Legal & Ethical Issues in Healthcare
State healthcare facility policies and procedures.
New Jersey healthcare facility policies and procedures are designed to ensure compliance with state regulations regarding safety, patient care, and operational standards. They address the following areas:
Admission and discharge procedures
Infection control practices
Emergency protocols
Patient rights and responsibilities
Staff training and continuing education requirements
Reporting and responding to incidents and grievances
Patient confidentiality and data protection
Policies related to medical records and documentation.
Identify national, state and local standards for workplace safety.
U.S.A. and New Jersey Standards for Workplace Safety
National Standards:
Occupational Safety and Health Administration (OSHA): Enforces standards ensuring safe and healthy working conditions, establishing regulations that employers must follow.
American National Standards Institute (ANSI): Provides guidelines and certifications for workplace safety across various industries.
State Standards (New Jersey):
New Jersey Division of Occupational Safety and Health (NJ-DOSH): Oversees the enforcement of workplace safety regulations and standards specific to the state.
Worker and Community Right to Know Act: Requires employers to inform workers about hazardous substances in the workplace.
Local Standards:
Local ordinances may vary; municipalities can set rules that may be more stringent than state or federal regulations, including specific safety protocols for construction sites, healthcare facilities, and industrial activities.
Determine laws governing healthcare professionals.
Laws governing healthcare professionals in the United States primarily encompass licensure, certification, and regulatory standards. Key sources include:
State Nursing Boards: Each state has its own board that governs the practice of nursing, issuing licenses and overseeing regulations for registered nurses (RNs), licensed practical nurses (LPNs), and advanced practice registered nurses (APRNs).
Health Resources and Services Administration (HRSA): An agency of the U.S. Department of Health and Human Services (HHS) that administers programs to ensure the availability of quality healthcare services through workforce training, support, and development.
American Medical Association (AMA): Provides guidelines and ethical principles for the practice of medicine, influencing state regulations and professionals' behavior in healthcare.
Centers for Medicare & Medicaid Services (CMS): Establishes standards for healthcare services and programs, ensuring healthcare professionals meet specific conditions for participation in federally funded healthcare programs.
Occupational Safety and Health Administration (OSHA): Ensures workplace safety for healthcare workers, establishing regulations to protect their health and safety on the job.
Overall, these laws and regulations are designed to ensure professionals meet necessary education, conduct standards, and operational protocols in delivering safe and effective healthcare.
State the purpose of a patient’s “Bill of Rights”.
The purpose of a patient’s "Bill of Rights" is to outline the rights and expectations of patients while receiving medical care. It is designed to ensure patients have a clear understanding of their rights regarding personal autonomy, informed consent, confidentiality, and the right to receive safe, respectful healthcare. This document empowers patients to participate actively in their care and to seek help if their rights are not being upheld.
Explain laws and standards associated with employment and labor.
In the U.S., laws and standards associated with employment and labor include:
Fair Labor Standards Act (FLSA): Establishes minimum wage, overtime pay, and youth employment standards.
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.
In New Jersey, additional laws include:
New Jersey's Law Against Discrimination (LAD): Prohibits discrimination in employment based on various 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.
Explain the purpose of Material Data Safety Sheets (MSDS) used in a healthcare setting.
The purpose of Material Safety Data Sheets (MSDS) in a healthcare setting is to provide essential information regarding the properties and handling of hazardous substances used in the facility. MSDS contain details about:
Occupational exposure limits
Personal protective equipment requirements
First-aid measures in case of exposure
Fire-fighting measures
Health hazards associated with the substances
Safe handling procedures
Accident response and spill cleanup information These sheets ensure that healthcare workers understand the risks associated with hazardous materials and how to mitigate them to safeguard their health and the safety of patients.
Explain laws associated with harassment.
Laws Associated with Harassment in the U.S.:
Title VII of the Civil Rights Act of 1964: Prohibits employment discrimination based on race, color, religion, sex, or national origin. This includes sexual harassment and harassment based on other protected characteristics.
The Age Discrimination in Employment Act (ADEA): Protects individuals 40 years of age and older from employment discrimination and harassment based on age.
The Americans with Disabilities Act (ADA): Prohibits discrimination against individuals with disabilities, including workplace harassment.
Sexual Harassment Guidelines by the Equal Employment Opportunity Commission (EEOC): Provides a framework for understanding sexual harassment in the workplace, outlining what constitutes harassment and the process for filing complaints.
State Laws: Many states have additional laws addressing harassment, which can provide broader protections than federal law. These laws vary widely and may include protections against harassment based on sexual orientation, gender identity, and other categories.
Local Ordinances: Some municipalities have their own laws which may include non-discrimination and anti-harassment provisions that provide further protections at a local level.
Overall, these laws aim to create a work environment free from harassment and to protect employees’ rights to work in an environment that is respectful and non-discriminatory.
Determine licensure and certification needed by healthcare professionals.
In the state of New Jersey, licensure and certification are required for various healthcare professionals to ensure they meet the necessary educational and competency standards to practice safely and effectively. Specific licensure requirements may include:
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.
These licensure and certification processes help ensure that healthcare providers in New Jersey uphold professional standards and provide quality patient care.
Identify standards of the Health Insurance Portability and Accountability Act (HIPAA).
