law and ethics Flashcards
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unregulated healthcare workers, do not need to be registered with a professional regulatory authority. This means these health care workers do not need a practising licence to work in the healthcare system.
Regulated health workers, however require a practising licence or registration in order to work in the health care system.
health professional possess:
the requisite educational qualifications,
is fit to practice their chosen professional and
maintain a standard of conduct and practice that is consistent with that expected by their peers and the public.
1st of July 2010 NRAS operate
AHPRA is responsible for the National Scheme works with 15 national health practitioners. functions of the National scheme is to keeping the public safe by ensuring that only the health practitioners who are appropriately educated and who practice their profession ethically and competently can be registered
NMBA protect public, register practitioners and students, set standards and polices that have to be met
codes of conduct
standards for practice
code of ethics
if complaint from HCC causes investigation and finds that standards have not been met or conducts have been broken they are unable to practice and may be unregistered
Anyone with concerns about the healthcare that they are receiving make a complaint to the Health Complaints Commissioner
‘notifiable conduct’ : nurses have to report this avoid misconducts from happening
* practiced while intoxicated by alcohol or drugs; or
* engaged in sexual misconduct
* placed the public at risk of substantial harm
because the practitioner has an impairment
* placed the public at risk of harm because the practitioner has practiced the profession in a
way that constitutes a significant departure from accepted professional standards
Disciplinary process from AHPRA lodgement, assessment, notice given to practitioner, board decision, possible outcomes
Mandatory reporting of child abuse
The Department of Human Services is responsible for overseeing and upholding child protection in
Victoria
Children, Youth and Families Act 2005
What is reportable?
What are reasonable grounds?
Who can report concerns? What is mandatory reporting?
Who is mandated to report child abuse?
What is failure to disclose?
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implied consent
verbal consent
written consent
Consent must be freely and voluntarily given
cover the procedure to be performed
informed
legal capacity
The only time consent is not necessary is in emergency situations, parental authority is not absolute and necessity
Medical Treatment Planning and Decisions Act 2016
The main purposes of the Act are:
patient not competent, competent patient to appoint a medical treatment decision maker with the authority to make medical treatment decisions should they lose the capacity to make decisions for themselves.
a form needs to be filled out, signed and have two people witness
change any time and more than one person can be Medical Treatment Decision Maker
VCAT can appoint a guardian or administrator to make decisions for them disability
Attorney was generally appointed to act on someone’s behalf and was to continue if and when that person is unable to make decisions for themselves. This Power may relate to managing a person’s financial or medical affairs
enduring Power of Attorney to act honestly, in good faith and to exercise reasonable skill and care.
An Enduring Power of Attorney who can make financial and other decisions, such as where the person may live or what happens to their house;
- A non-enduring Power of Attorney who may be appointed for a short period of time, such as when the person is overseas;
- Supportive Attorneys who may be appointed to support a competent person to make decisions and act on those decisions.
Trespass to a person comprises 3 element:
False imprisonment is the unlawful, intentional and complete application of restraint upon a person against their will which restricts their freedom to move.
Must only occur if there is a danger to the patient, other patients or staff Hospital guidelines and policy
Assault is the intentional act of making someone fear that you will cause them harm.
Battery is the intentional act of causing physical harm to someone
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Advanced care directive
* Instructional Directive
* Completed if patient knows the medical treatment that they do not want in
the future
* Is a statement of the medical treatment decision
* Takes effect as if patient had consented to, or refused, the medical
treatment
advance care planning Appointing a substitute decision maker
Discussing and documenting a person’s wishes for care
NFR orders must conform with the law of consent. If the patient refuses resuscitation, the patient must be mentally competent at the time of refusing , be adequately informed of the implications of refusing resuscitation and have made the refusal freely without any coercion.
The NFR order must be clearly documented in the patient notes and should be reviewed regularly in case there is improvement in the patient’s condition.
refusal of treatment Any competent person can refuse treatment
Withdrawal of treatment health team, in consultation with a patient’s family, can do if a patient is not competent.
