nursing jurisprudence and ethics

7/24/2019 Nursing Jurisprudence and Ethics

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NURSINGJURISPRUDENCE

BY: ATTY DEIRDREE CODAMON- GALLMAN, RN


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NURSING

JURISPRUDENCE-! department of law which comprise

all legal rules and principles

affecting the practice of nursing.


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NURSING LEGISLATION! the making of laws, or the body of

laws already affecting the practice

of nursing.


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LAW! a rule of civil

conduct

prescribed by thesupreme power ina statecommanding

what is right andprohibiting whatis wrong.


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LEGAL RIGHT! a claim which can

be enforced by

legal meansagainst a personwhose duty is torespect it.


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! COURT MECHANISM:

! LAWSUIT-

proceeding incourt for apurpose.

! Purpose:

1. to enforce a right2. to redress a

wrong

Q If thi k th t h


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Q:If you think that a person hasdone something seriously wrong toyou, the correct action to do get

redress for the injury received is to:

!A. systematically plan on how tohave a vindication for thedamage done

! B. file a lawsuit against theperson for damage

! C. hire someone to take revengefor you


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Parties to cases:! Civil case- Complainant/ defendant

! Criminal case- Plaintiff/ accused


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Q: The person who institutes

legal proceeding is called:!A. Plaintiff

! B. respondent

! C. defendant

! D. Accused


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Q:A hospital filed a case of damagesagainst nurse for breach of contract.

Who is the nurse in the case?

A. complainant

! B. accused

! C. defendant

! D. plaintiff


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STATUTE OF LIMITATIONS- the length of time following the

event during which the plaintiff

may file a suit.! Example: negligence- filed within

2-3 years from occurrence.


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DUE PROCESS! is a fair and

orderly process

which aims toprotect andenforce a

person

s right.


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FUNDAMENTAL REQUIREMENTS OF DUEPROCESS:

! 1. Right to

be informed


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2. Right to remain silent


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3. Right to a competentcounsel


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4. No use of violence, threat,

torture


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! PRE-TRIAL- eliminate matters notin dispute, agree on issues or settle

procedural matters.

! TRIAL-facts are presented and

determined; law applied at theend.


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! SUMMONS- is a writ commandingan authorized person to notify a

party to appear in court to answera complaint made against him.

! WARRANT- presented by an

arresting officer


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! SUBPOENA- is an order thatrequires a person to attend at a

specific time and place to testify asa witness.

! SUBPOENA DUCES TECUM-is a

subpoena that requires a witnessto bring documents/ papers in hispossession.


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A process whereby the BON only compel thepersonal attendance of a witness to bring withhim to the court books, papers and the like to

elucidate the matters in issue:

a.

Warrant

b.

Subpoena

c.

Subpoena duces tecum

d.

Summons


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WITNESS- person givingnecessary details


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Nurses as witness:

! Could not divulge PRIVILEGEDCOMMUNICATIONin a civil case- meansthat the nurse is incompetent to testify on the

communications made to him by the patients,all the device given and all the informationgathered by observation during the seal ofsecrecy.

Exceptions:1. criminal case2. with the patient

s consent3. patient sued doctor for damages


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Q:For privileged communication in thedoctor, the nurse and the patient, the sealof secrecy:

a. forever remains until removed bypatient

b. may be broken upon death of thepatient

c. may be disclosed when the patient is

insane

d. all of the above


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! Testimonies of Facts- factualinformation

! no opinion unless an expert witness

! PERJURY-is the willful telling of a lieunder oath.


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! HEARSAY EVIDENCE-rumors, notadmissible in evidence

! DYING DECLARATION or ANTEMORTEM STATEMENTS-considered

hearsay unless the dying person is a

victim of a crime.


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!APPEALS- review of the case byappellate court and when decided by it,

the final judgment results and matter isended.

! EXECUTION OF JUDGMENT

! Failure to comply means contempt ofcourt


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FELONIES

! acts or omissionspunishable by law.

