legal implications in health care

8/6/2019 Legal Implications in Health Care

1/31

LEGAL IMPLICATIONS IN HEALTH

CAREBy Wambua

Florence


2/31

COURSE OBJECTIVES

By the end of this presentation, the student

should be able to:

Define the major terminology used in legal

implications in health care.

Describe the legal responsibilities and obligations of

health care workers.

List the elements needed to prove negligence.

Give examples of legal issues that arise in health

care.


3/31

SOURCES OF LAW

Civil law.

Criminal law.


4/31

TORT

A tort is a civil wrong made against a person or

property.

It may be intentional or unintentional.

Intentional torts are willful acts that violateanothers rights. E.g assault, invasion of privacy

and false imprisonment.

An example of unintentional torts is negligence.


5/31

INTENTIONAL TORTS

Assault: physical or verbal that creates in

another person apprehension or fear of imminent

harm or offensive contact.

E.g, a nurse threatening to give a client injection.

Or a radiographer threatening to restrain a client

for an x-ray procedure that he has refused to give

consent for.


6/31

2. BATTERY

Battery: is any intentional physical contact with

a person without consent. It may cause injury to

a client or may be merely offensive.

E.g if the nurse gives the injection, it is battery.

Some times the battery could be life saving e.g in

blood transfusion.


7/31

3. INVASION OF PRIVACY

Invasion of privacy tort protects the clients right

to be free from unwanted intrusion into his or her

private affairs.

This includes confidentiality too.

E.g release of clients medical records or

information to an unauthorized person like the

press or the clients employer or even family

members.


8/31

4. MEDICAL INFORMATION

Computers and confidentiality: the medical

records are protected by passwords and magnetic

strip cards.

These devices should not be shared with others

and used only to retrieve files only when

warranted.

Improper use of the card to seek confidential

information could lead to legal repercussions.


9/31

FALSE IMPRISONMENT

This tort serves to protect a persons individual

liberty and basic rights.

Preventing a client from leaving a health care

facility voluntarily may constitute the tort of

false imprisonment.

The use of restrains physical or chemical, are

viewed as false imprisonment.


10/31

UNINTENTIONAL TORTS.

Negligence: a lawsuit against negligence is

termed malpractice.

It also conduct that falls below a standard of care

established by the law.

It is characterized by thoughtlessness,

carelessness or inattention.

E.g case study of fall off the examining table;

Downey v. Rothwell (1974).


11/31

PREVENTION OF NEGLIGENCE

Follow standards of care of your profession.

Give competent health care.

Insist on appropriate orientation, continued

education, adequate staffing and communicationwith other members of staff.

Develop a caring rapport with client.

Document care given to client fully.


12/31

2.DOCUMENTATION

Medical records are a permanent legal document

of the client or hospital.

If a client dies and no documentation of care is

found, legally, there was negligence.

Other care providers may harm the patient in

their care due to lack of up to date information.

physiotherapy.


13/31

3.

Truthful documentation is also essential.

Correction in case of a mistake should follow the

policies and procedures of the institution.

Example

Medication given signature of the one who has

erased.


14/31

CRIMINAL LIABILITY

The difference between a tort and criminal

liability is the degree to which the act deviates

from the standard of a reasonably competent

practitioner.

The law must prove that there was extreme

carelessness on the part of the health care

provider and wanton or reckless disregard for the

lives or safety of other persons.


15/31

2. CONSENT

A signed consent form is required for treatment,

treatment programs involving chemotherapy,

procedures and research.

If a client is deaf, illiterate or speaks a foreign

language, an official interpreter must be

available to explain the terms of the consent.

Family members should not be used except in as

a last resort.


16/31

3. INFORMED CONSENT

This is a persons agreement to allow something

to happen, such as surgery or an invasive

procedure, based on a full disclosure of the likely

risks, benefits, alternatives and consequences of

refusal.

Informed consent creates a legal duty to health

care providers to disclose the facts in terms the

client can understand.


17/31

4.

