Ethico Legal Aspects of Care

8/3/2019 Ethico Legal Aspects of Care

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Ethico Legal Aspects

of CarePresented by:

Darash S. VillafloresLykaLea G. Villamor


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Historical Background Beneficence the duty to benefit

Nonmaleficence the duty not toharm

The Code of Hammurabi (19551913B.C.) included penalties forphysicians/surgeons who did not

cure. Punishments were specifiedfor infractions of the code.

First medical malpractice suit wastried in England in 1374. The first

one in the United States occured in


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Legal Issues

Lawsuit- a legal action brought between twoprivate parties in a court of law.

Consumerism- the protection of the rights andinterests of consumers, especially with regardto price, quality, and safety.

Litigation- the act or process of bringing aboutor contesting a lawsuit or all lawsuitscollectively.


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Consumer Rights movement- a movement thatfocuses on consumer rights, a well informedpublic has developed an increasingly litigiousattitude demanding compensation for bodilyinjuries or damages to personal properties.

Causes of litigation- lie in patients and theirfamilies belief that physicians and/or healthcare organizations have not providedappropriate dx, tx, or results.


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Liability

Liability- legally responsible for personalactions

Negligence- the failure to use the care orskills that any caregiver in the same or asimilar situation would be expected to use.

Malpractice- any professional misconduct,unreasonable lack of skill or judgement, orillegal or immoral conduct.


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Good Samaritan Acts

Laws designed to protect health care providerswho provide assistance at the scene of anemergency against claims of malpractice unless itcan be shown that there was a gross departurefrom the normal standard of care or willfulwrongdoing on their part. Gross negligenceusually involves further injury or harm to theperson.

Ex.: An automobile may strike an injured child lefton the side of the road when the nurse leaves toobtain help.


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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


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Consent General Consent- most facilities require the

patient or his/her legal guardian to sign a generalconsent form on admission.

Informed Consent- recognizes thephysicians duty to inform the patient of the risks,benefits and alternatives of a procedure and toobtain consent before treatment.

Informed Consent for a Surgical Procedure

Responsibility forInformed Consent before a SurgicalProcedure


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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


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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 intoeffect.

1993- FDA began the voluntary MedWatch program


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THE STANDARD OF CARE AND

PROFESSIONALETHICSSOURCES OF PROFESSIONAL STANDARDS

Standards of care- acts that a reasonably prudent person withcomparable training and experience would perform under the sameor 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


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Association for the Advancement of MedicalInstrumentation (AAMI) device standards

Clinically based risk-control standards

REGULATORY STANDARDS

The 1965 Federal Medicare Act and all subsequentamendments 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


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RECOMMENDED PRACTICES


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Sou

rces: Tighe, Shirley M. (2008).Instrumentation for the Operating Room. (4th ed.) USA: Mosby Inc. Smeltzer, Suzanne C. & Brenda G. Bare, et. al. (2008). Brunner &

Suddarths Textbook of Medical and Surgical Nursing. (11th ed.)Philadelphia: Lippincot Williams & Wilkins.

Berman, A., Snyder, S.J., et. al. (2005) Kozier & Erbs Fundamentalsof Nursing: Concepts, process and practice. (7th ed.). New Jersey:Pearson Education, Inc.

Lewis, S. et. al. (2000). Medical-Surgical Nursing: Assessment andManagement of clinical problems. (5th ed.) USA: Mosby, Inc.

Black, J.M., Hawks, J.H. & Keene, A.M. (2001). Medical-SurgicalNursing. 6th Ed. W.B. Saunders Company: Philadelphia.

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Ethico Legal Aspects of Care