IntroductionTo

Lawand

Ethics

CHAPTER 1

• Patient

• Resident

• Client

• Families

• Colleagues

• Doctors / Nurses

• Facility Employees

• Vendors

WHO WILL YOU SERVE? WHO WILL BE YOUR CUSTOMERS?

Take out a piece of paper

Questions

1.Do they have a 4th of July in England?

2.Some months have 31 days. How many have 28?

3.A woman gives a beggar 1 dollar and 32 cents. The woman is the beggar's sister, but the beggar is not the woman's brother. How come?

4.Why can't a man living in the U.S. be buried in Canada?

5.How many outs are there in an inning?

Questions6. Is it legal for a man in California to marry his widow's sister? Why?

7.Two men play five games of checkers. Each man wins the same number of games. There are no ties. Explain this.

8. Divide 30 by 1/2 and add 10. What is the answer?

9. If there are 3 apples and you take away two, how many do you have?

10. I have two U.S. coins totaling 55 cents. One is not a nickel. What are the coins?

Questions11. If you have only one match and you walked into a room where there was an oil burner, a kerosene lamp, and a wood burning stove, which one would you light first?

12. A doctor gives you 3 pills telling you to take one every half hour. How long would the pills last?

13. A farmer has 17 sheep; all but 9 die. How many are left?

14. How many animals of each sex did Moses take on the ark?

Questions15. A clerk in the butcher shop is 5'10'' tall. What does he weigh?

16. How many two cent stamps are there in a dozen?

17. There once was a lady who really liked pink. In her cozy, little one-story house, everything was pink. Even her dog was pink. Her hair, her carpet, everything. What color are her stairs?

18. There was an evergreen tree in the dark, ugly forest where ghosts & witches lived. All of a sudden, a great gust of wind flew through the forest. Which way did the leaves on the tree fall?

Questions and Answers

1.Do they have a 4th of July in England?

2.Some months have 31 days. How many have 28?

3.A woman gives a beggar 1 dollar and 32 cents. The woman is the beggar's sister, but the beggar is not the woman's brother. How come?

4.Why can't a man living in the U.S. be buried in Canada?

5.How many outs are there in an inning?

Yes. Everyone has a July 4th.

All of them (12).

The beggar is her sister.

He can’t be buried if heisn’t dead.

6

Questions and Answers6. Is it legal for a man in California to marry his widow's sister? Why?

7.Two men play five games of checkers. Each man wins the same number of games. There are no ties. Explain this.

8. Divide 30 by 1/2 and add 10. What is the answer?

9. If there are 3 apples and you take away two, how many do you have?

10. I have two U.S. coins totaling 55 cents. One is not a nickel. What are the coins?

No. He’s dead.

They were playing different people.

70

2

A 50-cent piece & a nickel.Only one is not a nickel.

Questions and Answers11. If you have only one match and you walked into a room where there was an oil burner, a kerosene lamp, and a wood burning stove, which one would you light first?

12. A doctor gives you 3 pills telling you to take one every half hour. How long would the pills last?

13. A farmer has 17 sheep; all but 9 die. How many are left?

14. How many animals of each sex did Moses take on the ark?

The match.

1 Hour.

9

None. Moses didn’t have an ark,Noah did.

Questions and Answers15. A clerk in the butcher shop is 5'10'' tall. What does he weigh?

16. How many two cent stamps are there in a dozen?

17. There once was a lady who really liked pink. In her cozy, little one-story house, everything was pink. Even her dog was pink. What color are her stairs?

18. There was an evergreen tree in the dark, ugly forest where ghosts & witches lived. All of a sudden, a great gust of wind flew through the forest. Which way did the leaves on the tree fall?

Meat.

12

She didn’t have stairs. It was one story.

It was a pine tree – no leaves.

Common Sense

• What is it?

• Is it the same for everyone?

• Can it be taught?

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SOUND PRACTICAL JUDGMENT

No

No, but learning will expand common sense.

Common Sense Scenario

• Medical office with walk-in clinic

• Barbara, experienced CMA

• Elaine, new receptionist

• Elderly man, hard of hearing

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Critical Thinking

• What is it?

• Is it the same for everyone?

• Can it be taught?

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Critical Thinking

• Problem-solving process

1) Identify & clarify the problem

2) Gather information

3) Evaluate the evidence

4) Consider alternatives & implications

5) Choose & implement the best alternative

Benefits of Critical Thinking

• Improved patient care

• Enhanced patient satisfaction

• Better problem resolution

• Less blaming

• Improved staff morale

• Less staff turnover

Are You a Critical Thinker?

• Do more data gathering

• Avoid premature conclusions

• Fair minded

• See inconsistencies

• Monitor own decisions

• Involve patients

• Provide patients with options

• Communicate effectively

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Why Study Law and

Ethics?

Why Study Law and Ethics?

• To help you function at the highest possible professional level providing competent health care to your patients

• To help you avoid legal entanglements that can threaten your ability to earn a living as a successful health care professional

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Focus of Law and Ethics

• The legal and ethical issues facing society, patients, and health care practitioners

• The impact of rising costs on the laws & ethics of health care delivery

• The rights, responsibilities, and concerns of health care consumers

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Why Do

people sue?

Why Do People Sue?

• Unhappy or unsatisfied patient and/or family

• Patients who are injured

• Patients who perceive negligence occurred

Litigious

• Litigious = prone to engage in lawsuits

• People are more inclined to file lawsuits today than ever before.

“You may even see billboards or

television advertisements from

malpractice lawyers

soliciting patients!”

Frivolous• Frivolous = not having any serious

purpose or value; carefree and not serious; flippant; light-hearted

• Can cost the US economy billions of dollars every year!

