Legal and Ethical Aspects of Health Care Introduction to Health Science Virginia Parker

Legal vs. Ethics Ethics – a set of principles relating to what is morally right or wrong. Ethics – a set of principles relating to what is morally right or wrong. These principles help guide our decision making in health care, but… These principles help guide our decision making in health care, but… Legal – authorized based on the law Legal – authorized based on the law Legal responsibilities apply to many of our actions in health care. Legal responsibilities apply to many of our actions in health care.

Civil vs. Criminal Law Most law dealing with health care is Civil Law – focusing on legal relationship between people and protection of their right’s Most law dealing with health care is Civil Law – focusing on legal relationship between people and protection of their right’s However, Criminal Law may apply in such areas as practicing in a health care profession without a license, theft, misuse of narcotics and assault/battery or murder. However, Criminal Law may apply in such areas as practicing in a health care profession without a license, theft, misuse of narcotics and assault/battery or murder.

Torts Failure to meet legal responsibilities can result in a legal action against health care worker and their employer. Failure to meet legal responsibilities can result in a legal action against health care worker and their employer. A tort occurs when a person is injured or harmed because a health care provider does not meet the expected standard of care. This is a civil wrong as opposed to a crime. A tort occurs when a person is injured or harmed because a health care provider does not meet the expected standard of care. This is a civil wrong as opposed to a crime.

Malpractice The failure of a professional to use the degree of skill and learning commonly expected in that individual’s profession causing injury, loss, or damage to a person. The failure of a professional to use the degree of skill and learning commonly expected in that individual’s profession causing injury, loss, or damage to a person. Simply put – “bad practice” Simply put – “bad practice”

Malpractice Examples Patient who fell was taken to the hospital emergency room where a diagnosis of inebriation was made and pt was released from the hospital. The patient actually had a fractured spine and a severed spinal cord. The result was permanent paraplegia. Patient who fell was taken to the hospital emergency room where a diagnosis of inebriation was made and pt was released from the hospital. The patient actually had a fractured spine and a severed spinal cord. The result was permanent paraplegia. A laboratory report stated that a small growth removed from a patient's arm was simply a benign inflamed mole, when in fact it was malignant melanoma. A laboratory report stated that a small growth removed from a patient's arm was simply a benign inflamed mole, when in fact it was malignant melanoma.

Malpractice Examples A patient's obstetrician was twenty minutes late, and delivery room nurses had to deliver her child. Then, although the infant was suffering from respiratory distress, a pediatrician was not called for several hours. The child is brain-damaged and requires life-long care. A patient's obstetrician was twenty minutes late, and delivery room nurses had to deliver her child. Then, although the infant was suffering from respiratory distress, a pediatrician was not called for several hours. The child is brain-damaged and requires life-long care.

Negligence Failure to give care that is normally expected. Failure to give care that is normally expected. Can often be identified in nursing home cases where elderly or disabled clients are allowed to develop decubitus ulcers. Can often be identified in nursing home cases where elderly or disabled clients are allowed to develop decubitus ulcers. Can be clients that are injured from preventable falls. Can be clients that are injured from preventable falls. Also wound infections from improperly sterilized equipment, injury from faulty equipment or improperly applied devices Also wound infections from improperly sterilized equipment, injury from faulty equipment or improperly applied devices Can include wrong medication, wrong blood administration. Can include wrong medication, wrong blood administration.

Decubitus Ulcers

Assault and Battery Assault includes a threat or attempt to injure Assault includes a threat or attempt to injure Battery is unlawful touching of another person without their consent. Battery is unlawful touching of another person without their consent. While these can be criminal cases if it is mistreatment of a client, often they are tried under civil law when it is a medical issue such as performing a procedure or surgery without the client’s proper consent. While these can be criminal cases if it is mistreatment of a client, often they are tried under civil law when it is a medical issue such as performing a procedure or surgery without the client’s proper consent.

