Exam 2 Flashcards
What does ethics usually get confused with
Social norms, religious beliefs, or the legal system
Ethics itself is a standalone set of ____ and ___
Concepts and principles
Ethics help to make decisions about what
About what type of behaviors will help or harm other members of society
What is epistemology
In ethics the questions is how do we know what is right and wrong
Ethics seek to answer ___
What is truth
What are normative ethics
The use of concepts and principles discovered by metaethics to guide decision making about specific actions in determining what is right/wrong when interacting with people
What are applied ethics
Application to the real world
Used to resolve ethical dilemmas
What are descriptive ethics
Developing ethical principles based on what society is already doing rather than starting with ethical principles and applying them to society
What are values
Ideals or concepts that give meaning to an individual’s life
Where are values derived from
Derived from societal norms, religion and family orientation.
They serve as the framework for making decisions and taking action in daily life
What are morals
Fundamental standards of right and wrong that an individual learns
Often based on religious beliefs, with a role from societal influences
What are laws
Rules of social conduct made by humans to protect society
What are laws based on
They are based on concerns about fairness and justice
What are 2 important aspects when it comes to laws
That they are enforceable through some type of police force and that they should be applied equally to all persons
What are ethics
System of beliefs and behaviors that goes beyond the law
More focused on the quality of the society and long-term survival
What is an ethical dilemma
Situation that requires an individual to make a choice between two equally unfavorable alternative that usually involves conflict of an individual or groups rights with that of another individual or group, or of an individual’s obligations with the rights of another individual
What is autonomy
The right of self-determination, independence, and freedom. Refers to the clients right to make healthcare decisions for himself-herself even if the HCP or family doesn’t agree with these decisions
What is important for the nurse to know when it comes to autonomy
To know both state laws and the pts. rights/wishes to maintain autonomy
What is justice
Obligation to be fair to all people
What is distributive justice
Right to be treated equally regardless of race, gender, marital status, medical diagnosis, social standing, economic level, or religious belief, includes ideas of equal access to health care for all (limits can be placed when it interferes with the rights of others)
What is fidelity
The obligation of an individual to be faithful to commitments made to self and others.
What is the main support for the concept of accountability
Fidelity
What is beneficence
The primary goal of health care is doing good for others
What is nonmaleficence
Requirement that HCP do no harm, intentionally or unintentionally.
Nonmaleficence is the opposite side of the concept of what
Beneficence
Nonmaleficence requires what
That HCPs protect from harm those who can’t protect themselves such as children, MR, unconscious or those who are too weak or debilitated to protect themselves
What is veracity
Principles of truthfulness (right to know)
Requires the provider to tell the truth and not to intentionally deceive or mislead clients
What are primary limitations when it comes to veracity
They occur when telling client the truth would seriously harm the client’s ability to recover or would produce greater illness
What is standard of best interest
Decision made about a client’s health care when the client is unable to make the informed decision for themlves
Standard of best interest requires what
Requires a good faith decision be made, based on what HCP and the family decides is best for that individual
What are obligations
Demands made on an individual, a profession, a society or a government to fulfill and honor the rights of others
What are 2 types of obligations
Legal and moral obligations
What are legal obligations
Formal statements of law that are enforceable under the law
What are moral obligations
Based on moral or ethics but not enforceable under the law
What are normative ethics
Deals with questions and dilemmas that require choice of actions when there is a conflict of rights or obligations between two sides
(the nurse and the client, the nurse and the client’s family or the nurse and the physician)
What are bioethics
Questions concerning life and death, quality of life, life-sustaining and life altering technologies and biological science in general
What are other names for utilitarianism
Teleology, consequentialism, or situation ethics
What is utilitarianism
This is the system of utility associated with the decision of the greatest good for the greatest number and the end justifies the means, usually efficient and utility based
What is deontology also known as
The formalistic system, principle system of ethics, or duty-based
What is deontology
System of ethical decision making that is based on moral rules and unchanging principles based on discovery and confirmation of a set of morals or rules that govern the ethical dilemma
Code of ethics will help hold the profession ethically accountable which will assist in ___
professional autonomy
What are the 2 types of law
Statutory and common law
What is statutory law
Consists of law written and enacted by the US congress, state legislatures, and other governmental entities
Most laws that govern nursing are state level _______ because licensure is a function of the state’s authority
Statutory laws
Common law
Evolved from the decision of previous legal cases that form a precedent, often extends beyond the scope of statutory law, deals with matters outside the scope of laws enacted by legislature
What are the two major divisions of law
Criminal law and civil law
True or false criminal law and civil law can either be statutory or common types of law
True
Criminal law
Concerned with providing protection for all members of society
When someone is accused of violating a criminal law the government imposes a punishment that is appropriate for the crime
What are some common violations by nurses of the criminal law
Failure to renew nursing licenses which results in practicing without a license which is a crime in all other states
Illegal diversion of drugs, intention or unintentional deaths of clients, such as assisted suicide
Civil laws
Generally deal with the violation of one individual’s rights by another individual
In what kind of lawsuits are nurses more likely to be involved with
Civil lawsuits
The burden of proof rests with who
The plaintiff (person suing)
Tort law
Wrongful act committed against a person or his/her property
What is negligence
