Ncm Jurisprudence

7/31/2019 Ncm Jurisprudence

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Main Concept:

Nursing Ethicsis concerned with the principles and right conduct as they apply to the nursing profession. Itreinforces the nurses ideals and motives in order to maximize the affectivity of their service.

Nursing Jurisprudenceis that department of law which comprises all the legal rules and principles affectingthe practice of nursing. It also includes the interpretation of all these rules and principles and their applicationto the regulation of the practice of nursing.

Course Objectives:

At the end of 20 hours, the students should:

1. Be sensitive to ethical considerations and face ethical issues and responsibility in health care, community work,and public issues.

Specifically, the student will be able to:

1. Explain bioethical concepts and principles and integrate them in clinical practice.2. Apply the steps in ethical decision-making when given an ethical issue3. Analyze common bioethical issues affecting nursing practice4. Be able to integrate a basic understanding of nursing law, develop skills in the application of legal, ethico-moral

principles in nursing practice and recognize the importance of these principles in the nursing profession.

Definition of Terms

1. Profession an occupation or calling requiring advance training and experience in some specific orspecialized body of knowledge which provides service to society in that specific field.

2. Vocation an occupation of calling.3. Ethics refers to a standard to examine and understand moral life.4. Morality refers to social consensus about moral conduct for human beings and society.5. Professional Ethics a branch of moral science concerned with the obligations that a member of the

profession owes to the public.

6. Health Care Ethics the division of ethics that relates to human health.7. Bio-Ethics a specific domain of ethics that focuses on moral issues in the field of health care.8. Nursing Ethics related to all the principles of right conduct as they apply to the profession.9. Nursing Profession the performance for a fee, salary or other reward or compensation or professional

nursing service to individuals, families and communities in various stages of development. The promotion of

health, prevention of diseases, restoration of health and alleviation of suffering thru:

Utilization of Nursing Process Establishment of connection with community resources Motivation of individuals, families and communities Participation in teaching guidelines and supervision Undertaking nursing and health manpower development

Ethical Approaches


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A. Teleological Approach or Act of Utilitarianism

Teleology comes from the Greek word telos or goal or end. This is expressed as the right thing to do is the good thing to do.

The teleological approach is also termed as act utilitarianism where the good resides in the promotion ofhappiness or the greatest net increase of pleasure over pain.

Guidelines for making ethical decisions:

1. Consideration for people as human beings;2. Consideration of consequences;3. Proportionate good to come from choices;4. Propriety of actual needs over ideal or potential needs;5. A desire to enlarge choices and reduce chance; and6. A courageous acceptance of the consequence of the decision.

B. Deontological Approach or Duty-Oriented Theory

The basic rightness or wrongness of an act depends on the intrinsic natures rather than upon the situation orits consequences.

The word deontology came from the Greek word deon which means duty.

C. Virtue Ethics Approach

Virtue Ethics, known as aretaic ethics (from the Greek word arte) is focused primarily on the heart of theperson performing the act.

It focused on the traits and virtues of a good person such as courage, temperance, wisdom and justice. Intellectual virtue is the power to deliberate about things good for oneself. Moral virtues must be lived over time in order to be learned.

D. Divine Command Ethics

Is based on the theory that there is a Supreme or Divine being that sets down the rules to provide guidance tomoral decisions.

Universal Principles of Biomedical Ethics

1. A. Autonomy Comes from the Greek word autos meaning self and nomos meaning governance.


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It involves self-determination and freedom to choose and implement ones decision, free from deceit, duress,constraint or coercion.

1. B. Veracity To maximize the efficiency of health care, the patient and the health care providers are bound to tell the truth. The patient has the responsibility to provide, to the best of his knowledge, accurate and complete information

about his complaints, past illness, previous hospitalizations, medications taken, allergies, religious restrictions,

and other matters relevant to his health.

1. C. Beneficence / Peace Education The principle of beneficence promotes doing acts of kindness and mercy that directly benefit the patient. These acts promote the health of the patient, prevent illness or complications, alleviate suffering and assist

towards peaceful death if the inevitable comes.

1.

D. Nonmaleficence

Is stated as an admonition in the negative form to remind health practitioners to do no harm.1. E. Justice Refers to the right to demand to be treated justly, fairly and equally.

Importance of Ethical Codes

1. It is a systematic guide for developing ethical behavior.

2. It answers normative questions of what beliefs and values should be morally accepted.

Nursing Code of Ethics

1. 1. Importance:It strongly emphasizes the four-fold responsibility of nurse, the universality of the nursing practice, the scope

of their responsibilities to the people they serve, to their co-workers, to society and environment, and to their

profession.

