Ppt of Law & Ethics Seminar

1129 August 200929 August 2009

LAW & ETHICSLAW & ETHICS IN NURSINGIN NURSING

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MEANING OF MEANING OF LAWLAW

• The term law is derived from tentoric The term law is derived from tentoric root ,” Lag “ which means something root ,” Lag “ which means something which lies fixed or events. which lies fixed or events.

• ““Law” means body of rules to guide Law” means body of rules to guide human action. human action.

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DEFINITION OF LAWDEFINITION OF LAW 1 1 Law can be defined “ the sum total of Law can be defined “ the sum total of

rules and regulations by which a society rules and regulations by which a society is governed.” is governed.”

( Guido, 2001.p.2 )( Guido, 2001.p.2 )

2. The law is a system of rights and 2. The law is a system of rights and obligations which the state enforces. obligations which the state enforces. ( Green ) ( Green )

3. 3. The law is the body of principles The law is the body of principles recognized and applied by the state and recognized and applied by the state and the administration of justice . the administration of justice .

( Salmaind( Salmaind ) )

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MEANING -MEANING - The study of doing right is called The study of doing right is called

ethics.ethics. DEFINITION - DEFINITION -

Ethics may be defined as the system Ethics may be defined as the system or code of conduct and morals advocated or code of conduct and morals advocated by a particular individual or group.by a particular individual or group.

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BIOETHICSBIOETHICS MEANING MEANING

A situation that requires an A situation that requires an individual to make a choice individual to make a choice between two equally unfavorable between two equally unfavorable alternatives.alternatives.

e.g. Conflicts between one e.g. Conflicts between one individual’s rights and those of individual’s rights and those of another. another.

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NURSING NURSING ETHICSETHICS

Philosophical analysis of moral Philosophical analysis of moral phenomena in the Practice of nursing. phenomena in the Practice of nursing.

Nursing ethics are the professional Nursing ethics are the professional standard of conduct practiced by nurse standard of conduct practiced by nurse practitioners related to or in practitioners related to or in accordance with approved moral accordance with approved moral behavior in rendering health care behavior in rendering health care services.services.

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FUNCTIONS OF FUNCTIONS OF LAW IN NURSINGLAW IN NURSING

1.1. It provides a framework for It provides a framework for establishing the legal nursing activities. establishing the legal nursing activities.

2.2. It helps in establishing the boundaries It helps in establishing the boundaries of independent nursing activity.of independent nursing activity.

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FUNCTIONS OF LAW IN NURSINGFUNCTIONS OF LAW IN NURSING CONTD …..CONTD …..

3. 3. It differentiates the nurse’s responsibilities It differentiates the nurse’s responsibilities

among the health professionals. among the health professionals.

4. 4. It assists in maintaining the standard of It assists in maintaining the standard of

nursing practice which is accountable under nursing practice which is accountable under

the law.the law.

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TYPES OF LAWS

CIVIL CRIMINAL

CONTRACTS TORTS

INTENTIONAL UNINTENTIONAL

ASSAULT

BATTERY

INVASION OF PRIVACY

DEFAMATION OF CHARACTER

FALSE IMPRISONMENT

NEGLIGENCE MALPRACTICE

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TYPES OF TYPES OF LAWLAW

I - Criminal Law : I - Criminal Law :

1. Criminal law prevent harm to society 1. Criminal law prevent harm to society and provide punishment for crimes. and provide punishment for crimes.

( Black , 1999 )( Black , 1999 )

2. A crime is an act committed in 2. A crime is an act committed in violation of criminal Law and violation of criminal Law and punishable by a fine or imprisonment. A punishable by a fine or imprisonment. A crime does not have to be intended in crime does not have to be intended in order to be a crime.order to be a crime.

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TYPES OF LAW TYPES OF LAW contd…..contd…..

Crimes are classified as felonies and Crimes are classified as felonies and misdemeanor. misdemeanor.

FELONY - FELONY - Is a crime of a serious nature that Is a crime of a serious nature that has a penalty of imprisonment for greater has a penalty of imprisonment for greater than one year or even death. e.g. murder.than one year or even death. e.g. murder.

