1. Ethics and Legal Issues State Board of Nursing
Dee Matecki EdD,RN

2. Types Of Ethics Bioethics Clinical ethics Nursing ethics
Encompasses a number of fields “life sciences”
Clinical ethics
Concerned with ethical problems “at bedside”
Nursing ethics
Formal study of ethical issues that arise in the practice of nursing
Analysis used by nurses to make ethical judgments

3. Key Terms
Autonomy—respect rights of patients to make healthcare decisions
Nonmaleficence—avoid causing harm
Beneficence—benefit the patient
Justice—give each his or her due and act fairly
Fidelity—keep promises
Veracity, accountability, privacy, confidentiality .

4. Ethics
A set of guiding principles that all members of a profession accept
Helps professional groups settle questions about practice or behavior
Includes responsibility, accountability, and confidentiality

5. VALUE
A personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior
Value formation
Value clarification

6. Ethics and Philosophy Deontology Utilitarianism Feminine ethics
Defines actions as right or wrong
Utilitarianism
Proposes that the value of something is determined by its usefulness
Feminine ethics
Focuses on the inequality between people
Ethic of care
Emphasizes the importance of understanding relationships, especially as they are revealed in personal narratives

7. How to Process an Ethical Dilemma
Step 1: Ask if this is an ethical dilemma.
Step 2: Gather all relevant information.
Step 3: Clarify values.
Step 4: Verbalize the problem.
Step 5: Identify possible courses of action.
Step 6: Negotiate a plan.
Step 7: Evaluate the plan.

8. Issues in Bioethics Quality of life
Central to discussions about futile care, cancer therapy, physician-assisted suicide, and DNR
Futile care:
Interventions unlikely to produce benefit for the client
Allocating scare resources:
A key issue in discussions about access to care
The nursing shortage:
Produces difficult working conditions and affects clients outcomes

9. Legal Limits in Nursing
Sources of law:
Legal guidelines that come from statutory, regulatory, and common law
Standards of care:
Legal guidelines for defining nursing practice and identifying the minimum acceptable nursing care

10. Federal Law American with Disabilities Act
Emergency Medical Treatment and Active Labor Act
Mental Health Parity Act
Advance Directives
Living Wills, Durable Power of Attorney
Uniform Anatomical Gift Act
Health Insurance Portability and Accountability Act
Restraints

11. Consent
A signed form required for all routine treatment, hazardous procedures, and some other treatments
Provisions are made for deaf, illiterate, or foreign language clients

12. Malpractice Insurance
A contract between the nurse and the insurance company
Provides a defense when a nurse is in a lawsuit involving negligence or malpractice insurance
Nurses covered by institution’s insurance while working

13. Risk Management
A system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs
Steps involved:
Identify possible risks.
Analyze risks.
Act to reduce risks.
Evaluate steps taken.

14. State Law Licensure Good Samaritan laws Public health laws
The Uniform Determination of Death Act
Physician-assisted suicide

15. Abortion Issues 1973 Roe v. Wade
U.S. Supreme Court ruled that there is a fundamental right to privacy, which includes a woman’s right to have an abortion.
1989 Webster v. Reproductive Health Services
Some states require viability tests if the fetus is more than 28 weeks’ gestatio

16. Abandonment and Assignment Issues
Short staffing:
Legal problems occur if there are inadequate nurses to provide care.
Floating:
Based on census load and client acuities
Physician’s orders:
Nurses follow orders unless they believe an order is in error or harmful.

17. State Board Of Nursing
The State Board of Nursing establishes rules and regulations for the licensure and practice of professional and practical nursing in the Commonwealth of Pennsylvania and provides for the examination of all applicants.  The Board examines all applicants for licensure and issues licenses for professional nursing and practical nursing to persons passing such examinations and meeting other qualifications for licensure. .