1. 2. Brief History:1. a. 1982 The Philippine Nurses Association Special Committee, under the chairmanship of Dean Emeritus Julita V.

Sotejo, developed a Code of Ethics for Filipino nurses.


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1. b. 1984 The Board of Nursing, Professional Regulation Commission adopted the Code of Ethics of the International

Council for Nurses through Board Resolution No. 633 adding promotion of spiritual environment as the fifth-

fold responsibility of the nurse.

This was enforced up to 1989.

1. c. 1989 The Code of Ethics promulgated by the Philippine Nurses Association was approved by the Professional

Regulation Commission and through Board Resolution No. 1955 was recommended for use.

This was approved by the general assembly of the Philippine Nurses Association during the Nurses Weekconvention on October 25, 1990.

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3. Amended Code of Ethics for Nurses1. Pursuant to Section 3 of Republic Act No. 877, known as the Philippine Nursing Law, and Section 6 of PD No.

233, the amended Code of Ethics for Nurses recommended and endorsed by the Philippine Nurses Association

was adopted to govern the practice of nursing in the Philippines.

2. The Code was adopted under Republic Act 9173 and promulgated by the Board of Nursing under ResolutionNo. 220 Series of 2004 last July 14, 2004.

PRINCIPLES:

1. Nurses and People2. Nurses and Practice3. Nurses and Co-Workers4. Nurses and the Society1. Contributing members of the society2. Awareness for the call for change3. Nurses and the Profession4. Responsibility of the Nurse to Patient5. Responsibility of the Nurse to the Physician6. Responsibility of the Nurse to her Colleagues7. Responsibility of the nurse toward themselves

the icn code for nurses [2006] & the universal principles in nursing

1. Nurses and People Nursing care Environment that respects the rights, values, and spiritual beliefs of patients Informed consent/ information dissemination Confidentiality


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1. Nurses and Practice Responsibility and accountability for nursing practice and the maintenance of competence

Standard of care wherein the ability to provide care is not compromised Assess individual competency Maintain standards of personal conduct Client safety with regard to the use of technology and scientific advances2. Nurses and the Profession Assume the major role in determining and implementing acceptable standards in practice, management,

education and research

Be active in developing of core of research-based professional knowledge Participate in creating and maintaining safe, equitable, social, and economic working conditions in nursing

through professional organization

3. Nurses and Co-Workers Cooperation and collaboration Patient Protection from co-worker or other individuals

IMPLEMENTING RULES IN THE ICN CODE OF ETHICS

1. nurses shall perform professional duties in conformity with the existing laws and generally accepted principlesof moral and ethical conduct and proper decorum

2. Nurses must know responsibilities in the practice of the profession3. Solicitation, direct or indirect from patients is repugnant to the honor and dignity of nursing profession that

constitutes unethical conduct

4. Nurses must not allow the use of their names in the promotion of any commercial products or service

Responsibilities of the Nurse to the Patients

1. Give him/her the kind of care his/her condition needs regardless of his/her race, creed, color, nationality orstatus.

2. The patients care shall be based on needs, the physicians orders, and the ailment. 3. The nurse shall involve the patient and/or his/her family so that he/she or any of the family can participate in

his/her care.

4. Know the patients Bill of Rights.5. Be patient advocate. Treat patient in a manner that will show concern whether the patient is rich or poor.6. Nurses should not leave a patient or any agency without proper permission or resignation or without relief.7. Nurses should commit themselves to the welfare of those entrusted to their care.

Patients Bill of Rights

1. The patient has the right to considerate and respectful care.


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2. The patient has the right to obtain from his physician complete and current information concerning hisdiagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand.

3. The patient has the right to receive from his physician information necessary to give informed consent prior tothe start of any procedure and/or treatment.

4. The patient has the right to refuse treatment and to be informed of the medical consequences of his action.5.

The patient has the right to every consideration of his privacy concerning his own medical care program.

6. The patient has the right to expect that all communications and records pertaining to his care should betreated as confidential.

7. The patient has the right to expect within its capacity, a hospital must make reasonable response to therequest of a patent for services.

8. The patient has the right to obtain information as to any relationship his hospital has to other health care andeducational institutions insofar as his care is concerned.

9. The patient has the right to be advised if the hospital proposes t engage in or perform human experimentationaffecting his care or treatment.