MISDEMEANOR - MISDEMEANOR - Is a serious crime that Is a serious crime that has a penalty of a fine or imprisonment for has a penalty of a fine or imprisonment for less than one year.less than one year.

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TYPES OF TYPES OF LAW LAW contd….. contd…..

IIIICivil Law –Civil Law –

It protects the rights of individual It protects the rights of individual persons within our society and persons within our society and encourage fair and equitable encourage fair and equitable treatment among people. treatment among people.

( Black, 1999 ) ( Black, 1999 )

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Contract LawContract Law

• Contract Law Contract Law Involves the enforcement of agreements Involves the enforcement of agreements

among private individuals or payment of among private individuals or payment of compensation for failure to fulfill the compensation for failure to fulfill the agreements.agreements.

• Tort LawTort Law

A tort is a civil wrong made against a person or A tort is a civil wrong made against a person or property.property.

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Types of Types of TortsTorts Intentional Intentional

Are willful acts that violate another’s rights.Are willful acts that violate another’s rights.

They are deliberate or willful actions in which They are deliberate or willful actions in which

the intend is to cause injury to a person ( or )the intend is to cause injury to a person ( or )

Property.Property.

UnintentionalUnintentional

These are accidents that cause injury to These are accidents that cause injury to another person or property. it involves failure another person or property. it involves failure or breach of nursing duties that lead to harm. or breach of nursing duties that lead to harm.

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Types of Torts Types of Torts contd….contd…. IntentionalIntentional Unintentional Unintentional

11 Assault Assault 11 Negligence Negligence

22 BatteryBattery 2 2 MalpracticeMalpractice

33 Invasion of PrivacyInvasion of Privacy

44 Defamation of characterDefamation of character

55 False imprisonmentFalse imprisonment

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Intentional Intentional TortsTorts 1.1. Assault -Assault - can be described as an can be described as an

attempt or threat to touch another person attempt or threat to touch another person unjustifiably.unjustifiably.

Assault is any intentional treat to bring Assault is any intentional treat to bring about harmful or offensive Contact. about harmful or offensive Contact.

Example –Example – A nurse may threaten to give a A nurse may threaten to give a client an injection or restrain the client for client an injection or restrain the client for any procedure when client has refuse any procedure when client has refuse consent consent

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Intentional Intentional Torts Torts contd… contd…

2.2. Battery -Battery - Is any intentional touching Is any intentional touching

without consent. Battery always includes without consent. Battery always includes an assault.an assault.

Example – Example – A nurse threatening to give a A nurse threatening to give a client an injection without client’s consent, client an injection without client’s consent, if the nurse actually gives the injection it if the nurse actually gives the injection it

is called Battery. is called Battery.

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Intentional Intentional Torts Torts contd… contd…

3.3. Invasion of privacy - Invasion of privacy - The tort of invasion of privacy protects the The tort of invasion of privacy protects the client’s right to be free from unwanted client’s right to be free from unwanted intrusion into his/ her private affairs. intrusion into his/ her private affairs.

1.1. Use of client’s name Use of client’s name 22 Unreasonable intrusion Unreasonable intrusion

33 Public disclosure of private facts Public disclosure of private facts 44 Putting a person in a false light Putting a person in a false light

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Intentional Torts Intentional Torts

contd… contd…

4 Defamation of character4 Defamation of character Is the publication of false statements that Is the publication of false statements that

result in damage to a persons reputation.result in damage to a persons reputation. It is communication that is false, or made It is communication that is false, or made

with a careless disregard for the truth, and with a careless disregard for the truth, and results in injury to the reputation of a results in injury to the reputation of a person.person.

Example - Loss of Client Property, such as Example - Loss of Client Property, such as jewelry, money, eyeglasses and dentures jewelry, money, eyeglasses and dentures is a constant concern to hospital personnel.is a constant concern to hospital personnel.

