Ch 4 Ethical & Legal Issues Flashcards
Utilitarianism
Actions are right if they promote happiness and wrong if they produce the reverse of happiness. An ethical decision based on the utilitarian view looks at the end results of the decision
Ethical theory
moral principle or a set of moral principles that can be used in assessing what is morally right or morally wrong (e.g. Utilitarianism, Kantianism)
Kantianism
Also called deontology= “deon” meaning duty. Directly opposed to utilitarianism. You make decisions that are MORALLY RIGHT; not based on the outcome. -Immanuel Kant
Christian Ethics
“Do unto others as you would have them do unto you.” Advances the importance of virtues such as love, forgiveness, and honesty.
Natural Law
Based on Thomas Aquinas writings. As rational human beings, we inherently know the difference between good and evil (God-given).
Ethical Egoism
An individual’s actions are determined by what is to his or her advantage. The action may not be best for anyone else involved, but consideration is only for the individual making the decision.
Ethical dilemma
A situation that requires an individual to make a choice between two equally unfavorable alternatives
Ethical principles
Fundamental guidelines that influence decision-making: autonomy, beneficence, nonmaleficence, justice, and veracity
Autonomy
Presumes that individuals are always capable of making independent choices for themselves
Beneficence
Refers to one’s duty to benefit or promote the good of others. Actions that serve the client’s best interest. Ethical Egoism?
Nonmaleficence
The requirement that health-care providers do no harm to their clients, either intentionally or unintentionally.
Justice
The right of individuals to be treated equally regardless of race, sex, marital status, medical diagnosis, social standing, economic level, or religious belief.
Veracity
This requires that the healthcare provider tell the truth and not intentionally deceive or mislead clients.
Three criteria that must be met to force medication without client consent
- The client must exhibit behavior that is dangerous to self or others
- The medication must have a reasonable chance of providing help to the client
- A clients refusal must be judged as incompetent
Patient self-determination act
Requires healthcare facilities to provide clear written information for every patient concerning his or her legal rights: including the right to accept or refuse medication
Statutory Law
SLCCC those NPA! Laws that have been enacted by a legislative body such as a county or city council, or the U.S. Congress which would be considered a state legislature Ex- Nurse Practice Acts
Common Law
These laws are derived from decisions made in previous cases
Civil Law
Protects the private and property rights of individuals and businesses. Usually involving “compensation” for actions. Two basic types: torts and contracts CLASSIFICATION WITHIN STATUTORY AND COMMON LAW
Torts
One party asserts that wrongful conduct from another has caused harm and seeks compensation for harm suffered. May be international or unintentional. Ex- unintentional: malpractice and negligence actions intentional: touching of another person without that person’s consent (Battery)
Criminal law
Provides protection from conduct deemed injurious to the public welfare.
Punishment can include imprisonment, parole conditions, a loss of privilege (e.g. license), a fine, or any combination of these.
Ex- Theft by a hospital employee of supplies or drugs
CLASSIFICATION WITHIN STATUTORY AND COMMON LAW
Privileged communication
Some states grant certain professionals privileges under which they may refuse to reveal information about clients or the communications with clients.
A duty to warn
Protection of a third-party. Supreme Court ruling that states that a mental health professional has a duty not only to a client but also to individuals who are being threatened by that client
Legal liability for informed consent lies with the
Physician. A Nurse may sign the consent form as a witness for the client’s signature
Orders for restraint or seclusion must be renewed every __ hours for adults 18 & up
4 hrs
Orders for restraint or seclusion must be renewed every __ hours for children and adolescents 9-17 years old
2hrs
Orders for restraint or seclusion must be renewed every __ hours for children younger than 9 years old
Every hour
What must be conducted within one hour of initiating restraint or seclusion?
An in-person evaluation must be conducted within 1 hour. Appropriately trained registered nurses and physician assistants may also conduct this assessment but they must consult with the physician.
True or false? State standards require a specific impact or consequence to flow from the mental illness that involves danger or an inability to care for one’s own needs in order to involuntarily hospitalize (INPATIENT BASIS)
True. The US Supreme Court held that the existence of mental illness alone does not justify involuntary hospitalization. They must be a harm to themselves or others & unable to take care of basic personal needs (“gravely disabled”).(INPATIENT)!!
Involuntary outpatient commitment
A court-ordered mechanism used to compel a person with mental illness to submit to treatment on an outpatient basis. Esp if at risk of becoming homeless, incarcerated or violent, or of committing suicide. Or if history of repeated involuntary hospitalization. Likelihood that w/out treatment they will deteriorate. Severe and persistent mental illness like schizophrenia or bipolar disorder. The existence of an individualized plan likely to be effective.
“Kendra’s Law”- d/n wait for pt to be “dangerous” to become inpatient instead meet on outpatient basis to prevent the escalation.
Gravely Disabled
Defined as a condition in which an individual, as a result of mental illness, is in danger of serious physical harm resulting from inability to provide for basic needs such as food, shelter, medical care.
A legal action against Malpractice is weighed against
The professional standard
An legal action against negligence is weighed against
What a reasonably prudent professional would have done the same or similar circumstances
Nursing malpractice basic elements for lawsuit
- A duty 2. A breach of duty 3. The client was injured 4. The injury was directly caused by the breach of a standard of care
Most malpractice suits against nurses are
Civil
Libel
Defamation of character done in writing
Assault
An act that results in a persons genuine fear and apprehension that he or she will be touched without consent
Battery
The unconsented touching of another person
Avoid liability by
Responding to the patient, educating the patient, complying with the standard of care, supervising care, adhering to the nursing process, documenting carefully, following up by evaluating the care that was given
The nurse acts as a client advocate to ensure that the following three major elements of informed consent have been addressed:
- The client has received adequate information (knowledge)
- The clients cognition is not impaired to an extent that would interfere with decision-making, if so, the client should have legal representative (competency)
- Consent was given voluntarily without pressure or coercion (free will)
