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► Med Misc 57 > Legal And Ethical Issues > Flashcards

Legal And Ethical Issues Flashcards

1
Q

System of legal deference within judicial system

A
  1. Deference is accorded to higher courts within same jurisdiction
  2. State courts over local courts
  3. Appellate courts over lower courts
  4. Supreme court over appellate court
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2
Q

Common law rules change based on…

A

Changing societal values, norms and cultures

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3
Q

Statues

A
  1. Laws created by state or federal legislatures
  2. Modify existing law or regulate new subject matter
  3. Responsibility for promulgating rules can be delegated to an administrative agency
  4. May preempt rules and regulations of administrative agencies
  5. Reflect societal norms and social order
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4
Q

Federal law

A
  1. Based on the United States Constitution
  2. Basis for all other laws
  3. State statutes must comply with and be at least as strict as
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5
Q

State law

A

Regulates activities within the state’s jurisdiction

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6
Q

Civil law

A

Addresses the rights and duties of persons within a particular state

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7
Q

Criminal law

A

Enacted to preserve public order

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8
Q

Administrative law

A

Consists of rules and regulations established by administrative agencies within each state that give effect to the state laws

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9
Q

Tort

A

Refers to a private wrong against the person or property of another.

These wrongs are compensated with money damages

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10
Q

Examples of torts

A
  1. Fraud
  2. Invasion of privacy
  3. Defamation
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11
Q

Nursing negligence

A

The omission (failure to do something) or commission (doing something) that violates that standard of care of an occupational and environmental health nurse

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12
Q

Standard of care

A

Refers to what the average, reasonable and prudent occupational and environmental health nurse would do in the same or similar circumstances

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13
Q

Duty

A

The obligation that an occupational and environmental health nurse has to workers in a specific work setting to prevent foreseeable harm

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14
Q

Breach of duty

A

Occurs when the occupational and environmental health nurse fails to provide care according to the reasonable occupational health nurse standard

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15
Q

Examples of negligence

A
  1. Failure to assess and make proper nursing diagnosis
  2. Failure to observe and monitor
  3. Failure to take action
  4. Failure to communicate danger
  5. Delay in obtaining assistance
  6. Medication errors
  7. Failure to obtain informed consent
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16
Q

Informed consent

A

A worker’s decision about a treatment or action plan is made with a clear understanding, including material risks, benefits and alternative treatments

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17
Q

To give informed consent, the worker must be advised of the following…

A
  1. Nature and purpose of proposed treatment
  2. Diagnosis
  3. Material risks of proposed treatment
  4. Alternative treatments
  5. Consequences of lack of treatment
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18
Q

Purposes of informed consent include…

A
  1. Allows the worker to make a decision based upon all known information
  2. Ensures accountability of health professionals
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19
Q

In order to be valid, informed consent must have the following characteristics…

A
  1. Given freely and without coercion

2. Given with full understanding

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20
Q

The person giving informed consent must be…

A

Competent

  1. Mentally
  2. Physically
  3. Legally
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21
Q

Malpractice

A

Negligence that involves professional misconduct or unreasonable lack of skill

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22
Q

Statute of limitations

A

The period of time within which a lawsuit must be filed after a tort occurs

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23
Q

Statute of limitations for negligence

A

2 years

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24
Q

Statute of limitations for malpractice

A

1 year

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25
Q

Occupational and environmental health nurses are responsible for maintaining a current knowledge of laws affecting occupational health practice in the jurisdiction they practice including:

A
  1. Changes in state administrative rules for the practice of nursing (State Board of Nursing)
  2. Changes in state administrative rules that affect the practice of the occupational and environmental health nurse (State Board of Pharmacy or State Board of Medicine)
  3. Changes in state and federal legislation that affect the practice of the occupational and environmental health nurse (laws)
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26
Q

Why may there be inconsistencies in occupational and environmental health between actual practice and legal guidelines of practice

A

Because of the dynamic and evolving nature of occupational and environmental health

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27
Q

Why may interpretation of laws, rules, and regulations change?

