Legal ResponsibilitiesLegal Responsibilities

Legal Responsibilities HS-IHS-9Legal Responsibilities HS-IHS-9

The student will explain the legal The student will explain the legal responsibilities, limitations, and responsibilities, limitations, and implications of their actions within implications of their actions within the healthcare delivery setting. They the healthcare delivery setting. They will perform their duties according to will perform their duties according to regulations, policies, laws and regulations, policies, laws and legislated rights of clients.legislated rights of clients.

Legal Responsibilities HS-IHS-9aLegal Responsibilities HS-IHS-9a

Analyze the basic legal responsibilities Analyze the basic legal responsibilities of healthcare workers in regards to of healthcare workers in regards to torts, malpractice, negligence, torts, malpractice, negligence, invasion of privacy, privileged invasion of privacy, privileged communication, patient /client communication, patient /client confidentiality, doctrine of informed confidentiality, doctrine of informed consent including identification of consent including identification of HIPAA regulations and the impact on HIPAA regulations and the impact on healthcare communications.healthcare communications.

Legal Responsibilities HS-IHS-9aLegal Responsibilities HS-IHS-9a

What is a tort?What is a tort? A tort is a wrongful or illegal act of A tort is a wrongful or illegal act of civil civil

lawlaw NOT involving a contract. NOT involving a contract. A tort occurs whenA tort occurs when a healthcare worker a healthcare worker

does not meet the established or does not meet the established or expected standards of care.expected standards of care.

What is civil law?What is civil law? Civil law focuses on legal relationships Civil law focuses on legal relationships

between people and the protection of a between people and the protection of a person’s rights.person’s rights.

Legal Responsibilities HS-IHS-9aLegal Responsibilities HS-IHS-9a

Examples of torts:Examples of torts: MalpracticeMalpractice NegligenceNegligence Assault and batteryAssault and battery Invasion of privacyInvasion of privacy False imprisonmentFalse imprisonment AbuseAbuse DefamationDefamation

Legal Responsibilities HS-IHS-9aLegal Responsibilities HS-IHS-9a

What is criminal law? What is criminal law? Criminal law deals with wrongs against a Criminal law deals with wrongs against a

person, property, or society. person, property, or society.

Examples of criminal offenses include:Examples of criminal offenses include: Practicing without required licensePracticing without required license Misuse of narcoticsMisuse of narcotics TheftTheft MurderMurder

MalpracticeMalpractice

Literally interpreted as “bad practice”Literally interpreted as “bad practice”

Commonly called “professional Commonly called “professional negligence”negligence”

DefinitionDefinition: failure of a professional to : failure of a professional to use the degree of skill and learning use the degree of skill and learning commonly expected in a particular commonly expected in a particular profession, resulting in injury, loss or profession, resulting in injury, loss or damage to the person receiving the caredamage to the person receiving the care

MalpracticeMalpractice

Examples include:Examples include: Nurse performing surgery without Nurse performing surgery without

any training.any training. Physician administering Physician administering

inappropriate medication for a inappropriate medication for a patient.patient.

NegligenceNegligence

Definition: failure (neglect) to give Definition: failure (neglect) to give care that is normally expected of a care that is normally expected of a person in a particular position.person in a particular position.

Examples include:Examples include: Falls and injuries that occur when side Falls and injuries that occur when side

rails are left down.rails are left down. Using defective equipment.Using defective equipment.

Assault and BatteryAssault and Battery

Assault: a threat or attempt to Assault: a threat or attempt to injure.injure.

Battery: unlawful touching of Battery: unlawful touching of another person without consent. another person without consent.

Assault and battery are closely Assault and battery are closely related and often used together.related and often used together.

Assault and BatteryAssault and Battery

Remember that patients must give Remember that patients must give consent and have the right to refuse consent and have the right to refuse care.care.

Some procedures require written Some procedures require written consent from the patient.consent from the patient.

Examples: performing a procedure Examples: performing a procedure after patient has refused to give after patient has refused to give permission; improper handling and permission; improper handling and rough treatment of a patient.rough treatment of a patient.

Informed ConsentInformed Consent Permission granted voluntarily by a Permission granted voluntarily by a

person who is of sound mind and person who is of sound mind and after the procedure and all risks after the procedure and all risks involved have been explained in involved have been explained in terms the patient understands.terms the patient understands.

Invasion of PrivacyInvasion of Privacy Unnecessary exposure of a patientUnnecessary exposure of a patient Revealing personal information about a Revealing personal information about a

patient without consentpatient without consent Examples: Improperly draping or Examples: Improperly draping or

covering a patient during a procedure covering a patient during a procedure that allows others to see the exposed that allows others to see the exposed patient; sending information to an patient; sending information to an insurance company without written insurance company without written consent; informing the news media consent; informing the news media about a patient’s condition. about a patient’s condition.

False ImprisonmentFalse Imprisonment

Refers to restraining an individual or Refers to restraining an individual or restricting an individual’s freedom.restricting an individual’s freedom.