! Elements:

1. Deceit-( dolo)

2. Fault-(culpa) -

due to imprudence,negligence or lack offoresight/ skill


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Q: A crime can be committedwith the element of culpa if:

!A. the person committed the crimebecause of ignorance of the law

! B. the person knows the action is acrime and he chooses to do it

! C. the person committed the crime

because he lacked the competency toact correctly


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Stages of felonies

1. Consummated all elements executed,with successful result

2. Frustrated all elements executedbut no successful result

3. Attempted not all elementsexecuted, nosuccessful result


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Degree of Feloniesdegree penalty fine

grave Capitalpunishment or

>6yrs & 1 day

above P6k

Less grave 1 month and 1day to 6 years

not > P 6 Kbut not

P 200


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Q: If the penalty is the deathpenalty, what is the degree of the

felony?

!A. grave

! B. less grave

! C. light felony


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Q: If the fine is exactly P200.,what is the degree?

!A. grave

! B. less grave

! C. light felony


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CLASSIFICATION OF PERSONSCRIMINALLY LIABLE:

1. PRINCIPAL

a. By directparticipation-doer of the act


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b. By inducement-directly force orinduce others

c. By cooperation-indispensable


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2. ACCOMPLICE

-a person who cooperates

accessory before the fact

-absent

at the time crime is committed.


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3. ACCESSORY

accessory after the fact

a. Profits

b. Conceals/ destroys evidence

c.Assists in the escape of the principal


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Situation: Danaya is two-monthspregnant. Her parents do not know

this. Danaya informed her friendAlena about the problem. Alenareferred Danaya to Pirena , an

abortionist. Danaya had anabortion.


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If those involved will be chargedlegally, who is considered as the

principal?a. Danaya b.Alena

c. Pirena d. None of them


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Who is considered as anaccomplice?

a. Danaya b.Alena

c. Pirena d. None of them


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If during the investigation, thepieces of evidence were not found

because Gurna the maid of Pirenaburned it. Gurna is consider as:

a. accomplice b. accessory

c. principal d. co-principal


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A nurse is liable as an accomplice inan abortion if she:

a. Assist in the escape of the offenderb. Refers the pregnant mother to the

abortionist

c. Conceals the evidence of the crimed. None of these

Circumstances


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Circumstances

affectingcriminal

liabilityJ-E-M-A-A


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JUSTIFYING! SELF-DEFENSE

! Unlawful aggression

! Reasonable necessity! Lack of sufficient provocation

! Fulfillment of Duty

! Obedience to an order from superior

! Order must be lawful

! Superior acting within the scope ofpractice


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EXEMPTING! Insane/imbecile

! Performance of a lawful act causesinjury by mere accident

! Under 9 y/o

! Under compulsion of uncontrollable

force

! Under impulse of uncontrollable fear

! Failure to perform an act required bylaw when prevented by some lawful

cause


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MITIGATING! Under 18y/o or over 70 y/o

! No intention to commit so grave awrong

! Sufficient provocation/threat precedingthe act

! Immediate vindication of a graveoffense

! Voluntary surrender

! Deaf & dumb/ with physical defect

! Suffer from such illness that diminishes

willpower


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AGGRAVATING! Treachery/taking advantage of

superior strength or position

! Price, reward, promise

! Use of fire, poison, explosion

! Calamities

!

Craft, fraud or disguiseemployed

! Evident Premeditation

! Cruelty


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ALTERNATIVE! May increase/ decrease criminal

liability depending on the nature

and effects of the crimeRelationship

Intoxication

Degree of instruction/ education


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DRILLS

1. Under compulsion ofuncontrollable force

2. There is sufficient provocation

3. Act is committed with abuse ofconfidence

4. Fulfillment of a duty

5. Offender is over 70 years old


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6. Voluntary surrender

7. Disguise be employed

8. Defense of a stranger

9. Acts under the impulse of anuncontrollable fear

10. Offender is insane


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Q: Premeditating to commit acrime is considered as:

!A. justifying

! B. mitigating

! C. aggravating

! D. exempting


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Q: When the defendant killssomeone accidentally:

!A. justifying

! B. exempting

! C. aggravating

! D. mitigating


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CRIMES CONCERNING

THE NURSE


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! -the victim oroffender is the

! 1. father

! 2. mother

! 3. brothers/sisters

!

