1.04 #1 PPP Understand legal and ethical issues of the healthcare professional (4 days for PPP x5)

Divide into groups of 3-4 and brainstorm and record (you have 15 min): What do you know or want to know about legal and ethical issues in healthcare. Why is this information important to a healthcare professional?

1.04 Understand legal and ethical issues Importance for the healthcare professional to understand legal and ethical issues 1. Knowledge of legal responsibilities 2. Limitations of practice 3. Implications of their actions 3

1.04 Understand legal and ethical issues Importance for the healthcare professional to understand legal and ethical issues 4. Protection of a. Healthcare professionals b. Patients c. Co-workers d. Facility 4

1.04 Understand legal and ethical issues Importance for the healthcare professional to understand legal and ethical issues 5. Ethical behavior ensures a. Quality patient care b. Positive work relationships c. Well-managed workplace 5

1.04 Understand legal and ethical issues Legal and ethical dilemmas encountered by healthcare professionals 6

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas Abortion Termination of a pregnancy Termination of a pregnancy Spontaneous Spontaneous Induced Induced Abortion is legal. What are the ethical issues? 7

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas End of life 8

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas Euthanasia ( ( mercy killing) Voluntary Involuntary Assisted The act of ending the life of an individual in a painless manner. Individual is usually suffering from a terminal illness. 9

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas Advanced Directives Legal documents that allow the patient to state the end of life treatments they would or would not want, in the event that they become unable to make those decisions. 10

1.04 Understand legal and ethical issues Dilemmas Living Will Legal and Ethical Dilemmas Living Will Patient’s document that states specific measures to be taken or not taken to prolong life. Do Not Resuscitate (DNR) Hydration Medication 11

1.04 Understand legal and ethical issues Power of Attorney Legal and Ethical Issues Power of Attorney Document that names the person that will make healthcare decisions for the patient that is unable to do so. 12

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas Organ Donation The removal of healthy tissues from one person for the purpose of transplanting them into another person. Donor can be living or recently deceased. 13

1.04 Understand legal and ethical issues Legal and Ethical Dilemmas Research and Experimental Treatment Healthcare research seeks to develop treatments for a disease process, or to establish new knowledge for health and wellness maintenance. Healthcare research seeks to develop treatments for a disease process, or to establish new knowledge for health and wellness maintenance. AIDS AIDS Stem Cell Stem Cell Cancer Research Cancer Research 14

Homework for a future PPP You will each choose or be assigned a topic from next slide-you will search any available media (newspaper, internet, etc) for a court case that is an example of the offense. Be prepared to share your information with the class during the “THE LAW- System of Rules” PPP #4

1.04 #2 PPP Contracts (4 days for PPP x5)

1.04 Understand legal and ethical issues -Contract- Agreement between two or more people. Agreement between two or more people. Enforceable by law. Enforceable by law. 18

1.04 Understand legal and ethical issues Elements of a Contract -Offer- A proposal by one party to another indicating willingness to enter a contract. 19

1.04 Understand legal and ethical issues Elements of a Contract -Offer- In healthcare, an individual enters into a relationship with a healthcare provider and offers to be a patient 20

1.04 Understand legal and ethical issues Elements of a Contract -Acceptance- The willingness to go along with the offer. 21

1.04 Understand legal and ethical issues Elements of a Contract -Acceptance- Healthcare provider gives an appointment, examines, or treats the patient. 22

1.04 Understand legal and ethical issues Elements of a Contract -Genuine Agreement- Valid offer is met by a valid agreement 23

1.04 Understand legal and ethical issues Elements of a Contract -Genuine Agreement- Fraud, misrepresentation or undue influence can destroy the genuine agreement. 24

1.04 Understand legal and ethical issues Elements of a Contract -Capacity- The legal ability to enter a contract. 25

1.04 Understand legal and ethical issues Elements of a Contract -Capacity- Legal Disability Legal Disability Individual who can not legally enter into a contract 26

1.04 Understand legal and ethical issues Elements of a Contract -Capacity- Legal Disability Legal Disability Minors - younger than Minors - younger than 18 years of age unless 18 years of age unless married married Mentally incompetent Mentally incompetent Under the influence of Under the influence ofdrugs/alcohol Semi-conscious/unconscious Semi-conscious/unconscious 27

1.04 Understand legal and ethical issues Elements of a Contract -Consideration- The thing of value promised in exchange for something else of value. The thing of value promised in exchange for something else of value. Payment is made by the patient for the services received. Payment is made by the patient for the services received. 28

1.04 Understand legal and ethical issues Elements of a Contract -Legality- Persons entering a contract cannot agree to do something that is illegal or forbidden by law. Persons entering a contract cannot agree to do something that is illegal or forbidden by law. Ex: cannot agree to sell a kidney Ex: cannot agree to sell a kidney 29

