LEGAL AND ETHICAL

ASPECTS IN NURSING

Prepared by SALMAN

Law may be defined as “the principles and regulations established in a community by some authority and applicable to its people whether in the form of legislation or of custom and policies recognized by judicial decision

CRIMINAL LAW CIVIL LAW

LAW

A tort is a civil wrong or injury for which the court provides a remedy in the form of money damages (black ,1999)

Intentional torts Unintentional torts

TORT

Nursing standards of care are the legal guidelines for minimally safe and adequate nursing practice

Written policies and procedures of an employing institution defines the standards of care for nurses at that institution

NURSING STANDARDS OF CARE

ASSAULT BATTERY FALSE IMPRISONMENT FRAUD

INTENTIONAL TORTS

Assault is any intentional threat to bring about harmful or offensive contact with another individual, no actual contact is necessary

Eg. threatening a patient to give an injection

Restrain a patient for an x-ray procedure when the patient has refused consent

ASSAULT

Battery is an intentional touching without consent ,the contact is harmful to the patient and causes an injury , or it is merely offensive to the patient dignity

Eg. Giving an injection without patient consent

A patient gives consent for left knee repair but the surgeon performs right knee surgery

BATTERY

Making a person stay in pace against is wishes is false imprisonment

Eg. Restraining or confining a patient to a locked room without proper consent could constitute false imprisonment

FALSE IMPRISONMET

Fraud is a willful and purposeful misrepresentation that could cause or caused harm to a person or property

Eg. giving incorrect information to obtain a better positon or job

FRAUD

NEGLIGENCE MALPRACTICE

UNINTENTIONAL TORTS

Negligence is conduct that falls below the standard of care

Malpractice is one type of negligence called professional negligence

NEGLIGENCE & MALPRACTICE

Medication errors that result injury to patient

Burns caused by equipment or spills of hot liquids

Falls resulting in injury to patientsErrors in sponge ,instrument ,needle, count

in surgery casesFailure to give adequate report , notify

physician, adequate monitoring the patient

COMMON SOURCES OF NEGLIGENCE AND MALPRACTICE

INFORMED CONSENT Informed consent is a patients agreement to allow something to happen, such as surgery based on a full disclosure of risks, benefits alternatives and consequences of refusal (Black, 1999)

DOCUMENTATION EXECUTING PHYSICIANS ORDER GOOD SAMARITAN LAW PATIENT EDUCATION PRIVILEGED COMMUNICATION

LEGAL SAFEGAURDS FOR NURSES

INFORMED CONSENT

Informed consent is a patients agreement to allow something to happen, such as surgery based on a full disclosure of risks, benefits alternatives and consequences of refusal (Black, 1999)

CONFIDENTIALITY ADVANCE DIRECTIVE advance directives are legal documents stating the

wishes of individuals regarding health care in institutions in which they are no longer capable of giving personal informed consent

types; living wills durable power of attorny

AUTOPSIES

LEGAL ISSUES RELATED TO NURSING

ORGAN AND TISSUE DONATION In India 5,00,000 people die because of

non availability of organs per year and 1,50,000 people await a kidney transplant but only 5,000 get one 10 lakh people suffer from corneal blindness and await transplant (Times of india)

Types; live donation cedaveric donation

Contd.

The transplantation of human organs act, 1994

an act to provide for the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs and for matter connected with it.

transplantation of human organs bill 2013

INDIAN LAWS AND REGULATIONS RELATED TO HEALTH RELATED TO MEDICAL SURGIAL NURSING

Medical termination of pregnancy act -1971 The prenatal diagnostic techniques act and

rules

Related to obstetrics and gynaecology

Narcotics drugs and psychotropic substances act 1985

Mental health act ,1987

Laws Related to mental health nursing

Consumer protection act Prohibition of sexual harassment of women

at workplace bill,2010 Biomedical waste (management and

handling) rules,1998

some common laws affects nursing

ETHICAL ASPECTS IN NURSING

The word ethics derived from the Greek term ethos, which means ‘customs`

Ethics can be defined as a branch of philosophy that involves systematizing , defending and recommending concepts of right and wrong conduct, often addressing deputes of moral diversity(wikipedia)

ETHICS

1. Autonomy2. Beneficence3. Nonmaleficence4. Fidelity5. Justice6. veracity

ETHICAL PRINCIPLES

It involves the right of self-determination or choice, independence and freedom

Eg;the purposes of the preoperative consent is to assure in writing that the health care team respects the patients independence by obtaining permission to proceed

AUTONOMY

This principle promotes taking positive, active steps to help others

Eg; a child immunisation causes discomfort during administration but the benefits of protection from disease both individual and for society,outweigh the temporary discomforts

BENEFICENCE

It refers to the fundamental agreement to do no harm

Eg;

NONMALEFICENCE

It refers to the agreement to keep promises , commitments ,responsibilities that one has made oneself and others

Eg; if you assess a patient for pain and then offer a plan to manage it, this principle encourages you to do your best to keep the promise to improve the patients comfort

FIDELITY

Telling the truth or intentionally decieving or misleading patient

Eg; should you tell the truth when you know that it might cause harm to the client?

families go to great lengthens to protect a dying patient from the harsh truth of his prognosis ,and the patient himself may not wish to know

VERACITY

It refers principle of fairness It implies equal treatment of all clients

Eg ;a national multidisciplinary committee strives for fairness by ranking recipients according to need, rather than resorting to selling organs .

JUSTICE

Code of ethics is defined as `a specific set of professional behaviours and values the professional interpreter must know and abide by including confidentiality, accuracy, privacy, integrity.

CODE OF ETHICS

An ethical dilemma is a situation in which a choice must be made between two equally undesirable actions

ETHICAL DILEMMA

1. STAFF SHORTAGE2. CULTURAL AND RELGIOUS SENSITIVITY3. DELEGATION4. TRUTH TELLING VS DECEPTION

ETHICAL PROBLEMS IN NURSING

Knowledge of staff nurses regarding legal and ethical responsibilities in the field of psychiatric nursing

A study to assess knowledge ,attitude and practice of nurses regarding legal and ethical concepts of nursing care of children in nicu and picu of selected hospitals in chennai.

Nurses responses to ethical dilemmas in nursing practice ;meta analysis

RESERCH STUDIES RELATED TO LEGAL AND ETHICAL ISSUES IN NURSING

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