4. ascendants! 5. descendants

! 6. spouse

The killing of another human


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The killing of another humanbeing

Th killi f th h b i ith


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-The killing of another human being withany of the aggravating circumstancesprovided by law.


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treachery


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- the killing of an

infant less than

three daysor 72 hours.


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ACTS OF LASCIVIOUSNESS


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MALICIOUS MISCHIEF


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PHYSICAL INJURIES

1. Serious PhysicalInjuries

2. Less SeriousPhysical Injuries

3. Slight PhysicalInjuries


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ANTI- RAPE LAW(RA 8353)


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I.

! A. MARITAL RAPE

! B. STATUTORYRAPE


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II. Anyone who inserts his penis intothe oral orifice of another by force

is liable under this law.


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III. Anyone whoinserts anything

into the analorifice or genitaliaof another isliable under this

law.


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ROBBERY

- Anyone who getsthe personal

property ofanother with the

use offorce,violence or

intimidation.


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THEFT

-anyone who gets

the personal

property ofanother withoutthe latterspermission.


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ASSAULT

- imminent threatof harmful/

offensive bodycontact


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BATTERY

- intentional,unconsentedtouching ofanother person.

ILLEGAL DETENTION/ FALSE


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ILLEGAL DETENTION/ FALSEIMPRISONMENT

- Deprive anotherof his freedom of

movement or space.


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Patient restraint


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SIMULATION OF BIRTH

! 1. Pretend thata woman gave

birth


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2. Substitution orexchanging of

babies in thenursery


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! 3. intentionallyputting wrong

information inthe birthregistration

form


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DEFAMATION

1. Slander- oral


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2. Libel- written


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Q: The nurse writes the following note inthe clients chart The physician isincompetent because he ordered the

wrong drug dosage.This statementmay lead to a charge of:

a. Assault

b. slander

c. libel

d. Invasion of privacy


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INVASION OF PRIVACY

THE RIGHT TO BE LEFT ALONE, FREEFROM UNWARRANTED PUBLICITY,

RIGHT TO LIVE ONES LIFE* Nurses liable if they divulge any

information from patients chart

to improper or unauthorizedpersons.


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MISDEMEANOR

!An act less than a felony.

Q: A person uses the license of


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Q panother person to practice nursing.Liable for What?

!A. negligence

! B. malpractice

! C. misdemeanor

! D. invasion of privacy


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DRILLS

1. A student nurse is overheardtalking in the cafeteria about a

client and his suicidal tendencies.2. A nurse asks a client why he chose

Dr. Smith for her physician when

this doctor is always rude to thestaff.


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3. A client is told he must pay theremainder of his medical bill before hecan leave the facility.

4. A nurse told the client that she will

inject her with sedatives if he does notcooperate.

5. A nurse forcibly opened the mouth of apedia patient and gave his medication.


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6. A nurse takes the wallet of thepatient while the latter is sleeping.

7. A nurse takes the wallet of thepatient with the use of violence

and intimidation.


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8. A nurse gives a potent injectionof morphine to a patient causing

his death.9. A nurse poisons his client to endhis life.

10. A patient died because of wrongmedication given.

GUIDELINES TO PREVENT


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GUIDELINES TO PREVENTCRIMINAL LIABILITY:

1. Be very familiar with thePhilippine Nursing law

2. Be familiar with the laws affectingnursing practice

3. Know agency rules, regulations,

policies4. Upgrade skills and competence

Q:To upgrade your skills you


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Q:To upgrade your skills, youmust:

!A. enrol in the graduate school

! B. be a member of the PNA

! C. attend seminars and trainings

! D. renew license


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5. Develop good IPR with co-workers6. Consult superior as needed7. Verify vague/ erroneous orders

8. Always keep doctor updated regardingpatient

9. Ensure accurate recording andreporting

10. Get informed consent11. Do not delegate responsibilities to

others

LEGAL CONSIDERATIONS IN


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LEGAL CONSIDERATIONS INCHARTING:

1. Dont tamper withmedical records-(ARD)adding,rewriting and

destroying originalrecord

2. Observe agencysstandards ondocumentation

! complete, concise,specific, use

standardabbreviation


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TELEPHONE ORDERS

TIPS FOR AVOIDING LEGAL


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TIPS FOR AVOIDING LEGALPITFALLS:

1. Patient Falls

! do proper assessment

! appropriate assistance!

use protective measures

! document all nursing

interventions


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2. Medicationerrors

! observe 7 Rs of drug

administration!

