Exam 2 - Ethics and Legal Issues Flashcards
Legal and Ethical are
Not the same
Legal Illegal
Ethical Ethical
Legal Illegal
Unethical Unethical
Moral Indifference
vs
Moral Distress
vs
Moral Uncertainty
vs
Moral Outrage
Indifference:
Question why morality is necessary
Distress:
occurs when you know what’s right, but organizational constraints make it difficult
Uncertainty:
which values apply? Don’t know what the problem is
Outrage:
Witness immorality and feel powerless to stop it
Ethical dilemma can be solved? (T/F)
Nope
not by science
conflict between moral imperatives
The answer will have profound effect on the patient
Autonomy
vs
Beneficence
vs
Nonmaleficence
vs
Paternalism
vs
Justice
vs
Veracity
vs
Fidelity
vs
Utility
A: self-determination (even if bad decisions)
B: action taken to promote good
N: if no good, do least harm
P: one assumes right to decide for another
J: fairness, equality, treat inequals according to difference
V: tell the truth
F: keep promise
U: The good of many outweighs the needs of individuals
Ethical Decision Making process
> Gather facts >
brainstorm >
pros/cons >
decide >
follow through >
define clarify >
What is best for the patient/what do they want?
Moral decision making model (Crisham, 1985)
M: massage the dilemma
O: outline options
R: Review criteria and resolve
A: affirm position and act
L: look back: evaluate
ANA code of ethics
First code adopted in 1950
Has been revisited six times
Most recent: 2015
Do not have power of law, just stand as highest guide for nurses
Strategies to promote ethical behavior
- Separate legal and ethical probs
- Collaborate through ethics committees
- Use institutional review boards
- role model
NPA
Nurse Practice Act
Single most important piece of legislation
Define categories of nures
Set educational requirements
Establish SBON
Nursing license is a right (T/F)
F
It is a privilege
Torts
Unintentional (malpractice or negligence)
Quasi-intentional (breach of confidentiality, defamation)
Intentional (assault, battery, false imprisonment)
Burden of proof is a preponderance of evidence
Libel vs Slander
Written vs spoken
Malpractice vs Negligence
professional negligence vs carelessness
both concern Commission and Omission
Six elements of malpractice
- duty of care owed to patient (yours?)
- Breach of duty owed (failure)
- Foreseeability of harm (knowledge of harm - do you know better?) e.g. fall risk assessed/not assessed
- Causation (combines 2 and 3) - failure of duty and relationship provable
- Injury - physical harm occurs
- Damages - financial harm (med bills)
frequent causes of claims against nurses
Charting fail
Communicate patient conditions fail
Leaving harmful items w/in reach
Unattended falls
OR counts fail
Patient ID failli
Liability:
Personal vs vicarious vs corporate
individual
vs
employer accountability for employees
vs
hospital accountability for employees
Indemnification
you do something wrong
the harmed sues hospital
Hospital can countersue you
Malpractice concerns for nurse managers
Delegation and supervision
Duty to orient and evaluate
Failure to warn
Staffing issues
Protective/reporting lawsL
Legal responsibilities of nurse manager
Report dangerous understaffing
Check staff credentials
Carry out discipline
Protective/reporting laws
Ensure safety/rights of classes of individuals
Good Samaritan immunity
Mandatory reporting of child/elder
Mandatory reporting of incompetent practitioners
Informed Consent (vs implied consent)
authorization by pt or legal rep
based on legal capacity, comprehension, voluntary action
(implied is like helping someone in the ER prior to consent signed)
