Legal Responsibilities

Certain laws and legal responsibilities in every aspect of life.

Formulated to protect you and society.

Ø  Traffic laws

Ø  Medical and legal licenses

Health care workers also have certain legal responsibilities.

Important to be aware of and follow legal regulations.

Protects you, employer and safety and well being of patient.

Authorized or based on law.

Health care professions required to know and follow state laws that regulate their license or registration and set standards for their profession.

Can include civil law or criminal law

Ø  Civil law: dealing with legal relationships between people and protection of a person’s rights

Ø  Criminal law: dealing with wrongs against a person, property or society

Health care is mainly affected by civil law

Ø  Contracts

Ø  Torts: wrongful act that done not involve a contract

Criminal laws can apply

Ø  Practicing without a license

Ø  Misuse of narcotics

Ø  Theft

Ø  Murder

Torts

§    Civil wrongs as opposed to crimes

§    Can lead to legal action

§    Offenses may be complex and open to different legal interpretations

§    7 torts to know

Ø  Malpractice

Ø  Negligence

Ø  Assault and battery

Ø  Invasion of privacy

Ø  False imprisonment

Ø  Abuse

Ø  Defamation

Malpractice

Interpreted as “bad practice” and is commonly called “professional negligence”.

Defined as the failure of a professional to use the degree of skill and learning commonly expected in a particular profession.

Results in injury, loss or damage to the person receiving care.

Examples

Ø  Physician not administering a tetanus injection when a patient has a puncture wound

Ø  Nurse performing minor surgery without any training

Negligence

Failure to give care that is normally expected of a person in a particular position, with resulting injury to another person

Examples

Ø  Falls and injuries that occur when side rails are left down

Ø  Using or not reporting defective equipment

Ø  Infections caused by use of not-sterile instruments and/or supplies

Ø  Burns caused by improper heat or radiation treatments

Assault and Battery

Closely related and often used together

Ø  Assault: can include a threat or attempt to injure

Ø  Battery: unlawful touching of another person

Patients must give consent and have the right to refuse care

Some procedures require written consent from patient

Ø  Surgery

Ø  Certain diagnostic tests (HIV testing)

Ø  Treatment of minors

Ø  Side rail releases

Verbal consent permitted in other cases

Ø  Must be “informed consent” or permission granted voluntarily by a person who is of sound mind after the procedure and all risks involved have been explained in terms the person can understand

Ø  Important to remember that a person has the right to withdraw consent at any time

Ø  Explain all procedures to patient

Ø  Do not perform procedure if patient does not give consent

Examples

Ø  Performing procedure after patient has refused to give permission

Ø  Improper handling or rough treatment of patients

Invasion of Privacy

Unnecessary exposure of individual or revealing personal information about an individual without consent

Examples

Ø  Improper draping or covering of a pt during a procedure that allows other pts or personnel to see the pt exposed

Ø  Sending information to an insurance company without the pts written permission

Ø  Informing news media about individual’s condition without the individual’s permission

False Imprisonment

Restraining an individual or restricting an individual’s freedom

Examples

Ø  Keeping patient hospitalized against his/her will

Ø  Application of physical restraints without proper authorization or with no justification

Abuse

Any care those results in physical harm, pain or mental anguish

Types of abuse

Physical abuse

hitting, forcing persons against their will, restraining movements, depriving of food or water or not providing physical care

Verbal abuse:

speaking harshly, swearing or shouting, using inappropriate words to describe a person’s race or nationality or writing threats or abusive statements

Psychological abuse:

threatening harm; denying rights, belittling, intimidating or ridiculing the person; or threatening to reveal information about the person

Sexual abuse:

any unwanted sexual touching or act, using sexual gestures or suggesting sexual behavior.

