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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: ?
slide8
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?
slide9
7. Abuse: treatment of another that results in physical harm or mental anguish
  • Can be physical, verbal, psychological, sexual
  • Health care workers are required by law to report
  • Signs?
slide10
8. Defamation: false statements that damage reputation. Incorrect info given out in error can result in this
  • Slander: info. is spoken
  • Libel: info is written
  • Example?
  • 9. Fraud: deceitful practices depriving another of their rights
  • Example?
contracts
Contracts
  • 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
slide12
Two types of contracts:
  • 1. Implied Contract: obligations understood w/out verbal expression
  • 2. Expressed Contract: stated in distinct language either verbally or in writing
consent
Consent
  • 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
  • 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
  • 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
  • Employer: principal
  • Employee: agent
  • The principal is responsible for the actions of the agent
a case scenario
A case scenario
  • http://www.bestcare.org/mhsbase/mhs.cfm/SRC=SP/SRCN=serv_detail/GnavID=68/servid=420
privileged communication legal responsibilities
Privileged Communication & Legal Responsibilities
  • 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
  • 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
  • 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
  • Concise
  • Complete (and objective)
  • Clear (and legible)
  • Correct
  • Chronological
hippa health info privacy
HIPPA Health Info 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
slide29
OBRA
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
good samaritan law
Good Samaritan Law
  • 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
  • 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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