Legal and Medical Ethics Chapter 11 1. Understanding Laws, Morals, and Ethics Laws – a law, or statute, is a rule of conduct or action.

Legal and Medical Ethics

Chapter 111

Understanding Laws, Morals, and Ethics

Laws – a law, or statute, is a rule of conduct or action.

Criminal LawsCriminal Laws – protect members of society from certain harmful acts of others. A criminal act may be one of:Commission if there is a law forbidding a certain act.

Omission in violation of a law requiring a certain act.

Civil LawsCivil Laws – are concerned with private rights and remedies. Examples of the causes of civil disputes include:Contract violation.Slander or libel.Trespassing.Product liability.Automobile accidents.Family matters such as divorce, child support, and child custody.

Civil LawCourt judgments in civil cases often require the payment of a sum of money to the injured party

TortsTorts occur when a person is harmed or injured because a health care provider does not meet the established or expected standards of care.

Types of Health Care TortsMalpractice - means “bad practice” and is commonly called “professional negligence.”

Negligence- failure to give care that is normally expected of a person in a particular position

The 3 Ds must be present for negligence to occur:Duty – health care practitioner/client

relationship exists.Derelict – health care practitioner did not live

up to the obligation of caring for a client.Damage – the breach of duty results in

damages to the client or plaintiff.

Physicians are most likely to be charged with negligence. However, other health care practitioners may be subject to such charges.

Assault and battery: assault includes a threat or attempt to injure; battery includes the unlawful touching of another person without consent

Types of Health Care TortsInvasion of privacy: includes unnecessarily

exposing an individual or revealing personal information about an individual without that person's consent.

False imprisonment: refers to restraining an individual or restricting an individual’s freedom

Abuse: any care resulting in physical harm, pain, or mental anguish.

Types of Health Care TortsDefamation: occurs when false statements

either cause a person to be ridiculed or damage the person’s reputation.Slander: written defamationLibel: spoken defamation

MoralsMorals and ethics also affect your work

in a health care professionMorals are formed from your personal

values- your concept of right and wrong. You develop moral values through the influence of family, culture, and society. Acting morally toward others involves treating them the way you would like to be treated.

Ethics

Ethics are standards of behavior developed as a result of your moral values.

Ethics are not the same as lawsHowever, ethics may govern behavior more

strictly than laws

Code of Ethics

Codes of ethics related to health care delivery do not provide solutions to issues but have been developed by most health care organization to help their professional members with difficult decisions

NoncomplianceNoncompliant health care workers may face fines or prison sentences and can lose their licenses to practice their profession.

Unethical conduct may result in expulsion or censure from your professional organization, but only the state can revoke a license.

History of Ethics

HippocratesMaimonidesNightingale PledgeDeclaration of Geneva

Hippocrates

During the Greek AgeFather of Medicinewrote standards of ethics which is the basis

for today’s medical ethics

Maimonides

Lived during the middle agesImportant Jewish philosopherHe worked as a physician but also become

a scholar of Jewish law and a philosopherThe oath of Mainonides was written around

the late 1700’s

Florence NightengaleLived from 1820-1910Pioneer of Nursingreformer of hospital sanitation methods nursing students honor the dedication of

Nurse Nightingale and symbolically plan to carry the ideals for which she stood in the Candle lighting portion of the pinning ceremony. The tradition of Candle lighting and Pledge recognizes her ideals.

Declaration of GenevaThe World Medical Association is an

association of national medical associationsThe oath seems to be a response the

atrocities committed by doctors in Nazi Germany

The oath requires the physician to “not use (his) medical knowledge contrary to the laws of humanity”

Guiding Principles of Health Care EthicsPreserve Life: Give all patients

caring attention. Learn about the stages of death and dying. Be familiar with the laws regarding organ donation

Do Good: Treat every patient with respect and courtesy. Serve as role model for healthy living

Respect Autonomy: make sure patients have consented to all procedures. Know about advance directives

Uphold Justice: treat all patients equally, regardless of economic or social background. Follow all safety rules and OSHA guidelines to ensure the safety of yourself and others.

Honesty: admit mistakes promptly. Refuse to participate in any form of fraud. Never perform a procedure or give treatment that you are not qualified to perform. Give an “honest day’s work” everyday

Dependability: Complete assigned tasks and ask questions to be sure you understand an assignment before starting it.

Be discreet: never release patient information of any kind unless there is a signed release. Do not discuss patients with anyone who is not professionally involved in their care. Protect the physical privacy of patients.

Do No Harm: Focus on providing excellent customer service. Keep your skills up to date. Stay informed about new laws that affect health care.

Terms you need to know

LicensureLicensure – is required for certain professions within a state.

RegistrationRegistration

Adding one’s name in an official registry or record as having satisfied the requirements for a certain health care occupation.

Fulfilling certain education requirements and/or paying a registration fee.

CertificationCertification – usually voluntary.Reciprocity – when state licensing authorities accept a person’s valid license from another state.

Standard of CareStandard of care is the level of

performance expected of a health care worker in carrying out his or her professional duties

Scope of PracticeWorking outside your scope of practice can make you liable.

Working within your scope of practice ensures that you: Do not injure clients or put them at risk by performing procedures that are beyond your ability.

Will not be held liable for a standard of care that is beyond your training, experience, and job description if a legal situation arises

Law of AgencyThe Law of Agency – an

employer is legally liable for acts performed by employees.

Informed ConsentInformed Consent – in order for a client to make an informed decision regarding treatment, the client needs to be told the following:The proposed methods of treatment.Why the treatment is necessary.The risks involved in the proposed treatment.

All available alternative types of treatment.

The risks of any alternative methods of treatment.

The risks involved if treatment is refused.

People who cannot give informed consent include:Minors – individuals under the age of majority which is 18 years of age in some states and 21 in others.

Mentally incompetent individuals – persons judged by the court to be insane, senile, mentally retarded, or under the influence of drugs or alcohol.

Speakers of a foreign language who do not speak English

Confidentiality

It is illegal and unethical if a health care worker does not observe confidentiality.

Privileged communication refers to information held confidential within a protected relationship.