Legal and Ethical Responsibilities Chapter 5 Legal and Ethical Responsibilities

SPELLING WORDS confidentiality ethics defamation criminal negligence implied malpractice slander libel professional

Define Terms: Criminal law informed consent libel Civil law invasion of privacy implied contract Tort false imprisonment expressed contract Malpractice abuse legal disability Negligence defamation Assault and battery slander

Legal Responsibilities Legal responsibilities - responsibilities that are authorized or based on law Health care professionals/workers are required to know and follow the state laws that regulate their license or registration for their profession.

Legal Responsibilities Two main types of laws that affect health care workers: Criminal law- crime, wrongs against a person, property or society (ex. practicing without required license, illegal drugs, theft, etc. ) Civil law - legal relationships between people and the protection of a person’s rights, in health care civil law usually involves torts and contracts

Legal Responsibilities Tort - wrongful act that does not involve a crime, someone becomes harmed because health care provider did not meet standards of care, a “civil wrong” malpractice invasion of privacy negligence false imprisonment assault and battery abuse defamation

Legal Responsibilities Malpractice - “bad practice” or “professional negligence” The professional failed to use the degree of skill and learning expected in that profession, resulting in injury, loss or damage. Negligence - failure to give care that is normally expected of a person in a particular position, resulting in injury (ex. leaving siderail down and patient falls and injury occurs)

Legal Responsibilities Assault and battery - assault includes threats or attempt to injure, battery is unlawful touching of another person without their consent. Closely related and often used together. Ex: performing a procedure after a patient has refused permission, threatening a patient, improper handling, rough treatment. Informed consent is permission granted voluntarily by a person who is of sound mind after all risks have been explained. Can withdraw consent at any time.

Legal Responsibilities Invasion of privacy - Two kinds, physical and informational physical - ex. improperly covering a patient during a procedure so that others can see patient exposed informational - revealing personal information without that person’s consent, ex. sending information regarding a patient to insurance company without patient’s written permission

Legal Responsibilities False imprisonment - restraining an individual’s freedom without authorization. Ex. applying physical restraints without proper authorization or with no justification AMA - Against Medical Advice, patient decides to leave hospital without a physician’s permission

Legal Responsibilities Abuse - Any care that results in physical harm, pain or mental anguish Physical abuse - depriving of food & water, restraining movement, hitting Verbal abuse - swearing, shouting, inappropriate words to describe their race, nationality, and/or writing threats or abusive statements

Legal Responsibilities ABUSE - Psychological abuse - threatening harm, denying rights, belittling, ridiculing the person, threatening to reveal information about them Sexual abuse - any sexual touching or act, using sexual gestures, or suggesting sexual behavior even if the patient is willing or tries to initiate it

Legal Responsibilities Abuse - domestic abuse, child abuse, elder abuse Any form of abuse must be reported Possible signs and symptoms: unexplained bruises, fractures, burns or injuries signs of neglect, like poor personal hygiene irrational fears or change in personality aggressive of withdrawn behavior patient statements that indicate abuse or neglect

Legal Responsibilities Defamation - when false statements damage a person’s reputation or cause person to be ridiculed Slander - spoken defamation Libel - written defamation Examples: reporting to the health department that patient has an infectious disease when lab results are inaccurate, telling others that a person has a drug problem when actually another medical condition exists, or saying that a coworker is incompetent

Legal Responsibilities Contract - agreement between two or more parties. Implied contracts - obligations that are understood without verbally expressed terms Expressed contracts - stated in clear and distinct language, either orally or in writing, for example, a surgery permit

Legal Responsibilities Legal disability - person does not have the legal capacity to form a contract. Examples: minors, mentally incompetent persons, unconscious people. Parents/guardians must form the contract for the person.

Legal Responsibilities Privileged communications - all information given to health care personnel by a patient, can only share with other members of the health care team that are involved with their care

Legal Responsibilities Health care records are considered privileged communication. Contain info about the care that was given to patient The patient does have a right to obtain a copy Should be shredded or burned when disposed of

Legal Responsibilities EMRX - electronic medical record exchange allows all medical facilities to electronically transfer and receive patient health records.

Health Insurance Portability and Accountability Act Legal Responsibilities HIPAA Health Insurance Portability and Accountability Act A federal law that protects health information Authorization form signed by the patient is required for information to be released

Considerate and respectful care Patients’ Rights Patient’s Bill of Rights - list of rights that every patient can expect to receive while under the care of a health care provider Considerate and respectful care Obtain complete,current info concerning diagnosis Expect reasonable continuity of care Privacy concerning a medical care program

Omnibus Budget Reconciliation Act (OBRA) of 1987 - Protects the rights of residents in long term care facilities

Advance Directives Living Will - document that states what individual wishes are for end of life DNR - Do Not Resuscitate Designation of Health Care Surrogate (Durable Power of Attorney) - Permits a person (principal) to appoint another person (agent) to make health care decisions for them if the principal person should become unable to make decisions.

Professional Standards Perform only procedures you have been trained and legally permitted to do Use approved, correct methods while performing any procedure Obtain proper authorization before any procedure Identify the patient Obtain patient’s consent before procedure Observe all safety precautions

Professional Standards (continued) Keep all information confidential Think before you speak and carefully consider everything you say Treat all patients equally Accept no tips or bribes If any error occurs, report it immediately Behave professionally in dress, language, manners and actions