A
  • they are dynamic

- they will change as new cases are decided (common law) and legal precedents are established

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28
Q

OSH Act was signed into law on

A

December 29, 1970

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29
Q

The purpose of OSH Act is to…

A

Assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources

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30
Q

OSH Act applies to:

A

Employers and workers within the United States and any territory under US jurisdiction

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31
Q

The OSH Act does not apply to:

A
  1. Self employed persons
  2. Immediate members of farm families that do not employ outside workers
  3. Industries regulated by other federal agencies or state and local governments
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32
Q

Examples of industries regulated by federal agencies or state and local governments

A
  1. Mining
  2. Nuclear
  3. Air transportation
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33
Q

—— was created as a result of the OSH Act

A

OSHA

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34
Q

OSHA is a regulatory agency within…..

A

The US Department of Labor

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35
Q

OSHA is responsible for….

A

Enacting, administering and enforcing standards to provide workplace health and safety

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36
Q

OSHA was the first attempt by Congress to….

A

Provide a comprehensive program to protect the health and safety of American workers

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37
Q

States may choose to administer their own occupational helth and safety program with the following provisions:

A
  1. OSHA approves the state program
  2. State’s program applies to all workers and includes state, local and private sector workers
  3. The state’s statutes must be as strict as federal OSHA requirements; otherwise OSHA standards apply- states can be more restrictive
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38
Q

States and territories with Occuaotional Safety and Health Adminstrations

A
  1. Alaska
  2. Arizona
  3. California
  4. Connecticut
  5. Hawaii
  6. Indiana
  7. Iowa
  8. Kentucky
  9. Maryland
  10. Michigan
  11. Minnesota
  12. Nevada
  13. New Jersey
  14. New Mexico
  15. New York
  16. North Carolina
  17. Oregon
  18. Puerto Rico
  19. South Carolina
  20. Tennessee
  21. Utah
  22. Vermont
  23. Virginia
  24. Virgin Islands
  25. Washington
  26. Wyoming
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39
Q

States and territories with Occupational Safety and Health Administrations that cover public sector employees only

A
  1. Connecticut
  2. New Jersey
  3. New York
  4. Virgin Islands
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40
Q

General Duty Clause of the OSH Act:&

A

Employers are require to furnish all workers with employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm

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41
Q

The General Duty Clause can be invoked for…..

A

Hazards not covered by an OSHA standard as an important means of protecting workers, because setting standards is often a slow process

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42
Q

OSHA has the responsibility to ————- in accordance with Section 6 of the OSH Act

A

Promulgate legally enforceable occupational health and safety standards

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43
Q

Standards are developed to

A

Eliminate or reduce risks

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44
Q

OSHA standards must be….

A

Reasonably necessary or appropriate to provide safe of healthful employment and places of employment

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45
Q

The development of OSHA standards is an —- process

A

Interdisciplinary

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46
Q

OSHA standard development involves individuals from the fields of:

A
  1. Healthcare
  2. Epidemiology
  3. Law
  4. Economics
  5. Industrial hygiene
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47
Q

OSHA standards are written by:

A

OSHA employees and invited consultants

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48
Q

OSHA standards are developed by a…..

A

Public rule making process

49
Q

Features of the public rule making process by which OSHA standards are developed:

A
  1. Public notice
  2. Public hearings
  3. Public comment
50
Q

Public notice

A

The proposed standard and date of public hearing, which are published in the Federal Register

51
Q

Public hearings

A

Scheduled forums for public input

52
Q

Public comment

A

Written or offered at public hearing

53
Q

OSHA can implement ——-as proposed permanent standards and are effective for —–

A

Emergency standards

6 months

54
Q

There are —– standards that have medical surveillance provisions

A

23

55
Q

OSHA standards requiring medical surveillance

A
  1. Acrylonitrile
  2. Arsenic (inorganic)
  3. Asbestos (general industry)
  4. Asbestos (construction and shipyards)
  5. Benzene
  6. Blood borne pathogens
  7. 1,3-Butadiene
  8. Cadmium
  9. Carcinogens (suspect)
  10. Coke oven emissions
  11. Compressed air environments
  12. Cotton dust
  13. DBCP
  14. Ethylene oxide
  15. Formaldehyde
  16. HAZWOPER
  17. Hazardous chemicals in laboratories
  18. Lead
  19. Methylenedianiline
  20. Methylene chloride
  21. Noise
  22. Respiratory protection
  23. Vinyl chloride
56
Q

Z tables

A
  • OSHA part 1910 Occupational Safety and Health Standards sub-part Z
  • series of tables
  • lists permissible exposure limits for substances for which specific standards are in place and for those which a standard has not been generated
57
Q

OSHA is authorized to enforce established standards by….