Check dr

s order!

Understand themedication you willadminister

!

Consult drug

handbook/ pharmacy!

Not exempt fromliability for followingdrs order


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! A co-nurse confided that she has givena medication to the wrong patient.What will you do?

a. advise her to report the incident to the headnurse

b. advise her to keep quiet about what

happened

c.

accompany her to the head nurse to reportthe incidentd.

report her immediately to the head nurse


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3. Equipmentinjuries

! refuse to use a device

not know how to operate

! report adverse events

to superiors

! monitor patientregularly

! bring questionable

orders to the attention

of the doctor or superior


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Failure to communicate

! promptly reportchanges in thepatient

ssymptoms andsigns of distressto the Dr

! properdocumentationof allassessmentsand telephoneconversations

with the Dr

NURSES AND CONTRACTS


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NURSES AND CONTRACTS

! CONTRACT- agreement between atleast two parties which create an

obligation recognized by law.

Elements of a valid contract:


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Elements of a valid contract:

1. given freely/ voluntarily- no coercion/pressure

2. competent parties- 18 yrs old, soundmind

3. lawful object- within the bounds of law

4. valid consideration- has monetaryvalue


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Essential requisites:

1. Consent

2. Object certain

3. Cause of the obligation


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Types of Contract:

1. Implied-terms are inferred fromactions of contracting parties.

2. Expressed-verbal/ written, termsare specified/ given at the time the

contract is made.


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3. Void or inexistent-inexistent from thevery beginning therefore may not beenforced. Ex: contrary to law.

4. Illegal- expressly prohibited by law

like obtained through fraud, undueinfluence or duress.

5. Voidable/annullable-one of the partiesis incapable of giving consent


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5. Formal-agreement among partiesand is required to be in writing by

special laws. Ex: marriage, Deed ofsale

6. Informal-concluded as a result of

a written document where the lawdoes not require the same to be inwriting.

Q: A person entered the clinic of a doctor


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Q: A person entered the clinic of a doctorfor treatment.What type of contract?

!A. formal

! B. implied

! C. informal

! D. expressed

Q: A nurse and a pregnant woman agreedthat the nurse will do home delivery for a


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that the nurse will do home delivery for afee. What type of contract?

!A. informal

! B. implied

! C. expressed

! D. formal


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! BREACH OF CONTRACT-failurewithout legal excuse to

perform any promise whichforms the contract.

The following constitute breach


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The following constitute breachof contract for nursing service:

1. Prevention of performance

2.

Failure of performance because of

inconvenience or difficulty3.

Abandonment of duty

4.

Substitution of performance

Legal excuses in refusing or


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g gfailure to perform a contract:

1. Discovery of materialmisrepresentation

2. Where performance will be illegal3. Impossible by reason of illness

4. Impossible by death of patient ornurse

5. Made for other reasons

6. Contract is insufficient


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Will

! an act whereby aperson ispermitted with

formalities of lawto control tocertain degree thedisposition of a

state to takeeffect after hisdeath.


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! DECEDENT- person whose property is

transmitted through succession.! TESTATOR- a decedent who left a will

! HEIR- a person called to succession


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TYPES OF SUCCESSION:

1. Testate-a person dies leaving a

will.2. Intestate-a person dies without

leaving a will.