Examples: Keeping a patient Examples: Keeping a patient hospitalized against his will (patient hospitalized against his will (patient has the right to decide to leave AMA); has the right to decide to leave AMA); applying physical restraints without applying physical restraints without proper authorizationproper authorization

False Imprisonment – Special False Imprisonment – Special Notes About RestraintsNotes About Restraints

Two types of restraints: chemical and Two types of restraints: chemical and physicalphysical

Chemical restraints are medications used to Chemical restraints are medications used to affect patient behavior; examples: affect patient behavior; examples: tranquilizers, sedativestranquilizers, sedatives

Physical restraints are protective devices Physical restraints are protective devices that limit a patient’s movement.that limit a patient’s movement.

Restraints should be used ONLY to protect Restraints should be used ONLY to protect patients from harming themselves or others, patients from harming themselves or others, and when all other measures have failed.and when all other measures have failed.

False Imprisonment – Special False Imprisonment – Special Notes About RestraintsNotes About Restraints

There must be an explicit doctor’s There must be an explicit doctor’s order for restraint. order for restraint.

Least restrictive device must be tried Least restrictive device must be tried first.first.

Restraints must be removed q2h for at Restraints must be removed q2h for at least 10 minutes, with ROM and skin least 10 minutes, with ROM and skin care provided.care provided.

Restraint applied unnecessarily can be Restraint applied unnecessarily can be considered FALSE IMPRISONMENT.considered FALSE IMPRISONMENT.

AbuseAbuse

Abuse is any care that results in physical Abuse is any care that results in physical harm, pain, or mental anguish. harm, pain, or mental anguish.

Abuse may occur before a patient is seen Abuse may occur before a patient is seen by a healthcare professional, and must be by a healthcare professional, and must be reported to proper authorities.reported to proper authorities.

Signs include: unexplained bruises, Signs include: unexplained bruises, fractures, burns, signs of neglect (poor fractures, burns, signs of neglect (poor hygiene, malnutrition), irrational fears, hygiene, malnutrition), irrational fears, aggressive or withdrawn behavioraggressive or withdrawn behavior

Abuse – Four CategoriesAbuse – Four Categories

PhysicalPhysical: hitting; inflicting bodily harm or : hitting; inflicting bodily harm or injury; forcing someone against his/her injury; forcing someone against his/her will; deprivation (such as sleep, food, will; deprivation (such as sleep, food, water)water)

VerbalVerbal: speaking harshly, swearing or : speaking harshly, swearing or shouting, abusive statements, threatsshouting, abusive statements, threats

PsychologicalPsychological: threatening harm, denying : threatening harm, denying rights, belittling, intimidating, ridiculingrights, belittling, intimidating, ridiculing

SexualSexual: sexual touching, using sexual : sexual touching, using sexual gestures, suggesting sexual behaviorsgestures, suggesting sexual behaviors

DefamationDefamation

FALSEFALSE statements either cause a person statements either cause a person to be ridiculed or damage a patient’s to be ridiculed or damage a patient’s reputation.reputation.

If the information is spoken, it is If the information is spoken, it is slanderslander.. If it is written, it is If it is written, it is libellibel.. Examples: gossip about a patient, Examples: gossip about a patient,

exaggerating or embellishing actual exaggerating or embellishing actual events; reporting inaccurate diagnosis events; reporting inaccurate diagnosis for publication, such as a church prayer for publication, such as a church prayer listlist

Privileged CommunicationPrivileged Communication

Privileged communication is comprised of Privileged communication is comprised of all information given to health care all information given to health care personnel by a patient; by law this personnel by a patient; by law this information must be kept confidential and information must be kept confidential and shared only with other members of the shared only with other members of the patient’s health team on a “need to know” patient’s health team on a “need to know” basis. basis.

It cannot be told to anyone else without It cannot be told to anyone else without written consent , including health written consent , including health insurance companies.insurance companies.

Patient / Client ConfidentialityPatient / Client Confidentiality

Confidentiality means that information Confidentiality means that information about the patient must remain private about the patient must remain private and can be shared only with other and can be shared only with other members of the healthcare team.members of the healthcare team.

A legal violation can occur if the A legal violation can occur if the patient suffers personal or financial patient suffers personal or financial damage when confidential information damage when confidential information is shared with others, INCLUDING is shared with others, INCLUDING FAMILY MEMBERS!FAMILY MEMBERS!

HIPAAHIPAA

HEALTHHEALTH

INSURANCEINSURANCE

PORTABILITY andPORTABILITY and

ACCOUNTABILITYACCOUNTABILITY

ACT of 1996ACT of 1996

HIPAAHIPAA

Three Primary Provisions of HIPAAThree Primary Provisions of HIPAA::1.1. Standardization of electronic patient Standardization of electronic patient

health, administrative and financial data.health, administrative and financial data.

2.2. Unique health identifiers for individuals… Unique health identifiers for individuals… (similar to your student I.D. number).(similar to your student I.D. number).

3.3. Security standards protecting the Security standards protecting the CONFIDENTIALITY AND INTEGRITYCONFIDENTIALITY AND INTEGRITY of of “individually identifiable health “individually identifiable health information”, past, present or future.information”, past, present or future.