chapter 11 legal and ethical responsibilities health care science technology copyright © the...

Chapter 11Legal and Ethical Responsibilities

Health Care Science Technology

Copyright © The McGraw-Hill Companies, Inc.

Chapter 112 Copyright © The McGraw-Hill Companies, Inc.

Objectives

Describe the qualities of a successful health care worker.

Distinguish between laws, morals, and ethics.

Explain the purpose of professional codes of ethics.

Define standard of care. Describe informed consent.


Objectives (cont.)

Discuss the importance of confidentiality for health care professions.

Define the term advance directive and distinguish among living wills, durable powers of attorney, and health care proxies.

Describe clients’ rights and responsibilities. Successfully complete 1 recording

procedure.


The Qualities of a Successful Health Care Worker 11-1

Qualities for Success Understanding Laws, Morals, and Ethics Licensure, Registration, and Certification Standard of Care and Scope of Practice Informed Consent Confidentiality


Qualities for Success

Successful health care providers use the 3 Cs:– Courtesy– Compassion– Common sense


Qualities for Success (cont.)

Other helpful qualities include:– A relaxed attitude when meeting new people.– A willingness to learn new skills and

techniques.– An aptitude for working with the hands.– Empathy for others.– Good communication and listening skills.– Patience in dealing with others.



– The ability to work as a member of a health care team.

– Proficiency in English, science, and mathematics.

– Tact.– The ability to keep information confidential.– The ability to leave private concerns at home.– Trustworthiness.– A sense of responsibility.



Responsibilities to Employers– Deal morally, ethically, and legally with your

employer.– Report to work on time, properly dressed

and groomed.– Stay current in your chosen field by

attending seminars, continuing education courses, subscribing to professional journals, and obtaining in-house training.



The Health Care Team includes, but is not limited to:– Physicians– Registered nurses– Licensed practical or vocational nurses– Dietitians– Physical and occupational therapists– Respiratory therapists– Electrocardiography technicians– X-ray technicians– Medical transcriptionists– Nursing assistants


Section 11-1Apply Your Knowledge

List some members of the health care team.

Answer:• Physicians• Registered nurses• Licensed practical or vocational nurses• Dietitians• Physical and occupational therapists• Respiratory therapists• Electrocardiography technicians• X-ray technicians• Medical transcriptionists• Nursing assistants


Legal, Moral, and Ethical Standards 11-2

Understanding Laws, Morals, and Ethics Licensure, Registration, and Certification Standard of Care and Scope of Practice Informed Consent Confidentiality


Understanding Laws, Morals, and Ethics

Laws – a law, or statute, is a rule of conduct or action.


Understanding Laws, Morals, and Ethics (cont.)

– Criminal Laws – protect members of society from certain harmful acts of others. A criminal act may be one of:

Commission, if there is a law forbidding a certain act.

Omission, in violation of a law requiring a certain act.



– Civil Laws – are concerned with private rights and remedies. Examples of the causes of civil disputes include:

Contract violation.Slander or libel.Trespassing.Product liability.Automobile accidents.Family matters such as divorce, child support,

and child custody.



– TortsA tort is broadly defined as a civil wrong

committed against a person or property, excluding a breach of contract.

Torts may be intentional (willful) or unintentional (accidental) and, if intentional, may also be crimes.

Unintentional torts are acts that were not intended to cause harm. However, they are committed without regard for consequences.



An unintentional tort is caused by negligence. Negligence is also called medical malpractice.

– MalpracticeThe 3 Ds must be present for negligence to occur:

– Duty – health care practitioner/client relationship exists.

– Derelict – health care practitioner did not live up to the obligation of caring for a client.

– Damage – the breach of duty results in damages to the client or plaintiff.



– Physicians are most likely to be charged with negligence. However, other health care practitioners may be subject to such charges.

– Medical practice acts are state statutes that govern medical practices. They do the following:

Cover requirements and methods for licensing health care providers.

Establish medical licensing boards. List grounds for revoking licenses.



Morals and Ethics– Morals are formed from your personal

values – your concept of right and wrong.

– Ethics are standards of behavior developed as a result of your moral values.



Noncompliance– Noncompliant health care workers

may face fines or prison sentences and can lose their licenses to practice their profession.

– Unethical conduct may result in expulsion or censure from your professional organization, but only the state can revoke a license.


Licensure, Registration, and Certification

Licensure – is required for certain professions within a state.


Licensure, Registration, and Certification (cont.)

Registration– Adding one’s name in an official registry

or record as having satisfied the requirements for a certain health care occupation.

– Fulfilling certain education requirements and/or paying a registration fee.


Licensure, Registration, and Certification (cont.)

Certification – usually voluntary.– Reciprocity – when state licensing

authorities accept a person’s valid license from another state.


Standard of Care and Scope of Practice

Standard of care is the level of performance expected of a health care worker in carrying out his or her professional duties.


Standard of Care and Scope of Practice (cont.)

– Working outside your scope of practice can make you liable.

– Working within your scope of practice ensures that you:

Do not injure clients or put them at risk by performing procedures that are beyond your ability.

Will not be held liable for a standard of care that is beyond your training, experience, and job description if a legal situation arises.



The Law of Agency – an employer is legally liable for acts performed by employees.



Informed Consent – in order for a client to make an informed decision regarding treatment, the client needs to be told the following:

A SAMPLE CONSENT FORM



Informed Consent (cont.)– The proposed methods of treatment.– Why the treatment is necessary.– The risks involved in the proposed treatment.– All available alternative types of treatment.– The risks of any alternative methods of

treatment.– The risks involved if treatment is refused.



– People who cannot give informed consent include:

Minors – individuals under 18 years of age (21 in some states). Exceptions include those deemed mature minors by the court.

