1. CHAPTER 4 LEGAL AND ETHICAL PRINCIPLES

2. Professional Codes of Conduct
Health care workers must stay within a “scope of practice”
Illegal and unethical to perform skills or tasks that are outside scope of practice
Limits of practice are established by each state
Nurse Practice Acts
Laws that determine which tasks nurses may legally perform

3. Table 4-1 Sample Scope of Practice

4. Professional Codes of Conduct
Ethics are the principles and values that determine appropriate behavior
Respect for cultural, social, and ethical differences of the clients and other workers
Practicing within the guidelines of laws, policies, and regulations established for each type of employment
Morals are based on the experience, religion, and philosophy of the individual and the society

5. Box 4-1 Code of Ethics

7. Health Careers and the Law
Health care provider is legally responsible (liable) for his or her behavior and the care given
Employer may also be liable for the actions of a health care provider that are not reasonably prudent (negligent) or that reflect bad practice (malpractice)

8. Malpractice Liability
• It is considered malpractice when the health care worker is:
Performing skills that are beyond the level of the health care worker’s education and training
Neglecting to do something that is considered to be common practice, such as leaving the client in an unsafe situation

9. Common Law
A statutory law, for example, might say "Anyone who commits a burglary is guilty of a class 3 felony." If the language of the law itself defines the word "burglary" then that is the definition that will be used. If it does not, or if there is confusion over whether a specific act meets the definition, then the court will look to the common law definition, which has been established and refined by years of judicial precedent.  In civil law, which governs relations between private parties, common law comes into play much more frequently. For example, it is a given that you are not liable for damages resulting from your not coming to someone's aid when you could of, *unless* you owe that person a "duty of care". 

10. Confidentiality
A patient’s health care is considered confidential, or private
The health care worker is ethically responsible to maintain the patient’s privacy
Confidentiality is important so that the patient may tell the health care worker personal information related to health care without fear of it being shared with someone who is not involved in the patient’s health care.

11. Health Insurance Portability and Accountability Act
HIPAA passed by Congress in 1996
Established to try and reduce administrative overheads and protect electronic health information of an identifiable individual
Standards for “Privacy of Individually Identifiable Health Information” became effective in 2003

13. Patient’s Rights
Advisory Commission on Consumer Protection and Quality in the Health Care Industry
Issued report designed to protect consumers
Listed specific rights and responsibilities for the patient
Right and responsibility to participate or have a representative in making treatment decisions
Responsibility to communicate honestly and show respect for health care providers
Responsible for making a “good-faith” effort to pay for care
Responsible for following the procedures of the health care plan

14. Patient’s Rights (Continued)
American Hospital Association’s “Patient Bill of Rights”
Patient has right to confidentiality and personal privacy
All patients have right to quality care without mistreatment, neglect, or abuse
Patient has right to voice grievances without fear of retaliation
Patient’s personal possessions must be cared for and secure while care is being given

15. Legal Directives
Legal documents that allow patients to express their wishes about their health care and treatment
Two types of Advance Directives:
Living will allows a person to state in advance whether to receive life support and what life-support procedures to withhold if the person is terminally ill and permanently unconscious
Durable power of attorney allows a second person or agent to make decisions if the first person is unable to make them

16. Box 4-5 Elements of Advance Care Directives

17. Health Care and the Internet
• Patients can:
Access health care information
Join chat groups
Purchase drugs and other medical items
Consult a health care practitioner online

18. Documentation
A chart is the written documentation that serves as the legal record of the care given to the client
A chart must be precise, clear, and concise to show the activities of care