Medical law and ethics
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Medical Law and Ethics. TOPICS. Key Terms Legal responsibilities in health care Ethics Professional Standards. Law & Ethics in HC. The law affects all health care careers Awareness of the law protects you, your co-workers, your patients and your employer

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Topics
TOPICS

  • Key Terms

  • Legal responsibilities in health care

  • Ethics

  • Professional Standards


Law ethics in hc
Law & Ethics in HC

  • The law affects all health care careers

  • Awareness of the law protects you, your co-workers, your patients and your employer

  • Laws are created/enforced by federal, state and local government


Law ethics in hc1
Law & Ethics in HC

  • Health care workers must follow laws that affect health care, as well as those laws that regulate their license, registrations and/or standards for their profession

  • Failure to follow the law may result in legal action against you and/or your employer


Legal terminology
Legal Terminology

  • Liable: accountable under the law

  • Criminal Law: wrongs against a person, property or society (crime). Includes felonies and misdemeanors.

  • Civil Law: wrongful acts. Involve legal relationships between people and protection of rights

  • Civil law generally covers 2 areas: torts and contracts


Torts
Torts

  • Tort: wrongful act that does not involve a contract. Can be intentional or unintentional

  • Many torts can lead to legal action

  • Common torts that can affect health care workers:


Types of torts
Types of Torts

  • 1. Negligence: failure to give care normally expected for that position

    • Example: ?

  • 2. Malpractice: bad practice, professional negligence. Failure of a professional to use expected degree of skill; not following professional standards

    • Example: ?


  • 3. Assault: threaten to harm; results in fear

  • 4. Battery: unlawful touching without consent

  • 5. Invasion of Privacy: unnecessary exposure or revealing of personal information w/out consent

    • Example?

  • 6. False Imprisonment: unlawful restraint or confinement

    • Example?




Contracts
Contracts Incorrect info given out in error can result in this

  • Agreement between 2 or more parties; specific promises made for a consideration

  • Elements of a contract:

  • Agreement: offer is made and accepted

  • Consideration: something of value is bargained for as part of the agreement

  • Legal subject matter: legally enforceable

  • Contractual capacity: parties must be competent to enter contract


  • Two types of contracts: Incorrect info given out in error can result in this

  • 1. Implied Contract: obligations understood w/out verbal expression

  • 2. Expressed Contract: stated in distinct language either verbally or in writing


Consent
Consent Incorrect info given out in error can result in this

  • Permission from pt, either expressed or implied for something to be done.

  • Can be verbal, written or implied

  • All consent must be “informed”: implies that pt understands tx, why it is nec, tx risks, alternatives, risks if tx is refused

  • Pt must be of sound mind and legal age to give consent


Legal disability
Legal Disability Incorrect info given out in error can result in this

  • No legal capacity to enter into a contract

  • Includes: minor, mentally incompetent, unconscious, altered mental state

  • Parent, guardian, spouse must then form the contract for the legally disabled


Breach of contract
Breach of Contract Incorrect info given out in error can result in this

  • Contract not performed according to the agreement

  • Ex: pt fails to pay or provider fails to provide care

  • Can lead to legal action


Contract law
Contract Law Incorrect info given out in error can result in this

  • Employer: principal

  • Employee: agent

  • The principal is responsible for the actions of the agent


A case scenario
A case scenario Incorrect info given out in error can result in this

  • http://www.bestcare.org/mhsbase/mhs.cfm/SRC=SP/SRCN=serv_detail/GnavID=68/servid=420


Privileged communication legal responsibilities
Privileged Communication & Legal Responsibilities Incorrect info given out in error can result in this

  • All info given to hc personnel by the patient; held in confidence

  • Confidential and can only be shared w/ members of the hc team

  • Cannot be relayed w/out consent

  • Exempt: births, deaths, injury cb violence, drug abuse, communicable diseases, STDs


Medical records
Medical Records Incorrect info given out in error can result in this

  • Privileged communication

  • Property of facility but pt owns the info and has right to review/obtain copies

  • Legal record

  • Must be kept in secure area

  • Shred after legal retention date expires


Legal responsibilities
Legal Responsibilities Incorrect info given out in error can result in this

  • No erasures, blank spaces.