Patients may experience abuse before entering a health care facility

Domestic abuse:

intimate partner uses threatening, manipulative, aggressive or violent behavior to maintain power and control over another person

Child abuse:

abuse is directed toward a child

Elder abuse:

abuse is directed toward an older person

Be alert to the signs and symptoms that may indicate patients are victims of abuse

Ø  Unexplained bruises, fractures, burns or injuries

Ø  Signs of neglect such as poor personal hygiene

Ø  Irrational fears or a change in personality

Ø  Aggressive or withdrawn behavior

Ø  Patient statements that indicate abuse or neglect

Presence of signs and symptoms indicates a need for further investigation

Health care workers required to report any signs of abuse to immediate supervisor

Laws in all states require the reporting of any form of abuse to proper authorities

Defamation

False statements cause a person to be ridiculed or cause damage to his/her reputation

Incorrect information given out in error

Ø  Slander: information is spoken

Ø  Libel: information is written

Examples:

Ø  Reporting a pt has an infectious disease to a government agencies when lab results are inaccurate

Ø  Stating person has drug problem when another medical condition exists

Contracts

Agreement between two or more parties

Three parts of a contract

Offer: competent individual enters into a relationship with health care provider and offers to be a patient

 Acceptance: health care provider gives an appointment or examines or treats a patient

Consideration: payment made by patient for services provided

Two types of contracts

Ø  Implied

Ø  Expressed

Implied

Ø  Cause obligations that are understood without verbally expressed terms

Ø  Ex. Qualified health care worker prepares medication and patient takes medication – implied that patient accepts this treatment

Expressed

Ø  Stated in distinct and clear language, either orally or in writing

Ø  Ex. Surgery permit

Ø  Promises of care must be kept

Ø  All risks associated with treatment must be explained completely to the patient

Legal Disability

All parties in contract must be free of legal disability

Person with legal disability does not have legal capacity to form a contract

Parents, guardians or others permitted by law must form the contract on behalf of these individuals

Examples

Ø  Minors: individuals under legal age (18 in AR)

Ø  Mentally incompetent persons

Ø  Persons under influence of drugs that alter mental state

Ø  Semiconscious or unconscious people

Breach of Contract

Contract requires certain standards of care by competent, qualified individuals

If contract not performed according to agreement, contract is breached

Examples:

Ø  Failure to provide care and/or giving improper care

Ø  Failure to pay according to consideration

Can lead to legal action

Interpreters

Interpreter must be used when contract explained to a non-English speaking individual

Many states also require use of interpreter services for individuals who are deaf

Most agencies have list of interpreters that can be used

English-speaking relative or friend of patient can also serve as interpreter

Agent

A person who works under direction or control of another person

Employer is principal; employee is agent

Principal is responsible for actions of agent and can be required to compensate or pay people who have been injured by agent

Example

Ø  Dental assistant tells patient “ your dentures will look better than your real teeth”; dentist may have to compensate patient if statement proves false

Health care workers must be aware of role as agents and work to protect interests of employer

Privileged Communications

All information given to health personnel by a patient

By law this information must be kept confidential and shared only with other members of health care team

Information cannot be told to anyone else without written consent of the patient

Consent should state what information is to be released, to whom the information should be given and any time limits

Certain information exempt by law and must be reported

Ø  Births and deaths

Ø  Injuries caused by violence (assault and battery, abuse, stabbings, GSW) that may require police involvement

Ø  Drug abuse

Ø  Communicable diseases and sexually transmitted diseases

Health Care Records

Records containing information on the care that has been provided to the patient

Belong to health care provider, but pt has right to obtain a copy of any information in record

Can be legal record in a court of law

Erasures not allowed on records

Ø  Cross out errors with a single line

Ø  Insert correct information, initial and date

Must be properly maintained, kept confidential and retained for the amount of time required by state law

When records destroyed after legal time for retention, must be burned or shredded so confidentiality is maintained

Computerized records have created modern dilemmas on maintaining confidentiality

Ø  Many different individuals can have access to a patient’s records

Ø  Safeguards have been created to maintain confidentiality

§  Limiting personnel who have access

§  Using codes to prevent access to certain info

§  Requiring passwords to access certain information

§  Constantly monitoring and evaluating computer use

 

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