: legal obligations between an
individual and society or state.
 Felony: a more serious crime than a
misdemeanor in which the punishment is
imprisonment.
 Misdemeanor: a less serious offense than a
felony; may be punishable by a fine or
sentencing to a local prison for less than one
year.
 Tort: a civil wrongful act causing harm or
injury due to the healthcare worker not
performing the standard of care.
 Litigation: the determining of a person’s
legal rights either by a lawsuit or some
form of legal action.
 Licensure: legal permission to perform
an occupation given by governmental
agencies.
 An example of civil law are torts or
contracts.
 Examples of criminal law, commonly called
a crime, are: practicing without a license,
misuse of narcotics, theft and murder.
 Example of felony are murder, rape, arson,
robbery, burglary, manslaughter.
 Example of misdemeanor: petty theft,
disturbing the peace.
Legal implications in
health care
 Malpractice: harmful, incorrect, or
negligent practice or treatment of a
patient by a health care provider.
 Negligence: failure of a health care
provider to perform his/her duties in a
responsible manner that results in
injury to a patient.
 Examples of malpractice include: physician
not administering a tetanus injection when a
patient has a puncture wound or a nurse
performing minor surgery without training.
 Examples of negligence include: falls and
injuries that occur when siderails are left
down. Using or not reporting defective
equipment. Infections caused by use of
nonsterile instruments and/or supplies
 Liable: to be legally responsible for
failing to perform professional duties to
meet the standards of care and/or
causing harm or injury.
 Libel: a written statement that provides
false information which can cause
damage to a person’s reputation.
 Slander: spoken misrepresentations
that are proven false and can damage
another’s reputation.
 An example of liable is: During her delivery, a patient
suffers umbilical cord prolapse, which poses a serious
threat to the life of the baby if a c-section is not performed
immediately. The doctor fails to act in a timely manner,
delaying the c-section. As a result of the delay, the baby
suffers brain damage. If the doctor had acted in a timely
fashion as is standard, the baby would not have been
harmed.
 An example of libel is reporting a patient has an infectious
disease to a government agency when lab results are
inaccurate.
 Example of slander is stating a person has drug problems
when another medical condition exists.
 Conduct: the manner in which a
person displays his/her behavior.
 Consent: the giving of one’s
permission to another to perform a
procedure or action. Can be consent to
view medical records, consent to
perform surgery.
 Breach of contract: the breaking of a
promise, agreement, or contract in
which parties have agreed upon.
 A Contract can be Implied or Expressed:
– Implied-obligations that are understood without
verbally expressed terms; for example,
qualified health worker prepares medication
and patient takes medication; implied that
patient accepts this treatment.
– Expressed-stated in distinct and clear language,
either orally or in writing; for example, surgery
permit, promises must be kept and all risks
associated with tx must be explained to patient.
 Examples of Breach of Contract include
failure to provide care and/or giving
inproper care; patient refuses to pay for
care; can lead to legal action.
 Reasonable care: the legal obligation of
a health care worker to provide
competent care according to the
expected standards of practice.
 Assault: the threatening or attempt to
injure a person in an unlawful manner.
 Battery: the unlawful touching of
another that results in injury.
 Examples of assault and battery are:
performing procedure after patient has
refused to give permission or improper
handling and rough treatment of patients.
 **Patients must give consent and have the
right to refuse care at any time.
 Illegal restraint: holding a person
against his/her will by using a
restrictive device or other means.
 Invasion of privacy: the giving out of
information about an individual or
patient without his/her consent;
Unnecessary exposure of an
individual or revealing personal
information about an individual
without consent.
 Examples of illegal restraint include
keeping a patient hospitalized against his or
her will; application of physical restraints
without proper authorization or with no
justification.
 Examples of invasion of privacy improper
draping or covering of a patient during a
procedure that allows other patients or
personnel to see patient exposed.
 Continued examples of invasion of privacy
include: Sending information to an
insurance company without the patient’s
written permission; informing news media
about an individual’s condition without the
individual’s permission.
 Privileged communication: a patient’s
personal information given to a health
care worker that must be kept
confidential. By law this information must
be kept confidential and only shared with
members of health care team.
Privileged Communications
 Certain information exempt by law and
must be reported includes:
– Births and deaths
– Injuries caused by violence (assault and battery,
abuse, stabbings) that may require police
involvement.
– Drug abuse
– Communicable diseases
– STD’s
 Privileged Communications also include
Health Care Records, or records containing
information about the care that has been
provided to the patient. These records
belong to the health care provider, but the
patient has right to obtain a copy of any
information in record. Erasures not
allowed; cross out errors with single line,
insert correct info, initial and date.
 Computerized records have created modern
dilemmas on maintaining confidentiality.
Safeguards have been created to maintain
computer confidentiality such as:
– Limiting personnel who have access
– Using codes to prevent access to certain
information
– Requiring passwords to access specific
information on records
Legal documents in
healthcare
 Advanced directive: a written document
that specifies if extraordinary measures
are to be taken to prolong life if the
patient can no longer make his/her own
decision. Two main directives are a
Living Will and a Durable Power of
Attorney or POA.
 Living will: a legal document prepared
while a person is mentally competent
that specifies what his/her wishes are
regarding end-of life care.
 Durable power of attorney: a legal
document that designates another
person to make health care decisions in
the event that the person is mentally or
physically incapable of making their
own.
In summary:
 Legal responsibilities are an important
aspect of health care.
 All states have set rules and regulations
 Most health care agencies have specific
rules, regulations, and standards that
determine activities performed by
individuals in different positions.
 Standards vary from state to state, and even
agency to agency.
Application:
 Discuss the legal responsibilities in the
following cases:
– A geriatric assistant steals an elderly patient’s
watch
– A surgeon operates on the wrong leg
– A dental assistant slaps a screaming child
– A physical therapist fractures a patient’s leg
while performing exercises
Continued Application;
 A medical assistant sends a copy of a
patient’s record to an insurance company
without the patient’s consent.
 A nurse working for a plastic surgeon tells a
patient that a face lift will make the patient
look 10 years younger.
Ethics
 Are a set of principles dealing with what is
morally right or wrong
 Provide a standard of conduct or code of
behavior
 Allow health care provider to analyze
information and make decisions based on
what people believe is right and of good
conduct
Ethics Continued
 Modern health care advances have created
many ethical dilemmas:
– Is Euthansia (assisted death) justified in certain
patients?
– Should a patient be told that the health care
provider has AIDS?
– Should aborted fetuses be used for research?
– When should life support be discontinued?
– Do parents have a religious right to refuse lifesaving blood transfusion for their child?
Ethics Continued
– Can a health facility refuse expensive
treatment, such as a bone marrow transplant, if
a patient cannot pay for the treatment?
– Who decides if a 75 year old patient or a 56
year old patient gets a single kidney available
for transplant?
– Should people be allowed to sell organs for
transplants?
– Should animals be used in medical research
even if it results in the death of the animal?
Ethics Continued
– Should genetic researchers be allowed to
transplant specific genes to create the “perfect”
human being?
– Should human beings be cloned?
– Should aborted embryos be used to obtain stem
cells for research, especially as scientists may
be able to use the stem cells to cure diseases
such as diabetes, osteoporosis and Parkinson’s
disease?
Basic Rules of Ethics
 Put saving a life and promotion of health
above all else
 Make every effort to keep patient as
comfortable as possible and to preserve life
when possible.
 Respect the patient’s choice to die
peacefully and with dignity when all options
have been discussed with the patient and
family and/or predetermined by advanced
directives.
Basic Rules Continued…
 Treat all patient equally, regardless of race,
religion, social or economical status, sex and
nationality; avoid bias, prejudice, and
discrimination.
 Provide care for all persons to best of your
ability
 Maintain competent level of skill consistent
with occupation; stay informed and up to
date; pursue continuing education as
necessary
Basic Rules Continued….
 Maintain confidentiality
– Information about patient must remain private
and be shared only with others involved in care
– Information obtained from patients should not
be repeated or used for personal gain
– Gossiping about patients is ethically wrong
Basic Rules Continued….
 Refrain from immoral, unethical, and illegal
practices
– Report illegal action of others to proper
authority
– Avoid actions that are immoral or illegal
Show loyalty to patients, co-workers and
employer by avoiding negative comments and
always express a positive attitude
Basic Rules Continued….
 Be sincere, honest, and caring
– Treat others as you want to be treated-”Golden
Rule”
– Show respect and concern for the feelings,
dignity, and rights of others
In Summary:
 Study the code of ethics for occupation you
enter
 Abide by the code
 Become a competent and ethical health care
worker
 Earns you the respect and confidence of
patients, co-workers, and employers.
Questions/Things to Think About
 Why do health occupations have an ethical
code?
 Does a drug addict deserve the same care as
the president of the United States?
 What should you do if you see a co-worker
stealing drugs?
 A patient who is dying of cancer tells you he
is saving sleeping pills to commit suicide.
What should you do? Why?
Questions/Things to Think About
 “I hate this job” is a comment you hear in
the staff conference room. What is wrong
with this statement?
Crossword Puzzle
 Imprisonment
Practice
 Invasion of Privacy Negligence
 Malpractice
defamation
 Libel
personal battery
 Living will
slander
consent
 Assault written
tort
 verbal
Critical Thinking
 After reviewing the Code of Ethics, answer
the following:
– Why do healthcare workers need a code of
ethics?
– How would life in school be different if high
school students followed a code of ethics?
Who Should Get Custody?
 Josh Brown-father to Darcy since she was
born
 Lawyer for the Howards
 Lawyer for Mary Brooks
 Jury members
 Judge (The judge will keep order in the
court and throughout the proceedings)
Patient’s Rights
 Federal and State Legislation requires
health care agencies to have written policies
concerning patients’ rights, or the factors of
care that patients can expect to receive
 The American Hospital Association has
adopted a “Patient’s Bill of Rights” that is
recognized and honored by many health
care facilities. This bill of rights states, in
part, that a patient has the right to…..
Patient’s Rights
– Considerate and Respectful Care
– Obtain complete, current information
concerning diagnosis, treatment, and prognosis
(expected outcome)
– Receive information necessary to give informed
consent prior to the start of any procedure or
treatment
– Have advance directive for health care and/or
refuse treatment to the extent permitted under
law
Patient’s Rights
– Privacy concerning a medical care program
– Confidential treatment of all communications
and records
– Reasonable response to a request for services
– Obtain information regarding any relationship
of the hospital to other health care and
educational institutions
– Be advised of and have the right to refuse to
participate in any research project
Patient’s Rights
– Expect reasonable continuity of care
– Review medical records and examine bills and
receive an explanation of all care and charges
– Be informed of any hospital rules, regulations,
and/or policies and the resources available to
resolve disputes or grievances
Test Review
 Which of the following is an example of an
ethical practice?
– A. Practicing within the guidelines of the law
– B. Following agency policies
– C. Respecting cultural differences in clients
 The principles and values that determine
appropriate behavior are known as:
–
–
–
–
A.
B.
C.
D.
Slander
Malpractice
Libel
Ethics
 Which of the following statements is true
about ethical codes?
– A. Nurses established the first code of ethics
for a profession
– B. What is ethical in one profession may not
apply in another
– C. They are legally binding
– D. They are established by courts of public
opinon