Examples ofFrivolous Lawsuits?

Anatomy of a LawsuitLawsuit Anatomy

Basic Litigation Terminology

• Plaintiff

• Defendant

• Liable

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–Person bringing charges in lawsuit

–Person against whom charges are being brought

–Legally responsible or obligated

4 Elements of Healthcare-Related Lawsuit

The Plaintiff MUST prove all 4 of these:

• Duty (between defendant and plaintiff)

• Breach of Duty (broken)

• Injury Present

• Injury Caused by Breach of Duty

Question

Tell whether the following statement is

true or false.

From a legal standpoint the most important aspect of a trial is the outcome.

True

False

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Answer

False

From a legal standpoint the most important aspect of a court case is not the result, but whether the case represents good law and will be persuasive as other cases are decided.

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Court Case Rulings

• Precedent

• Summary judgment

1-36

–Decisions made by judges in various courts that become rule of law and apply to other cases• Also known as case law

–Decision made by a court that pleads no basis for trial

Liability for Manufacturers

• Manufacturers of health care equipment can be liable through:

–Breach of warranty

–Untrue statements

–Fraud

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WhATIS

FRAUD?INTENTIONAL DECEIT

2008 U.S. Supreme Court Decision

• Makers of medical equipment are immune from liability for personal injury as long as the Food and Drug Administration approved the product and it meets FDA specifications.

–Metronic Inc. Case

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Law vs. Ethics

1-43

WhatIs

LAW?

Law

• Rule of conduct or action formally recognized as binding by a controlling authority

–Enforcement made possible by penalties for disobedience• Fines, imprisonment, or both

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1-45

WhatIs

ethics?

Ethics

• Standards of behavior developed as a result of one’s concept of right and wrong

–Moral Values = one’s personal concept of right and wrong; formed through the influence of family, culture and society

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Codes of Ethics

• Govern behavior of association members

• Increase the level of competence and standards of care within the group

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Examples of Codes of Ethics

• American Nurses Association Code for Nurses

• American Medical Association Code of Medical Ethics

• American Health Information Management Association Code of Ethics

• American Society of Radiologic Technologists Code of Ethics

• Code of Ethics of the American Association of Medical Assistants

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Early Medical Codes of Ethics

• Code of Hammurabi

• Hippocratic Oath

• Percival’s Medical Ethics

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Hippocratic Oath

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• Around 400 BC

• Hippocrates (Greek Physician)

• “Father of Medicine”

• Pledge for physicians

Bioethics

• Discipline dealing with the ethical implications of biological research methods and results, especially in medicine

• Bioethicists are specialists who consult with medical professionals to help make difficult decisions

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Members of Ethics Committees

• Physicians

• Nurses

• Social workers

• Clergy

• Family members

• Community members

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WhatIs

ETIQUETTE?

Etiquette

• Standards of behavior considered good manners

• Protocol

–Standard rules of etiquette applied to place of employment

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Comparison of Law vs. Ethics

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Qualities for Success in Health Care

• Courtesy

–The practice of good manners

• Compassion

–Empathy

• Common sense

–Sound practical judgment

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ETIQUETTE

WHEN YOU IDENTIFY WITH & UNDERSTANDANOTHER’S SITUATION, FEELINGS, MOTIVES

Temporarilyputting oneself

in anotherperson’s shoes

Sincerelyattempting toknow how thepatient feels

Patient Advocate

Communication Framework

AIDET

= Acknowledge

= Introduce

= Duration

= Explanation

= Thank

AIDET … with sincerityA = Acknowledge

– Acknowledge the patient by name. Make eye contact. Greet with a smile.– Attitude is everything. Create a lasting impression.– Ask: "Is  there anything I can do for you?“ or “How are you today?”

I = Introduce– Introduce yourself– Tell them who you are (including title / dept.) and how you are going to help them.– Escort people where they need to go rather than just point or giving directions.

D = Duration– Give an accurate time expectation for tests, physician arrival, tray delivery.– Keep in touch to ease waiting times. – Let them know if there is a delay and how long it will be.

E = Explanation– Explain step by step what will happen, answer questions, leave number where you can be reached.– Talk, listen, and learn– Ask, “What questions do you have for me?” (This gives them permission to ask questions.)

T = Thank– Thank the patient for choosing your hospital, and for their time, communication and cooperation. – Thank the family for assistance and being there to support the patient.

AIDET

= Acknowledge

= Introduce

= Duration

= Explanation

= Thank

AIDET

Communicate

Eye CONTACT

Be respectful

Don’t rush

Skills for Success in Health Care

• People skills–Traits and capabilities that allow you

to get along well with others

• Technical skills–Abilities acquired in course of study

• Critical thinking skills–Problem solving skills

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Success in Health Care

• Objective

– Factual, unbiased, unchanged by anyone’s personal feelings or interpretations

– Measurable, repeatable

• Subjective

– Open to interpretation; personal opinion, not measurable

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Assignments – Due Next Class• Consider the professional role / job you are

striving for.– Research if there is a PROFESSIONAL

ORGANIZATION for that role.– Research if there is a CODE OF ETHICS for

that role.– Bring the results of your research to our

next class and be prepared to discuss what you found.

• Read Chapter 2

Assignments – Due Next Class• On page 28 in your text, pick one case

study (#26 or #27 or #28) and answer the questions … not one word answers but thoughtful discussion (essay)

• In your text, Chapter 1 “Check Your Progress” – bring answers to class

• EXTRA CREDIT …Find a recent article (not before 2011) about a legal or ethical question or issue that is health care related.