Legal and Ethical Responsibilities Chapter 05 Legal and Ethical Responsibilities

5:1 Legal Responsibilities Laws and legal responsibilities protect you and society Criminal law Wrongs against person, property, society Civil law Relationships between people, protection of person’s rights

Torts Wrongful act that does not involve a contract Malpractice Negligence Assault and battery Invasion of privacy

Torts False imprisonment Abuse Defamation Slander Libel

Contracts Components of contract Implied or expressed Offer Acceptance Consideration Implied or expressed

Contracts Contracted parties must be free of legal disability Breach of contract Use translator/interpreter with non-English-speaking party Principal and agent

Privileged Communications All information from a patient must be kept confidential Can only be released with a patient’s written consent (unless exempt information) Health care records are privileged

Privacy Act Health Insurance Portability and Accountability Act (HIPAA) of 1996 Standards for Privacy of Individually Identifiable Health Information (called the Privacy Rule) Patients must sign a consent form

Privacy Act Written authorization for release of information Refer to Figures 5-4 and 5-5 in text Health care workers must protect privacy and confidentiality of patients’ health care records

Regulation of Health Care Providers Scope of practice What each level of care a provider is legally able to perform Failure to abide by scope of practice can result in suspension or loss of license

5:2 Ethics Set of principles dealing with what is morally right or wrong Provide a standard of conduct or code of behavior Help health care workers analyze information and make appropriate decisions

5:2 Ethics Ethical dilemmas Euthanasia Confidentiality of AIDS diagnosis Use of aborted fetuses in research Continuing life support Expensive treatments and payment

5:2 Ethics Ethical dilemmas Transplant decisions Legal issues with medical marijuana use Animals and research Genetic research Cloning Stem cell research

5:2 Ethics Basic principles Save lives and promote health Patient comfort Respect a patient’s right to die peacefully and with dignity Treat all patients equally Provide the best care possible for every patient

5:2 Ethics Basic principles Maintain competent skills and knowledge Stay up-to-date and pursue continuing education Respect rules of confidentiality Refrain from immoral, unethical, and illegal practices

5:2 Ethics Basic principles Show loyalty to patients, coworkers, and employers Be sincere, honest, and caring Learn and abide by the code of ethics for your chosen career

5:3 Patients’ Rights Agencies must have written policies for patients’ rights All personnel must respect and honor these rights DHHS implemented Consumer Bill of Rights and Responsibilities

5:3 Patients’ Rights Residents of long-term care facilities have rights guaranteed under the Omnibus Budget Reconciliation Act (OBRA) of 1987 Long-term care facilities must post a Resident’s Bill of Rights

5:3 Patients’ Rights Patient Protection and Affordable Care Act (PPACA) Guarantees rights related to health care coverage Coverage of essential health benefits Preventive care Coverage if a preexisting condition exists Coverage up to age 26 on parent’s plan “Pre-existing” changed to “preexisting”

5:3 Patients’ Rights Patient Protection and Affordable Care Act (PPACA) Choose any participating primary care provider No preauthorization for emergency care No annual lifetime limits on benefits No arbitrary withdrawal or cancellation of coverage

5:3 Patients’ Rights Patient Protection and Affordable Care Act (PPACA) Appeal decisions for denial of services Outside review if denied payment or termination of coverage Refund a percentage of premiums based on percentage of premiums paid on health care versus administrative costs

5:3 Patients’ Rights Patient Protection and Affordable Care Act (PPACA) Refund a percentage of premiums based on percentage of premiums paid on health care versus administrative costs

5:4 Advance Directives for Health Care Also known as legal directives Allow individuals to state desired and undesired medical treatment in the event of incapacitation Legal document

5:4 Advance Directives for Health Care Two main directives Living will Designation of Health Care Surrogate or a Durable Power of Attorney (POA) for Health Care (refer to Figure 5-8 in text)

5:4 Advance Directives for Health Care Patient Self-Determination Act (PSDA) of 1990 Health care workers must be aware of and honor advance or legal directives Health care workers should consider preparing their own advance directives

5:5 Professional Standards Perform only those procedures for which you have been trained and are legally permitted to do Use approved, correct methods while performing any procedure Obtain proper authorization before performing any procedure

5:5 Professional Standards Identify the patient Obtain the patient’s consent Observe safety precautions Keep all information confidential Think before speaking, consider what you say Treat all patients equally

5:5 Professional Standards Do not accept tips or bribes for care you provide If an error or a mistake occurs, report it immediately to your supervisor Behave professionally in dress, language, manners, and actions

5:5 Professional Standards Liability insurance provides additional protection in case of legal action It is your responsibility to understand legal and ethical requirements of your career Obtain pertinent information from your state board of health or education