Informed Consent Permission granted voluntarily by a person of sound mind after they have had an explanation of the risks and benefits for a particular treatment or procedure. Permission granted voluntarily by a person of sound mind after they have had an explanation of the risks and benefits for a particular treatment or procedure.

Who can give consent??? A person having a legal disability cannot give informed consent. This would include: A person having a legal disability cannot give informed consent. This would include: Mental incompetence Mental incompetence Underage minors Underage minors Semi-conscious or unconscious persons Semi-conscious or unconscious persons Those under the influence of mind altering substances Those under the influence of mind altering substances In these instances, a parent, guardian, or next of kin would have to give consent In these instances, a parent, guardian, or next of kin would have to give consent

Invasion of Privacy Unnecessarily exposing a person or revealing personal information about them. Unnecessarily exposing a person or revealing personal information about them.

False Imprisonment Restraining a person or restricting their freedom. Restraining a person or restricting their freedom. This can be keeping a person in a hospital against their will or applying physical restraints without proper authorization. This can be keeping a person in a hospital against their will or applying physical restraints without proper authorization.

Abuse Any care that results in harm, pain or mental anguish. Physical Psychological Verbal Sexual

Abuse It is required by law that suspected abuse be reported by health care workers. This includes not just children but elders as well. Signs of abuse include: It is required by law that suspected abuse be reported by health care workers. This includes not just children but elders as well. Signs of abuse include: Unexplained bruises, fractures, burns or injuries Unexplained bruises, fractures, burns or injuries Signs of neglect or poor personal hygiene Signs of neglect or poor personal hygiene Irrational fears or personality changes Irrational fears or personality changes Aggressive or withdrawn behavior Aggressive or withdrawn behavior Patient statements that indicate abuse or neglect Patient statements that indicate abuse or neglect

Defamation False statements that cause a person to be ridiculed or damage a person’s reputation. False statements that cause a person to be ridiculed or damage a person’s reputation. Written is libel Spoken is slander. Written is libel Spoken is slander.

And on to Confidentiality.. Legally, all information given to a health care provider by a client is considered privileged communications and must be kept confidential. Legally, all information given to a health care provider by a client is considered privileged communications and must be kept confidential. Confidentiality means this information is kept private and only shared with members of health care team that need to know. Confidentiality means this information is kept private and only shared with members of health care team that need to know. This includes the health care records where this information is recorded. This includes the health care records where this information is recorded. This information cannot be released without written consent of person except in certain cases. This information cannot be released without written consent of person except in certain cases.

Reporting Required! Violence such as suspected abuse, gunshots, stab wounds must be reported to police – also information may be required by police in cases of drunk or impaired driving injury

Reporting Required! Births and deaths are automatically reported to government agencies Births and deaths are automatically reported to government agencies

Reporting Required! Communicable diseases and sexually transmitted disease cases are required to be reported to government monitoring agencies. Communicable diseases and sexually transmitted disease cases are required to be reported to government monitoring agencies.

Advance Directives These are legal documents that allow individuals to state what medical treatment they want or do not want in the event they become unable to state their wishes. Two main types are: These are legal documents that allow individuals to state what medical treatment they want or do not want in the event they become unable to state their wishes. Two main types are: Living Will Living Will Durable Power of Attorney for Health Care Durable Power of Attorney for Health Care

Durable Power of Attorney for Health Care A document that allows a person to appoint another person to make health care decisions for them is they become unable to make decisions for themselves. A document that allows a person to appoint another person to make health care decisions for them is they become unable to make decisions for themselves. Most frequently spouses and children are appointed but can be any qualified adult. Most frequently spouses and children are appointed but can be any qualified adult.

Documents that allow individuals to state what measures they want or do not want taken to prolong life when their conditions are terminal (death expected). Individual must be legally competent to sign and must be witnessed by two people who cannot benefit from person’s death.

DNR Do Not Resuscitate Do Not Resuscitate