Legal and Medical Ethics Chapter 11

Understanding Laws, Morals, and Ethics Laws – a law, or statute, is a rule of conduct or action.

Criminal Laws Criminal Laws – protect members of society from certain harmful acts of others. A criminal act may be one of: Commission if there is a law forbidding a certain act. Omission in violation of a law requiring a certain act.

Civil Laws Civil Laws – are concerned with private rights and remedies. Examples of the causes of civil disputes include: Contract violation. Slander or libel. Trespassing. Product liability. Automobile accidents. Family matters such as divorce, child support, and child custody.

Civil Law Court judgments in civil cases often require the payment of a sum of money to the injured party

Torts Torts occur when a person is harmed or injured because a health care provider does not meet the established or expected standards of care.

Types of Health Care Torts Malpractice - means “bad practice” and is commonly called “professional negligence.” Negligence- failure to give care that is normally expected of a person in a particular position The 3 Ds must be present for negligence to occur: Duty – health care practitioner/client relationship exists. Derelict – health care practitioner did not live up to the obligation of caring for a client. Damage – the breach of duty results in damages to the client or plaintiff.

Physicians are most likely to be charged with negligence Physicians are most likely to be charged with negligence. However, other health care practitioners may be subject to such charges. Assault and battery: assault includes a threat or attempt to injure; battery includes the unlawful touching of another person without consent

Types of Health Care Torts Invasion of privacy: includes unnecessarily exposing an individual or revealing personal information about an individual without that person's consent. False imprisonment: refers to restraining an individual or restricting an individual’s freedom Abuse: any care resulting in physical harm, pain, or mental anguish.

Types of Health Care Torts Defamation: occurs when false statements either cause a person to be ridiculed or damage the person’s reputation. Slander: written defamation Libel: spoken defamation

Morals Morals and ethics also affect your work in a health care profession Morals are formed from your personal values- your concept of right and wrong. You develop moral values through the influence of family, culture, and society. Acting morally toward others involves treating them the way you would like to be treated.

Ethics Ethics are standards of behavior developed as a result of your moral values. Ethics are not the same as laws However, ethics may govern behavior more strictly than laws

Codes of ethics related to Code of Ethics Codes of ethics related to health care delivery do not provide solutions to issues but have been developed by most health care organization to help their professional members with difficult decisions

Noncompliance Noncompliant health care workers may face fines or prison sentences and can lose their licenses to practice their profession. Unethical conduct may result in expulsion or censure from your professional organization, but only the state can revoke a license.

History of Ethics Hippocrates Maimonides Nightingale Pledge Declaration of Geneva

Hippocrates During the Greek Age Father of Medicine wrote standards of ethics which is the basis for today’s medical ethics

Maimonides Lived during the middle ages Important Jewish philosopher He worked as a physician but also become a scholar of Jewish law and a philosopher The oath of Mainonides was written around the late 1700’s

Florence Nightengale Lived from 1820-1910 Pioneer of Nursing reformer of hospital sanitation methods nursing students honor the dedication of Nurse Nightingale and symbolically plan to carry the ideals for which she stood in the Candle lighting portion of the pinning ceremony. The tradition of Candle lighting and Pledge recognizes her ideals.

Declaration of Geneva The World Medical Association is an association of national medical associations The oath seems to be a response the atrocities committed by doctors in Nazi Germany The oath requires the physician to “not use (his) medical knowledge contrary to the laws of humanity”

Guiding Principles of Health Care Ethics Preserve Life: Give all patients caring attention. Learn about the stages of death and dying. Be familiar with the laws regarding organ donation Do Good: Treat every patient with respect and courtesy. Serve as role model for healthy living Respect Autonomy: make sure patients have consented to all procedures. Know about advance directives

Uphold Justice: treat all patients equally, regardless of economic or social background. Follow all safety rules and OSHA guidelines to ensure the safety of yourself and others. Honesty: admit mistakes promptly. Refuse to participate in any form of fraud. Never perform a procedure or give treatment that you are not qualified to perform. Give an “honest day’s work” everyday Dependability: Complete assigned tasks and ask questions to be sure you understand an assignment before starting it.

Be discreet: never release patient information of any kind unless there is a signed release. Do not discuss patients with anyone who is not professionally involved in their care. Protect the physical privacy of patients. Do No Harm: Focus on providing excellent customer service. Keep your skills up to date. Stay informed about new laws that affect health care.

Terms you need to know

Licensure Licensure – is required for certain professions within a state.

Registration Registration Adding one’s name in an official registry or record as having satisfied the requirements for a certain health care occupation. Fulfilling certain education requirements and/or paying a registration fee.

Certification Certification – usually voluntary. Reciprocity – when state licensing authorities accept a person’s valid license from another state.

Standard of Care Standard of care is the level of performance expected of a health care worker in carrying out his or her professional duties

Scope of Practice Working outside your scope of practice can make you liable. Working within your scope of practice ensures that you: Do not injure clients or put them at risk by performing procedures that are beyond your ability. Will not be held liable for a standard of care that is beyond your training, experience, and job description if a legal situation arises

Law of Agency The Law of Agency – an employer is legally liable for acts performed by employees.

Informed Consent Informed Consent – in order for a client to make an informed decision regarding treatment, the client needs to be told the following: The proposed methods of treatment. Why the treatment is necessary. The risks involved in the proposed treatment. All available alternative types of treatment. The risks of any alternative methods of treatment. The risks involved if treatment is refused.

People who cannot give informed consent include: Minors – individuals under the age of majority which is 18 years of age in some states and 21 in others. Mentally incompetent individuals – persons judged by the court to be insane, senile, mentally retarded, or under the influence of drugs or alcohol. Speakers of a foreign language who do not speak English

Confidentiality It is illegal and unethical if a health care worker does not observe confidentiality. Privileged communication refers to information held confidential within a protected relationship.