  • Errors according to policy

  • Shred carbons

  • Don’t share computer passwords

  • Faxes & computer screens in secure area

  • Limit personnel who can access

  • Pt can request to amend

  • De-identify for use by students


5 c s of documentation
5 C’s of Documentation Incorrect info given out in error can result in this

  • Concise

  • Complete (and objective)

  • Clear (and legible)

  • Correct

  • Chronological


Hippa health info privacy
HIPPA Health Incorrect info given out in error can result in thisInfo Privacy

  • Enacted 1996, effective 2003

  • Standards to protect private communication

  • Patient rights:

  • Able to see/obtain med records

  • Able to set limits how health info used

  • Providers must keep PHI confidential

  • Right to state who can access

  • Info to report violations


Ethics
Ethics Incorrect info given out in error can result in this

  • Set of principles associated w/ what is right and wrong

  • Provide standard of conduct & code of behavior

  • Allow HCW to analyze situations and make decisions based on what is right or wrong


Ethics1
Ethics Incorrect info given out in error can result in this

  • Many ethical dilemmas today; primarily due to advancing technology

  • Important for individuals to consider how they would handle situations that would require ethical decision making


Rules of ethics
Rules of Ethics Incorrect info given out in error can result in this

  • Saving a life, health promotion comes first

  • Keep pt comfortable, preserve life

  • Respect pt choices

  • Tx pts equally

  • Provide care for all to best of ability

  • Maintain a competent skill level

  • Pursue continued education


Ethics in hc
Ethics in HC Incorrect info given out in error can result in this

  • Maintain pt confidentiality

  • Refrain from all illegal, unethical, immoral practices

  • Show loyalty to pt, co-workers and employer

  • Be sincere, honest, respectful and caring

  • Treat others as you would want to be treated


Patient rights
Patient Rights Incorrect info given out in error can result in this

  • Federal and state law require

  • AHA: Patient Bill of Rights

  • The patient is entitled to certain rights:

  • Considerate and respectful care

  • Info re dx, tx, prognosis

  • Info necessary to give informed consent

  • Confidentiality and privacy

  • Advanced Directives


Patient rights1
Patient Rights Incorrect info given out in error can result in this

  • To refuse to participate in research

  • Review med records and receive explanation of charges

  • Info about hosp rules, regs and policies

  • Continuity of care; Reasonable response to request for services

  • Info re: relationship of hosp to other hc and educational organizations


OBRA Incorrect info given out in error can result in this

  • OBRA: Residents Bill of Rights

  • Free to choose MD, tx, care

  • No abuse, chemical or physical restraints

  • Confidentiality and privacy

  • Accommodate needs and choice re activities, schedule and home care

  • Voice grievances

  • Participate in activities

  • Manage personal funds and possessions


Patient rights2
Patient Rights Incorrect info given out in error can result in this

  • Unlimited access to family

  • No transfer or d/c except for med reasons, failure to pay

  • Info about med benefits, survey results and facility deficiencies

  • These rights vary by state


Advanced directives
Advanced Directives Incorrect info given out in error can result in this

  • Legal documents that state what med tx may be carried out in the event that an individual becomes incapacitated or unable to express their wishes


1 living will
1. Living Will Incorrect info given out in error can result in this

  • What measures may or may not be taken to prolong life if there is a terminal condition or permanent unconsciousness

  • Must be signed when competent and witnessed by 2 adults

  • Most states have laws to protect this

  • May result in DNR


2 durable power of attorney
2. Durable Power of Attorney Incorrect info given out in error can result in this

  • Permits the appointment of another to make medical decisions if you become unable to do so

  • Includes providing or withholding tx or procedures

  • Must be signed by both parties and witnessed

  • Usually spouse or adult children


Pt self determination act
Pt Self Determination Act Incorrect info given out in error can result in this

  • Federal Law requiring hc facilities to inform pts of:

  • Their right to make decisions to refuse tx and right to die

  • Provide info on Adv Directives

  • Document Adv Dir in chart

  • Not discriminate based on Adv Dir


Professional standards
Professional Standards Incorrect info given out in error can result in this

  • Standard of care: level of performance expected when carrying out prof duties

  • Practice w/in scope of expertise and training: perform procedures you are trained and legally permitted to perform

  • Use approved, correct methods

  • Obtain appropriate authorization

  • Identify pt and obtain consent

  • Observe safety precautions

  • Maintain confidentiality


Professional standards1
Professional Standards Incorrect info given out in error can result in this

  • Accurate documentation

  • Follow legal and ethical guidelines

  • Meet requirements for professional credentialing

  • Think before you speak

  • Tx all pts =

  • No tips or bribes

  • Report all errors immediately

  • Professional manner, dress, language and action


Prof stand protect you your co workers and your patients
Prof. Stand. protect you, your co-workers and your patients Incorrect info given out in error can result in this


Good samaritan law
Good Samaritan Law Incorrect info given out in error can result in this

  • Protects Dr’s, RN’s and some other professions from liability when rendering emergency care

  • Must act within scope of practice

  • Proven willful wrongs or gross negligence will result in liability

  • Laws vary by state


Job classifications
Job Classifications Incorrect info given out in error can result in this

  • Licensure: mandatory credentialing process; required by state; grants right to practice

  • Certification: voluntary credentialing process; usually national in scope, sponsored by private groups

  • Registration: entry in an official registry: list of names who have satisfied certain requirements. May involve fees and education.


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