Legal & Ethical Issues in Healthcare

New Jersey Healthcare Facility Policies and Procedures

Designed to ensure compliance with state regulations regarding safety, patient care, and operational standards, including areas such as admission/discharge procedures, infection control, emergency protocols, patient rights, staff training, incident reporting, patient confidentiality, and medical record policies.

Occupational Safety and Health Administration (OSHA)

Enforces standards ensuring safe and healthy working conditions and establishes regulations that employers must follow.

American National Standards Institute (ANSI)

Provides guidelines and certifications for workplace safety across various industries.

New Jersey Division of Occupational Safety and Health (NJ-DOSH)

Oversees the enforcement of workplace safety regulations and standards specific to New Jersey.

Worker and Community Right to Know Act

requires public and private employers to provide information about hazardous substances in the workplace to protect workers and the community

State Nursing Boards

Boards that govern nursing practice in each state, issuing licenses and overseeing regulations for RNs, LPNs, and APRNs.

Health Resources and Services Administration (HRSA)

Agency of HHS that administers programs to ensure quality healthcare services through workforce training and support.

American Medical Association (AMA)

Provides guidelines and ethical principles for medicine, influencing state regulations and healthcare professionals' behavior.

Centers for Medicare & Medicaid Services (CMS)

Establishes standards for healthcare services and programs, ensuring compliance for participation in federally funded programs.

Occupational Safety and Health Administration (OSHA)

Regulates workplace safety for healthcare workers, establishing standards to protect their health and safety.

Laws Governing Healthcare Professionals

Comprised of licensure, certification, and regulatory standards overseen by state nursing boards, HRSA, AMA, CMS, and OSHA.

Patient's Bill of Rights

Outlines the rights and expectations of patients regarding personal autonomy, informed consent, confidentiality, and the right to receive safe, respectful healthcare.

Fair Labor Standards Act (FLSA)

Establishes minimum wage, overtime pay, and youth employment standards in the U.S.

Occupational Safety and Health Act (OSHA)

Ensures safe and healthful working conditions for employees by setting and enforcing standards.

Family and Medical Leave Act (FMLA)

Entitles eligible employees to take unpaid, job-protected leave for specified family and medical reasons.

Americans with Disabilities Act (ADA)

Prohibits discrimination against individuals with disabilities in all areas of public life, including jobs.

Title VII of the Civil Rights Act of 1964

Prohibits employment discrimination based on race, color, religion, sex, or national origin.

Age Discrimination in Employment Act (ADEA)

Protects individuals 40 years of age and older from employment discrimination based on age.

National Labor Relations Act (NLRA)

Protects the rights of employees to organize and to bargain collectively with their employers.

New Jersey's Law Against Discrimination (LAD)

Prohibits discrimination in employment based on protected categories such as race, gender, sexual orientation, and disability.

New Jersey Earned Sick Leave Law

Requires employers to provide earned sick leave to employees.

New Jersey Minimum Wage Law

Sets state minimum wage rates that may be higher than federal levels.

New Jersey Family Leave Act

Provides job protection and benefits for employees taking family leave.

New Jersey Industrial Safety and Health Act

Establishes safety and health standards for workplaces in New Jersey.

Material Safety Data Sheets (MSDS)

MSDS provide essential information regarding hazardous substances in healthcare settings, including exposure limits, protective equipment, first-aid measures, fire-fighting measures, health hazards, safe handling procedures, and accident response information.

Title VII of the Civil Rights Act of 1964

Prohibits employment discrimination based on race, color, religion, sex, or national origin, including sexual harassment.

Age Discrimination in Employment Act (ADEA)

Protects individuals 40 years and older from employment discrimination and harassment based on age.

Americans with Disabilities Act (ADA)

Prohibits discrimination against individuals with disabilities, including workplace harassment.

Sexual Harassment Guidelines by EEOC

Provide a framework for understanding sexual harassment in the workplace, detailing what constitutes harassment and the process for filing complaints.