The omission of an act that a reasonable and prudent person would perform in a similar situation or the commission of something a reasonable and prudent person would not perform in a similar situation
What is an example of negligence
Not raising the side rails up
What is malpractice
Type of negligence for which professional can be sued
What is malpractice also referred to as
Professional negligence
When is a professional expert witness often asked to testify to help establish the standard of care to which the prudent professional should be held accountable
In a malpractice
Professional misconduct
Involves malpractice which indicates unreasonable lack of skill in performing professional duties (incompetence)
What is nursing malpractice based on
Based on premise that a nurse can be held legally responsible for the personal injury of another individual if it can be proved and that the injury was the result of negligence
How many elements are needed for a person to make a claim of negligence
4
What are the 4 elements needed to prove negligence
- a duty was owed to the client (professional relationship
- The professional violated the duty and failed to conform to the standard of care (breach of duty)
- The professional’s failure to act was the proximate cause of the resulting injuries (causality)
- Actual injuries resulted from the breach of duty (damages)
If any of the 4 elements are missing from a case to prove negligence what can happen
The client will probably not be able to win the lawsuit
What is an intentional tort
Willful act that violates another person’s rights or property
What is used to distinguish malpractice from acts of negligence
3 requirements
How can you distinguish malpractice from negligence
- The nurses act must intend to bring about the consequence of the act
- The nurse must be intended to interfere with the client or client’s property
- The act must be a substantial factor in bringing about the injury or consequence
Assault
Unjustifiable attempt to touch another person or the threat of doing so
Battery
Actual harmful or unwarranted contact with another person without his or her consent
What is the most common intentional tort in nursing
Battery
False imprisonment
When a competent client is confined or restrained with intent to prevent him or her from leaving the hospital
Do restraints alone constitute false imprisonment if used to maintain the safety of the patient?
NO
How to prove intentional infliction of emotional distress
Must prove
- the conduct exceeds what is accepted by society
- HCP’s conduct is intended to cause mental distress
- the conduct actually does produce mental distress
When charged with assault, battery, or false imprisonment what charge is also seen
Intentional infliction of emotional distress
Client abandonement
When there is unilateral severance of the professional relationship with the client without adequate notice
When is the nurse/client relationship terminated
When there is mutual consent of both parties
What is a quasi-intentional tort
Voluntary act that directly causes injury/distress without intent
This is a mixture of unintentional and intentional torts that usually involve situations of communication and often violate a person’s reputation, personal privacy, or civil right
Quasi-intentional tort
Defamation of character
It is harmful to a person’s reputation (diminishing the esteem, respect, good will, or confidence that others have for the person)
What are two types of defamation of character
Slander and libel
Slander
spoken communication discussing another person that harms that person’s reputation
Libel
written communication where statements or language is used that harms another person’s reputation
What is a primary source of defamation of character
Medical record documentation
What do you need to prove to win a defamation lawsuit against a nurse
Prove that the nurse acted maliciously, abused the principle of privileged communication, and wrote or spoke a lie
Invasion of privacy
Violation of a person’s right to protection against unreasonable and unwarranted interference with one’s personal life example
Giving out private client info over the phone is an example of what
Invasion of privacy
Breach of confidentiality
When a client’s trust and confidence are violated by public revelation of confidential or privileged communications without the clients consent
When can you breach confidentiality
Suicide, court, child abuse, elder abuse
Do nurses gave privileged communication
NO but can if they were present at the time physician discussed this with patient
Disclosure of info to family members violates ____ unless the client is less than 18 or gives permission
HIPAA
What does HIPAA stand for
Health Insurance Portability and Accountability Act
What is the period of time that lawsuits against healthcare workers must be filed in called
Statute of limitations
When does statute of limitations begin
At the time of the injury or when injury is discovered
Until when does statute of limitations lasts
Until some specified time usually 1-6 years but most common 2
In most state the statute of limitations is what
6 years
In cases involving children, the statute of limitations extends until the person reaches what
21 years of age
What begins the litigation process
Filing of the complaint
Plaintiff
The client or the family member of the client is the alleged injured party or the person suing
Defendant
The person or entity being sued
Defendant must ____ to the allegations stated in the complaint within a specific time
Respond
The written response of the defendant is called the
Answer
What can the nurse outline in the answer
Nurse can outline specific defenses to the claims made against them
When does the discovery phase begin
After the complain and answer are filed
What is the purpose of the discovery
To uncover all information relevant to the malpractice suit and the incident in question
What kind of questions may the nurse be asked to answer
Questions that relation to the nurse’s education background and emotional state, the incident that led to the lawsuit, and any other pertinent info
The questions the nurse is asked to answer
Interrogatories
Documents r/t the lawsuit that the plaintiffs lawyer can ask for
Plaintiffs medical records Incident reports Electronic communications Address books or list of contacts The institutions policy and procedure manual concerning specific situation Nurses job description
Deposition
Formal legal process that involve the taking of testimony under oath and is recorded by a court reporter
When does the trial usually take place
Years after the complaint was filed
Main reason clients sue
To recover monetary compensation and other associated costs against the person or institution that harmed the client and to prevent defendant from doing it again
actual damages are awards that cover the actual cost of injuries and economic losses caused by the injury. These include all medical expenses related to the injury and any lost wages or income that resulted from extended hospitalization or recovery period.
