November 2, 2009

 In every aspect of life, there are certain laws and legal responsibilities formulated to protect you and society.  A worker in the health care industry also has certain responsibilities.

 Health care professionals are required to know and follow the state laws that regulate their respective licenses, registrations, or set of standards for their respective professions.

 Legal responsibilities are those that are authorized or based on law  Civil Law  Focuses on legal relationships between people and the protections of a person’s rights  Criminal Law  Focuses on the wrongs against a person, property, or society.  EXAMPLES ? ?

 Civil Law  Contracts  Torts  Criminal Law  Practicing a health profession without correct licensure and registration  Misuse of narcotics, drugs, prescriptions

 Torts: wrongful acts that do not involve contracts  A tort occurs when a person is harmed or injured because a health care provider does not meet the established or expected standards of care.

 Malpractice:  Bad Practice  Failure of a professional to use the degree of skill and learning commonly expected in that individual’s profession, resulting in injury, loss, or damage to the person receiving care.  Not administering tetanus shot after puncture wound  Nurse performing minor surgery

 Negligence  Failure to give care that is normally expected of a person in a particular position, resulting in injury to another person  Examples  Not reporting faulty equipment  Non sterile equipment

 Assault and Battery  Assault: Threat or attempt to injure  Battery: the unlawful touching of another person without consent  Example:  Performing surgery with no consent  Improper or rough treatment  Patients must give consent to care  Right to refuse care  Written Consent

 Informed Consent  Permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand.  Can withdraw consent at any time

 Invasion of Privacy  Unnecessarily exposing an individual or revealing personal information about an individual without that person’s consent.  Surgical drappings or coverings  Sending information

 False Imprisonment  Restraining an individual or restricting an individual’s freedom.  Examples  Keeping hospitalized against their will  Applying physical restraints without proper authorization or justification

 Abuse:  Any care that results in physical harm, pain, or mental anguish.  Physical Abuse  Verbal Abuse  Psychological Abuse  Sexual Abuse  Many other torts can lead to abuse.

 Defamation  Occurs when false statements either cause a person to be ridiculed or damage the person’s reputation.  Examples  Incorrect information given out  Report infectious disease to agency that has not been confirmed  Verbal = Slander  Written = Libel

 Contract:  An agreement between two or more parties  Three Parts:  Offer: offers to be patient  Acceptance : gives appointment or admitance  Consideration: Payment made

 Implied Contracts:  Those obligations that are understood without verbally expressed in terms.  Prepares medication and receives medication  Expressed Contracts  Stated in distinct and clear language, either orally or written

 Legal Disability  This person does not have the legal capacity to form a contract.  Minors  Mentally incompetent  Someone under the influence

 Privileged Communications  Confidential information must be kept confidential  Examples  Healthcare Records  History  Provide information about care provided to the patient  Exceptions  Births  Deaths

 Ethics are a set of principles relating to what is morally right or wrong.  Ethics provide a standard of conduct or code for behavior.  Modern health care has developed a lot of ethical dilemmas.

1. Is euthanasia justified to certain patients? 2. Should a patient be told that a health care provider has AIDS? 3. Should abortion be legal? 4. Should aborted fetuses be used for research? 5. Should humans be cloned? 6. Stem cell research? 7. Others ? ? ? ? ? ? ?

1. Put the saving of life and the promotion of health above all else. 2. Make every effort to keep the patient as comfortable as possible and to preserve life whenever possible. 3. Respect the patient’s choice to die peacefully and with dignity when all options have been discussed with the patient and family and/or predetermined by advance directives.

1. Treat all patients equally, regardless of race, religions, sex, social or economic status, or nationality. Bias, prejudice, and discrimination have no place in health care. 2. Provide care for all individuals to the best of your ability. 3. Maintain a competent level of skill consistent with you particular occupation. 4. Stay informed and up to date and pursue continuing education as necessary.

 Confidentiality  Information about the patient must remain private and can be shared ONLY with other members of the patient’s health care team.

 Federal and state legislation requires health care agencies to have written policy concerning patients rights.  The American Hospital Association has affirmed a ‘Patient’s Bill of Rights” that is recognized and honored by many health care facilities.  What does it state?

 Residents in long term care facilities are guaranteed certain rights under the Omnibus Budget Reconciliation Act of  These rights must be presented to each resident and guardian.  A copy must be posted in every long term care facility.

 Advance Directives  Legal documents that allow individuals to state what medical treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care.

 Living Wills  Documents that allow individuals to state what measures should or should not be taken to prolong life when their conditions are terminal.  Must be signed  DNR ( Do not Resusicitate)  Durable Power of Attorney  Permits an individual to appoint another person to make any decisions regarding health care if the principal should become unable to make decision

 Patient Self-Determination Act  Mandates that all health care facilities receiving any type of federal aid comply with the following requirements:

1. Inform every adult, both orally and in writing of their right under state law to make decisions concerning medical care, including the right to refuse treatment and right to die options. 2. Provide Information and assistance in preparing advance directives 3. Document any advance directives on the patient’s record 4. Have written statements to implement the patient’s rights in the decision-making process.

1. Affirm that there will be no discrimination or effect on care because of advance directives. 2. Educate the staff on the medical and legal issues of advance directives.

1. Perform only those procedures for which you have been trained and are legally permitted to do. 2. Use approved, correct methods while performing any procedures 3. Obtain proper authorization before performing any procedure. 4. Identify the patient and obtain patient’s consent before performing any procedure.

5. Observe all safety methods 6. Keep all information confidential 7. Think before you speak and carefully consider everything you say. 8. Treat all patients equally regardless of race, religion, social or economic status, seex, or nationality. 9. Accept no tips or bribes for the care you provide.

10. If any error occurs or you make a mistake report it immediately to your supervisor. 11. Behave professionally in dress, language, manners, and actions.

 Even when all legal, ethical, and professional standards are followed there are mistakes and errors.  All health care workers have a legal and ethical responsibility that exist to protect the health care worker and employer, and to proved the safety and well-being of the patients they serve.

 Research Tonight 1. Find a legal responsibility that was breached 2. Find an ethical dilemma 3. Find the American Hospital Association “Patients’ Bill of Rights” 4. Find the “Resident’s Bill of Rights” 5. Fin an example of a Living Will 6. What are local hospital standards or rights?  Mayo Clinic, Winona Health, Gunderson Lutheran, Franciscan Skemp, Olmsted Medical