LAWS & ETHICS IN HEALTH CARE

RIGHTS  Health care providers are obligated to protect patient’s rights.  Civil Rights—basic legal rights  Constitutional Rights—rights given by constitution  Human Rights—fundamental rights of all people regardless of citizenship status

LAW  American Legal System ensures rights of all citizens  Health care workers should understand legal nature of provider-patient relationship & role as patient’s advocate  Litigation – legal proceeding in court

TYPES OF LAW  Public Law-focuses on issues between government & citizens criminal law, constitutional law, administrative law  Civil Law(Private Law)- focuses on issues between private citizens tort law  Common Law- traditional civil law of an area or region resulting from rulings by judges on individual disputes or cases  Statutory Law—laws enacted by federal, state, & local legislations, enforced by courts

WHERE DO HEALTH CARE ISSUES FIT IN?  Health care issues could by either Public or Civil depending on circumstance  Examples: Public—practicing without license, civil rights violations, FDA, IRS Civil—medical malpractice

TORT LAW  Most issues in health care involve tort law.  Tort-wrongful act that results in harm for which restitution(compensation) must be made  Torts can be: intentional: deliberate acts unintentional: negligence, accidents, mistakes, dosage errors in meds, inaccurate info in files

EXAMPLE TORTS-INTENTIONAL  Assault: threat or attempt is made to touch a patient without permission  Battery: touching a non-consenting patient  Invasion of privacy: intentionally or unreasonably exposing a person’s body or sharing personal information  False imprisonment: any attempt to restrain or restrict freedom  Defamation of character: false or malicious statements that do harm to a person’s reputation; libel(written), slander(spoken)

EXAMPLE TORTS-UNINTENTIONAL  Negligence –careless or senseless behavior that results in harm  Malpractice-illegal, unethical negligent or immoral behavior that results in failure of duties or responsibilities

HEALTH CARE WORKER RESPONSIBILITIES  Reporting abuse—health care providers must report any abuse of people who are unable to protect themselves  Protecting patient’s rights- role of health care professional: maintain patient autonomy, maintain/improve health, promote good, do no evil, create relationship based on trust

GOOD SAMARITAN LAWS  Each state has a Good Samaritan Act  Laws are designed to encourage people to give emergency medical care without fear of being sued if something goes wrong.  Protected from litigation when following conditions are met:  Victim seeks or is willing to accept aid (if conscious)  Provider behaves in way that any reasonable person would  Provider doesn’t act recklessly & doesn’t intentionally do something wrong  Provider doesn’t expect payment

ADVOCACY  Supporting the best interests of all patients & securing quality care

CONSENT  Agreeing or giving approval  Informed consent- written consent after being provided with information about care before surgery, use of experimental drugs, dangerous procedures like stress test, any procedure involving risk to patient  Implied consent- situation involves action without being able to get consent, not written person is unconscious, calls to 911

CONSENT CONT.  Person should not be asked to sign a consent if: doesn’t understand treatment unanswered questions unable to read consent minor mentally incompetent under influence of drugs/alcohol

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT(HIPAA)  Protects patient’s right to privacy  Enacted in 1996  Protects personal health info

WHAT INFO IS CONFIDENTIAL?  Name  Age   Social security number  Address  Phone number  Medical history  Medications  Diagnosis  Observations on health  Medical record number  Unique identifier  If patient is in hospital

WHEN CAN INFO BE RELEASED?  You cannot share confidential info without written consent except: legal guardian, durable power of attorney, next of kin if incapacitated for operations of hospital(quality assurance, reports, teaching & education) allow for payment legal duty to report another health care provider treating same patient

RIGHT TO DIE  Patients can refuse or discontinue treatments that can sustain life  If unable to communicate wishes could have an advance care directive.  Types of advance care directives:  Living will: documents what steps are to be taken to save or prolong a person’s life  Durable power of attorney for health care— designates a person to make health care decisions on behalf of a patient unable to

ETHICS  Set of guidelines that determine right or wrong behavior  Standards of conduct based on moral principles

ETHICAL PRINCIPLES IN HEALTH CARE  Autonomy: respecting patient’s ability to make their own decisions  Justice: treating others fairly & equitably  Nonmaleficence: do no harm  Beneficence: do good  Veracity: honesty  Fidelity: keep promises  Confidentiality: keep things private

JOINT COMMISSION  Mission: to improve the safety & quality of health care by accrediting health care facilities & supporting performance improvement

JOINT COMMISSION’S CODE OF ETHICS  A health care professional should:  Be guided by your profession’s code  Maintain patient confidentiality  Be a patient advocate  Give care in nonjudgmental & nondiscriminatory manner, sensitive to patient diversity  Give care in manner that preserves & protects patient’s autonomy, dignity, and rights  Seek resources to help formulate ethical decisions

ETHICS COMMITTEES  Consists of people from diverse backgrounds who use a multidisciplinary approach to ethical decision making  Goals:  Promote patient’s rights  Promote shared decision making  Assist institutions in development of policies  Ensures policies are implemented  Serves as resource people

PROFESSIONAL CODES OF ETHICS  Quality of care  Primary commitment to patient  Education  Collegiality  Ethics  Collaboration  Research  Resource utilization  confidentiality

ETHICAL DECISION MAKING  Rational & systematic  Have to put emotions & intuition aside  Based on ethical principles & codes  Good decisions are made in the patient’s best interest & preserve integrity

ETHICAL DILEMMAS  Opposing ethical positions may arise because of modern medical advances  Genetic testing  Stem cell research  Cloning  Physician assisted suicide