Medical Law and Ethics. TOPICS Key Terms Legal responsibilities in health care Ethics Professional Standards.
Post on 26-Dec-2015
216 Views
Preview:
Transcript
Medical Law and EthicsMedical Law and Ethics
TOPICSTOPICS
Key TermsKey Terms
Legal responsibilities in health careLegal responsibilities in health care
EthicsEthics
Professional StandardsProfessional Standards
Law & Ethics in HCLaw & Ethics in HC
The law affects all health care The law affects all health care careerscareers
Awareness of the law protects you, Awareness of the law protects you, your co-workers, your patients and your co-workers, your patients and your employeryour employer
Laws are created/enforced by Laws are created/enforced by federal, state and local governmentfederal, state and local government
Law & Ethics in HCLaw & Ethics in HC
Health care workers must follow laws Health care workers must follow laws that affect health care, as well as that affect health care, as well as those laws that regulate their those laws that regulate their license, registrations and/or license, registrations and/or standards for their professionstandards for their profession
Failure to follow the law may result in Failure to follow the law may result in legal action against you and/or your legal action against you and/or your employeremployer
Legal TerminologyLegal Terminology
Liable: accountable under the lawLiable: accountable under the law Criminal Law: wrongs against a Criminal Law: wrongs against a
person, property or society (crime). person, property or society (crime). Includes felonies and misdemeanors. Includes felonies and misdemeanors.
Civil Law: wrongful acts. Involve legal Civil Law: wrongful acts. Involve legal relationships between people and relationships between people and protection of rightsprotection of rights
Civil law generally covers 2 areas: Civil law generally covers 2 areas: torts and contractstorts and contracts
TortsTorts
Tort: wrongful act that does not Tort: wrongful act that does not involve a contract. Can be intentional involve a contract. Can be intentional or unintentionalor unintentional
Many torts can lead to legal actionMany torts can lead to legal action Common torts that can affect health Common torts that can affect health
care workers:care workers:
Types of TortsTypes of Torts
1. Negligence: failure to give care 1. Negligence: failure to give care normally expected for that positionnormally expected for that position Example: ?Example: ?
2. Malpractice: bad practice, 2. Malpractice: bad practice, professional negligence. Failure of a professional negligence. Failure of a professional to use expected degree professional to use expected degree of skill; not following professional of skill; not following professional standardsstandards Example: ?Example: ?
3. Assault: threaten to harm; results in fear3. Assault: threaten to harm; results in fear 4. Battery: unlawful touching without 4. Battery: unlawful touching without
consentconsent 5. Invasion of Privacy: unnecessary 5. Invasion of Privacy: unnecessary
exposure or revealing of personal exposure or revealing of personal information w/out consentinformation w/out consent Example?Example?
6. False Imprisonment: unlawful restraint or 6. False Imprisonment: unlawful restraint or confinementconfinement Example?Example?
Types of Torts (Cont.)
7. Abuse: treatment of another that results 7. Abuse: treatment of another that results in physical harm or mental anguishin physical harm or mental anguish
Can be physical, verbal, psychological, Can be physical, verbal, psychological, sexualsexual
Health care workers are required by law to Health care workers are required by law to reportreport
Signs?Signs?
Types of Torts (Cont.)
8. Defamation: false statements that 8. Defamation: false statements that damage reputation. Incorrect info given damage reputation. Incorrect info given out in error can result in thisout in error can result in this
Slander: info. is spokenSlander: info. is spoken Libel: info is writtenLibel: info is written Example?Example? 9. Fraud: deceitful practices depriving 9. Fraud: deceitful practices depriving
another of their rightsanother of their rights Example?Example?
Types of Torts (Cont.)
ContractsContracts
Agreement between 2 or more parties; Agreement between 2 or more parties; specific promises made for a specific promises made for a considerationconsideration
Elements of a contract: Elements of a contract: Agreement: offer is made and acceptedAgreement: offer is made and accepted Consideration: something of value is Consideration: something of value is
bargained for as part of the agreementbargained for as part of the agreement Legal subject matter: legally enforceableLegal subject matter: legally enforceable Contractual capacity: parties must be Contractual capacity: parties must be
competent to enter contract competent to enter contract
Two types of contracts: Two types of contracts: 1. Implied Contract: obligations 1. Implied Contract: obligations
understood w/out verbal expressionunderstood w/out verbal expression
2. Expressed Contract: stated in 2. Expressed Contract: stated in distinct language either verbally or in distinct language either verbally or in writingwriting
ConsentConsent
Permission from pt, either expressed Permission from pt, either expressed or implied for something to be done.or implied for something to be done.
