Chapter 3

1. Chapter 3 Medical Ethics and Law

2. Values • Health Care workers are expected to live by values that show others respect. • Dignity- be honest, trustworthy, truthful, sincere and respectul to others. Can be shown by listening actively, being positive, showing understanding and respect. • Spirit ofService- responding to pt. w/ understanding of unique needs.

3. Excellence-taking responsibility for yourself, your team and the result of your actions. Learning new skills by accepting and seeking feedback for improvement. You can never be perfect! • Fairness/Justice-treat all people with respect and provide the same dignity, service and excellence regardless of the pt’s race/beliefs/background or financial resources.

4. Dignity • Know your limitations- • Be sincere • Be well groumed • Communicate Effectively

5. Service • Be a good citizen • Be caring • Have a good attitude • Body Language, Facial Expressions

6. Excellence • Be accountable • Be informed • Follow the rules and regulations • Be dependable

7. Fairness and Justice • Be loyal …to who • Respect the privacy of others-confidential • Be Honest

8. Patient Satisfaction • Do they always get what they want… • What do pt’s get… • Pt. should be informed about • What • Why • Who • When • How

9. Welcome pts and visitors in warm manner Listen to and communicate with one another Have respect for ea. Person and their privacy, comfort, dignity Use good elevator manners Provide a safe, clean environment Anticipate the wants and needs of those served. Strive to do your best. Communication Objectives

10. The Team Concept • Each member is an important part of Interdisciplinary team • Professionals with different backgrounds, education, interests all work together. • Delegates duties by using the five rights of delegation: • Right Tasks • Right circumstances • Right person • Right direction • Right supervision

11. Summary • You are part of a team and must act that way. • Ethical Behavior protects you and the pt. • Dignity, service, excellence and fairness/justice are essential for every health care worker.

12. http://www.ama-assn.org/ama/pub/category/2512.html

13. Patients Bill of Rights. • Legal Roles and Responsibilities of a Health Care Worker • Rights are legislated by both federal and state governments. • The health care worker is legally bound to provide care as it is stated in the • Patients Bill of Rights.

14. Bill of Rights • Right to considerate and respectful care • Right to relevant, current and understandable information • Right to discuss and request info. • Right to know identity of physicians, nurses and others involved with them • Right to know immediate and longterm financial implications

15. Right to make decisions about plan of care, and right to refuse treatment. • Right to an advanced care directive • Right to privacy and confidentiality • Except in cases such as suspected abuse and public health hazards when reporting is permitted. • Right to review records and have information explained. • Right to expect that a hospital will meet any reasonable request. • Right to decline or accept to participate in research studies • Right to be informed of hospital policies and practices that relate to pt. care

16. Natural Death Guidelines and Declarations • Advanced directive- a document that ensures the right to accept or refuse medical care. It provides pt’s a way to express how they want medical decisions made if they are unable to make decisions • Living Will- provides a way for a person to express his/her desire for or against extraordinary measures that could prolong life. Takes affect while a person is still living.

17. Health Care Power of Attorney- allows an authorized person to make health care decisions for an individual if they are unable to do so. More flexible than a living will and can cover temporary unconsciousness, or when a pt is unable to make decisions. • Durable Power of Attorney for Health Care- document that names an authorized person to make medical decisions for the individual if he/she is unable to make them. Includes instructions about treatment to avoid.

18. Ombudsman • A social worker, nurse or trained volunteer who makes certain that the pt is not abused and that the person’s rights are secure

19. Controls on HC workers • License, Certification and Registration • Tell what a hcw may or may not do • Determines scope of practice • Controls help to improve the quality of care

20. Licensure • Given by a govenmental agency when a person meets the qualifications for a particular occupation.

21. Certification • Given for Recognition • If specific guidelines must be met the certification = licensure

22. Registration • List of individuals on an official record who meet the qualifications for an occupation. • exp) registered nurse.

23. Legal Terms and boundaries • Assault- a threat or attempt to injure • Battery-unlawful touching w/out consent that may or may not end in injury • Often charged together because of a successful attempt to injure.

24. Informed consent- persmission granted by a person in his right mind • Crime-performing a forbidden act or from the omission or a duty commanded by public law. • Libel-writing defamatory matter about an individual or group to 3rd party. • Slander- spoken statement of false charges or misrepresentations that defame or damage another's rep.

25. False imprisonment- holding or retaining a person against their will • Felony-a serious crime that carries a penalty of imprisonment for more that 1 year and possibly death. • Invasion of privacy- civil wrong that makes public knowledge of any private or personal info w/o consent of person • malpractice- “bad practice” care that leads to faulty practice or neglect • Negligence- failure to perform in a reasonably prudent manner. • Privileged communication- any personal or private information given by a pt/client to hcw that is relevant to his/her care. (all info in chart) • Reasonable Care- is the legal obligation of hcw. Must perform to the standards of practice expected in their community

26. Sexual Harassment- unwelcome sexual advances, request for sexual favors and other verbal and physical contact of a sexual nature. Innocent remarks, inappropriate pictures and written material can be perceived as sexual. • Will- legal document that defines the disposition of property and takes effect after death. • Reportable incidents and conditions- the hcw is obligated to file a confidential report to the county health department when child abuse or adult abuse is suspected. Also required when certain diseases are diagnosed.

27. How should it be decided who receives scarce organs for transplantation? • Do people have a right to reproduce no matter what the risks or costs? (Consider cases where there is a high probability of passing on genetic disorders or diseases like Huntington's disease or AIDS, and cases of couples under 18 years of age or mentally impaired. If we have a right to reproduce, can such people be excluded? Also, consider cases of couples who cannot reproduce by "normal" means. Is society obligated to pay for their reproductive efforts if people have a right to reproduce? And if we have such a right, where does it come from (i.e., is it moral, legal, etc.)?)

28. Should parents alone control consent (i.e., agree to or refuse treatment) for medical procedures on their children? Who should get to decide consent for children if you think it shouldn't be left entirely to the parents?