Ethics and Legal Issues State Board of Nursing Dee Matecki EdD,RN

Types Of Ethics Bioethics Clinical ethics Nursing ethics Encompasses a number of fields “life sciences” Clinical ethics Concerned with ethical problems “at bedside” Nursing ethics Formal study of ethical issues that arise in the practice of nursing Analysis used by nurses to make ethical judgments

Key Terms Autonomy—respect rights of patients to make healthcare decisions Nonmaleficence—avoid causing harm Beneficence—benefit the patient Justice—give each his or her due and act fairly Fidelity—keep promises Veracity, accountability, privacy, confidentiality .

Ethics A set of guiding principles that all members of a profession accept Helps professional groups settle questions about practice or behavior Includes responsibility, accountability, and confidentiality

VALUE A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior Value formation Value clarification

Ethics and Philosophy Deontology Utilitarianism Feminine ethics Defines actions as right or wrong Utilitarianism Proposes that the value of something is determined by its usefulness Feminine ethics Focuses on the inequality between people Ethic of care Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives

How to Process an Ethical Dilemma Step 1: Ask if this is an ethical dilemma. Step 2: Gather all relevant information. Step 3: Clarify values. Step 4: Verbalize the problem. Step 5: Identify possible courses of action. Step 6: Negotiate a plan. Step 7: Evaluate the plan.

Issues in Bioethics Quality of life Central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNR Futile care: Interventions unlikely to produce benefit for the client Allocating scare resources: A key issue in discussions about access to care The nursing shortage: Produces difficult working conditions and affects clients outcomes

Legal Limits in Nursing Sources of law: Legal guidelines that come from statutory, regulatory, and common law Standards of care: Legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care

Federal Law American with Disabilities Act Emergency Medical Treatment and Active Labor Act Mental Health Parity Act Advance Directives Living Wills, Durable Power of Attorney Uniform Anatomical Gift Act Health Insurance Portability and Accountability Act Restraints

Consent A signed form required for all routine treatment, hazardous procedures, and some other treatments Provisions are made for deaf, illiterate, or foreign language clients

Malpractice Insurance A contract between the nurse and the insurance company Provides a defense when a nurse is in a lawsuit involving negligence or malpractice insurance Nurses covered by institution’s insurance while working

Risk Management A system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs Steps involved: Identify possible risks. Analyze risks. Act to reduce risks. Evaluate steps taken.

State Law Licensure Good Samaritan laws Public health laws The Uniform Determination of Death Act Physician-assisted suicide

Abortion Issues 1973 Roe v. Wade U.S. Supreme Court ruled that there is a fundamental right to privacy, which includes a woman’s right to have an abortion. 1989 Webster v. Reproductive Health Services Some states require viability tests if the fetus is more than 28 weeks’ gestatio

Abandonment and Assignment Issues Short staffing: Legal problems occur if there are inadequate nurses to provide care. Floating: Based on census load and client acuities Physician’s orders: Nurses follow orders unless they believe an order is in error or harmful.

State Board Of Nursing The State Board of Nursing establishes rules and regulations for the licensure and practice of professional and practical nursing in the Commonwealth of Pennsylvania and provides for the examination of all applicants.  The Board examines all applicants for licensure and issues licenses for professional nursing and practical nursing to persons passing such examinations and meeting other qualifications for licensure. .