1. Unit 4 Legal and Ethical Responsibilities

2. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2 4:1 Legal Responsibilities  All health care workers have legal responsibilities & all patients have rights.  Patients’ Bill of Rights: Care and consideration that a patient can expect to receive from health care facilities.

3. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.3 A patient has the right to: 1.Considerate and respectful care 2.Obtain complete and current info regarding their prognosis 3.Be given adequate information about a procedure in order to give consent 4.Have advanced directives for health care and refusal of treatment 5.Privacy concerning a medical care program

4. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.4 Continued 6.Confidential treatment of all health records 7.Reasonable response to request for services 8.Be given info regarding any relationship a hospital may have with education institutions 9.Be advised and have the right to refuse to participate in a research project

5. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.5 Continued 10.Expect reasonable continuity of care 11.Examine medical bills and be given an explanation of the charges 12.Be informed of hospital rules and policies

6. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.6 Advanced Directives  Legal documents that allow individuals to state what medical treatment they do and do not want in the event they are unable to express their wishes.  Two most common directives: –Living Wills –Durable Power of Attorney (AKA: Health Care Proxy)

7. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.7 Continued  Living Will: Document that gives specific instructions regarding what measures should and should not be taken to prolong life. –DNR: Do Not Resuscitate: CPR (or any life- sustaining measure) is not performed when the pt stops breathing

8. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.8 Continued  Durable Power of Attorney (AKA: Health Care Proxy): Allows an individual to appoint another person to make decisions about their medical care in the event they are unable to do so themselves

9. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.9 Confidentiality  A pt’s health information can be shared only with other members of the pt’s health care team  HIPPA: Health Insurance Portability and Accountability Act: Law enacted that protects patients’ health information

10. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.10 The Medical Record  Health care records (patient chart) can be used as legal records in court. Must be kept confidential. –No erasures allowed –Errors are crossed out with a single line with initials and date of charting error. Correction is inserted beside of error

11. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.11 Legal Action Against Health Care Workers  Tort: Wrongful act that results in a pt being harmed or injured because a health care provider did not meet the expected standards o care.  Examples of torts: –Malpractice: (bad practice): The failure of a professional to provide care that is commonly expected in that profession resulting in injury, loss, or damages to the pt.

12. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.12 Continued  Negligence: Failure to give care that is normally expected of a person in that particular position.  Assault & Battery: Assault is a threat or attempt to injure; battery includes the unlawful touching a someone  Invasion of privacy: Unnecessarily exposing and individual or revealing personal health info about the pt

13. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.13 Continued  False Imprisonment: Restraining an individual or restricting their freedom  Abuse: Care that results in physical harm, pain, or mental anguish. –Physical –Verbal –Psychological –Sexual

14. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.14 Continued  Defamation: Occurs when false statements cause an individual to be ridiculed or damage a person’s reputation –Slander: Spoken defamation –Libel: Written defamation

15. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.15 Consent  Permission granted voluntarily by a person who is of sound mind after a procedure has been explained

16. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.16 Stop

17. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.17 4:2 Ethics  Set principles dealing with what is morally right or wrong  Provide a standard of conduct or code of behavior  Help health care worker analyze information and make decisions

18. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.18 Ethical Dilemmas  Frequently created by modern medicine  Euthanasia ~ AKA: mercy killing  Confidentiality of AIDS diagnosis  Aborted fetuses and research  Continuing life support  Expensive treatments and payment

19. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.19 Ethical Dilemmas (continued)  Transplant decisions  Legal issues and marijuana  Animals and research  Genetic research  Cloning  Stem cell research

20. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.20 Basic Rules of Ethics  Save lives and promote health  Keep patients comfortable  Respect the patient’s right to die peacefully and with dignity  Treat all patients equally  Provide the best care possible

21. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.21 Basic Rules of Ethics (continued)  Maintain competent skills and knowledge  Maintain confidentiality  Refrain from immoral, unethical, and illegal practices  Show loyalty to patients, co-workers, and employers  Be sincere, honest, and caring

22. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.22 Top 10 Questions to Ask Yourself When Making an Ethical Decision 10.Could this decision become habit forming? If so don’t do it 9.Is it legal? If not don’t do it 8.Is it safe? If it isn’t don’t do it 7.Is it the right thing to do? If not, don’t do it 6.Will this stand the test of public scrutiny? If it won’t don’t do it 5. If something terrible were to happen, could I defend myself? If not, don’t do it

23. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.23 Top 10 Questions to Ask Yourself When Making an Ethical Decision 4.Is it just, balanced, and fair? If not, don’t do it 3.How will it make me feel about myself? If it’s lousy, don’t do it 2.Does this choice lead to the greatest good for the greatest number? If not, don’t do it 1. Would I do this in front of my mother? If you wouldn’t don’t do it

24. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.24 4:5 Professional Standards  Perform only those procedures for which you have been trained and are legally permitted to do  Use approved, correct methods while performing any procedure  Obtain correct authorization before performing any procedure

25. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.25 Professional Standards (continued)  Identify the patient and obtain their consent before performing any procedures  Observe all safety precautions  Keep all information confidential  Think before you speak and watch everything you say  Treat all patients equally

26. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.26 Professional Standards (continued)  Accept no tips or bribes for care you provide  If an error occurs or you make a mistake, report it immediately to your supervisor  Behave professionally in dress, language, manners, and actions  Always carry liability insurance

27. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.27 Summary  Know the legal and ethical implications for your particular health career  Ask questions or request written policies  Contact state board of health or education to obtain regulations and guidelines  Follow the basic standards listed  Protect yourself, your employer, and your patient for whom you provide health care