1.04 Understand legal and ethical issues Types of Contracts Implied contracts – non-verbal agreement of understanding Implied contracts – non-verbal agreement of understanding Expressed contracts – state the terms of the agreement in distinct and clear language, either oral or written Expressed contracts – state the terms of the agreement in distinct and clear language, either oral or written 30

1.04 Understand legal and ethical issues Healthcare Contract -Informed Consent- The patient or their healthcare power of attorney gives written permission for a treatment or procedure, based on a clear understanding of desired outcomes and possible complications. The patient or their healthcare power of attorney gives written permission for a treatment or procedure, based on a clear understanding of desired outcomes and possible complications. Informed consent is an essential component of a healthcare contract. Informed consent is an essential component of a healthcare contract. 31

Discussion: Have you ever had a contract? If yes, what type of contract? If no, teacher remind students of contracts they may not be aware of.

Research Homework: Assign students to research contracts on the internet. Students should review contracts of various types, identifying the: -Offer -Acceptance -Genuine agreement -Capacity -Consideration -Legality -Terms of the contract Students will develop a simulated contract with a healthcare provider.

1.04 #3 PPP Patient Rights Legislation (4 days for PPP x5)

1.04 Understand legal and ethical issues Patient Rights Legislation Patient’s Bill of Rights Patient’s Bill of Rights The Health Care Consumer The Health Care Consumer Consumer Bill of Rights Consumer Bill of Rights Consumer Responsibilities Consumer Responsibilities Omnibus Budget Reconciliation Act Omnibus Budget Reconciliation Act Patient Self-Determination Act Patient Self-Determination Act Health Insurance Portability and Accountability Act (HIPAA) Health Insurance Portability and Accountability Act (HIPAA) 35

1.04 Understand legal and ethical issues Patient Rights Legislation Patient’s Bill of Rights (1973, revised 1992) Statement of rights that patients are entitled to while in the care of a physician or in the hospital Statement of rights that patients are entitled to while in the care of a physician or in the hospital Includes: Includes: Choice of providers Choice of providers Confidentiality Confidentiality Information disclosure Information disclosure Participation in treatment decisions Participation in treatment decisions Respect Respect 36

1.04 Understand legal and ethical issues Patient Rights Legislation The Healthcare Consumer March 1998, the Advisory Commission on Consumer Protection and Quality in the Health Care Industry outlined the Consumer Bill of Rights and Responsibilities. March 1998, the Advisory Commission on Consumer Protection and Quality in the Health Care Industry outlined the Consumer Bill of Rights and Responsibilities. Purpose Purpose Build consumer confidence Build consumer confidence Support the healthcare provider and patient-provider relationship Support the healthcare provider and patient-provider relationship Emphasize the role of the consumer with regard to health improvement Emphasize the role of the consumer with regard to health improvement 37

1.04 Understand legal and ethical issues Patient Rights Legislation Consumer Bill of Rights Consumer Bill of Rights Information disclosure Information disclosure Choice of providers Choice of providers Access to emergency services Access to emergency services Participation in treatment decisions Participation in treatment decisions Respect and nondiscrimination Respect and nondiscrimination Confidentiality of health information Confidentiality of health information Complaints and appeals Complaints and appeals 38

1.04 Understand legal and ethical issues Patient Rights Legislation Consumer Responsibilities Consumer Responsibilities Healthy habits Healthy habits Participate in healthcare decisions Participate in healthcare decisions Communicate relevant information to healthcare provider Communicate relevant information to healthcare provider Avoid knowingly spreading disease Avoid knowingly spreading disease Recognize the risks and limits of medical care Recognize the risks and limits of medical care Know about healthcare insurance plan Know about healthcare insurance plan Show respect Show respect Make effort to pay your bills Make effort to pay your bills Report fraud or wrongdoing Report fraud or wrongdoing 39

1.04 Understand legal and ethical issues Patient Rights Legislation The Health Care Consumer Bill of Rights is used to develop healthcare insurance plans. The Health Care Consumer Bill of Rights is used to develop healthcare insurance plans. The Health Care Consumer must be familiar with their rights and responsibilities. The Health Care Consumer must be familiar with their rights and responsibilities. 40

1.04 Understand legal and ethical issues Patient Rights Legislation Omnibus Budget Reconciliation Act (1987) Regulates long term care and home health Regulates long term care and home health Requires nurse aide training/certification for nursing and geriatric assistants Requires nurse aide training/certification for nursing and geriatric assistants States specific skills to be mastered States specific skills to be mastered Requires continuing education, and work evaluations Requires continuing education, and work evaluations Requires retraining and/or testing if unemployed for 2 or more years Requires retraining and/or testing if unemployed for 2 or more years Limits use of restraints Limits use of restraints 41

