Unit 4 Ethical and Legal Issues Affecting the

Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant Copyright © 2008 Delmar Learning. All rights reserved.

Objectives • Spell and define terms. • Discuss ethical and legal situations in health care. • Describe the legal and ethical responsibilities of the nursing assistant concerning patient information. Copyright © 2008 Delmar Learning. All rights reserved.

Objectives • Describe tactful ways to refuse a tip offered by a patient. • Describe the legal responsibilities of a nursing assistant. Copyright © 2008 Delmar Learning. All rights reserved.

Objectives • Describe how to protect the patient’s right to privacy. • Define sexual harassment and give examples of activities that may be perceived as being sexually harassing. Copyright © 2008 Delmar Learning. All rights reserved.

Ethical Standards • Ethical standards – Guides to moral behavior • People who provide health care – Voluntarily agree to live up to these standards Copyright © 2008 Delmar Learning. All rights reserved.

Ethical Standards • When these rules are not followed: – Nursing assistant fails to live up to the promise to give safe, correct care and to do no harm Copyright © 2008 Delmar Learning. All rights reserved.

Legal Standards • Legal standards are guides to lawful behavior • When laws are not obeyed: – Nursing assistant may be prosecuted and found liable for injury or damage • Legal guilt can result in the payment of fines or imprisonment Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • At no other time in history have questions of medical ethics been under such scrutiny Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • Questions health care providers ask: – When is life gone from a person on life support systems? – How much lifesaving effort should be given in situations of terminal illness? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • When does human life actually begin? • How much assistance should be given to the conception process? • Should the body organs of a brain-dead person be harvested for transplants for the living? • Does an unborn baby have rights? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • Is assisting a patient before or after an abortion right or wrong? • Is euthanasia ever justified? • Should animals be used in research of potential value to human life? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • Should food and water be withheld to speed death when a patient has expressed the desire to have this action performed? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • Who makes decisions about removing life support systems when there is no direct expression of the patient’s wishes or there is conflict within the family? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • How will a choice be made when two or more people could benefit from an organ transplant but only one organ is available? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • How should the limited money available be spent when many serious disease conditions need to be researched? • Who has the final authority over whether a woman will carry a pregnancy to term? Copyright © 2008 Delmar Learning. All rights reserved.

Ethics Questions • Should marijuana be used for medicinal purposes? Copyright © 2008 Delmar Learning. All rights reserved.

Respect for Life • One of the most basic rules of ethics is that life is precious. Copyright © 2008 Delmar Learning. All rights reserved.

Respect for the Individual • Respect for each patient as a unique individual is another ethical principle • Uniqueness is shown by differences in: – Age – Race – Religion – Gender Copyright © 2008 Delmar Learning. All rights reserved.

Respect for the Individual • Uniqueness is shown by differences in: – Sexual preference – Culture – Attitudes – Background – Response to illness Copyright © 2008 Delmar Learning. All rights reserved.

The Golden Rule • Do unto others as you would have them do unto you – Implies your intent to provide proper care Copyright © 2008 Delmar Learning. All rights reserved.

The Golden Rule • Your good intentions are effective only when you act on them • To provide proper care: – You also have the ethical responsibility to maintain competence in your practice Copyright © 2008 Delmar Learning. All rights reserved.

Platinum Rule • Treat others the way they want to be treated • Platinum Rule – Shifts focus from treating everyone alike to providing highly individualized care Copyright © 2008 Delmar Learning. All rights reserved.

Platinum Rule • Find out what patients want – Give it to them, as much as possible, and in keeping with their plans of care • Use both principles to guide your practice Copyright © 2008 Delmar Learning. All rights reserved.

Patient Information • Discuss patient information only in appropriate places • Discuss patient information only with the proper people Copyright © 2008 Delmar Learning. All rights reserved.

Patient Information • Refer patient requests for information about laboratory results, the patient’s condition, or course of the illness to the nurse or physician. Copyright © 2008 Delmar Learning. All rights reserved.