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! TWO KINDS

1. Notarial will-acknowledged before a

notary public, with attestation clause2. Holographic will-entirely written,

dated and signed in the handwriting of

the testator

:


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Who makes wills:

1. those not expressly prohibited by

law2. 18 yrs old

3. sound mind


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Who could be witnesses:

1. sound mind

2. 18 and above

3. not blind, deaf or dumb4. able to read and write


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! Bakekang, 59 years old, is sufferingfrom a debilitating disease but ofsound mind. She has asked you to help

her make a will. How should yourespond to the situation?a. let her dictate and write for herb. call her intended beneficiaries as witnessesc.

assist patient to consult a legal officerd. refuse request since it is not your duty


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2. Note that the will is signedby the

testator.


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3. Note that thewitnesses shall bepresentat the time and sign in the

presence of testator.


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GIFTS MORTIS CAUSA

! disposing of giftsby a person inanticipation of

death/ belief inapproachingdeath.


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Limitations:

1. limited to personal properties

2. acceptance by the recipient3. gifts are revocable and subject to

the claims of creditors without

proof of intent of defrauding them


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! BOARD QUESTIONS:

1. The nurse out of pity unhooked

the patient from a respirator. Thepatient died after 15 minutes. This

type of felony is:

a. consummatedb. frustrated

c. attempted


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2. Circumstances which are said tobe in accordance with the law are

said to be:a. Justifying

b. Exempting

c. Mitigatingd. Aggravating


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3. All of the following are exemptingcircumstances except:

a. Imbecileb. 8 year old

c. performance of a lawful act

d. offender is deaf and dumb


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4. When a politician takes advantageof his power in the performance

of unlawful actions, this isconsidered as:

a. justifying circumstance

b. exempting circumstancec. mitigating circumstance

d. aggravating circumstance


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5. When one alters a record toconceal possible evidence of

negligence, she can be chargedas:

a. accomplice

b. accessoryc. principal

d. co-principal


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! BOARD QUESTIONS:1. A client in a long term care facility refuses to

take his oral medications. The nurse threatensthe client and tells him that, if the medication

isn

t taken, restraints will be applied. Thenurses statement constitutes which legaltort?

a. assaultb. battery

c. negligenced. right to refuse treatment


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2. The nurse is at risk for lawsuit. Which of thefollowing actions will shield her frompossible lawsuits?

1. knowledge and implementation of standardsof care

2. documentation of actions accurately andconcisely

3. document outcome of care

4. following all doctor

s ordera. 1,2,4 b. 2 & 3 c. 1,2,3 d. 2,3,4


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3. One of the midwives in the healthcenter injected Cotrimoxazole to a 5year old patient without the consent ofthe parents. Which of the followingcan the midwife be possibly accusedof?

a. malpracticeb. battery

c. negligenced. assault


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4. If that nurse divulges theinformation that she is caring for

the child of a patient withsexually transmitted disease, shecan be liable for:

a. libelb. slander

c. tort

d invasion of privacy


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5. Two janitors were having a heated argumentas to who shall dispose the waste of apatient with typhoid fever. The first onecalled the other lazyboneand pain in the

neck

within the hearing of the rest of thenurses.The case is:

a. libel

b. invasion of privacy

c. slanderd. negligence


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6. Should the accusation be writtenin the newsletter of the hospital,

such liability is a:a. assault

b. libel

c. slanderd. battery


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7. The nurse observed that in the hospital where sheworked, it is a practice to accept medical orders bytelephone. In this aspect, she should remember thefollowing:

a. T.O should be countersigned by the attendingphysician at the first opportunity to make it legalorder

b. T.O are risky and should not be acceptedc. The nurse could write on the the doctors order

sheet the exact date, time and full name of the drgiving the orderd. The nurse can sign for the doctor on the order sheet! a. 1,4 b. 1,2 c. 3 only d. 1, 3


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8. The nurse noticed that restraining patients is acommon practice. Which of the followingshould she remember?

a. Restraints are necessary so that the nursecould do more work for patients

b. Use of restraints is an effective intervention

c. Restraints require a physicians order

d. Refusal to be restrained is a ground for

terminating the nurse-patient relationship


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! 9. Patient records are very important in courtlitigations. Which of the following safeguardsshould be adopted by the nurse?

! A. follow standard charting

! b. photocopy pts chart before submitting tothe medical records Office

! c. maintain a logbook of potential legal case! all of the above

nursing jurisprudence and ethics

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