1. Professionals in Health Legal and Ethical Issues

2. A Professional is Guided by: b Personal code of ethics b A system of laws Violations are dealt with by a state board of the profession or via the courts. Violations may result in loss of license, disciplinary action, legal action resulting from an illegal action. b Code of ethics established by the profession

3. Jurisprudence b A system of laws b Laws and interpretations that affect the profession from a legal standpoint.

4. Licensure b Purpose of licensure: is to protect the public from unqualified or incompetent practitioners. b Differentiate: Licensure from Certification b Reciprocity: is an agreement between two or more states to allow practitioners licensed in one state to receive a license in another state, without further examination

5. Licensure Revocation b A suspension of or refusal to renew license. States vary but generally include conviction of felony or misdemeanor involving: moral turpitude, gross ignorance, drug addiction. Mental or physical impairment which would harm a patient Incompetence

6. State Practice Act b The public controls the practice of a profession through a state law known as a State Practice Act. b The primary purpose is to protect the public from being mistreated or misled by incompetent practitioners.

7. Practice Act continued b The Act specifies requirements for and restrictions upon the practice within that state, including eligibility for licensure, suspension or revoke of license, control of duties to allied personnel and a board to supervise the practice. b The state board is an agency of the state. Members are appointed by the governor.

8. Law b A set of rules established and enforced by sovereign authority (state or federal government). b Divided into two categories: Criminal Civil

9. Criminal Law b When a person commits a wrongful act against society

10. Civil Law b When one person sues another for satisfaction of a personal wrong done to him. b Civil law is divided into 2 categories: Contract law and Tort law

11. Contract Law b Specific agreements between people and violations of those agreements b A contract is an agreement between 2 or more competent parties covering a specified act for a consideration.

12. 3 Elements of a Valid Contract b Those entering upon the agreement must be legally competent and of legal age b The specific act or service covered by the agreement must be legal b There must be a “consideration” involved in the contract, such as a payment in the form of money or service

13. Types of Contracts b Implied:one that is made by certain actions on the part of the parties concerned, even though all essentials for a contract have not been discussed. b Expressed: one in which the consent is given orally or in writing. b Breach of contract: if either party fails to keep his part of an expressed contract

14. Tort Law b Covers the rights and duties toward each other and wrongs committed in violation of these rights and duties. b A tort is a wrongful act, except one involving a breach of contract.

15. 4 Elements of a Tort b A legal duty is owed by the professional to another b That duty must have been breached by the accused (dereliction) b There was damage or harm to the accuser b The damage or harm was caused directly by the accused person’s breach of duty. Each of the four elements must be present for a conviction

16. 9 Legal Duties Required of a Professional 1. Exercise reasonable skill, care and judgement Reasonable skill: knowledge plus the ability to use such knowledge Reasonable care: must exercise the degree of care which an ordinarily skilled and prudent professional would under the same conditions Reasonable judgment: decision in the choice of procedural methods.

17. 9 Legal Duties Required of a Professional 2. Use Standard Drugs, Materials and Techniques b Anything of an experimental nature requires an informed consent.

18. 9 Legal Duties Required of a Professional 3. Not to Abandon a Patient b Abandonment exposes the professional to liability either for breach of contract or for malpractice.

19. 9 Legal Duties Required of a Professional 4. Do Only What the Patient Has Consented To. b Consent: a rational voluntary act by which one person agrees to allow someone else to do something b Purpose: to protect health care providers and facilities against claims of unauthorized treatment & the client against unsanctioned surgery or treatment.

20. Content of a Consent b Clear statement of nature and extent b States risks involved b Who is responsible b Place and date b Signed and dated by the patient b Witnessed

21. Who May Consent? b Legal age person b Legal guardian b Emancipated minor

22. Types of Consent b Informed Consent-the patient must understand: the nature of the condition the proposed treatment the risks involved the chances of failure the results of not proceeding the alternative procedures

23. Types of Consent continued b Implied Consent: same as implied contract b Expressed consent: informed consent either oral or written b Blanket consent: allows provider to do any and all procedures b Consent by guardian-minors

24. 9 Legal Duties Required of a Professional 5. Give Adequate Instructions b Needs to be provided so that the patient understands and can give informed consent

25. 9 Legal Duties Required of a Professional 6. Reasonable Charge b The fee should be reasonable and customary for the community

26. 9 Legal Duties Required of a Professional 7. Arrange Coverage b Coverage for patient care must be arranged during an absence.

27. 9 Legal Duties Required of a Professional 8. Refer b Unusual cases need to be referred to a specialist.

28. 9 Legal Duties Required of a Professional 9. Hold Inviolate the Patient’s Privacy. Everything is confidential b This rule is extended to all who have access to the medical/dental record.

29. Doctrine of Respondeat Superior b “Let the master answer” b An employer is held responsible for the wrongdoings of the employees, if the wrongdoing is committed within the scope of their employment. b Does not relieve the employee of liability for the consequences of the negligent act.

30. Liabilities b If the professional violates the rights of others, or fails to perform legal duty to them, thereby committing a tort, he is said to be liable.

31. 5 Ways a Professional May be Liable For His/Her Own Acts b 1. Maligning a Patient- to say or write something which will damage the patient’s reputation. Slander-verbal Libel-written

32. 2. Breech of Contract b Failure to keep an expressed contract

33. 3. Technical Assault b Wrongful act b Intentional or inadvertent b Involving contact between people that is not consented to, nor permitted by social usage, even without injury

34. 4. Malpractice b Any professional misconduct or any unreasonable lack of skill or fidelity in performance of professional duties b Practice contrary to established rules

35. 5. Negligence b Failing to do what a reasonable person would do. b Doing something a reasonable person would not do.

36. Advanced Directives b A document stating your health care choices or naming someone to make the choices for you if unable to do so.

37. Life Sustaining Procedures b Any mechanical or artificial means that sustains, restores or supplants a vital body function and which would only prolong the dying process for a terminal patient.

38. Living will b Document that states that you do not wish to be subjected to life sustaining procedures if they will only prolong the dying process

39. Medical Power of Attorney b Document through which you name another person known as your “attorney in fact” or ”agent” to make health care decisions for you if you are not able to make them.

40. Code of Ethics b Standard of moral principles and practice to which a profession adheres. b Voluntary controls-not laws b Serve as a method of self policing b Enforcement handled through the professional organization b Standards imposed by a code of ethics are usually higher than those required by law.

41. Codes of Ethics Activity b Read the Code of Ethics for your profession. b Read the code of Ethics for at least one other profession b List of the ways in which they are similar b List of the ways in which they are different