Compensatory damages
monetary awards for injuries for which an exact dollar amount cannot be calculated, these awards include pain and suffering, loss of companionship, shortened life span, loss of reputation, and wrongful death.
General damages
also called exemplary damages, are awarded in addition to compensatory and general damages when the actions that caused the injury to the client were judged to be willful, malicious, or demonstrated an extreme measure of incompetence and gross negligence. The primary purpose of punitive damages is to “punish” the defendant and deter him or her from ever acting in the same way again.
Punitive damages
allow the judge in certain instances to triple the actual damage award amount as an additional form of punitive damages
Treble damages
can be awarded when the law requires a judge and jury to find a defendant guilty but no real harm happened to the plaintiff
Normal damages
are awarded to the plaintiff for out-of-pocket expenses related to the trial. It would cover the expenses of taking a taxi back and forth to the courthouse, use of special assistive equipment, and special home health care providers not covered under actual damages.
Special damages
In a state with ____ _____ plaintiffs are not allowed to receive money for injuries if they contributed to those injuries in any manner
Contributory negligence
In a state with ___ ____ the awards are based on the determination of the percentage of fault by both parties
Comparative negligence
When clients sign the ____ ____ form for a particular treatment, procedure, surgery, it is implied that they are aware of the possible complication of that treatment procedure or surgery
Informed consent
Under the ______ if one of those listed or named complications occurs the client has no grounds to sue the HCP
Assumption-of-risk defense
designed specifically to protect health care providers in emergency situations. A health-care professional who provides care in an emergency situation cannot be sued for injuries that may be sustained by the client if that care was given according to established guidelines and was within the scope of the professional’s education.
The Good Samaritan Act
The Good Samaritan Act protect the concept of ___
Implied consent
Based on the claim that the actions of the the nurse followed the standards of care or that even if the actions were in violation of the standard of care the actions themselves were not the direct cause of the injury
Defense of the fact
Informed consent
The voluntary permission by a client or by the client’s designated proxy to carry out a procedure on the client
Who has the responsibility to obtain the informed consent
The person who is performing the procedure
The informed consent can only be given by a client after the client receives sufficient info on
- treatment proposed
- material risk involves (potential complications )
- acceptable alternative treatments
- outcome hoped for
- consequences of not having treatment
True or false: Nurses should only supplement the material and reinforce info given by the physician when it comes to informed consent
True
Should the nurse be the primary or only source of info for the informed consent
NO
What are the 2 exceptions to informed consent
- Emergency situations: client is unconscious, incompetent, or otherwise unable to give consent
- Situations in which the HCP feels that it may be medically contraindicated to disclose the risks and hazards b/c it may result in illness or severe emotional distress
What are the two types of advance directives
- living will
2. medical durable power of attorney or health-care proxy
Document stating what health care client will accept or refuse after the client is no longer competent or able to make that decision
Living will
Designates another person to make health care decisions for a person if the client becomes incompetent or unable to make such decisions
Medical durable POA or health-care proxy
True or false DNR orders are legally separate from advance directives
True
For the health care professional to be legally protected there should be a ______ in patient’s chart written by physician
Written order indicate “no code” “allow natural death (AND) or DNR”
A lack of ____ in the medical records indicating how the DNR decision was reached can be a critical issue if a medical malpractice case is involved
Lack of proper documentation
Information about the DNR status of a client should be obtained _____
During shift reports
Standards of care are used to measure the actions of a nurse involved in a malpractice suit and are based on the actions that would probably be taken by a ____ ____
Reasonable person
What is the leading cause of health care related errors leading to injury death and lawsuits
Miscommunication among health care workers
The client’s health record is the single most frequently used piece of ___ evidence in a malpractice suit
Objective
The client record should not contain what
Personal opinion
The client record should be
Legible
Written in chronological order
Written and signed by the nurse
In the client’s record there should be no ___, should include ___ & ___ , ____ , ____ from family and patient and have nothing about anything that is not about the patient
Blank spaces
Date and time
Direct observations
Quotes
Laws ensure the preservation of a ___ by regulating conduct and are enforced by a police force
Society
Belief that an act is either right or wrong based on the consequences of the act
Utilitarianism
The belief that an act is either good or bad based on the act itself
Deontology
Federal law that requires all federally funded institutions to inform clients of their right to prepare advance directives
PSDA
Patient Self-Determination Act
Federal statute that protects private patient information from being disclosed
HIPAA
Health Insurance Portability Act
This statute protects workers with disabilities against discrimination
ADA
American Disability Act
This law improved the process for individuals to make anatomical donations
Uniform Anatomical Gift Act
This statute requires insurance companies provide coverage that includes mental health issues
Mental Health Parity Act