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Intentional Intentional Torts Torts contd… contd…55 False imprisonment – False imprisonment –

False imprisonment is the “ unjustifiable False imprisonment is the “ unjustifiable

detention of a person without legal detention of a person without legal warrant to confine the person”warrant to confine the person”

( Guido, 2001, ( Guido, 2001, p.98)p.98)

False imprisonment accompanied by False imprisonment accompanied by forceful restraint or threat of restraint is forceful restraint or threat of restraint is battery.battery.

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UnintentionaUnintentional l Torts Torts

• Negligence and malpractice are Negligence and malpractice are examples of unintentional torts that examples of unintentional torts that may occur in the health care setting. may occur in the health care setting.

• Negligence - Is misconduct or practice Negligence - Is misconduct or practice that is below the standard of care. that is below the standard of care.

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Unintentional Unintentional Torts Torts contd.. contd..

• MalpracticeMalpractice –Is negligence committed by –Is negligence committed by a professional such as nurse or physician. a professional such as nurse or physician.

Nurses are liable for malpractice in the Nurses are liable for malpractice in the following criteria.following criteria.

1.1.The nurse owed a duty to the client.The nurse owed a duty to the client.2.2.The nurse did not carry out that duty.The nurse did not carry out that duty.3.3. The client was injured.The client was injured.4.4.The nurses failure to carry out the duty The nurses failure to carry out the duty caused the injury.caused the injury.

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Measures to be taken Measures to be taken by nurse to avoid by nurse to avoid liability for liability for negligence and negligence and malpractice.malpractice.

11 Follow standard of cares.Follow standard of cares.

22 Give competent health care.Give competent health care.

33 Communicate with other health care Communicate with other health care providers.providers.

44 Develop a caring rapport with the client.Develop a caring rapport with the client.

55 Document assessments, interventions & Document assessments, interventions &

evaluations.evaluations.

66 Should know the current nursing literature inShould know the current nursing literature in

their areas of practice.their areas of practice.

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Measures Measures contd……contd……

..contd...contd.7. Should know and follow the policies and 7. Should know and follow the policies and

procedures of the institution in which they work.procedures of the institution in which they work.88 Should be sensitive to common sources of client Should be sensitive to common sources of client

injury such as falls and medication errors.injury such as falls and medication errors.99 Must communicate with the client.Must communicate with the client.10 Explain patients the tests concerns about the 10 Explain patients the tests concerns about the treatment treatment 11 Any significant changes in clients condition must 11 Any significant changes in clients condition must be reported to physician & documented in thebe reported to physician & documented in the chart.chart.

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SOURCESOF

LAW

ConstitutionalLaw

LegislativeLaw

AdministrativeLaw

CommonLaw

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SOURCES OF SOURCES OF LAWLAW

1 Constitutional Law1 Constitutional Law

The constitution creates legal rights The constitution creates legal rights and responsibilities and foundation of and responsibilities and foundation of a system of justice. e.g. the a system of justice. e.g. the constitution ensures each U.S. citizen constitution ensures each U.S. citizen the right to due process of law.the right to due process of law.

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SOURCES OF LAW SOURCES OF LAW CONTD..CONTD..2. Legislation ( Statutory Law )2. Legislation ( Statutory Law )

Laws enacts by any legislative body are Laws enacts by any legislative body are

called statutory laws. called statutory laws.

3. Administrative Law 3. Administrative Law

When a state legislature passes a When a state legislature passes a

statute, an administrative agency is given statute, an administrative agency is given

authority to create rules and regulations authority to create rules and regulations

to enforce the statutory laws. to enforce the statutory laws.

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SOURCES OF SOURCES OF LAW LAW CONTD.. CONTD..

4.Common Law4.Common Law

Laws evolving from court Laws evolving from court decisions are decisions are

referred to as common law. referred to as common law.