The standards of the Health Insurance Portability and Accountability Act (HIPAA) include:
Privacy Rule: Establishes national standards for the protection of individuals' medical records and personal health information (PHI). It governs how covered entities—healthcare providers, health plans, and healthcare clearinghouses—can use and disclose PHI.
Security Rule: Sets standards for safeguarding electronic protected health information (ePHI). It outlines administrative, physical, and technical safeguards that must be in place to protect ePHI.
Transaction and Code Sets Rule: Standardizes the coding systems used for billing and electronic health transactions to ensure consistency in how healthcare information is exchanged.
Unique Identifiers Rule: Requires the establishment of unique identifiers for healthcare providers (NPI), health plans, and employers (EIN) to streamline healthcare transactions.
Enforcement Rule: Details the procedures for compliance and investigations regarding HIPAA violations, including potential civil and criminal penalties.
Breach Notification Rule: Requires covered entities to notify individuals of breaches of unsecured PHI, ensuring transparency and accountability in the event of a data breach.
Maintain patient confidentiality.
To maintain patient confidentiality, healthcare providers must adhere to the following practices:
Restricted Access: Limit access to patient information only to those who need it for treatment, payment, or healthcare operations.
Secure Storage: Store patient records in a secure location, using locks or encryption to prevent unauthorized access.
Discretion in Communication: Discuss patient information privately and avoid discussing confidential details in public areas.
Informed Consent: Obtain patient consent before sharing their information, ensuring they understand how their data will be used and protected.
Training and Policies: Educate all staff about confidentiality policies and the importance of protecting patient information.
Reporting Breaches: Have a procedure in place to report breaches of confidentiality to mitigate risks and comply with legal obligations.
Identify threats to patient confidentiality. Threats to patient confidentiality can include:
Unauthorized Access: Individuals who do not have permission accessing patient records or information.
Data Breaches: Cyberattacks that result in unauthorized access to electronic health records (EHR).
Improper Disposal of Records: Failing to properly dispose of physical records, leading to information leaks.
Inadequate Training: Staff who are poorly trained in confidentiality policies may unintentionally disclose sensitive information.
Shared Devices: Use of shared computers or devices that can lead to unintentional exposure of patient information.
Social Engineering: Manipulating individuals to gain confidential patient information through deceptive practices.
Lack of Encryption: Failure to encrypt digital communications and records, making them vulnerable to interception.
Third-party Access: Allowing unauthorized third parties, such as vendors or contractors, access to confidential information.
Public Conversations: Discussing patient information in public areas where it can be overheard.
Weak Password Protocols: Use of easily guessable or shared passwords that can
Define expressed, implied and informed consent.
Expressed Consent: Expressed consent is a voluntary agreement given by a patient, typically in writing, authorizing a healthcare provider to perform a specific medical procedure or treatment. This form of consent is clear and explicit, often requiring the provider to inform the patient about the risks, benefits, and alternatives before obtaining agreement.
Implied Consent: Implied consent refers to a situation in which a patient's agreement to a procedure or treatment is inferred from their actions or the context of the situation rather than explicitly stated. For example, if a patient goes to an emergency room and allows medical staff to provide care, it is understood that they consent to treatment even if they do not verbally communicate it.
Informed Consent: Informed consent is the process by which healthcare providers ensure that patients have a comprehensive understanding of the medical procedure or treatment being proposed, including the risks, benefits, and potential alternatives. It requires the patient to be informed and to voluntarily agree to the treatment after understanding all relevant information.
Identify practices and behaviors that result in malpractice, liability, and/or negligence.
Practices and behaviors that may result in malpractice, liability, and/or negligence in healthcare include:
Failure to Assess: Not performing proper assessments or failing to recognize changes in a patient’s condition.
Inadequate Documentation: Poor or incomplete record-keeping regarding patient care, treatments, and outcomes.
Failure to Communicate: Not effectively sharing information about a patient's condition with other healthcare professionals or failing to inform patients about their treatment plans.
Inadequate Supervision: Failing to provide proper oversight to subordinate staff or interns.
Failure to Follow Protocols: Not adhering to established policies and procedures for patient care and safety.
Performing Unauthorized Procedures: Conducting treatments or procedures without obtaining informed consent from the patient.
Neglecting Patient Safety: Failing to provide a safe environment, leading to preventable accidents and injuries for the patient.
Use of Outdated Practices: Employing outdated or disproven treatment methods that do not reflect current medical standards.
Incompetence: Lacking the necessary skills or qualifications to perform medical tasks competently.
Disrespectful Treatment: Engaging in behavior that does not respect patient rights or dignity, which may lead to psychological harm.
Identify ethical issues related to healthcare.
Possible ethical issues related to healthcare include:
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.
Identify appropriate work habits and ethics. Identify appropriate work habits and ethics:
Punctuality: Arriving on time for work and meetings.
Dependability: Being reliable and fulfilling obligations.
Professionalism: Maintaining a professional demeanor in appearance and behavior.
Communication Skills: Effectively conveying information and listening to others.
Teamwork: Collaborating and cooperating with colleagues to achieve common goals.
Time Management: Prioritizing tasks effectively and managing time to complete responsibilities.
Accountability: Taking responsibility for one’s actions and decisions in the workplace.
Respect: Treating colleagues, patients, and superiors with dignity and consideration.
Continuous Learning: Engaging in ongoing education and skill development to improve professional competence.
Adherence to Policies: Following organizational policies, procedures, and ethical guidelines.