HC - Ch 3

Law, Ethics, and Professionalism in Health Care

Importance of Legal, Ethical, and Professional Responsibilities

  • The actions and decisions of health care providers significantly impact the lives of patients.

  • Health care workers are obligated to deliver optimal care while safeguarding patients' civil, constitutional, and human rights.

    • Civil Rights: Basic legal rights held by all U.S. citizens.

    • Constitutional Rights: Rights granted to citizens via the U.S. Constitution.

    • Human Rights: Fundamental rights applicable to all individuals, irrespective of citizenship status.

LAW
Role of the Legal System in Health Care

  • Citizens rely on the legal system to shield them from various wrongdoings.

  • The American legal system upholds citizens' rights through established guidelines for health care workers, patients, and employers.

  • Understanding the legal nature of the health care provider-patient relationship and responsibilities as an advocate is critical for all health care professionals.

Litigation in Health Care

  • Patients might pursue lawsuits if dissatisfied with received care, even amidst good provider-patient relationships.

  • Litigation: A legal process in court potentially arising from medical errors with varying consequences, from minor errors to severe mistakes leading to death.

  • A basic grasp of the legal system is essential for health care professionals.

Types of Law

  • Laws: Rules of conduct enforced by government authorities, categorized into:

    • Public Law: Issues between government and citizens, encompassing:

    • Criminal Law: Related to crimes threatening societal safety.

    • Constitutional Law: Involves rights such as abortion issues and civil rights violations.

    • Administrative Law: Laws enforced by agencies like the FDA and IRS.

    • Civil Law: Focuses on disputes between private citizens, including medical malpractice. Most health care legal issues encompass tort law, which defines wrongful acts leading to harm requiring compensation.

Tort Law

  • Tort: A wrongful act causing harm, typically leading to financial compensation instead of imprisonment.

  • Most health care lawsuits stem from tort claims, either intentional or unintentional.

Unintentional and Intentional Torts

  • Unintentional Torts: Accidental harm, e.g., dosage errors.

  • Intentional Torts: Deliberate acts causing harm, less frequent in health care.

Categories of Torts

  1. Unintentional: Negligence, Professional Negligence (Malpractice).

  2. Intentional: Assault, Battery, Invasion of Privacy, False Imprisonment, Defamation (slander and libel).

Assault and Battery

  • Assault: Threatening to harm a patient without consent, e.g., forcing medication.

  • Battery: Actual unwanted physical contact with a patient.

Invasion of Privacy

  • Patients have a right to privacy; exposing or disclosing patient information without consent constitutes invasion of privacy.

False Imprisonment

  • Restraining a patient against their will violates their rights, e.g., preventing a competent patient from leaving.

Defamation of Character

  • False statements damaging a person's reputation, classified into:

    • Slander: Spoken defamation.

    • Libel: Written defamation.

Liability and Negligence

  • Negligence arises from failing to protect patients, often leading to malpractice allegations. Examples include:

    • Medication errors

    • Inadequate assessments

    • Equipment misuse

Reporting Abuse

  • Health care providers must report abuse or neglect, especially in vulnerable populations such as children and the elderly, as mandated by state and federal laws.

  • Protections are in place for reporters to ensure confidentiality and shield them from lawsuits.

Protecting Patients' Rights

  • Patients have specific rights that health care providers must uphold, including:

    • Choosing their provider.

    • Determining treatment timelines.

    • Understanding treatment expectations.

  • Health care professionals must also respect physicians' rights regarding practice limitations and changes.

Advocacy

  • Advocating for patients’ best interests is a fundamental responsibility of health care professionals. This includes collaborating with insurance companies to ensure quality care for patients.

Consent

  • Informed Consent: Patients give approval for treatments based on understood risks, benefits, and alternatives. Written consent is required for:

    • Invasive procedures, experimental treatments, etc.

  • Implied Consent: Assumed consent in emergencies where patients can’t communicate.

  • Legal Guardian: A designated individual authorized to make decisions on behalf of minors or incompetent adults.

Confidentiality and HIPAA

  • Patients' privacy is protected under the Health Insurance Portability and Accountability Act (HIPAA), which mandates confidentiality of personal health information.

  • Health care professionals must ensure that all information, including medical records and details about treatment, remains confidential except under specific conditions.

Releasing Confidential Information

  • Patient information can only be shared without explicit consent in situations involving legal obligations, hospital operations, or ongoing patient care.

What is Confidential Information?

  • Includes personal identifiers such as:

    • Name, age, email address, social security number, and health history.

Right to Die

  • Patients have the right to refuse life-sustaining treatments. Health care providers must respect advance directives like living wills and durable power of attorney.

ETHICS
Differentiating Between Law and Ethics

  • Ethics serve as guidelines for moral conduct in health care, reflecting the specific values of health care providers.

  • While laws represent societal values, ethics relate specifically to health care practices.

Ethical Principles

  • Basic principles guiding health care ethics include:

    • Autonomy: Respecting patient self-determination.

    • Justice: Fairness in treatment and distribution of resources.

    • Nonmaleficence: Obligation to do no harm.

    • Beneficence: Duty to promote good.

    • Veracity: Commitment to honesty.

    • Fidelity: Keeping professional promises.

    • Confidentiality: Protecting patient privacy.

Joint Commission

  • The Joint Commission aims to enhance care quality by accrediting health facilities and setting ethical standards for patient care. Key areas include:

    • Following a profession's code.

    • Maintaining coordination, respect, and sensitivity toward patients.

Ethics Committees

  • Required by the Joint Commission, ethics committees address moral issues in patient care and guide policy development. Goals often include:

    • Promoting patient rights and shared decision-making.

    • Serving as resources for ethical dilemmas.

Professional Codes of Ethics

  • Common traits of ethical codes include:

    • Commitment to quality care, education, collaboration, and respect for privacy.

Ethical Decision Making
Process

  • A rational, systematic approach guiding ethical decisions based on established ethical codes instead of emotions. Factors include:

    • Best interests of the patient.

    • Integrities involved in the process.

Ethical Dilemmas

  • Ethical challenges arise from advancements in medicine, posing conflicts between opposing ethical positions. Examples include:

    • Genetic testing, physician-assisted suicide, etc.

PROFESSIONALISM
Definition

  • Professionalism in health care encompasses the values and behaviors that build trust between patients and providers.

Competence

  • Experts underscore the need for continuous learning and education in health care fields, with many requiring continuing education credits.

Professional Associations

  • Offer various career benefits, including:

    • Continuing education classes, subscriptions, and networking opportunities.