Ethical and Legal Issues Chapter 3

Ethics  Ethics – the study of morals; reflects standard Medical ethics has been important to medicine since 400 B.C. Hippocrates wrote the Hippocratic Oath – a document that first developed the standards of medical conduct and ethics  Morals- attitudes and behaviors that a society agree upon as desirable and necessary (minimum rules to keep society from destroying self vs. perfect society)

Ethics  Medical Ethics – whether the health care worker’s actions are right or wrong  Medical Law - Whether act is legal or illegal  Ethical behavior- behavior that is specific and represents the ideal conduct for a certain group

Hx of P.T. Ethics  1 st Code of Ethics was adopted in 1935 by the AMERICAN PHYIOTHERAPY ASSOCIATION focused solely on duties of the physical therapist  The code of ethics originally adopted by THE AMERICAN PHYSICAL THERAPY ASSOCIATION occurred in May 1948

Medical Law  Federal, State, and Local laws Licenses can be taken away Fines may be levied Prison sentences (rude = unethical/Telling neighbor of pt dz = illegal  Defamation Libel Slander

Ethical Behavior  Respect all pts  Keep all things confidential  Do your best at all times

The Pt’s Bill of Rights  Considerate and respectful care  Obtain info. from their Dr.  Informed consent  Refuse treatment  Consultation, examination, and treatment conducted discretely  Confidentiality  Make reasonable response to request  Human experimentation  Explanation of bill  Know hospital rules

Protection Under Law  Duty of care – protects the patient and entitles him/her to safe care, mandating that he/she is treated by average standards in similar situation  Reasonable care – protects health care worker – act reasonably as compared to fellow worker in similar situation  Negligence – failure to give reasonable care or giving unreasonable care (fails to give care required)

Good Samaritan  Good Samaritan Law – addresses the problem of medical malpractice suits for a physician or any trained health care professional who comes upon as accident scene and attempts to render aid to the victim

LEGAL  CRIMINAL LAW – concerned with offences against society  CIVIL LAW – Concerned with relationships between people Negligence Malpractice

 Malpractice – occurs when a health care provider improperly delivers care or provides the care with our having the proper training  Things need to prove malpractice Owed duty to pt Breech of duty (duty not carried out) Pt injury Pt injury was result of health care worker’s failure to carry out duty

Informed Consent  A form signed that indicates the pt fully accepts the risk of the procedure  Procedure must be explained to pt by physician  May be written or verbal  Informed consent consists of : Explanation of procedure Inform pt of alternatives Explain risks and benefits

Medical Record/Chart  A legal document (property of DR or hospital) Accurate Complete Up to date Evidence of truth in case of lawsuit  CONFIDENTIAL (confidentiality – keeping information a secret) – may be summoned to court

Confidentiality  confidentiality – keeping information a secret  HIPPA/ HIPAA - health insurance privacy and portability act or Health Insurance privacy and accountability act  Must report abuse  Accountability- being answerable for one’s own actions

Medical Ethics for the PTA  MOST BASIC RULE Life is precious  PROMOTE HEALTH  Preserve life, make comfortable, die with dignity

TIPPING  Under no circumstances are you allowed to accept monies or gifts for services you are paid and expected to do

Witnessing a will  As a PTA you are not trained to sign as a witness for a will

Restraints  You may have a pt with restraints  You should never be the one to initially apply restraints  Follow the Dr’s order  If you must untie restraints to perform a procedure make sure you reapply them before leaving the room  False Imprisonment – holding someone against their will by chemical or physical restraints

ADVANCE DIRECTIVES  Pt Determination Act – stated that all health care facilities inform pt’s of advance directives Durable Power of Attorney – a document that appoints someone to make medical decisions for you if you are unable Living Will – a document that states what life sustaining procedures (to withhold/withdraw) you want done if you are unable to acaat on your own behalf.