Registered Nurses (RNs)

Must pass the NCLEX-RN exam and obtain a license from the New Jersey Board of Nursing.

Licensed Practical Nurses (LPNs)

Required to pass the NCLEX-PN exam and must be licensed by the New Jersey Board of Nursing.

Physicians

Must complete a recognized medical program, pass the USMLE or COMLEX examinations, and obtain licensure from the New Jersey Division of Consumer Affairs.

Physical Therapists

Require a Doctor of Physical Therapy (DPT) degree and must pass a national board exam (NPTE) to get licensed in New Jersey.

Occupational Therapists

Must complete a master's or doctoral degree in occupational therapy and pass the NBCOT exam to become licensed.

Certified Nursing Assistants (CNAs)

Must complete state-approved training programs and pass the nurse aide competency exam.

HIPAA Privacy Rule

Establishes national standards for the protection of individuals' medical records and personal health information (PHI).

HIPAA Security Rule

Sets standards for safeguarding electronic protected health information (ePHI) with necessary safeguards.

HIPAA Transaction and Code Sets Rule

Standardizes coding systems used for billing and electronic health transactions.

HIPAA Unique Identifiers Rule

Requires unique identifiers for healthcare providers (NPI), health plans, and employers (EIN).

HIPAA Enforcement Rule

Details procedures for compliance and investigations regarding HIPAA violations.

HIPAA Breach Notification Rule

Requires notification to individuals of breaches of unsecured PHI to ensure accountability.

Patient Confidentiality Practices

To maintain patient confidentiality, healthcare providers should ensure restricted access, secure storage, discretion in communication, informed consent before sharing information, staff training on policies, and procedures for reporting breaches.

Threats to Patient Confidentiality

Factors that compromise the security of patient information, such as unauthorized access, data breaches, improper disposal of records, inadequate training, use of shared devices, social engineering, lack of encryption, unauthorized third-party access, public conversations, and weak password protocols.

Expressed Consent

A voluntary agreement given by a patient, typically in writing, authorizing a healthcare provider to perform a specific medical procedure or treatment after being informed of the risks, benefits, and alternatives.

Implied Consent

An agreement inferred from a patient’s actions or the context, rather than explicitly stated; for example, when a patient allows care in an emergency setting without verbal communication.

Informed Consent

The process where healthcare providers ensure patients fully understand a proposed medical procedure, including risks, benefits, and alternatives, before voluntarily agreeing to it.

Malpractice Practices

Practices that may result in malpractice, liability, and/or negligence in healthcare include: Failure to Assess, Inadequate Documentation, Failure to Communicate, Inadequate Supervision, Failure to Follow Protocols, Performing Unauthorized Procedures, Neglecting Patient Safety, Use of Outdated Practices, Incompetence, and Disrespectful Treatment.

Informed Consent

Ensuring patients fully understand the procedures and treatments they are undergoing, including risks and benefits.

Patient Autonomy

Respecting patients' rights to make decisions about their own healthcare and treatment options.

Confidentiality

Upholding the privacy of patients’ medical information and ensuring it is not disclosed without consent.

Equitable Access to Care

Addressing disparities in healthcare access and ensuring all patients receive fair treatment regardless of background.

End-of-Life Issues

Navigating decisions related to euthanasia, assisted suicide, and patient rights regarding the cessation of treatment.

Resource Allocation

Determining how limited healthcare resources (like organ transplants or funding) are distributed ethically.

Conflict of Interest

Avoiding situations where personal or financial interests might compromise patient care.

Cultural Competence

Being sensitive and responsive to the diverse cultural backgrounds of patients within healthcare settings.

Malpractice and Negligence

Ensuring healthcare professionals adhere to the highest standards to avoid harm to patients.

Work Habits and Ethics

Key attributes for effective professional behavior, including punctuality, dependability, professionalism, communication skills, teamwork, time management, accountability, respect, continuous learning, and adherence to policies.