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CATEGORY….EXAMPLESCATEGORY….EXAMPLES….….• ConstitutioConstitutio

nal nal

• StatutoryStatutory

• - Due Process- Due Process - Equal protection - Equal protection

• - Nurse Practice Act- Nurse Practice Act - Good Samaritan Act - Good Samaritan Act - Child and Adult Abuse Act - Child and Adult Abuse Act

- Living Wills - Living Wills - Sexual Harassment Laws - Sexual Harassment Laws - American Disability Act - American Disability Act

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CATEGORY….EXAMPLESCATEGORY….EXAMPLES….….• CriminalCriminal

• ContractContract

• Homicide Homicide • ManslaughterManslaughter• TheftActive TheftActive • EucanthesiaEucanthesia• Sexual assaultSexual assault• Illegal possession of control Illegal possession of control

drugsdrugs

• Nurse and clientNurse and client• Nurse and employerNurse and employer• Nurse and insurance Nurse and insurance • Client and agencyClient and agency

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CATEGORY….EXAMPLESCATEGORY….EXAMPLES….….• Torts Torts • Negligence / MalpracticeNegligence / Malpractice

• Libel and slanderLibel and slander

• Invasion of privacyInvasion of privacy

• Assault and batteryAssault and battery

• False imprisonment False imprisonment

• AbandonmentAbandonment

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AREAS OF AREAS OF LIABILITY IN LIABILITY IN NURSINGNURSING CrimeCrime

A crime is an act committed in A crime is an act committed in violation of public ( criminal ) law violation of public ( criminal ) law and punishable be a fine or and punishable be a fine or imprisonment.imprisonment.

A crime does not have to be A crime does not have to be intended in order to be a crime.intended in order to be a crime.

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AREAS OF LIABILITY IN AREAS OF LIABILITY IN NURSING NURSING contd…… contd…… Torts -Torts -A tort is a civil wrong A tort is a civil wrong

committed against a person or a committed against a person or a person’s property.person’s property.

Duty -Duty - The nurse must have ( or should The nurse must have ( or should have had) a relationship with the client that have had) a relationship with the client that involves providing care and following an involves providing care and following an acceptable standard of care.acceptable standard of care.

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AREAS OF LIABILITY IN AREAS OF LIABILITY IN NURSING NURSING contd….contd…. Breach of duty -Breach of duty - There must be a standard There must be a standard

of care that is expected in the specific of care that is expected in the specific situation but that the nurse did not observe.situation but that the nurse did not observe.

Foreseeability -Foreseeability - A link must exist between A link must exist between the nurse’s act and the injury suffered.the nurse’s act and the injury suffered.

Causation -Causation - It must be proved that the harm It must be proved that the harm occurred as a direct result of the nurse’s occurred as a direct result of the nurse’s failure to follow the standard of care.failure to follow the standard of care.

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AREAS OF LIABILITY IN AREAS OF LIABILITY IN NURSING NURSING contd….contd…. Harm of injury -Harm of injury - The client or The client or

plaintiff must demonstrate some plaintiff must demonstrate some type of harm or injury ( physical, type of harm or injury ( physical, financial or emotional ) as a result of financial or emotional ) as a result of the breach of duty owed the client. the breach of duty owed the client.

Damages-Damages- If malpractice caused the If malpractice caused the injury, the nurse is held liable for injury, the nurse is held liable for damages that may be compensated. damages that may be compensated.

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AREAS OF LIABILITY IN AREAS OF LIABILITY IN NURSING NURSING contd….contd….

Intervention Errors -Intervention Errors - Failing to Failing to Document all nursing interventions understand the Document all nursing interventions understand the

medications being administered.medications being administered. Always monitor the client as the condition warrants Always monitor the client as the condition warrants

and as ordered.and as ordered. Document the frequency of client monitoring and Document the frequency of client monitoring and

client status.client status. Promptly bring distressing symptoms and changes in Promptly bring distressing symptoms and changes in

client status to the attention of the physician.client status to the attention of the physician. Document the time and content of all telephone Document the time and content of all telephone

conversations with the physician.conversations with the physician.

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1. Informed Consent1. Informed Consent

Is the authorization by the patient and Is the authorization by the patient and based upon legal capacity, voluntary based upon legal capacity, voluntary action and compensation voluntary action and compensation voluntary action and comprehension. It is the action and comprehension. It is the person’s agreement to allow something person’s agreement to allow something to happen based on full disclosure of to happen based on full disclosure of facts needed to make an intelligent facts needed to make an intelligent decision.decision.