10. The patient has the right to expect reasonable continuity of care.

11. The patient has the right to examine and receive an explanation of his bill.

12. The patient has the right to know what hospital rules and regulations apply to his conduct as a patient.

Patients Responsibilities

1. Providing information2. Complying with instructions3. Informing the physician of refusal to treatment4. Paying hospital charges5. Following hospital rules and regulations6. Showing respect and consideration

Nurses Bill of Rights

1. Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receivenursing care.

2. Nurses have the right to practice in environments that allow them to act in accordance with professionalstandards and legally authorized scopes of practice.

3. Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance withthe Code of Ethics for Nurses and its interpretative statements.

4. Nurses have the right to freely and openly advocate for themselves and their patients, without fear ofretribution.

5. Nurses have the right to fair compensation for their work, consistent with their knowledge, experience andprofessional responsibilities.

6. Nurses have the right to a work environment that is safe for themselves and their patients.7. Nurses have the right to negotiate the conditions of their employment, either individuals or collectively, in all

practice settings.

Nurses Responsibilities in Research on Human Subjects


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1. Employment in settings where research is conducted.2. Vigilant protection of human subjects rights3. Scope of Application4. Supporting accrual of knowledge5. Informed consent6.

Representation of Human Rights Committee

Basic Human Rights of Research Subjects

1. Right to informed Consent2. The right to refuse and/or withdraw from participation3. Right to privacy4. Right to confidentiality or anonymity of data5. Right to be protected from harm

Experimental Subjects Bill of Rights

1. To be told about the nature and purpose of the study.2. To be told about the procedures to be followed in the research study, and whether any of the drugs, devices,

or procedures is different from what would be used in standard practice.

3. To receive a description of any side effects, discomforts, or risks that you can reasonably expect to occurduring the study.

4. To be told of any benefits that you may reasonably expect to from the participation in the study, if applicable.5. To receive a description of any alternative procedures, drugs, or devices that might be helpful, and their risks

and benefits compared to the proposed, drugs or devices.

6. To be told of what sort of medical treatment, if any, will be available if any complications should arise.7. To be given a chance to ask any questions concerning the research study both before agreeing to participate

and at any time during the course of the study.

8. To refuse to participate in the research study. Participation is voluntary. You may refuse to answer anyquestion or discontinue your involvement at any time without penalty or loss of benefits to which you might

otherwise be entitled. Your decision will not affect your right to receive the care you would receive if you were

not in the experiment.

9. To receive a copy of signed and dated written consent form and a copy of this form.10. To be given the opportunity to freely decide whether or not to consent to the research study without any

force, coercion, or undue influence.

Responsibilities of the Nurse to the Physician

Section 28(a) of RA 9173 states that: It shall be the duty of the nurse to:(a) Provide nursing care through utilization of the nursing process. Nursing care includes, but not limited to,

traditional and innovative approaches, therapeutic and innovative approaches, therapeutic use of self,

executing health care techniques and procedures, comfort measures, health teachings, and administration of


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written prescription for treatment, therapies, oral, topical and parental medications, internal examination

during labor in the absence of antenatal bleeding and delivery. In case of suturing or perineal laceration,

special training shall be provided according to protocol established.

Responsibilities of Nurses to Their Colleagues

1. Establish good working relationships with co-workers.2. Nurses shall adjust themselves to the organization and know its policies and procedures.

Responsibilities of Nurses to Themselves

1. Develop their own skills.2. Their conduct must bring credit to the profession.3. They shall endeavor to live a life that will uphold their self-respect.4. Wear uniform with respect and dignity (clean, neat hair style, moderate make-up, without jewelries)5.

Must act in a manner that is worth emulating especially while they are on duty.

Special Concepts and Principles which Guide Client-health Professional Relationship

1. Right to Health Care2. Right to Informed Consent3. Promise Keeping (Fidelity)4. Truth-Telling (Veracity)5. Confidentiality

Moral Principles

1. The Golden Rule2. The Two-fold Effect3. The Principle of Totality4. Epikia5. One who acts through an agent is himself responsible6. No one is obliged to betray himself/herself7. The end does not justify the means8. Defects of nature may be corrected9. If one is willing to cooperate in the act, no justice is done to him/her

10. A little more or less does not change the substance of an act

11. The greatest good for the greatest number

12. No one is held to the impossible

13. The morality of cooperation

14. Principle relating to the origin and destruction of life

The Good Samaritan Law


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It is based on the biblical story of a man who aided an injured person who was waylaid by thieves and was left

half-dead. A nurse, therefore, who renders first aid or treatment at the scene of an emergency and who does

so within the standard of care, acting in good faith, is relieved of the consequences of the act.

