Legal Implications in Health Care
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Transcript of Legal Implications in Health Care
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LEGAL IMPLICATIONS IN HEALTH
CAREBy Wambua
Florence
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COURSE OBJECTIVES
By the end of this presentation, the student
should be able to:
Define the major terminology used in legal
implications in health care.
Describe the legal responsibilities and obligations of
health care workers.
List the elements needed to prove negligence.
Give examples of legal issues that arise in health
care.
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SOURCES OF LAW
Civil law.
Criminal law.
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TORT
A tort is a civil wrong made against a person or
property.
It may be intentional or unintentional.
Intentional torts are willful acts that violateanothers rights. E.g assault, invasion of privacy
and false imprisonment.
An example of unintentional torts is negligence.
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INTENTIONAL TORTS
Assault: physical or verbal that creates in
another person apprehension or fear of imminent
harm or offensive contact.
E.g, a nurse threatening to give a client injection.
Or a radiographer threatening to restrain a client
for an x-ray procedure that he has refused to give
consent for.
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2. BATTERY
Battery: is any intentional physical contact with
a person without consent. It may cause injury to
a client or may be merely offensive.
E.g if the nurse gives the injection, it is battery.
Some times the battery could be life saving e.g in
blood transfusion.
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3. INVASION OF PRIVACY
Invasion of privacy tort protects the clients right
to be free from unwanted intrusion into his or her
private affairs.
This includes confidentiality too.
E.g release of clients medical records or
information to an unauthorized person like the
press or the clients employer or even family
members.
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4. MEDICAL INFORMATION
Computers and confidentiality: the medical
records are protected by passwords and magnetic
strip cards.
These devices should not be shared with others
and used only to retrieve files only when
warranted.
Improper use of the card to seek confidential
information could lead to legal repercussions.
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FALSE IMPRISONMENT
This tort serves to protect a persons individual
liberty and basic rights.
Preventing a client from leaving a health care
facility voluntarily may constitute the tort of
false imprisonment.
The use of restrains physical or chemical, are
viewed as false imprisonment.
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UNINTENTIONAL TORTS.
Negligence: a lawsuit against negligence is
termed malpractice.
It also conduct that falls below a standard of care
established by the law.
It is characterized by thoughtlessness,
carelessness or inattention.
E.g case study of fall off the examining table;
Downey v. Rothwell (1974).
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PREVENTION OF NEGLIGENCE
Follow standards of care of your profession.
Give competent health care.
Insist on appropriate orientation, continued
education, adequate staffing and communicationwith other members of staff.
Develop a caring rapport with client.
Document care given to client fully.
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2.DOCUMENTATION
Medical records are a permanent legal document
of the client or hospital.
If a client dies and no documentation of care is
found, legally, there was negligence.
Other care providers may harm the patient in
their care due to lack of up to date information.
physiotherapy.
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3.
Truthful documentation is also essential.
Correction in case of a mistake should follow the
policies and procedures of the institution.
Example
Medication given signature of the one who has
erased.
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CRIMINAL LIABILITY
The difference between a tort and criminal
liability is the degree to which the act deviates
from the standard of a reasonably competent
practitioner.
The law must prove that there was extreme
carelessness on the part of the health care
provider and wanton or reckless disregard for the
lives or safety of other persons.
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2. CONSENT
A signed consent form is required for treatment,
treatment programs involving chemotherapy,
procedures and research.
If a client is deaf, illiterate or speaks a foreign
language, an official interpreter must be
available to explain the terms of the consent.
Family members should not be used except in as
a last resort.
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3. INFORMED CONSENT
This is a persons agreement to allow something
to happen, such as surgery or an invasive
procedure, based on a full disclosure of the likely
risks, benefits, alternatives and consequences of
refusal.
Informed consent creates a legal duty to health
care providers to disclose the facts in terms the
client can understand.
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4.
The explanation should describe treatment
alternatives, risk involved in all treatment
options.
In emergencies however, informed consent that is
not obtained may not result in a lawsuit.
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5.
Factors required for informed consent:
Brief complete explanation of the procedure or
treatment.
Names and qualifications of people performing and
assisting in the procedure. A description of any possible harm, including damage
or death that may occur as a result of the procedure.
An explanation of alternative therapies to the
proposed as well as the risks of doing nothing.
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6. STUDENTS AND LEGAL LIABILITY
Students are liable if their actions cause harm to
clients.
The liability is generally shared by the student,
instructor, hospital or health care facility and
university or educational facility.
If a student is employed as an aide, they should
not perform procedures beyond the scope of an
assistant which will be their job description.
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PROFESSIONAL LIABILITY PROTECTION
Health care professionals who practice under
hospitals are covered by legally by the legal
advisor of the hospital.
If one should operate independently like in a
private clinic, they are liable for their own care.
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SHORT STAFFING
During shortages, or staff down sizing, if the
health care provider finds that they are working
more than their required workload, they should
report to their supervisors and if possible put it
in writing and a copy kept off.
No walk out should be staged in times of
shortages as it raises the issue of abandonment.
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PHYSICIANS ORDER.
All orders should be assessed and if found to
erroneous or harmful further clarification should
be sought.
A pharmacist may be sought to clarify the order.
Physicians should write all orders including
DNR. Verbal orders are not encouraged as they
increase the room for error.
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LEGAL ISSUES IN HEALTH CARE
Abortion: in Rwanda its illegal, so those health
care providers found to be performing abortions
are liable for prosecution.
Drug regulation: Federal acts control
manufacture, distribution and sale of drugs,
cosmetics and therapeutic devices. The food and
drugs act and the controlled drugs and
substances acts.
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2.
Communicable diseases: HIV, SARS has legal
implications for health care providers.
Death and dying: definitions of death. brain
death, emergence of artificial life support devices,
organ transplants and euthanasia.
Advance directive: is a mechanism enabling a
mentally competent person to plan for a time
when he or she may lack mental capacity to
make medical decisions.
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3.
A living will: is a document in which the person
makes an anticipatory refusal of llife prolonging
measures during a future state of mental
incompetence.
Psychiatric advance directive: is a new type of
advance directive. Individuals with mental
health problems complete it during periods of
mental stability and competence outlining how
they wihs to be treated in future should theirunderlying mental illness causes them to loose
decision making capacity.
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4.
Organ donation: legally competent people are
free to donate their bodies or organs for medical
use.
Mental health issues: mental health act, suicidal
patients.
Public health issues: reporting suspected abuse
and neglect, communicable diseases and other
health related issues enacted to protect the
publics health.
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RISK MANAGEMENT
It is a system of ensuring appropriate health care
by identifying potential hazards and eliminating
them before harm occurs.
Tools used in risk management is the incidence
report or adverse occurrence report.
These reports are analyzed to see how future
problems can be avoided.
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QUALITY ASSURANCE
The underlying rationale for quality assurance in
risk management programs is the highest
possible quality of care.
Quality assurance is the responsibility of both
the employer and the individual care provider.
Good documentation is essential as proof that the
health care provider acted ethically, reasonably
and safely.
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SUMMARY
With increased emphasis on clients rights, care
providers should understand their legal
obligations.
The civil law system protects a persons private
rights and the criminal law system with the
rights of an individual and society.
Clients are entitled to confidential health care
and freedom from unauthorized release of
information.
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2.
A health care provider can be found negligent if
the duty to the client is not well carried out, not
carried out, the client was injured and the failure
for care to be given caused injury.
Informed consent document should be consulted
and obtained always.
Know all the laws that apply to your practice.
Incident reports should be filed in all situations
when someone could or did get hurt.
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The end!