Legal Responsibilities

Legal Responsibilities
Certain laws and legal responsibilities in every
aspect of life
Formulated to protect you and society
Traffic laws
Medical and legal licenses
Health care workers also have certain legal
responsibilities
Important to be aware of and follow legal
regulations
Protects you, employer and safety and wellbeing
of patient
 Legal Responsibilities
Authorized or based on law
Health care professions required to know and
follow state laws that regulate their license or
registration and set standards for their profession
Can include civil law or criminal law
Civil law: dealing with legal relationships between
people and protection of a persons rights
Criminal law: dealing with wrongs against a person,
property or society
 Legal Responsibilities
Health care is mainly affected by civil law
Contracts
Torts: wrongful act that done not involve a
contract
Criminal laws can apply
Practicing without a license
Misuse of narcotics
Theft
Murder
 Torts
Civil wrongs as opposed to crimes
Can lead to legal action
Offenses may be complex and open to
different legal interpretations
 Torts
7 torts to know
Malpractice
Negligence
Assault and battery
Invasion of privacy
False imprisonment
Abuse
Defamation
 Malpractice
Interpreted as bad practice and is commonly
called professional negligence
Defined as the failure of a professional to use the
degree of skill and learning commonly expected in
a particular profession
Results in injury, loss or damage to the person
receiving care
Examples
Physician not administering a tetanus injection when a
patient has a puncture wound
Nurse performing minor surgery without any training
 Negligence
Failure to give care that is normally expected of a
person in a particular position, with resulting injury
to another person
Examples
Falls and injuries that occur when siderails are left down
Using or not reporting defective equipment
Infections caused by use of not-sterile instruments
and/or supplies
Burns caused by improper heat or radiation treatments
 Assault and Battery
Closely related and often used together
Assault: can include a threat or attempt to injure
Battery: unlawful touching of another person
Patients must give consent and have the right to
refuse care
Some procedures require written consent from
patient
Surgery
Certain diagnostic tests (HIV testing)
Treatment of minors
Siderail releases
 Assault and Battery
Verbal consent permitted in other cases
Must be informed consent or permission granted
voluntarily by a person who is of sound mind after the
procedure and all risks involved have been explained in
terms the person can understand
Important to remember that a person has the right to
withdraw consent at any time
Explain all procedures to patient
Do not perform procedure if patient does not give
consent
 Assault and Battery
Examples
Performing procedure after patient has refused
to give permission
Improper handling or rough treatment of
patients
 Invasion of Privacy
Unnecessary exposure of an individual or
revealing personal information about an individual
without consent
Examples
Improper draping or covering of a pt during a procedure
that allows other pts or personnel to see the pt exposed
Sending information to an insurance company without
the pts written permission
Informing news media about individuals condition
without the individuals permision
 False Imprisonment
Restraining an individual or restricting an
individuals freedom
Examples
Keeping patient hospitalized against his/her will
Application of physical restraints without proper
authorization or with no justification
 Abuse
Any care that results in physical harm, pain
or mental anguish
Types of abuse
Physical: hitting, forcing persons against their
will, restraining movements, depriving of food or
water or not providing physical care
Verbal: speaking harshly, swearing or shouting,
using inappropriate words to describe a
persons race or nationality or writing threats or
abusive statements
 Abuse
Psychological: threatening harm; denying rights,
belittling, intimidating or ridiculing the person; or
threatening to reveal information about the
person
Sexual: any unwanted sexual touching or act,
using sexual gestures or suggesting sexual
behavior
 Abuse
Patients may experience abuse before
entering a health care facility
Domestic abuse: intimate partner uses
threatening, manipulative, aggressive or violent
behavior to maintain power and control over
another person
Child abuse: abuse is directed toward a child
Elder abuse: abuse is directed toward an older
person
 Abuse
Be alert to the signs and symptoms that may
indicate patients are victims of abuse
Unexplained bruises, fractures, burns or injuries
Signs of neglect such as poor personal hygiene
Irrational fears or a change in personality
Aggressive or withdrawn behavior
Patient statements that indicate abuse or