SELECTED LEGAL SELECTED LEGAL ASPECTS OF ASPECTS OF NURSING PRACTICENURSING PRACTICE

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SELECTED LEGAL ASPECTS SELECTED LEGAL ASPECTS OF NURSING PRACTICEOF NURSING PRACTICE

1.1. Explaination of treatment procedure. Explaination of treatment procedure.

2 The purpose of the treatment2 The purpose of the treatment

3. What the client can expect to feel or 3. What the client can expect to feel or

experienceexperience

44 The intended benefits of the The intended benefits of the treatmenttreatment

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SELECTED LEGAL SELECTED LEGAL ASPECTS OF NURSING ASPECTS OF NURSING PRACTICEPRACTICE

55 Possible risks or negative outcomes Possible risks or negative outcomes of the treatmentof the treatment

66 Advantages and Disadvantages of Advantages and Disadvantages of possible alternatives to the possible alternatives to the treatment ( including no treatment )treatment ( including no treatment )

7.Name of the persons performing the 7.Name of the persons performing the procedure.procedure.

8.Statement that patient may 8.Statement that patient may withdraw his consent at anytime. withdraw his consent at anytime.

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There are three major elements of There are three major elements of informed consent.informed consent.

1.1.The consent must be given voluntarily.The consent must be given voluntarily.2.2.The consent must be given by a client or The consent must be given by a client or

individual with a capacity and competence individual with a capacity and competence to understand.to understand.

3.3.The client or individual must be given The client or individual must be given enough information to be the ultimate enough information to be the ultimate decision maker..decision maker..

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2. Delegation 2. Delegation

Definition by The National Council of Definition by The National Council of State Boards of Nursing (1995) defines State Boards of Nursing (1995) defines delegation as, “ Transferring to a delegation as, “ Transferring to a competent individual the authority to competent individual the authority to perform a selected nursing task in a perform a selected nursing task in a selected situation.”selected situation.”

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3. Violence, Abuse and Neglect 3. Violence, Abuse and Neglect

Violent behavior can include Violent behavior can include domestic violence, child abuse, elder domestic violence, child abuse, elder abuse and sexual abuse. Neglect is abuse and sexual abuse. Neglect is the absence of care necessary to the absence of care necessary to maintain the health and safety of a maintain the health and safety of a vulnerable individual such as a child vulnerable individual such as a child or elder.or elder.

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4. Sexual Harassment4. Sexual Harassment

Sexual Harassment is a violation of the Sexual Harassment is a violation of the individual’s rights and a form of individual’s rights and a form of discrimination. The Equal Employment discrimination. The Equal Employment Opportunity Commission ( EEOC) defines Opportunity Commission ( EEOC) defines sexual harassment as “ Unwelcome sexual sexual harassment as “ Unwelcome sexual advances, requests for sexual favors, and advances, requests for sexual favors, and other verbal or physical conduct of a other verbal or physical conduct of a sexual nature.” sexual nature.”

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5. Abortions5. Abortions Abortion Law provide specific guidelines for Abortion Law provide specific guidelines for

nurses about what is legally permissible. In nurses about what is legally permissible. In 1973, when the Roe V. Wade and Doe V. 1973, when the Roe V. Wade and Doe V. Bolton cases were decided, the Supreme Bolton cases were decided, the Supreme Court of the United States held that the Court of the United States held that the constitutional rights of privacy gives a woman constitutional rights of privacy gives a woman the right to control her own body to the the right to control her own body to the extend that she can abort her fetus in the extend that she can abort her fetus in the early to the extent that she can abort her early to the extent that she can abort her fetus in the early stages of pregnancy.fetus in the early stages of pregnancy.

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6. Death and related Issues6. Death and related Issues

Legal issues associated with death Legal issues associated with death include advance directives, include advance directives, euthanasia, do not resuscitate ( DNR ) euthanasia, do not resuscitate ( DNR ) orders, certification of death, autopsy, orders, certification of death, autopsy, inquest, and organ donation.inquest, and organ donation.