1.04 Understand legal and ethical issues Patient Rights Legislation Nursing Home Reform Act (1990) Patient must be fully evaluated upon admission to a nursing home Patient must be fully evaluated upon admission to a nursing home Health Health Memories Memories Habits Habits Hobbies Hobbies A plan of care must be written and maintained A plan of care must be written and maintained Must have annual re-evaluation Must have annual re-evaluation 42

1.04 Understand legal and ethical issues Patient Rights Legislation Patient Self-Determination Act (1990) Healthcare agency receiving Federal Aid must inform a patient about advanced directives at the time of admission Healthcare agency receiving Federal Aid must inform a patient about advanced directives at the time of admission Healthcare agency must provide education for staff Healthcare agency must provide education for staff 43

1.04 Understand legal and ethical issues Patient Rights Legislation Health Insurance Portability and Accountability Act (HIPAA) (1996) Protects the individual medical information of a patient and includes: Protects the individual medical information of a patient and includes: Name Name Address Address Diagnosis billing information Diagnosis billing information Provides for security of that Provides for security of thatinformation 44

1.04 Understand legal and ethical issues Patient Rights Legislation Health Insurance Portability and Accountability Act (HIPAA) Gives patient more control over their Gives patient more control over their health information Sets boundaries on the use and release Sets boundaries on the use and release of health records Establishes safeguards to protect records Establishes safeguards to protect records Punishes violators Punishes violators Enables patients to make choices Enables patients to make choices Gives patients the right to obtain a copy of their records Gives patients the right to obtain a copy of their records 45

1.04 Understand legal and ethical issues Patient Rights Legislation Health Insurance Portability and Accountability Act (HIPAA) Permits release of information Permits release of information needed to protect public health Prevent disease Prevent disease Protect from injury or Protect from injury ordisability 46

1.04 Understand legal and ethical issues Patient Rights Legislation Health Insurance Portability and Accountability Act (HIPAA) Exempt information: Births Births Deaths Deaths Injuries caused by violence Injuries caused by violence Communicable diseases Communicable diseases Sexually transmitted diseases Sexually transmitted diseases 47

1.04 Understand legal and ethical issues Patient Rights Legislation Patient’s Bill of Rights Patient’s Bill of Rights The Healthcare Consumer The Healthcare Consumer Consumer Bill of Rights Consumer Bill of Rights Consumer Responsibilities Consumer Responsibilities Omnibus Budget Reconciliation Act Omnibus Budget Reconciliation Act Patient Self-Determination Act Patient Self-Determination Act Health Insurance Portability and Accountability Act (HIPAA) Health Insurance Portability and Accountability Act (HIPAA) 48

1.04 Understand legal and ethical issues 1.04 #4 PPP -THE LAW- System of Rules (4 Days for PPP X5) 51

1.04 Understand legal and ethical issues - Criminal Law- 52

1.04 Understand legal and ethical issues Criminal Law Criminal Law Protects all people from those who: Protects all people from those who: pose a threat to society. pose a threat to society. are a danger to the public. are a danger to the public. Can result in being arrested. Can result in being arrested. Could prevent a person from being employed. Could prevent a person from being employed. A felony is a serious crime punishable by imprisonment or death. 53

1.04 Understand legal and ethical issues Criminal Law Assault Criminal Law Assault Any threat or attempt to injure another person with the apparent ability to do so 54

1.04 Understand legal and ethical issues Criminal Law Battery Criminal Law Battery Unlawful touching of another person without consent 55

1.04 Understand legal and ethical issues Criminal Law Misuse of Narcotics May relate to: Personal use by healthcare professionals Patient use of prescribed dosage 56

1.04 Understand legal and ethical issues Criminal Law Murder Criminal Law Murder Taking another person’s life 57

1.04 Understand legal and ethical issues Criminal Law Practicing Without a License Individual providing healthcare services without a license Individual providing healthcare services without a license Required It’s the law. 58

1.04 Understand legal and ethical issues Criminal Law Sexual Assault Rape Forced sexual act by a male against a female Statutory rape: the victim is under age. The consent of the under age person does not matter. The age of the offender does not matter. A minor can be charged with statutory rape. Date rape 59

1.04 Understand legal and ethical issues Criminal Law Theft Taking another person’s possessions 60

1.04 Understand legal and ethical issues - Civil Law- 61

1.04 Understand legal and ethical issues - Civil Law- Involves disputes between people or organizations and protection of people’s rights. 62

1.04 Understand legal and ethical issues Civil Law -Torts- Wrongful acts, not involving a contract, that result in physical injury, property damages, or damages to a person’s reputation for which the injured person is entitled to compensation for damages done. 63

1.04 Understand legal and ethical issues Civil Law -Torts- Physical Abuse Depriving of nutrition Hitting Restraining a patient 64

