Chapter 05 Legal and Ethical Responsibilities Copyright 2017

Chapter 05 Legal and Ethical Responsibilities Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 1 Legal Responsibilities • Laws and legal responsibilities protect you and society • Criminal law – Wrongs against person, property, society • Civil law – Relationships between people, protection of person’s rights Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Torts • • • Wrongful act that does not involve a contract Malpractice Negligence Assault and battery Invasion of privacy Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Torts • False imprisonment • Abuse • Defamation – Slander – Libel Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Contracts • Components of contract – Offer – Acceptance – Consideration • Implied or expressed Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Contracts • Contracted parties must be free of legal disability • Breach of contract • Use translator/interpreter with non-Englishspeaking party • Principal and agent Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Privileged Communications • All information from a patient must be kept confidential • Can only be released with a patient’s written consent (unless exempt information) • Health care records are privileged Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Privacy Act • Health Insurance Portability and Accountability Act (HIPAA) of 1996 • Standards for Privacy of Individually Identifiable Health Information (called the Privacy Rule) • Patients must sign a consent form Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Privacy Act • Written authorization for release of information • Refer to Figures 5 -4 and 5 -5 in text • Health care workers must protect privacy and confidentiality of patients’ health care records Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Regulation of Health Care Providers • Scope of practice – What each level of care a provider is legally able to perform – Failure to abide by scope of practice can result in suspension or loss of license Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Set of principles dealing with what is morally right or wrong • Provide a standard of conduct or code of behavior • Help health care workers analyze information and make appropriate decisions Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Ethical dilemmas – Euthanasia – Confidentiality of AIDS diagnosis – Use of aborted fetuses in research – Continuing life support – Expensive treatments and payment Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Ethical dilemmas – Transplant decisions – Legal issues with medical marijuana use – Animals and research – Genetic research – Cloning – Stem cell research Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Basic principles – Save lives and promote health – Patient comfort – Respect a patient’s right to die peacefully and with dignity – Treat all patients equally – Provide the best care possible for every patient Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Basic principles – Maintain competent skills and knowledge – Stay up-to-date and pursue continuing education – Respect rules of confidentiality – Refrain from immoral, unethical, and illegal practices Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 2 Ethics • Basic principles – Show loyalty to patients, coworkers, and employers – Be sincere, honest, and caring • Learn and abide by the code of ethics for your chosen career Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Agencies must have written policies for patients’ rights • All personnel must respect and honor these rights • DHHS implemented Consumer Bill of Rights and Responsibilities Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Residents of long-term care facilities have rights guaranteed under the Omnibus Budget Reconciliation Act (OBRA) of 1987 • Long-term care facilities must post a Resident’s Bill of Rights Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Patient Protection and Affordable Care Act (PPACA) – Guarantees rights related to health care coverage – Coverage of essential health benefits – Preventive care – Coverage if a preexisting condition exists – Coverage up to age 26 on parent’s plan Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Patient Protection and Affordable Care Act (PPACA) – Choose any participating primary care provider – No preauthorization for emergency care – No annual lifetime limits on benefits – No arbitrary withdrawal or cancellation of coverage Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Patient Protection and Affordable Care Act (PPACA) Appeal decisions for denial of services Outside review if denied payment or termination of coverage Refund a percentage of premiums based on percentage of premiums paid on health care versus administrative costs Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 3 Patients’ Rights • Patient Protection and Affordable Care Act (PPACA) – Refund a percentage of premiums based on percentage of premiums paid on health care versus administrative costs Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 4 Advance Directives for Health Care • Also known as legal directives • Allow individuals to state desired and undesired medical treatment in the event of incapacitation • Legal document Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 4 Advance Directives for Health Care • Two main directives – Living will – Designation of Health Care Surrogate or a Durable Power of Attorney (POA) for Health Care (refer to Figure 5 -8 in text) Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 4 Advance Directives for Health Care • Patient Self-Determination Act (PSDA) of 1990 • Health care workers must be aware of and honor advance or legal directives • Health care workers should consider preparing their own advance directives Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 5 Professional Standards • Perform only those procedures for which you have been trained and are legally permitted to do • Use approved, correct methods while performing any procedure • Obtain proper authorization before performing any procedure Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 5 Professional Standards • • • Identify the patient Obtain the patient’s consent Observe safety precautions Keep all information confidential Think before speaking, consider what you say Treat all patients equally Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 5 Professional Standards • Do not accept tips or bribes for care you provide • If an error or a mistake occurs, report it immediately to your supervisor • Behave professionally in dress, language, manners, and actions Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

5: 5 Professional Standards • Liability insurance provides additional protection in case of legal action • It is your responsibility to understand legal and ethical requirements of your career • Obtain pertinent information from your state board of health or education Copyright © 2017 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.