Can be verbal, written or impliedCan be verbal, written or implied All consent must be “informed”: All consent must be “informed”:
implies that pt understands tx, why it implies that pt understands tx, why it is nec, tx risks, alternatives, risks if tx is nec, tx risks, alternatives, risks if tx is refusedis refused
Pt must be of sound mind and legal Pt must be of sound mind and legal age to give consentage to give consent
Legal DisabilityLegal Disability
No legal capacity to enter into a contractNo legal capacity to enter into a contract
Includes: minor, mentally incompetent, Includes: minor, mentally incompetent, unconscious, altered mental stateunconscious, altered mental state
Parent, guardian, spouse must then form Parent, guardian, spouse must then form the contract for the legally disabledthe contract for the legally disabled
Breach of ContractBreach of Contract
Contract not performed according to Contract not performed according to the agreementthe agreement
Ex: pt fails to pay or provider fails to Ex: pt fails to pay or provider fails to provide careprovide care
Can lead to legal actionCan lead to legal action
Privileged Communication & Privileged Communication & Legal Responsibilities Legal Responsibilities
All info given to hc personnel by the All info given to hc personnel by the patient; held in confidencepatient; held in confidence
Confidential and can only be shared w/ Confidential and can only be shared w/ members of the hc teammembers of the hc team
Cannot be relayed w/out consentCannot be relayed w/out consent Exempt: births, deaths, injury cb violence, Exempt: births, deaths, injury cb violence,
drug abuse, communicable diseases, STDsdrug abuse, communicable diseases, STDs
Medical RecordsMedical Records
Privileged communicationPrivileged communication Property of facility but pt owns the Property of facility but pt owns the
info and has right to review/obtain info and has right to review/obtain copiescopies
Legal recordLegal record Must be kept in secure areaMust be kept in secure area Shred after legal retention date Shred after legal retention date
expiresexpires
Legal ResponsibilitiesLegal Responsibilities
No erasures, blank spaces. No erasures, blank spaces. Errors according to policyErrors according to policy Shred carbonsShred carbons Don’t share computer passwordsDon’t share computer passwords Faxes & computer screens in secure Faxes & computer screens in secure
areaarea Limit personnel who can accessLimit personnel who can access Pt can request to amendPt can request to amend De-identify for use by studentsDe-identify for use by students
5 C’s of Documentation5 C’s of Documentation
ConciseConcise Complete (and objective)Complete (and objective) Clear (and legible)Clear (and legible) CorrectCorrect ChronologicalChronological
HIPPA Health Info Privacy HIPPA Health Info Privacy
Enacted 1996, effective 2003Enacted 1996, effective 2003 Standards to protect private Standards to protect private
communicationcommunication Patient rights:Patient rights: Able to see/obtain med recordsAble to see/obtain med records Able to set limits how health info usedAble to set limits how health info used Providers must keep PHI confidentialProviders must keep PHI confidential Right to state who can accessRight to state who can access Info to report violationsInfo to report violations
EthicsEthics
Set of principles associated w/ what Set of principles associated w/ what is right and wrongis right and wrong
Provide standard of conduct & code Provide standard of conduct & code of behaviorof behavior
Allow HCW to analyze situations and Allow HCW to analyze situations and make decisions based on what is make decisions based on what is right or wrongright or wrong
EthicsEthics
Many ethical dilemmas today; Many ethical dilemmas today; primarily due to advancing primarily due to advancing technologytechnology
Important for individuals to consider Important for individuals to consider how they would handle situations how they would handle situations that would require ethical decision that would require ethical decision makingmaking
Rules of EthicsRules of Ethics
Saving a life, health promotion Saving a life, health promotion comes firstcomes first
Keep pt comfortable, preserve lifeKeep pt comfortable, preserve life Respect pt choicesRespect pt choices Tx pts equallyTx pts equally Provide care for all to best of abilityProvide care for all to best of ability Maintain a competent skill levelMaintain a competent skill level Pursue continued educationPursue continued education
Ethics in HCEthics in HC
Maintain pt confidentialityMaintain pt confidentiality Refrain from all illegal, unethical, Refrain from all illegal, unethical,
immoral practicesimmoral practices Show loyalty to pt, co-workers and Show loyalty to pt, co-workers and
employeremployer Be sincere, honest, respectful and Be sincere, honest, respectful and
caringcaring Treat others as you would want to be Treat others as you would want to be
treatedtreated
Patient RightsPatient Rights Federal and state law requireFederal and state law require AHA: Patient Bill of RightsAHA: Patient Bill of Rights The patient is entitled to certain rights:The patient is entitled to certain rights: Considerate and respectful careConsiderate and respectful care Info re dx, tx, prognosisInfo re dx, tx, prognosis Info necessary to give informed Info necessary to give informed
consentconsent Confidentiality and privacyConfidentiality and privacy Advanced DirectivesAdvanced Directives
OBRAOBRA