Patient Information • Let the nurse or physician relay information about a patient’s death. • Follow the ethical code to ensure respect of a patient’s personal religious beliefs. Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • Laws are passed by governments and are to be obeyed by citizens. • Anyone who fails to obey a law may be liable for fines or imprisonment. Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Stay within your scope of practice – Not overstep your authority – Do only those things you have been taught • Within the scope of your training Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Carry out procedures carefully and as you were taught – Keep your skills and knowledge up to date Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Request guidance from the proper person before you take action in a questionable situation Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Always keep the safety and well-being of the patient a priority – Make sure you thoroughly understand the instructions for the care you are to give Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Perform your job according to facility policy – Stay within OBRA guidelines Copyright © 2008 Delmar Learning. All rights reserved.

Legal Issues • You need not fear breaking laws if you are careful to: – Maintain in-service requirements of OBRA – Do no harm to the patient – Respect the patient’s belongings Copyright © 2008 Delmar Learning. All rights reserved.

Negligence • Nursing assistants – Are educated care providers and are expected to perform in certain ways Copyright © 2008 Delmar Learning. All rights reserved.

Negligence • You would be guilty of negligence if you injured a patient by: – Not performing your work as taught – Not carrying out your job in a conscientious manner Copyright © 2008 Delmar Learning. All rights reserved.

Negligence • Negligence may be accidental or deliberate • It may be the result of an action or omission – Failure to act • In either situation, the patient is not given the expected level of care Copyright © 2008 Delmar Learning. All rights reserved.

False Imprisonment • Restraining a person’s movement or actions without proper authorization constitutes unlawful or false imprisonment. Copyright © 2008 Delmar Learning. All rights reserved.

Assault and Battery • Assault – Intentionally attempting to touch the body of a person or even threatening to do so • Battery – Touching a person without that person’s permission Copyright © 2008 Delmar Learning. All rights reserved.

Abuse • Abuse – Any act or failure to act that is nonaccidental and causes or could cause harm or death to a patient • Verbal abuse – May be directed toward a patient or expressed about a patient Copyright © 2008 Delmar Learning. All rights reserved.

Abuse • Sexual abuse – Use of physical means or verbal threats to force a patient to perform sexual acts. Copyright © 2008 Delmar Learning. All rights reserved.

Abuse • Physical abuse – Does actual physical harm to a patient • Psychological abuse – Involves making a patient fearful of you • Such as threatening not to respond when he or she calls Copyright © 2008 Delmar Learning. All rights reserved.

Abuse • Involuntary seclusion – Involves separating a patient from other patients against the patient’s will • Misappropriation of property – Involves taking or using the patient’s belongings without permission Copyright © 2008 Delmar Learning. All rights reserved.

Abuse by Others • If you suspect a person in your care is being abused by others – Discuss this matter with your supervisor • You are not responsible for determining whether abuse has occurred Copyright © 2008 Delmar Learning. All rights reserved.

When Your Patience Is Stressed • If you feel like your own tolerance level is being tested – You need to find ways to safeguard the patient and release your stress Copyright © 2008 Delmar Learning. All rights reserved.

Neglect • Failure to provide the services or care necessary to avoid physical harm, mental anguish, or mental illness. Copyright © 2008 Delmar Learning. All rights reserved.

Invasion of Privacy • Patients have a right to have their person and personal affairs kept confidential. Copyright © 2008 Delmar Learning. All rights reserved.

Sexual Harassment • Physical, verbal, or nonverbal actions or advances that are unwelcome by the other person. Copyright © 2008 Delmar Learning. All rights reserved.

Sexual Harassment • This may be in the form of sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. Copyright © 2008 Delmar Learning. All rights reserved.

Sexual Harassment • Sexual harassment is illegal Copyright © 2008 Delmar Learning. All rights reserved.

Sexual Harassment • Your facility will have policies and procedures listing actions to take and penalties if harassment occurs. Copyright © 2008 Delmar Learning. All rights reserved.

Sexual Harassment • Upon being informed that an incident of sexual harassment has occurred: – Hospital is responsible for investigating the situation • During investigation: – Facility must protect the victim from further harassment Copyright © 2008 Delmar Learning. All rights reserved.