Transcript Chapter 11 Legal and Ethical Responsibilities

Chapter 11
Legal and Ethical Responsibilities
Health Care
Science
Technology
Copyright © The McGraw-Hill Companies, Inc.
Objectives
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Describe the qualities of a successful
health care worker.
Distinguish between laws, morals, and
ethics.
Explain the purpose of professional codes
of ethics.
Define standard of care.
Describe informed consent.
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Chapter 11
Objectives (cont.)
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Discuss the importance of confidentiality
for health care professions.
Define the term advance directive and
distinguish among living wills, durable
powers of attorney, and health care proxies.
Describe clients’ rights and responsibilities.
Successfully complete 1 recording
procedure.
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Chapter 11
The Qualities of a Successful
Health Care Worker 11-1
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Qualities for Success
Understanding Laws, Morals, and Ethics
Licensure, Registration, and Certification
Standard of Care and Scope of Practice
Informed Consent
Confidentiality
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Chapter 11
Qualities for Success
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Successful health care providers use the
3 Cs:
– Courtesy
– Compassion
– Common sense
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Chapter 11
Qualities for Success (cont.)
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Other helpful qualities include:
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A relaxed attitude when meeting new people.
A willingness to learn new skills and
techniques.
An aptitude for working with the hands.
Empathy for others.
Good communication and listening skills.
Patience in dealing with others.
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Chapter 11
Qualities for Success (cont.)
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The ability to work as a member of a health
care team.
Proficiency in English, science, and
mathematics.
Tact.
The ability to keep information confidential.
The ability to leave private concerns at home.
Trustworthiness.
A sense of responsibility.
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Chapter 11
Qualities for Success (cont.)
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Responsibilities to Employers
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Deal morally, ethically, and legally with your
employer.
Report to work on time, properly dressed
and groomed.
Stay current in your chosen field by
attending seminars, continuing education
courses, subscribing to professional
journals, and obtaining in-house training.
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Chapter 11
Qualities for Success (cont.)
 The Health Care Team includes, but is not limited to:
– Physicians
– Registered nurses
– Licensed practical or vocational nurses
– Dietitians
– Physical and occupational therapists
– Respiratory therapists
– Electrocardiography technicians
– X-ray technicians
– Medical transcriptionists
– Nursing assistants
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Copyright © The McGraw-Hill Companies, Inc.
Chapter 11
Section 11-1
Apply Your Knowledge
List some members of the health care
team.
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Answer:
• Physicians
• Registered nurses
• Licensed practical or vocational nurses
• Dietitians
• Physical and occupational therapists
• Respiratory therapists
• Electrocardiography technicians
• X-ray technicians
• Medical transcriptionists
• Nursing assistants
Copyright © The McGraw-Hill Companies, Inc.
Chapter 11
Legal, Moral, and
Ethical Standards 11-2
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Understanding Laws, Morals, and Ethics
Licensure, Registration, and Certification
Standard of Care and Scope of Practice
Informed Consent
Confidentiality
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Chapter 11
Understanding Laws, Morals,
and Ethics
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Laws – a law, or statute, is a
rule of conduct or action.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Criminal Laws – protect members of
society from certain harmful acts of
others. A criminal act may be one of:
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Commission, if there is a law
forbidding a certain act.
Omission, in violation of a law
requiring a certain act.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Civil Laws – are concerned with private
rights and remedies. Examples of the causes
of civil disputes include:
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Contract violation.
Slander or libel.
Trespassing.
Product liability.
Automobile accidents.
Family matters such as divorce, child support,
and child custody.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Torts
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A tort is broadly defined as a civil wrong
committed against a person or property,
excluding a breach of contract.
Torts may be intentional (willful) or
unintentional (accidental) and, if intentional,
may also be crimes.
Unintentional torts are acts that were not
intended to cause harm. However, they are
committed without regard for consequences.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Malpractice
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An unintentional tort is caused by negligence.
Negligence is also called medical malpractice.
The 3 Ds must be present for negligence to occur:
– Duty – health care practitioner/client
relationship exists.
– Derelict – health care practitioner did not live
up to the obligation of caring for a client.
– Damage – the breach of duty results in
damages to the client or plaintiff.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Physicians are most likely to be charged
with negligence. However, other health
care practitioners may be subject to such
charges.
Medical practice acts are state statutes
that govern medical practices. They do
the following:
 Cover requirements and methods for
licensing health care providers.
 Establish medical licensing boards.
 List grounds for revoking licenses.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Morals and Ethics
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Morals are formed from your personal
values – your concept of right and
wrong.
Ethics are standards of behavior
developed as a result of your moral
values.
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Chapter 11
Understanding Laws, Morals, and
Ethics (cont.)
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Noncompliance
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Noncompliant health care workers
may face fines or prison sentences
and can lose their licenses to practice
their profession.
Unethical conduct may result in
expulsion or censure from your
professional organization, but only the
state can revoke a license.
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Chapter 11
Licensure, Registration, and
Certification
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Licensure – is required
for certain professions
within a state.
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Chapter 11
Licensure, Registration, and
Certification (cont.)
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Registration
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Adding one’s name in an official registry
or record as having satisfied the
requirements for a certain health care
occupation.
Fulfilling certain education requirements
and/or paying a registration fee.
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Chapter 11
Licensure, Registration, and
Certification (cont.)
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Certification – usually voluntary.
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Reciprocity – when state licensing
authorities accept a person’s valid
license from another state.
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Chapter 11
Standard of Care and Scope
of Practice
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Standard of care is the level of
performance expected of a health
care worker in carrying out his or
her professional duties.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
– Working outside your scope of practice can
make you liable.
– Working within your scope of practice ensures
that you:
 Do not injure clients or put them at risk by
performing procedures that are beyond your
ability.
 Will not be held liable for a standard of care
that is beyond your training, experience, and
job description if a legal situation arises.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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The Law of Agency – an employer is
legally liable for acts performed by
employees.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Informed Consent – in
order for a client to
make an informed
decision regarding
treatment, the client
needs to be told the
following:
A SAMPLE CONSENT FORM
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Informed Consent (cont.)
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The proposed methods of treatment.
Why the treatment is necessary.
The risks involved in the proposed treatment.
All available alternative types of treatment.
The risks of any alternative methods of
treatment.
The risks involved if treatment is refused.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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People who cannot give informed consent
include:
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Minors – individuals under 18 years of age (21
in some states). Exceptions include those
deemed mature minors by the court.
Mentally incompetent individuals – persons
judged by the court to be insane, senile,
mentally retarded, or under the influence of
drugs or alcohol.
Speakers of a foreign language who do not
speak English.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality
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It is illegal and unethical if a health
care worker does not observe
confidentiality.
Privileged communication refers to
information held confidential within a
protected relationship.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality (cont.)
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Keeping client medical information
confidential means:
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Not informing any unauthorized person
about the information contained in a client’s
medical records.
Not showing written information to an
unauthorized third party.
Taking proper precautions when
communicating such information over a
computer, telephone, or fax machine.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality (cont.)
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CONSENT TO RELEASE INFORMATION
Written consent must be
obtained before
releasing information to
a third party.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality (cont.)
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Guidelines to follow if you have access to a
client’s information:
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Do not decide if information is confidential based
on your approval or agreement.
Do not reveal financial information about a client.
Do not use the client’s name or other information
if others in the room might overhear.
Use caution in giving the results of medical tests
to clients over the telephone.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality (cont.)
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Guidelines to follow if you have access
to a client’s information: (cont.)
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Do not leave medical charts or insurance
reports where clients or others can see
them.
If the client has not given written permission
to release information, do not release it.
Do not discuss clients in public places
where others may overhear, such as the
cafeteria or elevator.
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Chapter 11
Standard of Care and Scope of
Practice (cont.)
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Confidentiality (cont.)
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Confidentiality for client medical records
may be waived under the following
circumstances:
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When a third party requests a medical
examination, such as a preemployment
examination, and that third party pays the
client’s bill.
When a client sues a physician or other health
care practitioner for malpractice.
When the client signs a waiver allowing the
release of information.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 11
Section 11-2
Apply Your Knowledge
When must written consent be
obtained?
Answer:
Consent must be obtained for many
procedures such as surgery and tests.
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Chapter 11
Medical Records and Policies 11-3
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Medical Records
Client Autonomy
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Chapter 11
Medical Records
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Facilities providing health care
services are required by licensing
authorities to keep and maintain health
care records of clients.
Medical records provide:
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A format for tracking, documenting, and
maintaining a client’s health data.
