Warm UP As a medical professional, do you think legal or ethical guidelines are more important? Why? Ethics in Health Care 9/12/2018

Legal and Ethical Responsibilities in Health Care

Objectives Define and differentiate between civil law and criminal law Define and cite examples of torts which occur in health care including: Malpractice Negligence Assault & Battery Invasion of Privacy Abuse Defamation Define Ethics Ethics in Health Care 9/12/2018

Objectives (continued) List basic rules of ethics for the health care worker (HCW) Discuss and debate varying ethical dilemmas which have resulted from modern medicine List the rights of patients who are receiving health care Review long-term care Bill of Rights Define advance directives Explain how professional standards meet legal and ethical requirements in health care Ethics in Health Care 9/12/2018

Legal Responsibilities Every aspect of our life is governed by certain laws and legal responsibilities. Ex: traffic laws It is important for the health care worker to be aware of and follow legal regulations Protects worker, employer and safety and well-being of the patient Ethics in Health Care 9/12/2018

Legal Responsibilities Legal Responsibilities are authorized or based on law Law is a rule that must be followed Failure to meet your legal responsibilities can result in legal action against you and your employer Two types Civil law Criminal law Health care professionals are required to know and follow state laws regulating their license or registration or set standards for their professions Ethics in Health Care 9/12/2018

Legal Responsibilities Civil Law Criminal Law Deals with legal relationships between people and protection of a person’s rights Health care mainly affected by civil law which involve torts and contracts Deals with behavior known as crime; deals with the wrongs against a person, property, or society Ex: Practicing without a license, illegal possession of drugs, misuse of narcotics, theft, sexual assault or murder Ethics in Health Care 9/12/2018

Torts Wrongful act that does not involve a contract Civil wrong Occurs when a person is harmed or injured because a HCW does not meet the established or expected standard of care Common Torts: Malpractice Negligence Assault and Battery Invasion of Privacy False Imprisonment Abuse Defamation Ethics in Health Care 9/12/2018

Torts Malpractice Negligence “Bad Practice” Failure of a professional to use the degree of skill and learning commonly expected to in that individual’s profession- resulting in injury, loss, or damage to the person receiving care Failure to give care that is normally expected of a person in a particular position, resulting in injury to another person Ethics in Health Care 9/12/2018

Torts Assault- threats or attempts to injure Assault and Battery Invasion of Privacy Assault- threats or attempts to injure Battery- unlawful touching of another person without consent Physical- unnecessarily exposing an individual Informational- revealing personal information about that person without consent Ethics in Health Care 9/12/2018

Torts Defamation Abuse Includes any care that results in physical harm, pain, or mental anguish Physical Verbal Psychological Sexual Domestic Child Elder Occurs when false statements either cause a person to be ridiculed or damage that person’s reputation Ethics in Health Care 9/12/2018

Contracts An agreement between two or more partied Most contracts have three parts Offer Health care facility or provider has a treatment or services they can offer to a patient; also a competent individual offers to be a patient Acceptance Patient makes appointment with health care facility and accepts treatment/services offered; provider accepts individual as a patient Consideration Patient receives treatment or services; health care facility receives payment from patient Implied Contracts Expressed Contracts Ethics in Health Care 9/12/2018

Contracts Implied Consent Expressed Consent Obligations that are understood without verbally expressed terms Stated in distinct and clear language, either orally or in writing Ethics in Health Care 9/12/2018

Important Terms Informed Consent – permission granted voluntarily by a person who is of sound mind and who has been instructed, in terms the person can understand, about all the risks involved Verbal Consent Slander- Spoken Defamation Libel- Written Defamation Legal Disability- does not have legal capacity to enter a contract- ex: minors Ethics in Health Care 9/12/2018

Important Terms Privileged Communication – comprise of all information given to health care personnel- Ex: Health care records HIPAA- Health Insurance Portability and Accountability Act of 1996 Standards to protect health information Scope of Practice- procedures, processes, and actions HCWs are legally permitted to perform in keeping with the terms of their professional license or registration Ethics in Health Care 9/12/2018

Ethics Ethics are a set of principles relating to what is morally right or wrong Provide a standard of conduct or code of behavior Allows HCWs to analyze information and make decisions based on what people believe is right and good conduct Modern health care advances have created many ethical dilemmas for HCWs Each profession has their own code of ethics developed by their national organizations Most contain the same basic principles however they may differ slightly Ethics in Health Care 9/12/2018

Ethical Dilemmas Modern health care technology has created many ethical dilemmas Assisted suicide – is it justified in certain patients? Who decides whether a 75 yr old pt or a 56 yr old gets a single kidney available for transplant? Stem cell research- should aborted fetuses be used? Should a patient be permitted to smoke marijuana if it eases effects of chemotherapy? Should human beings be cloned? NO EASY ANSWERS- only guidelines provided by an ethical code Ethics in Health Care 9/12/2018

