1. Copyright © 2008 Delmar Learning. All rights reserved. Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant

2. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Spell and define terms. Discuss ethical and legal situations in health care. Describe the legal and ethical responsibilities of the nursing assistant concerning patient information.

3. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Describe tactful ways to refuse a tip offered by a patient. Describe the legal responsibilities of a nursing assistant.

4. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Describe how to protect the patient’s right to privacy. Define sexual harassment and give examples of activities that may be perceived as being sexually harassing.

5. Copyright © 2008 Delmar Learning. All rights reserved. Ethical Standards Ethical standards –Guides to moral behavior People who provide health care –Voluntarily agree to live up to these standards

6. Copyright © 2008 Delmar Learning. All rights reserved. Ethical Standards When these rules are not followed: –Nursing assistant fails to live up to the promise to give safe, correct care and to do no harm

7. Copyright © 2008 Delmar Learning. All rights reserved. Legal Standards Legal standards are guides to lawful behavior When laws are not obeyed: –Nursing assistant may be prosecuted and found liable for injury or damage Legal guilt can result in the payment of fines or imprisonment

8. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions At no other time in history have questions of medical ethics been under such scrutiny

9. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions Questions health care providers ask: –When is life gone from a person on life support systems? –How much lifesaving effort should be given in situations of terminal illness?

10. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions When does human life actually begin? How much assistance should be given to the conception process? Should the body organs of a brain-dead person be harvested for transplants for the living? Does an unborn baby have rights?

11. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions Is assisting a patient before or after an abortion right or wrong? Is euthanasia ever justified? Should animals be used in research of potential value to human life?

12. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions Should food and water be withheld to speed death when a patient has expressed the desire to have this action performed?

13. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions Who makes decisions about removing life support systems when there is no direct expression of the patient’s wishes or there is conflict within the family?

14. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions How will a choice be made when two or more people could benefit from an organ transplant but only one organ is available?

15. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions How should the limited money available be spent when many serious disease conditions need to be researched? Who has the final authority over whether a woman will carry a pregnancy to term?

16. Copyright © 2008 Delmar Learning. All rights reserved. Ethics Questions Should marijuana be used for medicinal purposes?

17. Copyright © 2008 Delmar Learning. All rights reserved. Respect for Life One of the most basic rules of ethics is that life is precious.

18. Copyright © 2008 Delmar Learning. All rights reserved. Respect for the Individual Respect for each patient as a unique individual is another ethical principle Uniqueness is shown by differences in: –Age –Race –Religion –Gender

19. Copyright © 2008 Delmar Learning. All rights reserved. Respect for the Individual Uniqueness is shown by differences in: –Sexual preference –Culture –Attitudes –Background –Response to illness

20. Copyright © 2008 Delmar Learning. All rights reserved. The Golden Rule Do unto others as you would have them do unto you –Implies your intent to provide proper care

21. Copyright © 2008 Delmar Learning. All rights reserved. The Golden Rule Your good intentions are effective only when you act on them To provide proper care: –You also have the ethical responsibility to maintain competence in your practice

22. Copyright © 2008 Delmar Learning. All rights reserved. Platinum Rule Treat others the way they want to be treated Platinum Rule –Shifts focus from treating everyone alike to providing highly individualized care

23. Copyright © 2008 Delmar Learning. All rights reserved. Platinum Rule Find out what patients want –Give it to them, as much as possible, and in keeping with their plans of care Use both principles to guide your practice

24. Copyright © 2008 Delmar Learning. All rights reserved. Patient Information Discuss patient information only in appropriate places Discuss patient information only with the proper people

25. Copyright © 2008 Delmar Learning. All rights reserved. Patient Information Refer patient requests for information about laboratory results, the patient’s condition, or course of the illness to the nurse or physician.

26. Copyright © 2008 Delmar Learning. All rights reserved. Patient Information Let the nurse or physician relay information about a patient’s death. Follow the ethical code to ensure respect of a patient’s personal religious beliefs.

27. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues Laws are passed by governments and are to be obeyed by citizens. Anyone who fails to obey a law may be liable for fines or imprisonment.

28. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Stay within your scope of practice –Not overstep your authority –Do only those things you have been taught Within the scope of your training

29. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Carry out procedures carefully and as you were taught –Keep your skills and knowledge up to date

30. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Request guidance from the proper person before you take action in a questionable situation

31. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Always keep the safety and well-being of the patient a priority –Make sure you thoroughly understand the instructions for the care you are to give

32. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Perform your job according to facility policy –Stay within OBRA guidelines

33. Copyright © 2008 Delmar Learning. All rights reserved. Legal Issues You need not fear breaking laws if you are careful to: –Maintain in-service requirements of OBRA –Do no harm to the patient –Respect the patient’s belongings

34. Copyright © 2008 Delmar Learning. All rights reserved. Negligence Nursing assistants –Are educated care providers and are expected to perform in certain ways

35. Copyright © 2008 Delmar Learning. All rights reserved. Negligence You would be guilty of negligence if you injured a patient by: –Not performing your work as taught –Not carrying out your job in a conscientious manner

36. Copyright © 2008 Delmar Learning. All rights reserved. Negligence Negligence may be accidental or deliberate It may be the result of an action or omission –Failure to act In either situation, the patient is not given the expected level of care

37. Copyright © 2008 Delmar Learning. All rights reserved. False Imprisonment Restraining a person’s movement or actions without proper authorization constitutes unlawful or false imprisonment.

38. Copyright © 2008 Delmar Learning. All rights reserved. Assault and Battery Assault –Intentionally attempting to touch the body of a person or even threatening to do so Battery –Touching a person without that person’s permission

39. Copyright © 2008 Delmar Learning. All rights reserved. Abuse –Any act or failure to act that is non- accidental and causes or could cause harm or death to a patient Verbal abuse –May be directed toward a patient or expressed about a patient

40. Copyright © 2008 Delmar Learning. All rights reserved. Abuse Sexual abuse –Use of physical means or verbal threats to force a patient to perform sexual acts.

41. Copyright © 2008 Delmar Learning. All rights reserved. Abuse Physical abuse –Does actual physical harm to a patient Psychological abuse –Involves making a patient fearful of you Such as threatening not to respond when he or she calls

42. Copyright © 2008 Delmar Learning. All rights reserved. Abuse Involuntary seclusion –Involves separating a patient from other patients against the patient’s will Misappropriation of property –Involves taking or using the patient’s belongings without permission

43. Copyright © 2008 Delmar Learning. All rights reserved. Abuse by Others If you suspect a person in your care is being abused by others –Discuss this matter with your supervisor You are not responsible for determining whether abuse has occurred

44. Copyright © 2008 Delmar Learning. All rights reserved. When Your Patience Is Stressed If you feel like your own tolerance level is being tested –You need to find ways to safeguard the patient and release your stress

45. Copyright © 2008 Delmar Learning. All rights reserved. Neglect Failure to provide the services or care necessary to avoid physical harm, mental anguish, or mental illness.

46. Copyright © 2008 Delmar Learning. All rights reserved. Invasion of Privacy Patients have a right to have their person and personal affairs kept confidential.

47. Copyright © 2008 Delmar Learning. All rights reserved. Sexual Harassment Physical, verbal, or nonverbal actions or advances that are unwelcome by the other person.

48. Copyright © 2008 Delmar Learning. All rights reserved. Sexual Harassment This may be in the form of sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature.

49. Copyright © 2008 Delmar Learning. All rights reserved. Sexual Harassment Sexual harassment is illegal

50. Copyright © 2008 Delmar Learning. All rights reserved. Sexual Harassment Your facility will have policies and procedures listing actions to take and penalties if harassment occurs.

51. Copyright © 2008 Delmar Learning. All rights reserved. Sexual Harassment Upon being informed that an incident of sexual harassment has occurred: –Hospital is responsible for investigating the situation During investigation: –Facility must protect the victim from further harassment