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8. Loss or damage to patient’s property – 8. Loss or damage to patient’s property –

The nurse is held responsible if she handles the The nurse is held responsible if she handles the

patient’s property carelessly and as a result thepatient’s property carelessly and as a result the

property is lost. e.g. Handing of patient’s jewelry property is lost. e.g. Handing of patient’s jewelry

to patient’s nearest relative after written to patient’s nearest relative after written consent.consent.

Money, eyeglasses and dentures is a another Money, eyeglasses and dentures is a another

concern of loss in the hospital personnel.concern of loss in the hospital personnel.

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LEGAL PROTECTION IN LEGAL PROTECTION IN NURSING PRACITCENURSING PRACITCE

I.I. LICENSURELICENSURE

1.1.All nurses in the nursing practice must All nurses in the nursing practice must possess a valid licensure issued to the possess a valid licensure issued to the state council.state council.

2.2.This license is to practice with ones own This license is to practice with ones own authority.authority.

3.3.The licensure on one hand is to secure The licensure on one hand is to secure society the benefits which comes from the society the benefits which comes from the services of skilled growth.services of skilled growth.

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LEGAL PROTECTION IN LEGAL PROTECTION IN NURSING PRACITCENURSING PRACITCE

II GOOD RAPPORTII GOOD RAPPORT 1.1.Developing good rapport with the patient is Developing good rapport with the patient is

very important to prevent malpractice.very important to prevent malpractice.

2.Nurses must never underestimate a rapport 2.Nurses must never underestimate a rapport with the client in malpractice prevention.with the client in malpractice prevention.

3.3.Good rapport with the client depends on Good rapport with the client depends on good IPR. Communication skills e.g. good IPR. Communication skills e.g. listening.listening.

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GOOD SAMARITAN ACTSGOOD SAMARITAN ACTS

Good Samaritan acts are laws designed Good Samaritan acts are laws designed to protect the healthcare providers to protect the healthcare providers who provide assistance at the scene of who provide assistance at the scene of an emergency against claims of an emergency against claims of malpractice unless it can be shown malpractice unless it can be shown that there was a gross departure from that there was a gross departure from the normal standard of care or willful the normal standard of care or willful wrongdoing on their part. wrongdoing on their part.

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PROFESSIONAL LIABILITY PROFESSIONAL LIABILITY INSURANCE INSURANCE

Because of the increase in the Because of the increase in the number of malpractice lawsuits number of malpractice lawsuits againstagainst

health professionals, nurses are health professionals, nurses are advised to carry their own liability advised to carry their own liability insurance.insurance.

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PROVIDING COMPETENT PROVIDING COMPETENT NURSING CARENURSING CARE

Complete practice is a major legal Complete practice is a major legal safeguard for nurses. Nurses need to safeguard for nurses. Nurses need to

provide care that is within the legal provide care that is within the legal boundaries of their practice andboundaries of their practice and

within the boundaries of agency within the boundaries of agency policies and procedures. policies and procedures.

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RECORD KEEPINGRECORD KEEPING

• The client’s medical record is a legal The client’s medical record is a legal document and can be produced in document and can be produced in court as an evidence. Often, the court as an evidence. Often, the record is used to remind a witness of record is used to remind a witness of events surrounding a lawsuit, events surrounding a lawsuit, because several months or years because several months or years usually elapse before the suit goes to usually elapse before the suit goes to trail. trail.

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ETHICS IN ETHICS IN NURSINGNURSING

• Ethics is derived from the word,” Ethos “. Ethics is derived from the word,” Ethos “. It is a tradition or sharing of customs and It is a tradition or sharing of customs and

commitment to a particular system of commitment to a particular system of values. values.

• Ethics refers to the science of moral duty, Ethics refers to the science of moral duty, ideal character and moral principles of a ideal character and moral principles of a practice of a profession. practice of a profession.

