Chapter 3Medical Ethics and Law

ValuesHealth Care workers are expected to live by values that show others respect.Dignity- be honest, trustworthy, truthful, sincere and respectul to others. Can be shown by listening actively, being positive, showing understanding and respect. Spirit of Service- responding to pt. w/ understanding of unique needs.

Excellence-taking responsibility for yourself, your team and the result of your actions. Learning new skills by accepting and seeking feedback for improvement. You can never be perfect!Fairness/Justice-treat all people with respect and provide the same dignity, service and excellence regardless of the pts race/beliefs/background or financial resources.

DignityKnow your limitations-Be sincereBe well groumedCommunicate Effectively

ServiceBe a good citizenBe caringHave a good attitudeBody Language, Facial Expressions

ExcellenceBe accountableBe informedFollow the rules and regulationsBe dependable

Fairness and JusticeBe loyal to whoRespect the privacy of others-confidentialBe Honest

Patient SatisfactionDo they always get what they want

What do pts getPt. should be informed about WhatWhyWhoWhenHow

CommunicationObjectivesWelcome pts and visitors in warm mannerListen to and communicate with one another

Have respect for ea. Person and their privacy, comfort, dignityUse good elevator manners

Provide a safe, clean environment

Anticipate the wants and needs of those served.

Strive to do your best.

The Team ConceptEach member is an important part of Interdisciplinary teamProfessionals with different backgrounds, education, interests all work together.

Delegates duties by using the five rights of delegation:Right TasksRight circumstancesRight personRight directionRight supervision

SummaryYou are part of a team and must act that way.Ethical Behavior protects you and the pt.Dignity, service, excellence and fairness/justice are essential for every health care worker.

http://www.ama-assn.org/ama/pub/category/2512.html

Patients Bill of Rights.

Legal Roles and Responsibilities of a Health Care WorkerRights are legislated by both federal and state governments.The health care worker is legally bound to provide care as it is stated in the Patients Bill of Rights.

Bill of RightsRight to considerate and respectful careRight to relevant, current and understandable informationRight to discuss and request info.Right to know identity of physicians, nurses and others involved with themRight to know immediate and longterm financial implications

Right to make decisions about plan of care, and right to refuse treatment. Right to an advanced care directiveRight to privacy and confidentialityExcept in cases such as suspected abuse and public health hazards when reporting is permitted.Right to review records and have information explained.Right to expect that a hospital will meet any reasonable request.Right to decline or accept to participate in research studiesRight to be informed of hospital policies and practices that relate to pt. care

Natural Death Guidelines and DeclarationsAdvanced directive- a document that ensures the right to accept or refuse medical care. It provides pts a way to express how they want medical decisions made if they are unable to make decisions Living Will- provides a way for a person to express his/her desire for or against extraordinary measures that could prolong life. Takes affect while a person is still living.

Health Care Power of Attorney- allows an authorized person to make health care decisions for an individual if they are unable to do so. More flexible than a living will and can cover temporary unconsciousness, or when a pt is unable to make decisions.

Durable Power of Attorney for Health Care- document that names an authorized person to make medical decisions for the individual if he/she is unable to make them. Includes instructions about treatment to avoid.

OmbudsmanA social worker, nurse or trained volunteer who makes certain that the pt is not abused and that the persons rights are secure

Controls on HC workersLicense, Certification and RegistrationTell what a hcw may or may not doDetermines scope of practiceControls help to improve the quality of care

LicensureGiven by a govenmental agency when a person meets the qualifications for a particular occupation.

CertificationGiven for RecognitionIf specific guidelines must be met the certification = licensure

RegistrationList of individuals on an official record who meet the qualifications for an occupation.exp) registered nurse.

Legal Terms and boundariesAssault- a threat or attempt to injureBattery-unlawful touching w/out consent that may or may not end in injuryOften charged together because of a successful attempt to injure.

Informed consent- persmission granted by a person in his right mindCrime-performing a forbidden act or from the omission or a duty commanded by public law.Libel-writing defamatory matter about an individual or group to 3rd party.Slander- spoken statement of false charges or misrepresentations that defame or damage another's rep.

False imprisonment- holding or retaining a person against their willFelony-a serious crime that carries a penalty of imprisonment for more that 1 year and possibly death.Invasion of privacy- civil wrong that makes public knowledge of any private or personal info w/o consent of personmalpractice- bad practice care that leads to faulty practice or neglectNegligence- failure to perform in a reasonably prudent manner.Privileged communication- any personal or private information given by a pt/client to hcw that is relevant to his/her care. (all info in chart)Reasonable Care- is the legal obligation of hcw. Must perform to the standards of practice expected in their community

Sexual Harassment- unwelcome sexual advances, request for sexual favors and other verbal and physical contact of a sexual nature. Innocent remarks, inappropriate pictures and written material can be perceived as sexual.Will- legal document that defines the disposition of property and takes effect after death.Reportable incidents and conditions- the hcw is obligated to file a confidential report to the county health department when child abuse or adult abuse is suspected. Also required when certain diseases are diagnosed.

How should it be decided who receives scarce organs for transplantation? Do people have a right to reproduce no matter what the risks or costs? (Consider cases where there is a high probability of passing on genetic disorders or diseases like Huntington's disease or AIDS, and cases of couples under 18 years of age or mentally impaired. If we have a right to reproduce, can such people be excluded? Also, consider cases of couples who cannot reproduce by "normal" means. Is society obligated to pay for their reproductive efforts if people have a right to reproduce? And if we have such a right, where does it come from (i.e., is it moral, legal, etc.)?)

Should parents alone control consent (i.e., agree to or refuse treatment) for medical procedures on their children? Who should get to decide consent for children if you think it shouldn't be left entirely to the parents?