Chapter 5.1 Legal Responsibilities Objectives Describe how contract laws affect health care Describe privileged communications and explain how they might affect health care

Legal Responsibilities Certain laws and legal responsibilities are found in every aspect of life Formulated to protect you and society For example, traffic laws Health care workers must be aware of and follow all legal regulations This protects you, employer, and patient

Legal Responsibilities Authorized or based on law A law is a rule that must be followed Laws are created and enforced by local, state, and federal governments Failure to meet your legal responsibilities can result in legal action against you

Two main types of laws affect health care workers 1. Criminal law- focuses on behaviors know as crime. Deals with wrongs against a person, property, or society Examples: practicing without the required license, illegal possession of drugs, theft, sexual assault, murder 2. Civil law- focuses on the legal relationships between people and the protections of a person’s rights. Examples are torts and contracts

Torts Tort- a wrongful act that does not involve a contract Called a civil wrong instead of a crime Occurs when a person is harmed or injured because a health care provider does not meet the established or expected standard of care Examples of Torts

Malpractice The failure of a professional to use the degree of skill and learning commonly expected in a particular profession Results in injury, loss, or damage to the person receiving care Example: Physician not administering a tetanus shot when a patient has a puncture wound

Negligence Failure to give care that is normally expected of a person in a particular position, with resulting injury to another person Examples: Falls and injury that occur when side rails are left down, using defective equipment, burns caused by improper radiation treatment

Assault and Battery Assault- can include a threat or attempt to injure Battery- unlawful touching of another individual without consent Examples: Performing a procedure after a person has refused to give permission, rough treatment of a patient

Verbal Consent Must be Informed Consent- person grants consent is of sound mind and understands all the risk Person has the right to withdraw consent at any time Do not perform procedure without consent

Invasion of Privacy Unnecessary exposure of an individual or revealing personal information about an individual without consent Examples; improper draping or covering of a patient during a procedure that allows other patients or personnel to see the patient exposed Sending information to an insurance company without the patients written permission

False Imprisonment Restraining an individual or restricting an individuals freedom Examples: keeping a patient hospitalized against their will, Application of physical restraints without proper authorization or justification Physical restraints should only be used to protect patients from harming themselves or others when all other measures have failed Physicians order must be obtained in writing before restraining a patient AMA- against medical advice- patient is asked to sign form if leaving against the advice of the physician

Abuse Any care that results in physical harm, pain, or mental anguish 1. Physical-hitting, forcing people against their will, restraining movement, depriving food or water 2. Verbal- speaking harshly, swearing or shouting, racial slurs, writing threats or abusive statements 3. Psychological- threatening harm, belittling, intimidating, threatening to reveal information 4. Sexual- any unwanted sexual touching or act, using sexual gestures, or suggesting sexual behavior

Abuse Domestic abuse occurs when an intimate partner uses threatening, manipulative, aggressive, or violent behavior to maintain power and control over another person Child abuse Elder abuse Health care workers are required to report any signs of abuse to immediate supervisor and the proper authorities

Defamation False statements that cause a person to be ridicules or cause damage to their reputation Slander- information that is spoken Libel – information that is written

Contracts Agreement between two or more parties Three parts to a contract 1. Offer- competent individual enters into a relationship with a health care provider and offers to be a patient 2. Acceptance- health care provider gives an appointment or examines or treats patient 3. Consideration- payment made by patient

Implied contract Cause implications that are understood without verbally expressed terms Example; qualified health care worker prepares medication and patient takes medication, implied that patient accepts this treatment

Expressed contract Stated in distinct and clear language either orally or written Example; surgery consent

Legal Disability All parties in a contract must be free of legal disability Person with a legal disability does not have legal capacity to form a contract Examples Minors Mentally incompetent Under the influence of drugs or alcohol Semiconscious or unconscious Parent or guardian must form contract for these individuals

contracts Interpreter must be used for non English speaking patients Agent- person who works under direction or control of another person Employer is the principle and the employee is the agent Principle is responsible for actions of the agent and can be required to compensate patients injured by the agent

Privileged Communications All information given to a health care provider by a patient is privileged By law must be kept confidential Cannot be told to anyone without written consent of patient Consent should state implicitly what information can be released and to whom, and any time limits

Exceptions Birth and Death records Injuries caused by violence that may require police involvement Drug abuse Communicable diseases and sexually transmitted diseases

Health Care Records Records containing information about the care that has been provided to the patient Belongs to the health care provider, but the patient has a right to obtain a copy Computers have created dilemmas on maintaining confidentiality because many people have access to patient records Safeguards; limit personnel, passwords, codes

Privacy Act HIPPA Health Insurance Portability and Accountability Act Established standards to protect health information Must inform patients how their information will be used Requires authorization to release information Patient have a right to file a complaint against provider