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Chapter 11
Medical Records (cont.)
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Documentation of a client’s lifelong
health care.
A basis for managing a client’s health
care.
Background information in the event of
a lawsuit.
Clinical data for education, research,
statistical tracking, and assessing the
quality of health care.
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Chapter 11
Medical Records (cont.)
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Medical records may be kept on paper,
microfilm, or computer tapes or disks.
They belong to the owners of the
facility, even though the client owns
the information contained in them.
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Chapter 11
Medical Records (cont.)
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Advance Directives –
legal documents that
make known a person’s
wishes about life-support
measures.
– Living Will – provides
instructions directly to
physicians, hospitals,
and other health care
providers involved in a
client’s medical
treatment.
Copyright © The McGraw-Hill Companies, Inc.
SAMPLE LIVING WILL
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Medical Records (cont.)
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Advance Directives (cont.)
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Durable Power of Attorney – not
specifically a medical document, but
it may serve that purpose. It gives a
person, called a designee, the
authority to make a variety of legal
decisions on behalf of another
person, called the grantor.
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Chapter 11
Medical Records (cont.)
SAMPLE HEALTH CARE PROXY
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Advance Directives (cont.)
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Health Care Proxy – or
health care power of
attorney, is also an end-oflife document. With it,
clients specify an agent to
make medical decisions
for them in the event that
they lose the ability to
reason or communicate.
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Chapter 11
Medical Records (cont.)
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Advance Directives (cont.)
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Organ Donor Directives – a
document that indicates
client’s wish to donate
organs for transplantation
or medical research when
client dies.
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Chapter 11
Client Autonomy
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Clients’ Rights
– The American Hospital Association’s Patient’s
Bill of Rights is followed in most states. It
guarantees the client’s right to:
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Receive considerate and respectful care.
Receive complete and current information
concerning his or her diagnosis, treatment, and
prognosis.
Know the identity of physicians, nurses, and
others involved with his or her care, as well as
when those involved are students, residents, or
trainees.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Rights (cont.)
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Know the immediate and long-term costs of
treatment choices.
Receive information necessary to give informed
consent prior to the start of any procedure or
treatment.
Have an advance directive concerning treatment
or be able to choose a representative to make
decisions.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Rights (cont.)
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Refuse treatment to the extent permitted by
law.
Receive every consideration of his or her
privacy.
Be assured of confidentiality.
Obtain reasonable responses to requests for
services.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Rights (cont.)
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Obtain information about his or her health care
and be allowed to review his or her medical
record and to have any information explained or
interpreted.
Know whether treatment is experimental and be
able to consent or decline to participate in
proposed research studies or human
experimentation.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Rights (cont.)
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Expect reasonable continuity of care.
Ask about and be informed of the existence of
business relationships between the hospital and
others that may influence the client’s treatment
and care.
Know which hospital policies and practices relate
to client care, treatment, and responsibilities.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Rights (cont.)
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The American Hospital Association’s Patient’s
Bill of Rights (cont.)
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Be informed of available resources for resolving
disputes, grievances, and conflicts, such as ethics
committees or patient representatives.
Examine his or her bill and have it explained and
be informed of available payment methods.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Responsibilities – clients are
responsible for:
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Providing information about past illnesses,
hospitalizations, medications, and other
matters related to their health status.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Responsibilities (cont.)
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Participating in decision making by asking for
additional information about their health
status or treatment.
Providing health care agencies with a copy of
their written advance directive if they have
one.
Informing physicians and other caregivers if
they anticipate problems in following a
prescribed treatment.
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Chapter 11
Client Autonomy (cont.)
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Clients’ Responsibilities (cont.)
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Following a physician’s orders for treatment.
The client has the right to refuse treatment to
the extent permitted by law.
Providing health care agencies with necessary
information for insurance claims and working
with the health care facility to make
arrangements to pay fees when necessary.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 11
Section 11-3
Apply Your Knowledge
Who owns the information in a
client’s medical records?
Answer:
Clients own the information in their
medical records.
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Chapter 11
Procedures in Student Text
11A
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Recording Information on a
Client’s Medical Record
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Chapter 11
Chapter 11 Credits
Slide 5
Slide 9
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PhotoDisc
Will and Deni McIntyre/Photo Researchers
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Chapter 11