Legal issues Ch 7

1. Legal issuesCh 7

2. Legal issues are those that are decided by law.

3. Law:- • is the system of binding rules of action or conduct that governs the behavior of people in respect to relationship with others and with government

4. Basic function of law in society • Define relationships among members of society and to declare which actions are and are not permitted • Describe what constraints may be applied to maintain rules, and by whom they may be applied • To furnish solution to problem • Redefine relationships between people and groups when circumstances of life change

5. Laws ensure the safety of citizen, protect property, promote non discrimination ,regulate profession….. • The law establishes rules that define our right and obligations, and sets penalties for people who violate them

6. Relation of law with ethics • Reflect moral belief • Convert morality into social guide lines • Congruency

7. Why Ethics & law different some times • Ethical point of view (deontology and utilitarianism) • Human behavior & motivation are complex than can be fairly reflected in law as in moral development) • Legal judge actions not motivation • Law change (abortion, organ transplant)

8. Why nurses should be familiar with law • Authorize & regulate nursing actions • scrutinizes nursing actions (Dynamic profession) • Legal knowledge necessary for ethical decision making

9. Sources of law: • Constitutional(Jordan,USA) • Statutory /Legislative(Congress) • Administrative (Nsg state board) • Common (Court rules)

10. Constitutional • formal set of rules and principles that describe power of government and the rights of the people. The principles laid out in a constitution, coupled with a description of how these principles are to be interpreted and carried out

11. Example: Bills of rights • Citizen rights, freedom of speech, freedom of religion • ( nurse must be aware that Bills of rights of united state constitution are consistent with ethical principles autonomy, confidentiality, respect of person and veracity

12. Statutory/legislative • A statue is a rule or formal regulation established by governmental legislative authority that appears in writing • Violation of a statute is legally punishable • It is published in codes and written down as specific rules • E.g. statutory recognition of nurses in advanced practice (prescriptive authority), health care legislation

13. Administrative:- • the operation of governmental agencies, national, state and local government set up administrative agencies to do work of government • These agencies regulate such activities as education, public health, proffession • E.g: state board of nursing. • The role of board of nursing is protect the public rather than advocate for nurses

14. Common law( case law) • are constituting the basis of the judicial system • These are known as precedents. Over time take on the force of law • In the common law, decision are based upon earlier court ruling in similar cases

15. Public Types of law Private • Public law • Define person’s rights and obligations in relation to government, describe division of government and their power • One branch of Public law is criminal law (deals with crimes)- actions that considered harmful to society (Criminal law deals with felonies&misdemeanor)

16. Nurse can be accused of crime related to their actual relationship with government. these include such actions as falsifying narcotic records, failure to renew licenses

17. Criminal law • Branch of public law that deals with crimes that is action considered harmful to society • Felonies are serious crime, that carry significant fines and jail sentence ( A nurse who unintentially cause death of pt by administrating a medication to which pt is allergic • Misdemonater less serious crime, usually punishable by fine or a short jail sentence or both (nurse slapping pt or given an injection without consent)

18. Private law (civil law) : • (determine person’s legal rights and obligation in many kinds of activities that involve other people include every thing from borrowing to buying a home

19. Six branches: • Contract and commercial law • Tort law • Property law • Inheritance law • Family law • Corporation law • Applicable to nursing practice: contract law and tort law

20. Contract law • deals with rights and obligations of people who make a contract • Contract is an agreement between two or more people that can by enforced by law • May be either written or oral • In health care contract may be expressed or implied

21. Expressed contract occur when the two parties agree explicitly to its terms as in employment contract • Implied contract occur when there has been no discussion between the parties, but the law consider that contract exist • Nurse –patient relationship (implied contract nurse agree to give competent care

22. Tort law:- • is wrong or injury that person suffers because of someone else’s action either intentional or unintentional • The tortious action may: • cause bodily harm • invade another’s privacy • damage a person’s property, business, or reputation • Make unauthorized use of a person’s property

23. Many torts are unintentional; accident damage • Most familiar with nurses: it involves negligence and malpractice

24. Intentional (Fraud, assault, invasive privacy, false imprison, defamation (slander, libel) • Unintentional (Negligence, malpractice)

25. Unintitentional torts occur when an actor omission causes unintended injury or harm to another person • The most common cause of an unintentional tort are: • Negligence • Malpractice

26. Negligence: The omission to do something that a reasonable person would do, or doing something which a reasonable person would not do. • e.g. throwing rocks • e.g. The nurse who ignored that the patient had spilled water

27. Malpractice is a type or subset of negligence, committed by a person in professional capacity • Any professional misconduct, unreasonable lack of professional skill or no adherence to the accepted standard of care causes injury to pt. • To be held liable for malpractice ,the nurse must fail to act as other reasonable professional nurse who have the same knowledge & education would have act under similar circumstances

28. Malpractice…cont • Malpractice claims against nurses in studies: • Inadequate communication with the doctor • Inadequate nursing assessment • Medication errors • Inadequate nursing interventions • Inadequate care/poor nursing care • Unsafe environment • Inadequate infection control • Improper use of equipment/defective technology • Failure to protect the patient from poor medical care

29. Nurse has duty to assess and evaluate / held liable • Failure to record a plan of care/ evidence that the nurse is negligent • Implementation / beneficence / maintaining expertise in practice & report dangerous practice to others / • medication errors are e.g of failure to implement property.

30. Neglecting to remove foreign object like spongy are left in pt body cavity . Nsg care focuses on person as a whole ( psycho-social-spiritual as physical / failure to implement care in this area result in Nsg malpractice ( intentional emotional distress) e.g : announcing death for close relative

31. Four Components required to prove liability of malpractice • Duty owed to the patient • Breach of standards of care or failure to carry out duty • Actual harm or injury suffered by the patient • Causal relationship between the breach of standards of care or duty and the injury

32. Nurse are responsible for safe and appropriate administration of medication regardless of physician order, workload • Pt burns (heating pad) may also be considered a failure to implement Nsg care

33. Intentional tort are willful or intentional acts that violate another person’s rights or property • 3 Components: • The act must be intended to interfere with plaintiff or his property • Must be intent to bring about the consequences • There is no legal requirement that the act causes damage-proof of intention is sufficient

34. Fraud • Is deliberate deception for the purpose of securing An unfair or unlawful gain • (Falsification of information on employment application, untruthful billing procedure or falsification pt records to cover up an error or avoid legal action )

35. Right to privacy: right to be left alone or to be free from unwanted publicity • Intentional tort of invasion of privacy occurs when person's privacy is invaded

36. Types of invasion privacy • Intrusion on the pt’s physical and mental seclusion • Public disclosure of private facts • Publicity that places the pt in a false light in the public eye • Appropriation of pt’s name or likeness for the defendant’s advantage

37. Assault • As unjustifiable attempt or threat to touch person without consent that result in fear of immediately harmful (touching need not actually occur) • Battery is unlawful, harmful, unwarranted touching of another or carrying physical harm. • battery includes any willfull,angry,violent,or negligent touching of a person's body or clothes, or any thing held by or attached to the person

38. If nurse threaten to give an injection to an unruly or noncompliant adult pt without consent ( assault) • Battery: e.g. touching without consent, slapping, pinching, ( surgical procedures that are performed without informed consent ). Also when nurse ignore the objections of the pt and performs an invasive procedure

39. False imprisonment • Is the unjustifiable detection of a person within fixed boundaries or an act intended to result in such confinement without consent and without authority of law. • nurses have been accused of false imprisonment for restraining patient, locking patient in room and detaining patients for payment of bill

40. Defamation occurs when one harms person's reputation and good name, diminishes others value or esteemor arouses negative feelings toward the person in others by the communication of false or harmful words. • Defamation only occurs when the words are communicated to third person

41. Forms of defamation • Slander occurs when one defames the reputation of another by speaking unprivileged or false wards.( e.g. by voicing the opinion that pt is uncooperative, unintelligent, or drug-seeking ,treated for something while its wrong) • Libel consists of printed defamation by written words and image that injure person's reputation or cause others to avoid

42. E.g. when writing information in pt chart that can be damaging, judgmental, critical or speculative statement such as “ the pt is drug-seeking” .” the pt is rude”

43. Recent Legal Trends • Managed care organizations(MCO’S) • Increase number of malpractice claims against nurses • Criminalization of nurse’s professional negligence • Confidentiality of electronic communication

44. Reducing Risk Of Malpractice • Maintain good communication • Maintain expertise in practice • Maintain autonomy & empowerment • Liability insurance • Nurses as expert witnesses

45. Liability insurance • Is an important risk management strategy that protects, assets and income affords nurses peace of mind • Occurrence –based policies provide coverage only in instances in which both injury and claim are made during the time in who the policy is effect

46. Malpractice policies offer coverage exclusively for claims of malpractice • Professional liability insurance offer protection against various injuries that are not directly related to malpractice

47. Nurses as expert witness • Honest and give objective opinion to the court • Involve a complete and extensive process of examining evidence and reviewing pertinent nursing literature, giving deposition and testifying in the court

48. Expected to be familiar with • All medical record during incidence • Pertained written policies and procedure of institution towered institution in self and sustain patterns of power and control • Most institution are fairly rigid about nurse’s work hours

50. Chapter 8 & 9Professional Issues & Professional Relationship Issues