OBRA: Residents Bill of RightsOBRA: Residents Bill of Rights Free to choose MD, tx, careFree to choose MD, tx, care No abuse, chemical or physical restraintsNo abuse, chemical or physical restraints Confidentiality and privacyConfidentiality and privacy Accommodate needs and choice re Accommodate needs and choice re
activities, schedule and home careactivities, schedule and home care Voice grievancesVoice grievances Participate in activitiesParticipate in activities Manage personal funds and possessionsManage personal funds and possessions
Patient RightsPatient Rights
To refuse to participate in researchTo refuse to participate in research Review med records and receive Review med records and receive
explanation of chargesexplanation of charges Info about hosp rules, regs and policiesInfo about hosp rules, regs and policies Continuity of care; Reasonable Continuity of care; Reasonable
response to request for servicesresponse to request for services Info re: relationship of hosp to other hc Info re: relationship of hosp to other hc
and educational organizationsand educational organizations
Patient RightsPatient Rights
Unlimited access to familyUnlimited access to family No transfer or d/c except for med No transfer or d/c except for med
reasons, failure to payreasons, failure to pay Info about med benefits, survey Info about med benefits, survey
results and facility deficienciesresults and facility deficiencies These rights vary by stateThese rights vary by state
Advanced DirectivesAdvanced Directives
Legal documents that state what Legal documents that state what med tx may be carried out in the med tx may be carried out in the event that an individual becomes event that an individual becomes incapacitated or unable to express incapacitated or unable to express their wishes their wishes
1. Living Will1. Living Will
What measures may or may not be What measures may or may not be taken to prolong life if there is a taken to prolong life if there is a terminal condition or permanent terminal condition or permanent unconsciousnessunconsciousness
Must be signed when competent and Must be signed when competent and witnessed by 2 adultswitnessed by 2 adults
Most states have laws to protect thisMost states have laws to protect this May result in DNRMay result in DNR
2. Durable Power of Attorney2. Durable Power of Attorney
Permits the appointment of another Permits the appointment of another to make medical decisions if you to make medical decisions if you become unable to do sobecome unable to do so
Includes providing or withholding tx Includes providing or withholding tx or proceduresor procedures
Must be signed by both parties and Must be signed by both parties and witnessedwitnessed
Usually spouse or adult children Usually spouse or adult children
Pt Self Determination ActPt Self Determination Act
Federal Law requiring hc facilities to Federal Law requiring hc facilities to inform pts of:inform pts of:
Their right to make decisions to Their right to make decisions to refuse tx and right to dierefuse tx and right to die
Provide info on Adv DirectivesProvide info on Adv Directives Document Adv Dir in chartDocument Adv Dir in chart Not discriminate based on Adv DirNot discriminate based on Adv Dir
Professional StandardsProfessional Standards
Standard of care: level of performance Standard of care: level of performance expected when carrying out prof dutiesexpected when carrying out prof duties
Practice w/in scope of expertise and Practice w/in scope of expertise and training: perform procedures you are training: perform procedures you are trained and legally permitted to performtrained and legally permitted to perform
Use approved, correct methodsUse approved, correct methods Obtain appropriate authorizationObtain appropriate authorization Identify pt and obtain consentIdentify pt and obtain consent Observe safety precautionsObserve safety precautions Maintain confidentialityMaintain confidentiality
Professional StandardsProfessional Standards
Accurate documentationAccurate documentation Follow legal and ethical guidelinesFollow legal and ethical guidelines Meet requirements for professional Meet requirements for professional
credentialingcredentialing Think before you speakThink before you speak Tx all pts =Tx all pts = No tips or bribesNo tips or bribes Report all errors immediatelyReport all errors immediately Professional manner, dress, language Professional manner, dress, language
and actionand action
Prof. Stand. protect you, your co-Prof. Stand. protect you, your co-workers and your patientsworkers and your patients
Good Samaritan LawGood Samaritan Law
Protects Dr’s, RN’s and some other Protects Dr’s, RN’s and some other professions from liability when professions from liability when rendering emergency carerendering emergency care
Must act within scope of practiceMust act within scope of practice Proven willful wrongs or gross Proven willful wrongs or gross
negligence will result in liabilitynegligence will result in liability Laws vary by stateLaws vary by state
Job ClassificationsJob Classifications
Licensure: mandatory credentialing Licensure: mandatory credentialing process; required by state; grants right to process; required by state; grants right to practicepractice
Certification: voluntary credentialing Certification: voluntary credentialing process; usually national in scope, process; usually national in scope, sponsored by private groupssponsored by private groups
Registration: entry in an official registry: Registration: entry in an official registry: list of names who have satisfied certain list of names who have satisfied certain requirements. May involve fees and requirements. May involve fees and education.education.
top related