1. Unit 4 Legal and Ethical Responsibilities

2. 4:1 Legal Responsibilities
Legal responsibilities are based on law
Civil law – legal relationships btw people
Protection of person’s rights
Main type of law affecting health care
Tort – wrongful act that does not involve a contract
Criminal law – wrongs against a person, property or society
Can also affect health care
Ex: Practicing without a license, misuse of narcotics, murder

3. 4:1 Legal Responsibilities - Torts
Many offenses qualify as a tort (civil wrong)
Malpractice – aka “bad practice”, “prof negligence”
Failure to use proper skill and techniques
Results in injury, loss or damage to patient
Negligence – failure to give care normally expected
Results in injury of patient
Assault and battery
Assault – threat or attempt to injure
Battery – unlawful touching of another person
All patients must give informed consent for treatment

4. 4:1 Legal Responsibilities - Torts (continued)
Invasion of privacy – unnecessarily exposing patient
Also includes revealing personal info without patient’s consent
False imprisonment – restraining an individual
Abuse – any care resulting in physical or mental harm
Physical, verbal, psychological and/or sexual
All health care workers are required to report all types of abuse, even if it occurred before the patient arrived
Domestic, child, elder

5. 4:1 Legal Responsibilities - Torts (continued)
Defamation – false statement damaging person’s reputation
Slander (spoken) or Libel (written)

6. Contracts Contract law is another aspect of civil law
Def: Agreement between two or more parties
Components of contract
Offer – competent individual offers to be a patient
Acceptance – health care provider treats patient
Consideration – payment for services
Implied contract – obligations understood without verbally expressed terms
Expressed contract – stated in distinct, clear language

7. Contracts (continued)
Legal disability – if a person is legally disabled, cannot enter a contract
Need parent, guardian, spouse
Breach of contract – if contract not performed according to agreement
May be cause for legal action
Non-English speaking party – need interpreter
Agent – works under the direction of another person
Principal – employs the agent, may be held accountable for actions of the agent

8. Privileged Communications
Encompass all info given to health care personnel by patient
Info must be kept confidential
Shared only with members of patient’s health care team
Exempt info: births, deaths, injuries due to violence, drug abuse, STD, communicable diseases
Health Care Records
Considered privileged communications
Only kept for a certain amount of time, then destroyed
Patient has right to obtain a copy
Can be used in court as legal records, nothing can be erased
Corrected info should be initialed and dated, wrong info crossed out

9. Summary Important aspect of health care
All states have set rules and regulations
Most health care agencies have specific rules, regulations, and standards
Standards vary from state to state and agency to agency
Health care worker must know all legalities of what is expected of them

10. 4:2 Ethics
Def: Set principles, deals w/ what is morally right or wrong
Provide a standard of conduct or code of behavior
Help health care worker analyze information and make decisions
Ethical Dilemmas:
Euthanasia
Health care workers with HIV
Aborted fetuses – use for research?
Life support – when to discontinue?
Religion v. medical treatments

11. Basic Rules of Ethics Save lives and promote health Patient comfort
Respect the patient’s right to die peacefully
Treat all patients equally
Provide the best care possible
Maintain competency and level of skill needed
Stay informed and up to date

12. Basic Rules of Ethics (continued)
Maintain confidentiality – No Gossiping!
Refrain from immoral, unethical, illegal actions
Report others taking part in illegal actions
Show loyalty to patients, co-workers, and employers
Be sincere, honest, and caring
Treat others the way you would like to be treated

13. Summary Study the code of ethics for the occupation you enter
Abide by the code
Become a competent and ethical health care worker
Earns you the respect and confidence of patients, co-workers, and employers

14. 4:3 Patients’ Rights
Def: factors of care that patients can expect to recieve
Agencies must have written policies for patients’ rights
All personnel must respect and honor these rights
American Hospital Association has affirmed a “Patient’s Bill of Rights”
Long-term care facilities has affirmed a “Resident’s Bill of Rights”

15. Patient’s Bill of Rights
Patient has the right to:
Considerate and respectful care
Obtain complete, current info concerning diagnosis, treatment and prognosis
Receive info needed to give informed consent
Refuse treatment
Privacy and confidential treatment
Reasonable response to a request for services
Obtain info about relationship btw hospital & other institutions
Be advised of right to participate in any research project
Expect continuity of care
Review medical records & examine bills, get explanation of care
Be informed of any hospital rules or regulations

16. Resident’s Bill of Rights
Resident has the right to:
Free choice on physician, treatment, care, research participation
Freedom from abuse and chemical/physical restraints
Privacy and confidentiality of records
Accommodation of needs and choice regarding activities, schedules, heath care
Voice grievances without fear of retaliation
Organize in social, religious and community activities
Info on medical benefits, medical records, survey results, deficiencies in facility
Manage personal funds and use personal possessions
Unlimited access to family/relatives, to share a room w/ spouse
Remain in facility and not be discharged, with some exceptions

17. 4:4 Advance Directives
Def: legal documents that allow individuals to state what medical treatment they want in the event they become unable to express wishes
Also known as legal directives
Two main directives
Living wills – documents that allow individual to state what measures should be taken if in terminal condition
Must be signed with witnesses when individual is competent
Durable Power of Attorney (POA) – document that permits an individual to appoint another person to make health care decisions

18. Advance Directives (continued)
Patient Self-Determination Act (PSDA)
Law requiring health care facilities receiving federal aid comply with certain requirements
Ensures patients are informed of their rights
Health care workers must be aware of the act and honor it
Health care workers should give serious consideration to preparing their own advance directives

19. Summary
Agencies, states, and organizations have created statements on patient’s rights
By observing rights, health care workers assure patient’s safety, privacy, and well-being, and provide quality care
Advance directives must be recognized and respected by health care workers

20. 4:5 Professional Standards
Perform only those procedures for which you have been trained and are legally permitted to do.
Use approved, correct methods while performing any procedure.
Obtain correct authorization before performing any procedure.
Identify the patient and obtain patient’s consent before performing any procedures.
Observe all safety precautions.
Keep all information confidential.

21. Professional Standards (continued)
Think before you speak and watch everything you say.
Treat all patients equally.
Don’t accept tips or bribes.
If any error occurs or you make a mistake, report it immediately to your supervisor.
Behave professionally in dress, language, manners and actions.
Always carry liability insurance.

22. Summary
Know the legal and ethical implications for your particular health career
Ask questions or request written policies
Contact state board of health or education to obtain regulations and guidelines
Follow the basic standards listed
Protect yourself, your employer, and your patient for whom you provide health care