Basic Rules of Ethics Put the saving of life and promotion of health above all else Make every effort to keep patient as comfortable as possible and to preserve life when possible Respect patient’s choice to die peacefully and with dignity (advanced directive) Treat all patients equally (avoid bias, prejudice, and discrimination) Show loyalty to patients, co-workers, and employer Be sincere, honest and caring Ethics in Health Care 9/12/2018

Rules of Ethics (cont) Provide care for all persons to the best of your ability Maintain competent level of skill consistent with occupation Maintain confidentiality Gossiping about patients is ethically wrong Avoid immoral, unethical, or illegal practice Stay informed and up to date, pursue continuing education Ethics in Health Care 9/12/2018

Patients’ Rights Most of us have seen the sign in retail stores “The Customer is Always Right” Patient and customer satisfaction is essential to health care facilities just as pleasing the customer is for retail stores Ethics in Health Care 9/12/2018

Ethics in Health Care 9/12/2018

Patients’ Rights Patients’ rights are factors of care that patients can expect to receive Health care facilities have written policies concerning patients' rights All health care workers must honor these Ethics in Health Care 9/12/2018

Rights (continued) Privacy concerning medical care Confidential treatment of all communications and records Reasonable response to request for services Obtain information regarding any relationship of the hospital to other health care and educational institutions Ethics in Health Care 9/12/2018

Rights (cont) Be advised of and have the right to refuse to participate in any research project Expect reasonable continuity of care Review medical records and examine bill with all charges explained Be informed of any hospital rules or regulations Ethics in Health Care 9/12/2018

Advance Directives A patient’s instructions, usually relating to end-of-life issues regarding what medical treatment they want or do not want if they are unable to express their wishes Advance directives are legally binding documents Ethics in Health Care 9/12/2018

Advance Directives Health care workers must be aware of and honor advance directives regardless of their beliefs Patients will be asked if they have one upon admission to a health care facility Ethics in Health Care 9/12/2018

Advance Directives Must be signed when the individual is competent and witnessed by two adults who will not benefit from the death Ethics in Health Care 9/12/2018

Two Main Types Durable Power of Attorney (POA) for health care Living wills Ethics in Health Care 9/12/2018

Living Will Document allowing individuals to state what measures should or should not be used to prolong life if their condition is terminal Ex: CPR, ventilator, feeding tube, etc. Frequently results in a “do not resuscitate” (DNR) order Ethics in Health Care 9/12/2018

Durable Power of Attorney (POA) Document permitting an individual (principal) to appoint another person (agent) to make any decisions regarding health care if the principal is unable to make those decisions Usually give POA’s to spouses or adult children May be given to any qualified adult however Must be signed by principal, agent, and two adult witnesses Ethics in Health Care 9/12/2018

Professional Standards Perform only those procedures for which you have been trained and you are legally permitted to do Use approved, correct methods while performing any procedure Obtain proper authorization before performing any procedure Identify the patient Obtain patient consent before performing any procedure Ethics in Health Care 9/12/2018

Professional Standards Observe all safety precautions Keep all information confidential Think before you speak and carefully consider everything you say Treat all patients equally Accept no tips or bribes for the care you provide If any error occurs or you make a mistake, report it immediately Behave professionally in dress, language, manners and actions Ethics in Health Care 9/12/2018

Summary Always remember, it is your responsibility to understand the legal and ethical implications of your particular health career Never hesitate to ask questions or request written policies from your employer By following the basic standards, you will protect yourself, your employer, and the patient for whom you care for Ethics in Health Care 9/12/2018

Current Legal/Ethical Issues RESEARCH Research a current health care issue that has a legal or ethical implications As a future member of the medical community, you will need to stay current on current issues involving health care. It is important to be able to identify these issues. Identify a controversy or issue related to the medical field and write a 2- to 3-page paper, typed, double-spaced. In your paper, you should explain the controversy (including enough background of the issue to make it clear), explain your feelings on the issue or take a position, and defend your position with evidence. Your paper should include an introduction, a statement issue or position, and a conclusion. You should also include references, which don’t count in page length. Must be from 2016 or 2017 Due end of class Friday November 17, 2017 Ethics in Health Care 9/12/2018

Current Legal/Ethical Issues RUBRIC Student Name: ________________________________ Max Points Points Received Comments   Topic explained/ summarized thoroughly: 25 Thoughts/stance 25 stated and supported: Conclusion: 20 Grammar/punctuation: 10 2-3 pages long: 10 Works Cited: 10 Total Points ________/100 Ethics in Health Care 9/12/2018