Ethical & Legal Considerations

statutory law

laws passed by legislatures

constitutional law

rights protected by the US constitution

administrative (regulatory) law

rules established by Boards of Nursing

common law

court decisions and legal precedent

ethics

the study of conduct and character, guided by moral principles and values that direct behavior and judgments about what is right and wrong

autonomy

the right to make one’s own personal decisions, even when those decisions might not be in that person’s own best interest

beneficence

action that promotes good for others, without any self-interest

nonmaleficence

a commitment to do no harm

veracity

a commitment to tell the truth

fidelity

fulfillment of promises

justice

fairness in care delivery and use of resources

criminal law

laws that govern offenses and crimes committed against society as a whole or the government, where the state prosecutes the offender and must prove guilt beyond a reasonable doubt

civil law

laws that protect individual rights and resolve disputes or harms between private individuals or organizations, typically resulting in monetary compensation or damages awarded to the injured party

tort

a civil wrong resulting in injury or harm

malpractice

professional negligence; when a nurse fails to meet the accepted standards of care, resulting in patient injury

duty, breach of duty, causation, damages

what are the 4 elements of malpractice? (without these, malpractice cannot be established)

Nurse Practice Act (NPA)

the law that regulates nursing practice; defines scope of practice, licensure requirements, standards of nursing practice, grounds for disciplinary action, and authority of the Board of Nursing

Board of Nursing (BON)

regulatory agency for licensing nurses, enforcing the NPA, approving nursing education programs, investigating complaints, and taking disciplinary action

Emergency Medical Treatment and Labor Act (EMTALA)

requires every emergency department to provide a medical screening exam, stabilize emergency conditions, and transfer patients appropriately if needed

Health Insurance Portability and Accountability Act (HIPPA)

protects patient privacy, personal health information, and electronic health records

privacy

patient right to control personal information

confidentiality

healthcare provider’s responsibility to protect patient information

Just Culture

a values-supportive model of shared accountability, fairness, and mindfulness; promotes an environment where errors can be reported and learned from safely

informed consent

a legal and ethical process that ensures patients understand proposed treatment/procedures, benefits and risks, alternatives, and the right to refuse treatment

advance directives

communicate healthcare wishes if patients cannot speak for themselves

Living Will

a legal document that expresses a client's specific wishes regarding medical and life-sustaining treatments in the event they become incapacitated and are unable to make decisions for themselves

Medical Power of Attorney

a legal document in which a client designates a trusted individual (a healthcare proxy) to make healthcare decisions on their behalf if they become unable to do so

delegation

the transfer of responsibility for performing a task while the RN retains accountability for patient outcomes

right task, right circumstance, right person, right direction & communication, right supervision & evaluation

what are the 5 rights of delegation?

Occupational Safety and Health Administration (OSHA)

protect employees by promoting safe and healthy workplaces

Centers for Medicare and Medicaid Services (CMS)

manages federal funding for healthcare facilities and influences healthcare quality, safety, and financial operations through reimbursement policies and quality reporting

Provisions 1-3: Commitment to the Patient

practice compassion and respect, protect patient dignity, advocate for patients, and promote health and safety

Provisions 4-6: Responsibility to Practice

being accountable for nursing practice, maintaining competence, promote safe environments and practice ethically

Provisions 7-9: Commitment to the Profession

advance nursing knowledge, participate in research, improve healthcare policy, collab with healthcare teams, and promote social justice