1.04 Understand legal and ethical issues Civil Law -Torts- Sexual Abuse Sexual harassment Any unwanted sexual touching or act 65

1.04 Understand legal and ethical issues Civil Law -Torts- Verbal Abuse Swearing Talking harshly Teasing 66

1.04 Understand legal and ethical issues Civil Law -Torts- Defamation of Character A statement that causes injury to a person’s reputation A statement that causes injury to a person’s reputation Libel Libel Slander Slander Slander Libel 67

1.04 Understand legal and ethical issues Defamation of Character Libel Untrue written statements that cause injury to a person’s reputation Civil Law -Torts- 68

1.04 Understand legal and ethical issues Defamation of Character Slander Untrue spoken statements that cause injury to a person’s reputation Civil Law -Torts- 69

1.04 Understand legal and ethical issues A person is confined or retained against his/her will Civil Law -Torts- False Imprisonment 70

1.04 Understand legal and ethical issues  Make personal information public without the consent of the patient  Unnecessary physical exposure of a patient Civil Law -Torts- Invasion of Privacy 71

1.04 Understand legal and ethical issues Civil Law -Torts- Malpractice Providing bad care, resulting in injury. Act of Commission 72

1.04 Understand legal and ethical issues Civil Law -Torts- Negligence Failure to provide care that is normally expected, resulting injury to the patient. Act of Omission 73

1.04 Understand legal and ethical issues - Civil Law- Involves relationships between peopleInvolves relationships between people Torts as reviewedTorts as reviewed 74

1.04 Understand legal and ethical issues Reasonable Care The legal obligation of healthcare professionals to provide care according to the standards of practice expected within their community for healthcare professionals. Ex. all physical therapists follow the same guidelines for ROM exercises 75

Post-It/Flip Chart Activity *(will need post-it notes and flip chart paper) Place Post-it notes on flip chart paper that contains examples of criminal and civil legal offenses Then identify the offense and compare criminal & civil law

Last 10 min of class activity: Write an example similar to, but not identical to the example given in class for three of the terms presented and discussed in the PowerPoint. Give to teacher before leaving class.

1.04 #5 PPP Ethics in healthcare (4 days for PPP x5)

1.04 Understand legal and ethical issues Healthcare professionals’ ethical obligations Ethics Standard of conduct or code of behavior for a person or group of people Standard of conduct or code of behavior for a person or group of people Involves: Involves: Personal values Personal values Professional standards expected of a healthcare professional Professional standards expected of a healthcare professional Organizational standards expected of an employee Organizational standards expected of an employee 79

1.04 Understand legal and ethical issues Aspects of Ethics Ability to determine “right” from “wrong” Ability to determine “right” from “wrong” Commitment to do what is right Commitment to do what is right 80

1.04 Understand legal and ethical issues Personal Ethics Ethical Foundations: Personal values Personal values Dependable Dependable Honest Honest Responsible Responsible Trustworthy Trustworthy 81

1.04 Understand legal and ethical issues Professional Ethics Code of Ethics Specific for each healthcare career Specific for each healthcare career Two components Two components 1. Principles of Ethics Standards of exemplary professional behavior for all members of the association Standards of exemplary professional behavior for all members of the association 2. Rules of Ethics Mandatory, direct standards of minimally acceptable professional conduct Mandatory, direct standards of minimally acceptable professional conduct 82

1.04 Understand legal and ethical issues Organizational Ethics Moral values that guide the way corporations make decisions Moral values that guide the way corporations make decisions Governed by Governed by Legislation/laws Legislation/laws Professional codes Professional codes Individual values Individual values Never compromise your ability to perform in the best interest of the organization Never compromise your ability to perform in the best interest of the organization 83

1.04 Understand legal and ethical issues Healthcare professionals’ ethical obligations Recognize Illegal and Unethical Behavior Report any event that has adverse affects on the health, safety or welfare of any person within the healthcare agency Report any event that has adverse affects on the health, safety or welfare of any person within the healthcare agency Healthcare professional must Healthcare professional must Obey the law Obey the law Follow code of ethics for his/her job description Follow code of ethics for his/her job description Treat everyone with respect Treat everyone with respect 84

1.04 Understand legal and ethical issues Healthcare professionals’ ethical obligations Report Illegal and Unethical Behavior Ensures health, safety and welfare of any person within the healthcare agency Ensures health, safety and welfare of any person within the healthcare agency Follow employee handbook for reporting procedures Follow employee handbook for reporting procedures Consult manager/supervisor Consult manager/supervisor Contact human resources supervisor Contact human resources supervisor 85

Discussion: Explain the difference between legal and ethical. Why are ethics important in our personal and professional lives? Would you report an unethical behavior? Why or why not?

1.04 Understand legal and ethical issues in healthcare THE END