( Bernard Harding )( Bernard Harding )

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IMPORTANCE OF IMPORTANCE OF ETHICS IN NURSINGETHICS IN NURSING

• Ethics has always been an integral part of Ethics has always been an integral part of nursing.nursing.

• Caring for, comforting the sick, and protecting Caring for, comforting the sick, and protecting the suffering is human activity and it should be the suffering is human activity and it should be seen how society views directly affect the morals, seen how society views directly affect the morals, customs and beliefs of human kind. customs and beliefs of human kind.

• Nursing ethics provide the standards for Nursing ethics provide the standards for professional behavior.professional behavior.

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INTERNATIONAL COUNCIL INTERNATIONAL COUNCIL FOR NURSES CODE OF FOR NURSES CODE OF ETHICSETHICS

Within any given profession , a code of Within any given profession , a code of ethics serve as a means of self regulation ethics serve as a means of self regulation and a source guidelines for individuals and a source guidelines for individuals behavior and responsibility. behavior and responsibility.

Code of ethics is an inclined contact Code of ethics is an inclined contact through which the profession informs through which the profession informs society the principles and rules by which it society the principles and rules by which it functions.functions.

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NURSES AND PEOPLENURSES AND PEOPLE• The nurse’s primary responsibility is to those The nurse’s primary responsibility is to those

people who require nursing care.people who require nursing care.

• The Nurse holds confidence, personal The Nurse holds confidence, personal information and uses Judgment in sharing information and uses Judgment in sharing their information. their information.

• The Nurse provides care, promotes good The Nurse provides care, promotes good environment in which the values, customs environment in which the values, customs and spiritual beliefs of the individuals are and spiritual beliefs of the individuals are respected respected

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NURSES AND PRACTICENURSES AND PRACTICE• The nurse carries personal responsibilities The nurse carries personal responsibilities

for nursing practice and for maintaining for nursing practice and for maintaining competency by continuously learning. competency by continuously learning.

• The nurse maintains the higher standards The nurse maintains the higher standards of nursing care possible with in the reality of nursing care possible with in the reality of the specific situation. of the specific situation.

• The nurse uses judgment in relation to The nurse uses judgment in relation to individual competence when accepting individual competence when accepting and delegating responsibilities and delegating responsibilities

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NURSE AND SOCIETYNURSE AND SOCIETY

The nurse shares with other citizens the responsibility forThe nurse shares with other citizens the responsibility forinitiation and supporting action to meet the health andinitiation and supporting action to meet the health andsocial needs of public.social needs of public.

NURSES AND COWORKERSNURSES AND COWORKERSThe nurse sustains a cooperative relation with coworkers inThe nurse sustains a cooperative relation with coworkers innursing and other fields.nursing and other fields.

The nurse takes appropriate action to safeguard theThe nurse takes appropriate action to safeguard theindividual when his care endangered by a coworker or anyindividual when his care endangered by a coworker or anyother person other person

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NURSES AND THE NURSES AND THE PROFESSIONPROFESSION

The nurse plays a major role in delivering andThe nurse plays a major role in delivering andimplementing desirable standards of nursing implementing desirable standards of nursing education. education.

The nurse is active in developing a care ofThe nurse is active in developing a care ofprofessional knowledge.professional knowledge.

The nurse acting through the professionalThe nurse acting through the professionalorganization in establishing and maintainingorganization in establishing and maintainingequitable social and looking for condition inequitable social and looking for condition in nursing nursing

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ETHICAL DECISION MAKINGETHICAL DECISION MAKING

Nurses decisions are increasingly Nurses decisions are increasingly constrained by ethical issues. Ethical constrained by ethical issues. Ethical decision making involves reflection on the decision making involves reflection on the following. Who should make the choice, following. Who should make the choice, possible option or courses of action, possible option or courses of action, available options, consequences, both available options, consequences, both good or bad, of all possible options, desiredgood or bad, of all possible options, desired

outcomes. outcomes.