Laws and Organizations Protecting Nurses:

1. International Labor Organization Convention 1492. ILO Recommendation 19773. International Council of Nurses4. Code of Ethics for Nurses5. Magna Carta for Health Workers (RA 7305)6. Philippine Nursing Law7. Philippine Constitution

JURISPRUDENCE

1. A. Definition of Terms2. Law the sum total of rules and regulations by which society is governed.3. Jurisprudence the science of law.4. Nursing Jurisprudence that department of law which comprises all the legal rules and principles affecting

the practice of nursing. It also includes the interpretation of all these rules and principles and their application

to the regulation of the practice of nursing.

5. Plaintiff the party to a civil suit who brings the suit seeking damages or other legal relief; complainant.(ACCUSER)

6. Defendant (In criminal case) the person accused of committing a crime; (In civil suit) the party againstwhom suit is brought demanding that he pays the other party legal relief.

7. Subpoena a court order requiring one to appear in court to give testimony.8. Summons a notice to a defendant ordering him to speak in a court at a specified time and date to answer a

complaint against him.

9. Witness one who is called to give testimony in a court of law.10. Felony a crime of a serious nature usually punishable for a period of longer than one year or by death.

10. Principal a person who takes direct part in the execution of the act.

11. Accomplice- those people who not being principals, cooperate in execution of the offense by previous

simultaneous acts.

12. Legal Right a right or claim which can be enforced by legal means against the person of the

community.

13. Jurisdiction the legal right or authority of a court to hear and decide on a legal case or controversy.

14. Legislation the act or process of making laws.

Aspects of the Profession with Provisions with Provisions of the Law:

1. Examination and registration of applicants.2. Professional conduct of practitioners.


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3. Maintenance of ethical and technical standards of the profession.4. Illegal practice of unregistered persons.5. Exercise of powers and duties to examine applicant and administer the law regulating the profession.

Classification of Laws:

1. A. According to Source of Authority1. Divine Law laws authored by God2. Human Law laws authored by men

1. B. Groups of Human Law1. Public Law department of law which is concerned with the state in its political or sovereign capacity. It is a

law that applies generally to people of the state adopting or enacting it.

1.1 Criminal Law treats the nature, extent and degree of every crime and adjusts to it the adequate and

necessary penalty.

1.2 International Law the law which regulates the intercourse of nations

1.2.1 Public International Law control the conduct of independent state in their relation to each

other.

1.2.2 Private International Law conflict law

1.3 Political Law Threats the science of politics (Government) Regulates the relation between the state

and individuals that compose it.

1.3.1 Constitutional Law - law that relates the constitution, as a permanent system of political and

juridical government, as distinguished from statutory and common law, which relate to matters subordinate to

such constitution.

1.3.2 Administrative Law the body of rules and regulations and orders and decisions created by

administrative agencies of government.

1.3.3 Law of Public Administration

1.3.4 Law of Public Corporation

1.4 Private Law law that relates the private matters which do not concern the public at large

(Administrative between citizen and citizen)

1.4.1 Civil Law organizing the family and regulating property.

1.4.2 Commercial Law relates to the rights of property and the relations of persons engaged in

commerce.

1.4.3 Remedial Law methods of enforcing rights or obtaining redress (correcting the wrong)

The Evolution of the Philippine Nursing Law

Republic Act No. 2493dated February 5, 1915 The first law affecting the practice of nursing in the

Philippines. It consists of two sections:

a. Sec. 7 states that every person desiring to practice nursing in the Philippines shall apply to the Director of

Health for a Certificate of registration as a nurse.


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May 13, 1982 Coping of the propose amendment of the Philippine Nursing Act of 1982 was submitted tohealth minister Azurin for him to sponsor at Batasan Pambansa.

These events laid the foundation for RA 7164 with Senator Heherson Alvarez as primary sponsor. It was finally

passed in the lower house and appraisal in November 21, 1991 by Pres. Corazon Aquino Nursing as a dynamicprofession continues to seek ways and means to make it more responsive and relevant. This is the prime

motive for the birth of RA 9173sponsored by Hon. Carlos M. Padilla of the House of Representatives. Said

bill was approved on the third meeting by the low House on August 22, 2000 but was not acted upon by the

Senate.

The counterpart bill in the Senate (SB No. 2292) with Senator Flavier as sponsor. The BM and PNA and

Legislation Committee worked and put the bill in its final form. The Pres. GM Arroyo during the 80th

Anniversary of the Nurses Week celebration on October 21, 2002 in Manila Midtown Hotel.

RA 9173October 21, 2002 an act providing for a more responsive nursing profession repealing for thepurpose RA # 7164, otherwise known as the Philippine Nursing Act of 1991.

