1. Legal and Ethical responsibility
Chapter 4

2. Legal REsponsibility Legal responsibilities are based on law.
Civil Law- legal relationships
Criminal Law- wrong committed against a person, property or society.
Healthcare is generally affected by civil law. Primarily TORTS

3. TORTS Torts- Wrongful acts that do not involve contracts.
Failure to meet your legal responsibility.
Doctor did not meet the established or expected standards. (reasonable standard)

4. Tort violations Malpractice
Bad practice. More commonly thought of as PROFESSIONAL NEGLIGENCE.
Ie. Dr. fails to give tetanus shot after a puncture wound
Negligence- failure to give care normally expected, resulting in injury to another person.

5. Tort Violations Assault-Threat or attempt to injure
Battery- unlawful touching without consent
Patients have the right to refuse care. Sometimes verbal consent is allowed. Ie. Put the side rail down on the bed.
Some MUST be signed ie. INFORMED CONSENT
Permission granted after all risks have been explained. Patient must be of sound mind to be legally bound to the document. HOWEVER: Patient always retains the right to withdraw consent.
A and B may be rough handling of a patient or procedure performed against the patient’s will.

6. Tort violations cont… Invasion of Privacy False imprisonment
Revealing personal information without consent.
Not properly covering a patient to maintain modesty
False imprisonment
Restraining or restricting and individual’s freedom (hospitalization against will)
Abuse: Verbal, physical, psychological, sexual abuse, (ELDERLY)

7. Tort Violations
Defamation of character- false statements that cause ridicule or damage to reputation
Slander that is written as LIBEL

8. contracts
Contracts: Agreement between 2 or more parties. Contains the following:
Offer
Acceptance
Consideration (payment made)
Implied Contract- understood without verbally stating. If nurse gives meds and patient voluntarily takes them, it is implied that the patient accepts treatment.

9. Contracts cont…
Expressed contract- stated clearly and distinctly either orally or in writing.
Legal disability- all parties in a contract must have the legal capability to enter the contract ie. Legal adult, sound mind, power of attorney.
TRANSLATOR-must be present if person does not speak language or documents are not in their language.

10. Privileged communications
Legal responsibility- information about their health can only be shared with other members of that patients healthcare team, must stay confidential (dr/pt confidentiality)
Only shared by written consent UNLESS:
Death, birth, battery, abuse, stabbing, drug abuse, disease communicable, STD, gun shot etc…
Healthcare records- privileged information that belongs to the doctor. Patient has a right to obtain copy. May be used in a court of law.

11. ethics
Ethics- set of principles relating to what is morally right or wrong. Standard of conduct or code of behavior.
LOTS of dilemma’s arise due to ethics!!!!!
Euthanasia
If doctor has HIV should he have to disclose that to his patients?
Page 93: Pick 2 and write answer

12. Basic Ethics principles
Saving life and promotion of health
Keep patient comfortable
Respect patients choice to die peacefully with dignity
Treat all patients equally regardless of race, etc…
Provide care for all individuals to the best of your ability
Maintain competent skill level
Stay up to date through continuing education
Maintain confidentiality
Refrain from immoral unethical and illegal practices
Loyalty to patients and employers
Be sincere honest and caring

13. Patient rights
Written rights and policies are federal and state law required.
Pg 94 Patient Bill of Rights
Resident bill of rights for long term care

14. Advance directives
Legal directives- allow individuals to state what treatment they want or do not want in the event that they become incapacitated and are unable to express their wishes regarding medical care.
1) LIVING WILL
States what measures should be taken to prolong life when conditions are terminal
Document must be signed when patient competent.
DNR Do not resuscitate (extremely hard to determine.

15. Advanced directives 2)DURABLE POWER OF ATTORNEY
Principal (pt)- appoints another person to make any decisions regarding health care if the principal should not be able to make those decisions.
POA- must be signed by principal agent and 2 legal witnesses.
1990 Patient self determination act (PSDA). All healthcare agencies requiring federal aide must inform patients of their legal rights and directives.
Page 97: Professional standards