Mentally incompetent individuals – persons judged by the court to be insane, senile, mentally retarded, or under the influence of drugs or alcohol.

Speakers of a foreign language who do not speak English.



Confidentiality– It is illegal and unethical if a health

care worker does not observe confidentiality.

– Privileged communication refers to information held confidential within a protected relationship.



Confidentiality (cont.)– Keeping client medical information

confidential means: Not informing any unauthorized person

about the information contained in a client’s medical records.

Not showing written information to an unauthorized third party.

Taking proper precautions when communicating such information over a computer, telephone, or fax machine.



Confidentiality (cont.)– Written consent must be

obtained before releasing information to a third party.

CONSENT TO RELEASE INFORMATION



Confidentiality (cont.)

– Guidelines to follow if you have access to a client’s information:

Do not decide if information is confidential based on your approval or agreement.

Do not reveal financial information about a client.Do not use the client’s name or other information

if others in the room might overhear.Use caution in giving the results of medical tests

to clients over the telephone.



Confidentiality (cont.)

– Guidelines to follow if you have access to a client’s information: (cont.)

Do not leave medical charts or insurance reports where clients or others can see them.

If the client has not given written permission to release information, do not release it.

Do not discuss clients in public places where others may overhear, such as the cafeteria or elevator.



Confidentiality (cont.)– Confidentiality for client medical records may

be waived under the following circumstances: When a third party requests a medical

examination, such as a preemployment examination, and that third party pays the client’s bill.

When a client sues a physician or other health care practitioner for malpractice.

When the client signs a waiver allowing the release of information.


Section 11-2 Apply Your Knowledge

When must written consent be obtained?

Answer:

Consent must be obtained for many procedures such as surgery and tests.


Medical Records and Policies 11-3

Medical Records Client Autonomy


Medical Records

Facilities providing health care services are required by licensing authorities to keep and maintain health care records of clients.

Medical records provide:– A format for tracking, documenting, and

maintaining a client’s health data.


Medical Records (cont.)

– Documentation of a client’s lifelong health care.

– A basis for managing a client’s health care.

– Background information in the event of a lawsuit.

– Clinical data for education, research, statistical tracking, and assessing the quality of health care.



– Medical records may be kept on paper, microfilm, or computer tapes or disks. They belong to the owners of the facility, even though the client owns the information contained in them.



Advance Directives – legal documents that make known a person’s wishes about life-support measures.– Living Will – provides

instructions directly to physicians, hospitals, and other health care providers involved in a client’s medical treatment.

SAMPLE LIVING WILL



Advance Directives (cont.)

– Durable Power of Attorney – not specifically a medical document, but it may serve that purpose. It gives a person, called a designee, the authority to make a variety of legal decisions on behalf of another person, called the grantor.




– Health Care Proxy – or health care power of attorney, is also an end-of-life document. With it, clients specify an agent to make medical decisions for them in the event that they lose the ability to reason or communicate.

SAMPLE HEALTH CARE PROXY




– Organ Donor Directives – a document that indicates client’s wish to donate organs for transplantation or medical research when client dies.


Client Autonomy

Clients’ Rights– The American Hospital Association’s Patient’s

Bill of Rights is followed in most states. It guarantees the client’s right to:

Receive considerate and respectful care. Receive complete and current information

concerning his or her diagnosis, treatment, and prognosis.

Know the identity of physicians, nurses, and others involved with his or her care, as well as when those involved are students, residents, or trainees.


Client Autonomy (cont.)

Clients’ Rights (cont.)– The American Hospital Association’s Patient’s

Bill of Rights (cont.)Know the immediate and long-term costs of

treatment choices.Receive information necessary to give informed

consent prior to the start of any procedure or treatment.

Have an advance directive concerning treatment or be able to choose a representative to make decisions.




Bill of Rights (cont.) Refuse treatment to the extent permitted by

law. Receive every consideration of his or her

privacy. Be assured of confidentiality. Obtain reasonable responses to requests for

services.




Bill of Rights (cont.) Obtain information about his or her health care

and be allowed to review his or her medical record and to have any information explained or interpreted.

Know whether treatment is experimental and be able to consent or decline to participate in proposed research studies or human experimentation.




Bill of Rights (cont.)Expect reasonable continuity of care.Ask about and be informed of the existence of

business relationships between the hospital and others that may influence the client’s treatment and care.

Know which hospital policies and practices relate to client care, treatment, and responsibilities.




Bill of Rights (cont.)Be informed of available resources for resolving

disputes, grievances, and conflicts, such as ethics committees or patient representatives.

Examine his or her bill and have it explained and be informed of available payment methods.



Clients’ Responsibilities – clients are responsible for:– Providing information about past illnesses,

hospitalizations, medications, and other matters related to their health status.



Clients’ Responsibilities (cont.)– Participating in decision making by asking for

additional information about their health status or treatment.

– Providing health care agencies with a copy of their written advance directive if they have one.

– Informing physicians and other caregivers if they anticipate problems in following a prescribed treatment.



Clients’ Responsibilities (cont.)– Following a physician’s orders for treatment.

The client has the right to refuse treatment to the extent permitted by law.

– Providing health care agencies with necessary information for insurance claims and working with the health care facility to make arrangements to pay fees when necessary.


Section 11-3 Apply Your Knowledge

Who owns the information in a client’s medical records?

Answer:

Clients own the information in their medical records.


Procedures in Student Text

11A Recording Information on a Client’s Medical Record


Chapter 11 Credits

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chapter 11 legal and ethical responsibilities health care science technology copyright © the...

Documents

mcgrawhill companies

health care team

health care professions

health care proxies

successful health care

helpful qualities

certification standard

success understanding