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Health Laws and ethics report
Transcript of Health Laws and ethics report
ANDREA LOU IWARAT, RN
ARMI GRACE DEOCAMPO, RN
MARIDINE MARAMOT, RN
LARA MISTICA, RN
At the end of the discussion, the students will be able to:
Differentiate unintentional tort from intentional tort and informed consent from contract.
Illustrate the differences of these principles and utilize it in the nursing practice.
Empathize the value of these principles to be a patient advocate.
A contract is an agreement between two or more competent persons, on sufficient consideration (remuneration), to do or not to do some lawful act. (Kozier, 2008)
A contract is considered to be expressed when the two parties discuss and agree, orally or in writing, to terms and conditions during the creation of the contract.
An implied contract is one that has not been explicitly agreed to by the parties but that the law nevertheless considers existing.
A lawful contract requires the following four features (Guido, 2006):
1. Promise or agreement between two or more persons for the performance of an action or restraint from certain actions
2. Mutual understanding of the terms and meaning of the contract by all
3. A lawful purpose (the activity must be legal)
4. Compensation in the form of something of value—in most cases, compensation is monetary
Informed consent is an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment, alternatives to the treatment, and prognosis if not treated by a health care provider. (Venzon, 2010)
Two types of consent:
may be either an oral or written agreement. Usually, the more invasive a procedure and/or the greater the potential for risk to the client, the greater the need for written permission.
In an emergency, where the life of the patient is in danger and the patient cannot give the consent because of his/her condition, and his/her relatives, legal guardian or significant others are not available; the law generally agrees the consent is assumed. The doctor may proceed to the treatment as a therapeutic privilege.
The law says that a "reasonable amount" of information required for the client to make an informed decision is what any other reasonable physician or practitioner would disclose under similar circumstances (Quallich, 2005). General guidelines include the following:
a. The diagnosis or condition that requires treatment
b. The purposes of the treatment
c. What the client can expect to feel or experience
d. The intended benefits of the treatment
e. Possible risks or negative outcomes of the treatment
f. Advantages and disadvantages of possible alternatives to the treatment (including no treatment)
exists when the individual's nonverbal behavior indicates agreement.
Three major elements of informed consent:
1. The consent must be given voluntarily.
2. The consent must be given by a client or individual with the capacity and competence to understand.
3. The client or individual must be given enough information to be the ultimate decision maker.
Minors – a parent or guardian must give consent before minors can obtain treatment. Certain group of minors (married, pregnant, members of military, or emancipated – living on their own) is often legally permitted to provide their own consent.
Unconscious or injured – consent is obtained from the closest adult relative if existing statutes permit.
Mentally ill persons
The nurse is not responsible for explaining the procedure but for witnessing the client’s signature on the form. The nurse should confirm that:
1. The client gave consent voluntarily
2. The signature is authentic
3. The client appears competent to give consent
Figure 4-3 • Obtaining informed consent is the responsibility of the person performing the procedure. The nurse may be asked to witness the client's signature on the consent form.
is a civil wrong committed against a person or a person's property. Torts are usually litigated in court by civil action between individuals. In other words, the person or persons claimed to be responsible for the tort are sued for damages. Tort liability almost always is based on fault, which is something that was done incorrectly (an unreasonable act of commission) or something that should have been done but was not (an act of omission). (Kozier, 2008)
do not require intent but do require the element of harm
refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not do, and acting or the non-acting of which is the proximate cause of injury to another person or his property. (TRED, April 2012)
is the failure of a person with professional training to act in a reasonable and prudent manner. This is also called professional negligence. (Venzon, 2010)
There are five elements of professional negligence: (Venzon, 2010)
1. The existence of a duty on the part of the person charged to use standard of care in the performance of such duty;
2. Failure to meet the standards of care (breach of duty);
3. Foreseeable harm that may come if standard of care is not observed;
4. A direct relationship between the failure to use the standard of care and injury can be proved; and
5. A resulting injury
Several legal doctrines or principles related to negligence.
A lawsuit for a negligent act performed by a nurse will also name the nurse's employer. In addition, employers may be held liable for negligence if they fail to provide adequate human and material resources for nursing care, fail to properly educate nurses on the use of new equipment or procedures, or fail to orient nurses to the facility.
Res ipsa loquitur ("the thing speaks for itself").
In some cases, the harm cannot be traced to a specific health care provider or standard but does not normally occur unless there has been a negligent act.