neglect
 Abuse
Presence of signs and symptoms indicates
a need for further investigation
Health care workers required to report any
signs of abuse to immediate supervisor
Laws in all states require the reporting of
any form of abuse to proper authorities
 Defamation
False statements cause a person to be ridiculed or
cause damage to his/her reputation
Incorrect information given out in error
Slander: information is spoken
Libel: information is written
Examples:
Reporting a pt has an infectious disease to a
government agencies when lab results are inaccurate
Stating person has drug problem when another medical
condition exists
 Contracts
Agreement between two or more parties
Three parts of a contract
Offer: competent individual enters into a
relationship with health care provider and offers
to be a patient
Acceptance: health care provider gives an
appointment or examines or treats a patient
Consideration: payment made by patient for
services provided
 Contracts
Two types of contracts
Implied
Expressed
Implied
Cause obligations that are understood without
verbally expressed terms
Ex. Qualified health care worker prepares
medication and patient takes medication
implied that patient accepts this treatment
 Contracts
Expressed
Stated in distinct and clear language, either
orally or in writing
Ex. Surgery permit
Promises of care must be kept
All risks associated with treatment must be
explained completely to the patient
 Legal Disability
All parties in contract must be free of legal
disability
Person with legal disability does not have
legal capacity to form a contract
Parents, guardians or others permitted by
law must form the contract on behalf of
these individuals
 Legal Disability
Examples
Minors: individuals under legal age (18 in AR)
Mentally incompetent persons
Persons under influence of drugs that alter
mental state
Semiconscious or unconscious people
 Breach of Contract
Contract requires certain standards of care
by competent, qualified individuals
If contract not performed according to
agreement, contract is breached
Examples:
Failure to provide care and/or giving improper
care
Failure to pay according to consideration
Can lead to legal action
 Interpreters
Interpreter must be used when contract
explained to a non-English speaking
individual
Many states also require use of interpreter
services for individuals who are deaf
Most agencies have list of interpreters that
can be used
English-speaking relative or friend of patient
can also serve as interpreter
 Agent
A person who works under direction or
control of another person
Employer is principal; employee is agent
Principal is responsible for actions of agent
and can be required to compensate or pay
people who have been injured by agent
 Agent
Example
Dental assistant tells patient your dentures will
look better than your real teeth; dentist may
have to compensate patient if statement proves
false
Health care workers must be aware of role
as agents and work to protect interests of
employer
 Privileged Communications
All information given to health personnel by a
patient
By law this information must be kept confidential
and shared only with other members of health
care team
Information cannot be told to anyone else without
written consent of the patient
Consent should state what information is to be
released, to whom the information should be given
and any time limits
 Privileged Communications
Certain information exempt by law and must
be reported
Births and deaths
Injuries caused by violence (assault and battery,
abuse, stabbings, GSW) that may require police
involvement
Drug abuse
Communicable diseases and sexually
transmitted diseases
 Health Care Records
Records containing information on the care
that has been provided to the patient
Belong to health care provider, but pt has
right to obtain a copy of any information in
record
Can be legal record in a court of law
Erasures not allowed on records
Cross out errors with a single line
Insert correct information, initial and date
 Health Care Records
Must be properly maintained, kept
confidential and retained for the amount of
time required by state law
When records destroyed after legal time for
retention, must be burned or shredded so
confidentiality is maintained
 Health Care Records
Computerized records have created modern
dilemmas on maintaining confidentiality
Many different individuals can have access to a patients
records
Safeguards have been created to maintain
confidentiality
Limiting personnel who have access
Using codes to prevent access to certain info
Requiring passwords to access certain information
Constantly monitoring and evaluating computer use
 Legal Responsibilities
Important aspect of health care
All states have set rules and regulations
It is your responsibility to learn exactly what
you are legally permitted to do and what
your responsibilities are