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ETHICAL PRINCIPLESETHICAL PRINCIPLES • Respect for person.Respect for person. • Respect for autonomyRespect for autonomy• Respect for freedomRespect for freedom• Respect for beneficence ( doing good )Respect for beneficence ( doing good )• Respect for non-malfeasance (avoiding Respect for non-malfeasance (avoiding

harm to others )harm to others ) • Respect for veracity ( truth telling )Respect for veracity ( truth telling )• Respect for justice ( Fair and equal Respect for justice ( Fair and equal

treatment )treatment ) • Respect for rightsRespect for rights• Respect for fidelity.( Fulfilling promises )Respect for fidelity.( Fulfilling promises )• Respect for confidentiality (Protecting Respect for confidentiality (Protecting

privileged information)privileged information)

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ETHICAL DECISION ETHICAL DECISION MAKINGMAKING • M- Massage the dilemma. Identify and M- Massage the dilemma. Identify and

define the issues in the dilemma. Consider define the issues in the dilemma. Consider the options of all the major players in the the options of all the major players in the dilemma as well as their value system.dilemma as well as their value system.

• O- Outline the options. Examine all O- Outline the options. Examine all options including those less realistic and options including those less realistic and conflicting. Three stages are designed conflicting. Three stages are designed only for considering options and not for only for considering options and not for making final decision.making final decision.

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ETHICAL DECISION MAKING ETHICAL DECISION MAKING ....C ....Contdontd• R- Resolve the dilemma. Review the issues R- Resolve the dilemma. Review the issues

and options, applying the basic Principles of and options, applying the basic Principles of ethics to each option. Decide the best option ethics to each option. Decide the best option based upon the views of all those concerned in based upon the views of all those concerned in dilemma.dilemma.

• A- Act by applying chosen option. This step is A- Act by applying chosen option. This step is usually the most difficult as it requires actual usually the most difficult as it requires actual implementation. While the previous steps had implementation. While the previous steps had only allowed for dialogue or discussion.only allowed for dialogue or discussion.

• L- Look back and evaluate the entire process L- Look back and evaluate the entire process including the implementation.including the implementation.

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ETHICAL DILEMMAETHICAL DILEMMA

A dilemma is defined as a situation A dilemma is defined as a situation requiring a choice between two requiring a choice between two equally desirable or undesirable equally desirable or undesirable alternatives. In ethical dilemma alternatives. In ethical dilemma each alternative course of action each alternative course of action can be justified by two in which a can be justified by two in which a person views a course of action person views a course of action based on his/her value based based on his/her value based system. system.

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ETHICAL COMMITTEEETHICAL COMMITTEE

• The members are - Physicians, Nurses, The members are - Physicians, Nurses, Clergy and ethicists. Clergy and ethicists.

• Functions are – The committees analyze Functions are – The committees analyze situations.situations.

• Help to clarify issues.Help to clarify issues.

• Identify the options available.Identify the options available.

• Influence policy makingInfluence policy making

• Teach staff and clients about ethical rights Teach staff and clients about ethical rights and ethical decision making.and ethical decision making.

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ROLE AND FUNCTIONS OF NURSE / ROLE AND FUNCTIONS OF NURSE / ADMINISTRATOR / MANAGER IN LEGAL ADMINISTRATOR / MANAGER IN LEGAL

& ETHICAL ISSUES.& ETHICAL ISSUES. • PROVIDER OF SERVICEPROVIDER OF SERVICE • EMPLOYEE OR CONTRACTOR EMPLOYEE OR CONTRACTOR

FOR SERVICEFOR SERVICE • RESPONSIBILITY IN QUALITY RESPONSIBILITY IN QUALITY

CONTROLCONTROL • RESPONSIBILITY FOR EQUIPMENTRESPONSIBILITY FOR EQUIPMENT • RESPONSIBILITY FOR RESPONSIBILITY FOR

OBSERVATION AND REPORTINGOBSERVATION AND REPORTING

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LEGAL ROLES OF LEGAL ROLES OF NURSESNURSES

• Provider of ServiceProvider of Service

• Employee or contractor for Employee or contractor for ServiceService

• Citizen Citizen

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THANK YOUTHANK YOU

Ppt of Law & Ethics Seminar

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Transcript of Ppt of Law & Ethics Seminar