The explanation should describe treatment

alternatives, risk involved in all treatment

options.

In emergencies however, informed consent that is

not obtained may not result in a lawsuit.


18/31

5.

Factors required for informed consent:

Brief complete explanation of the procedure or

treatment.

Names and qualifications of people performing and

assisting in the procedure. A description of any possible harm, including damage

or death that may occur as a result of the procedure.

An explanation of alternative therapies to the

proposed as well as the risks of doing nothing.


19/31

6. STUDENTS AND LEGAL LIABILITY

Students are liable if their actions cause harm to

clients.

The liability is generally shared by the student,

instructor, hospital or health care facility and

university or educational facility.

If a student is employed as an aide, they should

not perform procedures beyond the scope of an

assistant which will be their job description.


20/31

PROFESSIONAL LIABILITY PROTECTION

Health care professionals who practice under

hospitals are covered by legally by the legal

advisor of the hospital.

If one should operate independently like in a

private clinic, they are liable for their own care.


21/31

SHORT STAFFING

During shortages, or staff down sizing, if the

health care provider finds that they are working

more than their required workload, they should

report to their supervisors and if possible put it

in writing and a copy kept off.

No walk out should be staged in times of

shortages as it raises the issue of abandonment.


22/31

PHYSICIANS ORDER.

All orders should be assessed and if found to

erroneous or harmful further clarification should

be sought.

A pharmacist may be sought to clarify the order.

Physicians should write all orders including

DNR. Verbal orders are not encouraged as they

increase the room for error.


23/31

LEGAL ISSUES IN HEALTH CARE

Abortion: in Rwanda its illegal, so those health

care providers found to be performing abortions

are liable for prosecution.

Drug regulation: Federal acts control

manufacture, distribution and sale of drugs,

cosmetics and therapeutic devices. The food and

drugs act and the controlled drugs and

substances acts.


24/31

2.

Communicable diseases: HIV, SARS has legal

implications for health care providers.

Death and dying: definitions of death. brain

death, emergence of artificial life support devices,

organ transplants and euthanasia.

Advance directive: is a mechanism enabling a

mentally competent person to plan for a time

when he or she may lack mental capacity to

make medical decisions.


25/31

3.

A living will: is a document in which the person

makes an anticipatory refusal of llife prolonging

measures during a future state of mental

incompetence.

Psychiatric advance directive: is a new type of

advance directive. Individuals with mental

health problems complete it during periods of

mental stability and competence outlining how

they wihs to be treated in future should theirunderlying mental illness causes them to loose

decision making capacity.


26/31

4.

Organ donation: legally competent people are

free to donate their bodies or organs for medical

use.

Mental health issues: mental health act, suicidal

patients.

Public health issues: reporting suspected abuse

and neglect, communicable diseases and other

health related issues enacted to protect the

publics health.


27/31

RISK MANAGEMENT

It is a system of ensuring appropriate health care

by identifying potential hazards and eliminating

them before harm occurs.

Tools used in risk management is the incidence

report or adverse occurrence report.

These reports are analyzed to see how future

problems can be avoided.


28/31

QUALITY ASSURANCE

The underlying rationale for quality assurance in

risk management programs is the highest

possible quality of care.

Quality assurance is the responsibility of both

the employer and the individual care provider.

Good documentation is essential as proof that the

health care provider acted ethically, reasonably

and safely.


29/31

SUMMARY

With increased emphasis on clients rights, care

providers should understand their legal

obligations.

The civil law system protects a persons private

rights and the criminal law system with the

rights of an individual and society.

Clients are entitled to confidential health care

and freedom from unauthorized release of

information.


30/31

2.

A health care provider can be found negligent if

the duty to the client is not well carried out, not

carried out, the client was injured and the failure

for care to be given caused injury.

Informed consent document should be consulted

and obtained always.

Know all the laws that apply to your practice.

Incident reports should be filed in all situations

when someone could or did get hurt.


31/31

The end!

legal implications in health care

Documents