Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Textbook for Nursing Assistants Chapter 4: Legal and Ethical Issues

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Legal and Ethical Issues

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors that influence behavior – Society’s laws – Governing authority – Personal ethical code – Moral sense – Values instilled by the family – Spiritual beliefs

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patients’ and Residents’ Rights

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Revision of Patients’ Bill of Rights by American Hospital Association 12 points in the Patients’ Bill of Rights –Guidelines established to protect patients –Now call the Patient Care Partnership Patients’ responsibilities in the bill –States what the patients responsibilities are in their own care Patients’ Rights

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Guidelines as part of the Omnibus Budget Reconciliation Act (OBRA) –Must be followed for Medicare reimbursement 12 points in the Residents’ Rights –Similar rights that protect LTC residents Purpose of rights – Sets legal and ethical standards – Creates atmosphere of open communication – Protects residents Residents’ Rights

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Decision-making capacity is the ability to make thoughtful decisions based on an understanding of the risks and benefits related to the decision. –An unconscious or otherwise cognitively impaired patient has an effected decision- making capacity Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Advance directives are documents that allow for decisions concerning health care can be made to family, friends and health care providers at times when decision making is impaired –Durable Power of Attorney for Health Care –Living Will Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Durable Power of Attorney for Health Care –The authority to make health care decisions is transferred to a health care agent in times when the patient’s decision making abilities are impaired Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Living Will –Allows the patient to make known their wishes concerning end-of-life medical treatment Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Advanced Directives help preserve the patient’s right to make informed health care–related decisions Advanced Directives

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Legal Aspects of Health Care Delivery

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Laws A way of preserving a patient and or residents rights Rules made by a local, state or federal authority which establish principles to help guide behaviors allows us to settle disputes in an orderly and civilized manner

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of laws: –Civil Law – concerned with the relationship between individuals –Criminal Law – concerned with the relationship between an individual and society Litigation: Legal action taken against a person breaking the law Liability: Responsibility of an individual to act within the confines of the law Laws

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Legal Violations

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of tort: –Unintentional tort- you do not intend to cause harm A person who commits unintentional tort is considered negligent Negligence committed by people licensed to practice their profession is called malpractice –Intentional tort- intend to cause harm Includes defamation, assault, battery, fraud, false imprisonment, invasion of privacy and larceny Violations of Civil Law: Tort

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Avoiding Legal Dilemmas

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Abuse is a repetitive and deliberate infliction of injury on another person. Forms of abuse –Physical abuse –Psychological abuse—involuntary seclusion –Sexual abuse –Financial abuse Risk factors for abuse –Elder Abuse Violations of Criminal Law: Abuse

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Perpetrators of abuse –Have the need to overpower and dominant another person Role of nursing assistant/PCT in reporting abuse –Must report to proper authorities –Follow specific reporting authority of your facility –Not your responsibly to investigate –Do not cover up abuse– you can be held culpable as well Violations of Criminal Law: Abuse

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins HIPAA Health Insurance Portability and Accountability Act preserves the right of privacy for residents and patients. –HIPAA protects the right keep health related information private

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Ethics: Guidelines for Behavior

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Moral principles or standards that govern conduct –Professional Ethics: code stated by the American Nurse Association Beneficence, Nonmaleficence, Justice, Fidelity, Autonomy, Confidentiality –Personal Ethics: derived from values Value: a cherished belief or principle Ethics

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Define the following terms in your notes: Beneficence, Nomaleficence, Justice, Fidelity, Autonomy Confidentiality

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Terms: Beneficence –Do good to those in your care by preventing harm and promoting health Nomaleficence –Avoid harming those in your care/ Use kindness & gentleness Justice –Treating others fairly and equally despite- color, race, sex, religion, culture, disability or ability to pay

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Terms: Fidelity –Act with integrity to earn trust from others Autonomy –Respecting ones rights and personal preferences Confidentiality –Maintaining privacy by allowing others to disclose personal information with the knowledge that the information shared will be kept a secret

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation