The term law is derived from tentoric root , Lag which means something which lies fixed or events.
Law means body of rules to guide human action. 29 August 2009 3 DEFINITION OF LAW 1 Law can be defined the sum total of rules and regulations by which a society is governed. ( Guido, 2001.p.2 ) 2. The law is a system of rights and obligations which the state enforces. ( Green ) 3. The law is the body of principles recognized and applied by the state and the administration of justice . ( Salmaind ) 29 August 2009 4
MEANING - The study of doing right is called ethics. DEFINITION - Ethics may be defined as the system or code of conduct and morals advocated by a particular individual or group.
29 August 2009 5 BIOETHICS MEANING A situation that requires an individual to make a choice between two equally unfavorable alternatives.
e.g. Conflicts between one individuals rights and those of another.
29 August 2009 6 NURSING ETHICS Philosophical analysis of moral phenomena in the Practice of nursing.
Nursing ethics are the professional standard of conduct practiced by nurse practitioners related to or in accordance with approved moral behavior in rendering health care services. 29 August 2009 7
FUNCTIONS OF LAW IN NURSING
1. It provides a framework for establishing the legal nursing activities.
2. It helps in establishing the boundaries of independent nursing activity.
29 August 2009 8 FUNCTIONS OF LAW IN NURSING CONTD ..
3. It differentiates the nurses responsibilities among the health professionals.
4. It assists in maintaining the standard of nursing practice which is accountable under the law.
29 August 2009 9 TYPES OF LAWS CIVIL CRIMINAL CONTRACTS TORTS INTENTIONAL UNINTENTIONAL ASSAULT BATTERY INVASION OF PRIVACY DEFAMATION OF CHARACTER FALSE IMPRISONMENT NEGLIGENCE MALPRACTICE 29 August 2009 10 TYPES OF LAW
I - Criminal Law :
1. Criminal law prevent harm to society and provide punishment for crimes. ( Black , 1999 )
2. A crime is an act committed in violation of criminal Law and punishable by a fine or imprisonment. A crime does not have to be intended in order to be a crime.
29 August 2009 11 TYPES OF LAW contd.. Crimes are classified as felonies and misdemeanor.
FELONY - Is a crime of a serious nature that has a penalty of imprisonment for greater than one year or even death. e.g. murder.
MISDEMEANOR - Is a serious crime that has a penalty of a fine or imprisonment for less than one year. 29 August 2009 12 TYPES OF LAW contd..
II Civil Law
It protects the rights of individual persons within our society and encourage fair and equitable treatment among people. ( Black, 1999 ) 29 August 2009 13 Contract Law Contract Law Involves the enforcement of agreements among private individuals or payment of compensation for failure to fulfill the agreements.
Tort Law A tort is a civil wrong made against a person or property.
29 August 2009 14 Types of Torts Intentional Are willful acts that violate anothers rights. They are deliberate or willful actions in which the intend is to cause injury to a person ( or ) Property. Unintentional These are accidents that cause injury to another person or property. it involves failure or breach of nursing duties that lead to harm. 29 August 2009 15 Types of Torts contd. Intentional Unintentional
1 Assault 1 Negligence 2 Battery 2 Malpractice 3 Invasion of Privacy 4 Defamation of character 5 False imprisonment 29 August 2009 16 Intentional Torts 1. Assault - can be described as an attempt or threat to touch another person unjustifiably. Assault is any intentional treat to bring about harmful or offensive Contact.
Example A nurse may threaten to give a client an injection or restrain the client for any procedure when client has refuse consent 29 August 2009 17 Intentional Torts contd
2. Battery - Is any intentional touching without consent. Battery always includes an assault. Example A nurse threatening to give a client an injection without clients consent, if the nurse actually gives the injection it is called Battery. 29 August 2009 18 Intentional Torts contd
3. Invasion of privacy - The tort of invasion of privacy protects the clients right to be free from unwanted intrusion into his/ her private affairs. 1. Use of clients name 2 Unreasonable intrusion 3 Public disclosure of private facts 4 Putting a person in a false light
29 August 2009 19 Intentional Torts contd
4 Defamation of character Is the publication of false statements that result in damage to a persons reputation. It is communication that is false, or made with a careless disregard for the truth, and results in injury to the reputation of a person. Example - Loss of Client Property, such as jewelry, money, eyeglasses and dentures is a constant concern to hospital personnel. 29 August 2009 20 Intentional Torts contd 5 False imprisonment False imprisonment is the unjustifiable detention of a person without legal warrant to confine the person ( Guido, 2001, p.98) False imprisonment accompanied by forceful restraint or threat of restraint is battery. 29 August 2009 21 Unintentional Torts
Negligence and malpractice are examples of unintentional torts that may occur in the health care setting.
Negligence - Is misconduct or practice that is below the standard of care. 29 August 2009 22 Unintentional Torts contd.. Malpractice Is negligence committed by a professional such as nurse or physician. Nurses are liable for malpractice in the following criteria. 1. The nurse owed a duty to the client. 2. The nurse did not carry out that duty. 3. The client was injured. 4. The nurses failure to carry out the duty caused the injury. 29 August 2009 23
Measures to be taken by nurse to avoid liability for negligence and malpractice.
1 Follow standard of cares. 2 Give competent health care. 3 Communicate with other health care providers. 4 Develop a caring rapport with the client. 5 Document assessments, interventions & evaluations. 6 Should know the current nursing literature in their areas of practice. 29 August 2009 24 Measures contd ..contd. 7. Should know and follow the policies and procedures of the institution in which they work. 8 Should be sensitive to common sources of client injury such as falls and medication errors. 9 Must communicate with the client. 10 Explain patients the tests concerns about the treatment 11 Any significant changes in clients condition must be reported to physician & documented in the chart. 29 August 2009 25 SOURCES OF LAW Constitutional Law
Legislative Law Administrative Law
Common Law
29 August 2009 26 SOURCES OF LAW
1 Constitutional Law
The constitution creates legal rights and responsibilities and foundation of a system of justice. e.g. the constitution ensures each U.S. citizen the right to due process of law. 29 August 2009 27 SOURCES OF LAW CONTD.. 2. Legislation ( Statutory Law ) Laws enacts by any legislative body are called statutory laws. 3. Administrative Law When a state legislature passes a statute, an administrative agency is given authority to create rules and regulations to enforce the statutory laws. 29 August 2009 28 SOURCES OF LAW CONTD..
4.Common Law
Laws evolving from court decisions are referred to as common law. 29 August 2009 29 CATEGORY.EXAMPLES. Constitutional
Statutory - Due Process - Equal protection
- Nurse Practice Act - Good Samaritan Act - Child and Adult Abuse Act - Living Wills - Sexual Harassment Laws - American Disability Act 29 August 2009 30 CATEGORY.EXAMPLES. Criminal
Contract Homicide Manslaughter TheftActive Eucanthesia Sexual assault Illegal possession of control drugs
Nurse and client Nurse and employer Nurse and insurance Client and agency 29 August 2009 31 CATEGORY.EXAMPLES. Torts Negligence / Malpractice Libel and slander Invasion of privacy Assault and battery False imprisonment Abandonment 29 August 2009 32 AREAS OF LIABILITY IN NURSING Crime A crime is an act committed in violation of public ( criminal ) law and punishable be a fine or imprisonment.
A crime does not have to be intended in order to be a crime.
29 August 2009 33 AREAS OF LIABILITY IN NURSING contd
Torts -A tort is a civil wrong committed against a person or a persons property.
Duty - The nurse must have ( or should have had) a relationship with the client that involves providing care and following an acceptable standard of care.
29 August 2009 34 AREAS OF LIABILITY IN NURSING contd. Breach of duty - There must be a standard of care that is expected in the specific situation but that the nurse did not observe.
Foreseeability - A link must exist between the nurses act and the injury suffered.
Causation - It must be proved that the harm occurred as a direct result of the nurses failure to follow the standard of care. 29 August 2009 35 AREAS OF LIABILITY IN NURSING contd. Harm of injury - The client or plaintiff must demonstrate some type of harm or injury ( physical, financial or emotional ) as a result of the breach of duty owed the client. Damages- If malpractice caused the injury, the nurse is held liable for damages that may be compensated. 29 August 2009 36 AREAS OF LIABILITY IN NURSING contd. Intervention Errors - Failing to Document all nursing interventions understand the medications being administered. Always monitor the client as the condition warrants and as ordered. Document the frequency of client monitoring and client status. Promptly bring distressing symptoms and changes in client status to the attention of the physician. Document the time and content of all telephone conversations with the physician. 29 August 2009 37 1. Informed Consent Is the authorization by the patient and based upon legal capacity, voluntary action and compensation voluntary action and comprehension. It is the persons agreement to allow something to happen based on full disclosure of facts needed to make an intelligent decision. SELECTED LEGAL ASPECTS OF NURSING PRACTICE 29 August 2009 38 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 1. Explaination of treatment procedure.
2 The purpose of the treatment
3. What the client can expect to feel or experience 4 The intended benefits of the treatment 29 August 2009 39 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 5 Possible risks or negative outcomes of the treatment 6 Advantages and Disadvantages of possible alternatives to the treatment ( including no treatment ) 7.Name of the persons performing the procedure. 8.Statement that patient may withdraw his consent at anytime. 29 August 2009 40 SELECTED LEGAL ASPECTS OF NURSING PRACTICE There are 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 a capacity and competence to understand. 3. The client or individual must be given enough information to be the ultimate decision maker..
29 August 2009 41 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 2. Delegation Definition by The National Council of State Boards of Nursing (1995) defines delegation as, Transferring to a competent individual the authority to perform a selected nursing task in a selected situation. 29 August 2009 42 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 3. Violence, Abuse and Neglect Violent behavior can include domestic violence, child abuse, elder abuse and sexual abuse. Neglect is the absence of care necessary to maintain the health and safety of a vulnerable individual such as a child or elder. 29 August 2009 43 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 4. Sexual Harassment Sexual Harassment is a violation of the individuals rights and a form of discrimination. The Equal Employment Opportunity Commission ( EEOC) defines sexual harassment as Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. 29 August 2009 44 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 5. Abortions Abortion Law provide specific guidelines for nurses about what is legally permissible. In 1973, when the Roe V. Wade and Doe V. Bolton cases were decided, the Supreme Court of the United States held that the constitutional rights of privacy gives a woman the right to control her own body to the extend that she can abort her fetus in the early to the extent that she can abort her fetus in the early stages of pregnancy. 29 August 2009 45 SELECTED LEGAL ASPECTS OF NURSING PRACTICE
6. Death and related Issues
Legal issues associated with death include advance directives, euthanasia, do not resuscitate ( DNR ) orders, certification of death, autopsy, inquest, and organ donation. 29 August 2009 46 SELECTED LEGAL ASPECTS OF NURSING PRACTICE 8. Loss or damage to patients property
The nurse is held responsible if she handles the patients property carelessly and as a result the property is lost. e.g. Handing of patients jewelry to patients nearest relative after written consent. Money, eyeglasses and dentures is a another concern of loss in the hospital personnel. 29 August 2009 47 LEGAL PROTECTION IN NURSING PRACITCE I. LICENSURE 1. All nurses in the nursing practice must possess a valid licensure issued to the state council. 2. This license is to practice with ones own authority. 3. The licensure on one hand is to secure society the benefits which comes from the services of skilled growth. 29 August 2009 48 LEGAL PROTECTION IN NURSING PRACITCE II GOOD RAPPORT 1. Developing good rapport with the patient is very important to prevent malpractice.
2.Nurses must never underestimate a rapport with the client in malpractice prevention.
3. Good rapport with the client depends on good IPR. Communication skills e.g. listening. 29 August 2009 49 GOOD SAMARITAN ACTS Good Samaritan acts are laws designed to protect the healthcare providers who provide assistance at the scene of an emergency against claims of malpractice unless it can be shown that there was a gross departure from the normal standard of care or willful wrongdoing on their part. 29 August 2009 50 PROFESSIONAL LIABILITY INSURANCE
Because of the increase in the number of malpractice lawsuits against health professionals, nurses are advised to carry their own liability insurance. 29 August 2009 51 PROVIDING COMPETENT NURSING CARE
Complete practice is a major legal safeguard for nurses. Nurses need to provide care that is within the legal boundaries of their practice and within the boundaries of agency policies and procedures. 29 August 2009 52 RECORD KEEPING The clients medical record is a legal document and can be produced in court as an evidence. Often, the record is used to remind a witness of events surrounding a lawsuit, because several months or years usually elapse before the suit goes to trail. 29 August 2009 53 ETHICS IN NURSING Ethics is derived from the word, Ethos . It is a tradition or sharing of customs and commitment to a particular system of values.
Ethics refers to the science of moral duty, ideal character and moral principles of a practice of a profession. ( Bernard Harding ) 29 August 2009 54 IMPORTANCE OF ETHICS IN NURSING
Ethics has always been an integral part of nursing.
Caring for, comforting the sick, and protecting the suffering is human activity and it should be seen how society views directly affect the morals, customs and beliefs of human kind.
Nursing ethics provide the standards for professional behavior. 29 August 2009 55 INTERNATIONAL COUNCIL FOR NURSES CODE OF ETHICS
Within any given profession , a code of ethics serve as a means of self regulation and a source guidelines for individuals behavior and responsibility.
Code of ethics is an inclined contact through which the profession informs society the principles and rules by which it functions.
29 August 2009 56 NURSES AND PEOPLE The nurses primary responsibility is to those people who require nursing care.
The Nurse holds confidence, personal information and uses Judgment in sharing their information.
The Nurse provides care, promotes good environment in which the values, customs and spiritual beliefs of the individuals are respected 29 August 2009 57 NURSES AND PRACTICE The nurse carries personal responsibilities for nursing practice and for maintaining competency by continuously learning.
The nurse maintains the higher standards of nursing care possible with in the reality of the specific situation.
The nurse uses judgment in relation to individual competence when accepting and delegating responsibilities 29 August 2009 58
NURSE AND SOCIETY
The nurse shares with other citizens the responsibility for initiation and supporting action to meet the health and social needs of public.
NURSES AND COWORKERS The nurse sustains a cooperative relation with coworkers in nursing and other fields.
The nurse takes appropriate action to safeguard the individual when his care endangered by a coworker or any other person 29 August 2009 59 NURSES AND THE PROFESSION The nurse plays a major role in delivering and implementing desirable standards of nursing education.
The nurse is active in developing a care of professional knowledge.
The nurse acting through the professional organization in establishing and maintaining equitable social and looking for condition in nursing 29 August 2009 60 ETHICAL DECISION MAKING
Nurses decisions are increasingly constrained by ethical issues. Ethical decision making involves reflection on the following. Who should make the choice, possible option or courses of action, available options, consequences, both good or bad, of all possible options, desired outcomes. 29 August 2009 61 ETHICAL PRINCIPLES Respect for person. Respect for autonomy Respect for freedom Respect for beneficence ( doing good ) Respect for non-malfeasance (avoiding harm to others ) Respect for veracity ( truth telling ) Respect for justice ( Fair and equal treatment ) Respect for rights Respect for fidelity.( Fulfilling promises ) Respect for confidentiality (Protecting privileged information)
29 August 2009 62 ETHICAL DECISION MAKING M- Massage the dilemma. Identify and define the issues in the dilemma. Consider the options of all the major players in the dilemma as well as their value system.
O- Outline the options. Examine all options including those less realistic and conflicting. Three stages are designed only for considering options and not for making final decision. 29 August 2009 63 ETHICAL DECISION MAKING ....Contd R- Resolve the dilemma. Review the issues and options, applying the basic Principles of ethics to each option. Decide the best option based upon the views of all those concerned in dilemma. A- Act by applying chosen option. This step is usually the most difficult as it requires actual implementation. While the previous steps had only allowed for dialogue or discussion. L- Look back and evaluate the entire process including the implementation. 29 August 2009 64 ETHICAL DILEMMA
A dilemma is defined as a situation requiring a choice between two equally desirable or undesirable alternatives. In ethical dilemma each alternative course of action can be justified by two in which a person views a course of action based on his/her value based system. 29 August 2009 65 ETHICAL COMMITTEE The members are - Physicians, Nurses, Clergy and ethicists. Functions are The committees analyze situations. Help to clarify issues. Identify the options available. Influence policy making Teach staff and clients about ethical rights and ethical decision making. 29 August 2009 66 ROLE AND FUNCTIONS OF NURSE / ADMINISTRATOR / MANAGER IN LEGAL & ETHICAL ISSUES. PROVIDER OF SERVICE EMPLOYEE OR CONTRACTOR FOR SERVICE RESPONSIBILITY IN QUALITY CONTROL RESPONSIBILITY FOR EQUIPMENT RESPONSIBILITY FOR OBSERVATION AND REPORTING
29 August 2009 67 LEGAL ROLES OF NURSES Provider of Service Employee or contractor for Service Citizen 29 August 2009 68