Ethico Legal Aspects of Care
Presented by: Darash S. Villaflores Lyka Lea G. Villamor
Historical Background
Beneficence the duty to benefit Non maleficence the duty not to harm The Code of Hammurabi (1955 1913 B.C.) included penalties for physicians/surgeons who did not cure. Punishments were specified for infractions of the code. First medical malpractice suit was tried in England in 1374. The first one in the United States occured in 1794.
Legal Issues
Lawsuit- a legal action brought between two
private parties in a court of law.
Consumerism- the protection of the rights and
interests of consumers, especially with regard to price, quality, and safety.
Litigation- the act or process of bringing about
or contesting a lawsuit or all lawsuits collectively.
Consumer Rights movement- a movement that
focuses on consumer rights, a well informed public has developed an increasingly litigious attitude demanding compensation for bodily injuries or damages to personal properties.
Causes of litigation- lie in patients
and their families belief that physicians and/or health care organizations have not provided appropriate dx, tx, or results.
Liability Liability- legally responsible for personal
actions
Negligence- the failure to use the care or
skills that any caregiver in the same or a similar situation would be expected to use.
Malpractice- any professional misconduct,
unreasonable lack of skill or judgement, or illegal or immoral conduct.
Good Samaritan Acts
Laws designed to protect health care 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. Gross negligence usually involves further injury or harm to the person. Ex.: An automobile may strike an injured child left on the side of the road when the nurse leaves to obtain help.
Liability
Liability Prevention for the Facility and the Team Liability Insurance Borrowed Servant Rule Independent Contractor Doctrine of the Reasonable Man Doctrine of Res Ipsa Loquitur Doctrine of Respondent Superior Doctrine of Corporate Negligence Extension Doctrine Assault and Battery Invasion of Privacy Crimes and Torts
Consent
General Consent- most facilities require the patient or his/her legal guardian to sign a general consent form on admission. Informed Consent- recognizes the physician s duty to inform the patient of the risks, benefits and alternatives of a procedure and to obtain consent before treatment.
Informed Consent for a Surgical Procedure Responsibility for Informed Consent before a Surgical Procedure
Validation of Consent
Witnessing a Consent Consent in Emergency Situations Right to Refuse a Surgical Procedure Second Opinion
Advance Directives
The patient Self-Determination Act
LEGAL ASPECTS OF DRUGS AND MEDICAL DEVICES
1906- Pure Food and Drug Act The Food, Drug, and Cosmetic Act of 1938 The Kefauver-Harris Drug Amendments of 1962 The Medical Device Amendments of 1976 1998- reclassification of many devices
Class I Class II Class III
1984- mandatory reporting regulation was put into effect. 1993- FDA began the voluntary MedWatch program
THE STANDARD OF CARE AND PROFESSIONAL ETHICS
SOURCES OF PROFESSIONAL STANDARDS Standards of care- acts that a reasonably prudent person with comparable training and experience would perform under the same or similar circumstances. SOURCES OF PERIOPERATIVE PATIENT CARE STANDARDS: Standards of Perioperative Nursing:
± ± ± ± ± Standards of Perioperative Administrative Nursing Standards of Perioperative Clinical Practice Standards of Perioperative Professional Performance Quality Improvement Standards for Perioperative Nursing Patient Outcomes: Standards of Perioperative Care
Association of Surgical Technologists Standards of Practice JCAHO standards National Fire Protection Association (NFPA) standards
Association for the Advancement of Medical Instrumentation (AAMI) device standards Clinically based risk-control standards REGULATORY STANDARDS The 1965 Federal Medicare Act and all subsequent amendments to this Social Security Act American National Standards Institute (ANSI) standards Federal Food and Drug Administration (FDA) performance standards Agency for Healthcare Research and Quality (AHRQ) clinical practice guidelines Occupational Safety and Health Administration (OSHA) standards
RECOMMENDED PRACTICES
Sources:
Tighe, Shirley M. (2008).Instrumentation for the Operating Room. ( 4th ed.) USA: Mosby Inc. Smeltzer, Suzanne C. & Brenda G. Bare, et. al. (2008). Brunner & Suddarth s Textbook of Medical and Surgical Nursing. (11th ed.) Philadelphia: Lippincot Williams & Wilkins. Berman, A., Snyder, S.J., et. al. (2005) Kozier & Erb s Fundamentals of Nursing: Concepts, process and practice. (7th ed.). New Jersey: Pearson Education, Inc. Lewis, S. et. al. (2000). Medical-Surgical Nursing: Assessment and Management of clinical problems. (5th ed.) USA: Mosby, Inc. Black, J.M., Hawks, J.H. & Keene, A.M. (2001). Medical-Surgical Nursing. 6th Ed. W.B. Saunders Company: Philadelphia.