Philippine Nursing Law (RA 9173)

Title of the law and its provision (Article I) Declaration of Policy (Article II) Organization of the Board of Nursing (Article III) Examination and Registration (Article IV) Nursing Education (Article V) Nursing Practice (Article VI) Health Human Resources Production, Utilization and Development (Article VII) Penal and Miscellaneous Provisions (Article VIII)

Reference for RA 9173Primer of RA 9173, Twelfth Congress, Second Regular SessionBoard of Nursing

Resolution No. 425, Series of 2003, Implementing Rules and Regulation of the Philippine Nursing Act of 2002.

Elements Involved in Legal Liability:

1. Negligence refers to the commission or omission of an act, pursuant to a duty, that a reasonably prudentperson in the same or similar circumstance would or would not do, and acting or non-acting of which is the

proximate cause of injury to another person or his property.

2. Malpracticethe idea of improper or unskillful care of a patient by a nurse; denotes stepping beyond onesauthority with serious consequences. It is the term for negligence or carelessness of professional personnel.

3. Incompetence the lack of ability, legal qualifications or fitness to discharge the required duty.4. Ignorance means want of knowledge.5. Moral Turpitude an act of baseness, vileness or depravity in social or private duties.


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6. Fraud a wrong doing or misconduct, an act resulting from a willful act to deceive; deceitful practice, rules ofcommon honesty.

7. Deceit any act. Declaration or practice which misleads a person or which causes him to believe what is false.8. False Statement an allegation or statement that is deceitful with intention to commit a fraud.

Professional Negligence

1. A. Elements of Professional Negligence1. Existence of duty on the part of the person charged to use due care under circumstances.2. Failure to meet the standard of due care.3. The foreseeability of harm resulting from failure to meet the standard.4. The fact that the breach of this standard resulted in an injury to the plaintiff.

1. B. Five Legal Doctrines to Describe Professional Negligence1. Res Ipsa Loquitorthree conditions are required to establish a defendants negligence without proving specific

conduct.

2. Doctrine of Force Majeure - means an irresistible force, one that is unforeseen or inevitable.3. Doctrine of Respondeat Superiorlet the master answer for the acts of the subordinate.4. Captain of the Ship Doctrine5. Doctrine of Corporate Liability

Torts

a legal wrong, committed against a person or property independent of a contract which renders the person

who commits it liable for damages in a civil action.

Examples of Torts:

1. Assault the imminent threat of harmful or offensive bodily contact.2. Battery an intentional, unconsented touching of another person.3. False Imprisonment or Illegal Detention means the unjustifiable detention of a person without a legal

warrant within boundaries fixed by the defendant by an act or violation of duty intended to result in such

confinement.

4. Invasion of Right to Privacy and Breach of Confidentiality5. Defamation Slander oral defamation of a person by speaking unprivileged or false words by which his reputation is

damaged.

Libel defamation by written words, cartoons or such representations that cause a person to be avoided,ridiculed or held in contempt or tend to injure him in his work.


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Crimes, Misdemeanors and Felonies

1. Crimes an act committed or omitted in violation of the law.2.

Elements of Criminal Offenses:

1. Criminal Act2. Evil/ Criminal Intent

Conspiracy to commit a crime Criminal Actions Criminal Negligence Criminal Intent

Classification of Felony:

1. A. According to Degree of the acts of Execution:1. Consummated when all the elements necessary for its execution and accomplishment are present.2. Frustrated when the offender performs all the acts or execution which will produce the felony as a

consequence but which nevertheless, do not produce it by reason of causes independent of the will of the

perpetrator.

3. Attempt when the offender commences the commission of the same directly overt (open or manifest) acts,and does not perform all the acts or execution which shall produce the felony, by reason of some cause or

accident other than his own spontaneous desistance.

1. B. According to Degree of Punishment:1. Grave Felonies those to which the law attaches the capital punishment (death) or penalties which in any of

their periods are afflictive (imprisonment ranging from six (6) years and one (1) day to life imprisonment not

exceeding P6,000.00).

2. Less Grave Felonies those which the law punishes with penalties which in their maximum period arecorrectional (imprisonment ranging from one month and one day to six (6) years, or a fine not exceeding

P6,000.00 but not less than P200.00).

3. Light Felonies those infractions of law for the commission of which the penalty ofarresto menor(imprisonment for one (1) day to thirty (30) days or a fine not exceeding P200.00 or both of which are

imposed). This is punishable only when they have been consummated, with the exception of those committed

against a person or property.

Circumstances Affecting Criminal Liability

1. Justifying Circumstances2. Exempting Circumstances


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