CIVIL CODE, Article 19
One shall act with justice, give every man his due, observe honesty and good faith
CIVIL CODE, Article 20
Those who, in the performance of their obligations through negligence cause any injury to another, is liable for damages.
No harm need be caused by intentional torts for liability to exist.
is the "unjustifiable detention of a person without legal warrant to confine the person" (Guido, 2006, p. 98).
Invasion of privacy
is a direct wrong of a personal nature. It injures the feelings of the person and does not take into account the effect of revealed information on the reputation of the person in the community. The right to privacy is the right of individuals to withhold themselves and their lives from public scrutiny. It can also be described as the right to be left alone. (Kozier, 2008)
At the end of the discussion, the students will be able to:
Differentiate written defamation from oral defamation and assault form battery.
Employ the ethical principles in the nursing practice.
Share the value of these ethical principles to protect the patient and people in the health care field.
Reference to Nursing Code of Ethics Board of Nursing Resolution No. 220, Series of 2004
ARTICLE II REGISTERED NURSES AND PEOPLE
1. Values, customs, and spiritual beliefs held by individuals shall be respected.
2. Individual freedom to make rational and unconstrained decisions shall be respected.
3. Personal information acquired in the process of giving nursing care shall be held in strict confidence.
Guidelines to be observed:
REGISTERED Nurses must…
a. consider the individuality and totality of patients when they administer care.
b. respect the spiritual beliefs and practices of patients regarding diet and treatment.
c. uphold the rights of individuals.
d. take into consideration the culture and values of patients in providing nursing care. However, in the event of conflicts, their welfare and safety must take precedence.
ARTICLE III REGISTERED NURSES AND PRACTICE
1. Human life is inviolable.
2. Quality and excellence in the care of the patients are the goals of nursing practice.
3. Accurate documentation of actions and outcomes of delivered care is the hallmark
of nursing accountability.
Guidelines to be observed:
REGISTERED Nurses must
a. know the definition and scope of nursing practice which are in the provisions of R. A. No. 9173, known as the “Philippine Nursing Act of 2002” and Board Res. No. 425, Series of 2003, the “Rules and Regulations Implementing the Philippine Nursing Act. of 2002”, (the IRR).
b. be aware of their duties and responsibilities in the practice of their profession as defined in the “Philippine Nursing Act of 2002” and the IRR.
c. acquire and develop the necessary competence in knowledge, skills, and attitudes to effectively render appropriate nursing services through varied learning situations.
d. if they are administrators, be responsible in providing favorable environment for the growth and developments of Registered Nurses in their charge.
e. be cognizant that professional programs for specialty certification by the BON are accredited through the Nursing Specialty Certification Council (NSCC).
f. see to it that quality nursing care and practice meet the optimum standard of safe nursing practice.
g. insure that modification of practice shall consider the principles of safe nursing practice.
h. if in position of authority in a work environment, be normally and legally responsible for devising a system of minimizing occurrences of ineffective and unlawful nursing practice.
i. ensure that patients’ records shall be available only if they are to be issued to those who are professionally and directly involved in their care and when they are required by law.
Guidelines to be observed:
a. respect the “Patients’ Bill of Rights” in the delivery of nursing care.
b. provide the patients or their families with all pertinent information except those which may be deemed harmful to their well-being.
c. uphold the patients’ rights when conflict arises regarding management of their care.
4. Registered Nurses are the advocates of the patients: they shall take appropriate steps to safeguard their rights and privileges.
5. Registered Nurses are aware that their actions have professional, ethical, moral,
and legal dimensions. They strive to perform their work in the best interest of all concerned.
Guidelines to be observed
REGISTERED Nurses must:
a. perform their professional duties in conformity with existing laws, rules regulations, measures, and generally accepted principles of moral conduct and proper decorum.
b. not allow themselves to be used in advertisement that should demean the image of the profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc.).
c. decline any gift, favor or hospitality which might be interpreted as capitalizing on patients.
d. not demand and receive any commission, fee or emolument for recommending or referring a patient to a physician, a co-nurse or another health care worker; not to pay any commission, fee or other compensations to the one referring or recommending a patient to them for nursing care.
e. avoid any abuse of the privilege relationship which exists with patients and of the privilege access allowed to their property, residence or workplace.
TYPES OF LAW
FAILURE TO MEET STANDARD OF CARE
MUST BE PRESENT
BREACH OF DUTY
INVASION OF PRIVACY
INTENDED TO BRING ABOUT CONSEQUENCE