1. Legal and Ethical Responsibilities
Chapter 5
Legal and Ethical Responsibilities

2. SPELLING WORDS confidentiality ethics defamation criminal
negligence implied
malpractice slander
libel professional

3. Define Terms:
Criminal law informed consent libel
Civil law invasion of privacy implied contract
Tort false imprisonment expressed contract
Malpractice abuse legal disability
Negligence defamation
Assault and battery slander

4. Legal Responsibilities
Legal responsibilities - responsibilities that are authorized or based on law
Health care professionals/workers are required to know and follow the state laws that regulate their license or registration for their profession.

5. Legal Responsibilities
Two main types of laws that affect health care workers:
Criminal law-
crime, wrongs against a person, property or society (ex. practicing without required license, illegal drugs, theft, etc. )
Civil law -
legal relationships between people and the protection of a person’s rights, in health care civil law usually involves torts and contracts

6. Legal Responsibilities
Tort - wrongful act that does not involve a crime, someone becomes harmed because health care provider did not meet standards of care, a “civil wrong”
malpractice invasion of privacy
negligence false imprisonment
assault and battery abuse
defamation

7. Legal Responsibilities
Malpractice - “bad practice” or “professional negligence”
The professional failed to use the degree of skill and learning expected in that profession, resulting in injury, loss or damage.
Negligence - failure to give care that is normally expected of a person in a particular position, resulting in injury (ex. leaving siderail down and patient falls and injury occurs)

8. Legal Responsibilities
Assault and battery - assault includes threats or attempt to injure, battery is unlawful touching of another person without their consent. Closely related and often used together.
Ex: performing a procedure after a patient has refused permission, threatening a patient, improper handling, rough treatment.
Informed consent is permission granted voluntarily by a person who is of sound mind after all risks have been explained. Can withdraw consent at any time.

9. Legal Responsibilities
Invasion of privacy - Two kinds, physical and informational
physical - ex. improperly covering a patient during a procedure so that others can see patient exposed
informational - revealing personal information without that person’s consent, ex. sending information regarding a patient to insurance company without patient’s written permission

10. Legal Responsibilities
False imprisonment - restraining an individual’s freedom without authorization.
Ex. applying physical restraints without proper authorization or with no justification
AMA - Against Medical Advice, patient decides to leave hospital without a physician’s permission

11. Legal Responsibilities
Abuse - Any care that results in physical harm, pain or mental anguish
Physical abuse - depriving of food & water, restraining movement, hitting
Verbal abuse - swearing, shouting, inappropriate words to describe their race, nationality, and/or writing threats or abusive statements

12. Legal Responsibilities
ABUSE -
Psychological abuse - threatening harm, denying rights, belittling, ridiculing the person, threatening to reveal information about them
Sexual abuse - any sexual touching or act, using sexual gestures, or suggesting sexual behavior even if the patient is willing or tries to initiate it

13. Legal Responsibilities
Abuse -
domestic abuse, child abuse, elder abuse
Any form of abuse must be reported
Possible signs and symptoms:
unexplained bruises, fractures, burns or injuries
signs of neglect, like poor personal hygiene
irrational fears or change in personality
aggressive of withdrawn behavior
patient statements that indicate abuse or neglect

14. Legal Responsibilities
Defamation - when false statements damage a person’s reputation or cause person to be ridiculed
Slander - spoken defamation
Libel - written defamation
Examples: reporting to the health department that patient has an infectious disease when lab results are inaccurate, telling others that a person has a drug problem when actually another medical condition exists, or saying that a coworker is incompetent

15. Legal Responsibilities
Contract - agreement between two or more parties.
Implied contracts - obligations that are understood without verbally expressed terms
Expressed contracts - stated in clear and distinct language, either orally or in writing, for example, a surgery permit

16. Legal Responsibilities
Legal disability - person does not have the legal capacity to form a contract. Examples: minors, mentally incompetent persons, unconscious people.
Parents/guardians must form the contract for the person.

17. Legal Responsibilities
Privileged communications - all information given to health care personnel by a patient, can only share with other members of the health care team that are involved with their care

18. Legal Responsibilities
Health care records are considered privileged communication.
Contain info about the care that was given to patient
The patient does have a right to obtain a copy
Should be shredded or burned when disposed of

19. Legal Responsibilities
EMRX - electronic medical record exchange
allows all medical facilities to electronically transfer and receive patient health records.

20. Health Insurance Portability and Accountability Act
Legal Responsibilities
HIPAA
Health Insurance Portability and Accountability Act
A federal law that protects health information
Authorization form signed by the patient is required for information to be released

21. Considerate and respectful care
Patients’ Rights
Patient’s Bill of Rights - list of rights that every patient can expect to receive while under the care of a health care provider
Considerate and respectful care
Obtain complete,current info concerning diagnosis
Expect reasonable continuity of care
Privacy concerning a medical care program

22. Omnibus Budget Reconciliation Act (OBRA) of 1987 -
Protects the rights of residents in long term care facilities

23. Advance Directives
Living Will - document that states what individual wishes are for end of life
DNR - Do Not Resuscitate
Designation of Health Care Surrogate (Durable Power of Attorney) -
Permits a person (principal) to appoint another person (agent) to make health care decisions for them if the principal person should become unable to make decisions.

24. Professional Standards
Perform only procedures you have been trained and legally permitted to do
Use approved, correct methods while performing any procedure
Obtain proper authorization before any procedure
Identify the patient
Obtain patient’s consent before procedure
Observe all safety precautions

25. Professional Standards (continued)
Keep all information confidential
Think before you speak and carefully consider everything you say
Treat all patients equally
Accept no tips or bribes
If any error occurs, report it immediately
Behave professionally in dress, language, manners and actions