It is better if withdrawal of treatment is in line with the patient’s wishes as determined by prior discussion with them when they were competent
Not for resuscitation orders requested by a person when competent, or by the medical
treatment decision maker if the patient is not competent. if that person’s condition deteriorates to the point that they are likely to die without medical intervention
Voluntary assisted dying:
means administering a medication for the purpose of causing death in accordance with the steps and process set out in law
must be voluntary and initiated by the patient themselves, and it will usually be self-administered medication
is only for those who face an inevitable, imminent death as a result of an incurable disease, illness or medical condition
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Negligence is the failure to exercise reasonable care in one’s action, which results in injury and damage to another person.
elements:
1. The patient was owed a legally recognised duty of care by the health professional (defendant)
2. There was a breach of that duty of care owed, as the defendant’s conduct fell below the required standard of care
3. As a result of the defendant’s negligent act, the plaintiff suffered harm/damage and loss
4. The caused damage and loss the plaintiff is complaining of was a reasonably foreseeable consequence of the defendant’s negligent act.
defences available to a defendant are:
- to deny that a duty of care was owed to the plaintiff
- the defendant’s action was reasonable at the time and is ‘widely accepted’ by ‘other peers/colleagues’
- to establish that there was no damage suffered by the plaintiff
- there is no relationship between breach of duty of care alleged and the damage to the plaintiff
- the alleged harm/damage is too remote from the negligent act
doctrine of vicarious liability is when the employer is made liable when an employee has been proven to be negligent.
The financial responsibility is shifted from the individual employee to the employer or entity who has a greater financial capacity to bear the loss
if you provide assistance, advice or care to an individual at risk of death or injury with no
expectation of financial award, you will not be liable in any civil proceedings for anything
done or omitted to be done in good faith at the scene of an emergency or accident.
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Confidentiality tends to be concerned with inappropriate disclosure or
communication of information.
Privacy focuses on the collection, storage and handling of patient information
information be disclosed?
1. When the patient consents
2. The information does not identify the patient e.g. research
where the information is de-identified
3. To other health professionals who are actually responsible
for treatment – ‘need to know’ basis
4. When required by legislation such as child abuse, child protection, Infectious diseases
ACCESSING RECORDS
Make a request in writing to the organisation
Freedom of Information Act 1982
Health Records Act 2001
The process of discovery
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Criminal law relates to crime and is essentially concerned with protecting society as a whole
Public wrongs Initiated by the State=Incarceration, Fine. proof=beyond reasonable doubt
Civil law is concerned with the responsibilities and rights that people have towards each other that do not fall under the criminal code.
Private matters Initiated by the person who suffers the harm=monetary compensation proof is balance of probabilities
The activity that constitutes the offence (Actus reus) and
The intention to carry out the particular activity or a high degree of reckless indifference as the probable outcome of a particular activity (mens rea)
Homicide :
Refers to the killing of a person and includes murder, manslaughter and infanticide.
Murder:
The actus reus (the act of killing) and the mens rea (the malice afterthought)
Sound memory and age: the accused must be of legal capacity – sound of mind and are of an age to understand the crime.
Unlawfully kills – no lawful justification for the killing
The victim must be a reasonable creature ‘in being’
manslaughter:
Voluntary manslaughter: occurs when the accused intended to kill, but liability is reduced because of a relevant defence, which provides some justification for the action.
Involuntary manslaughter: occurs when the accused killed as a result of an unlawful or dangerous act, or is reckless or grossly negligent.
Negligent manslaughter: occurs when the accused owes a duty to the victim and the accused’s conduct significantly departs from what is considered to be the reasonable standard of care.
double effect refers to when a patient is terminally ill and requires ‘larger’ doses of analgesia, which may hasten death (pain relieved from medication, comfort not because they’re dead, ethically justifiable when there is no better alternative)
coroner was established to provide a means for investigating certain deaths where negligent activity was suspected.
investigate deaths and fire
reduce preventable deaths
promote public health and safety administration of justice
reportable deaths ‘suspicious’ deaths, but are unexpected, unnatural, accidental or violent deaths. , where the person’s identity is not known, the cause of death is not known or where a death certificate has not been signed, deaths in custody
death of a child is a reviewable death if the deceased child is the second or subsequent child of either of the deceased child’s parents to have died
coroners court? Preliminary examinations Autopsies inquest, finding of investigation, coroners findings, Coroners recommendations
role of the nurse/midwife
* Preparation of the deceased body
* ETT, NGT, IDC, IV, drain tubes etc to remain insitu
Nurses and midwives as a reporting party
* Nurses and midwives as a witnesses
* Nurses and midwives directed Coroners’
recommendations
* Nurses and midwives reported to AHPRA and Nurses Board
Nurses and midwives providing expert evidence to a medico-legal investigation