A

Performing inspections, with or without advance notice to the employer

58
Q

OSHA inspections may include:

A
  1. Review of records
  2. Walk-through
  3. Worker interviews
59
Q

OSHA has established a system of inspection priorities; inspections occur in the following order:

A
  1. Imminent danger situations
  2. Fatalities and catastrophes resulting in hospitalization of three or more workers
  3. Worker complaints of alleged violation of standards or of unsafe or unhealthful working conditions
  4. Follow up inspections
  5. Planned inspections
60
Q

Imminent danger situations

A

When there is reasonable certainty that danger exists that can be expected to cause death or serious physical harm immediately or before the danger can be eliminated through normal enforcement procedures

61
Q

Fatalities and catastrophes resulting in hospitalization of three or more workers must be reported to OSHA by the employer within…..

A

8 hours of the incident

62
Q

Purpose of follow up inspections

A

To confirm abatement of previously identified violations

63
Q

Planned inspections are aimed at….

A

Special high hazard industries, occupations or substances

64
Q

—— or ——- may request OSHA to perform an inspection

A

Workers

Authorized worker representatives

65
Q

If an inspection occurs, the employer has the right to:

A
  1. See a copy of the complaint

2. Right to refuse entry without a court order

66
Q

The worker who files the complaint has the right to…

A

Have name withheld from complaint if requested

67
Q

OSHA consults with business and industry about health and safety issues; these consultation services primarily target…..

A

Small businesses

68
Q

The OSHA consultation service is a ——- program

A

Voluntary

69
Q

Focus of OSHA consultation service

A

Lending assistance to employers to make the workplace free or safe from recognized hazards

70
Q

OSHA consultation service is not….

A
  • Punitive

- Employers who use it are not subject to fines as long as they make efforts to correct deficiencies

71
Q

Employers can request OSHA consultation to accomplish the following:

A
  1. Identify and correct hazards
  2. Provide technical assistance related to work site hazards
  3. Provide education and training to health and safety personnel
72
Q

OSHA consultation service is funded by….

A

OSHA

73
Q

OSHA consultation services is delivered by….

A

State governments using well trained professional staff

74
Q

OSHA provides basic to advanced occupational health and safety classes through….

A

The OSHA Training Institute

75
Q

OSHA’s Voluntary Protection Program (VPP) was adopted in…

A

1982

76
Q

VVP was initiated as a cooperative effort among:

A
  1. Industry management
  2. Labor
  3. OSHA
77
Q

Purpose of VPP

A

To recognize excellence in employer-provided programs and services that go beyond basic regulatory compliance

78
Q

VPP requirements include the following:

A
  1. A comprehensive written program demonstrating management commitment and planning
  2. A thorough worksite analysis
  3. Hazard prevention and control systems
  4. Safety and health training
  5. Active worker involvement
  6. A lost workday case rate of below 50% of the national average for the specific industry
  7. Periodic program evaluation with annual report submission
  8. Worker commitment
79
Q

How is a lost workday case rate that is below 50% of national average determined?

A

Based of review of 3 years of OSHA 300 logs

80
Q

VPP award levels

A
  1. Star
  2. Merit
  3. Star demonstration
81
Q

Star award level

A

Exemplary work sites with comprehensive, successful safety and health management systems

82
Q

Merit award level

A
  • Effective stepping-stone to “star”
  • have good safety and health management systems
  • systems need some improvement to be judged excellent
83
Q

Star demonstration level

A

Designed for worksites with Star quality safety and health protection to test alternatives to current Star requirements

84
Q

In —–, OSHA instituted measures to ensure nursing representation in policy making

A

Nursing

85
Q

The first occupational health nurse was hired by OSHA in…..

A

1988

86
Q

An Occupational Health Nurse Intern Program was introduced in…

A

1988

87
Q

The Occupational Health Nurse Intern Program is a available to….

A

Nurses in graduate school who are specializing in occupational health

88
Q

The Office of Occupational Health Nursing was formally recognized and established

A

1993

89
Q

NIOSH was created by….

A

The OSH Act

90
Q

NIOSH is an institute within

A

Centers for Disease Control and Prevention (CDC) which is a part of US Department of Health and Human Services (US DHHS)

91
Q

NIOSH functions

A

Conducts or funds occupational health and safety research to establish safe levels of toxic materials

92
Q

NIOSH research is the basis for…

A

OSHA standards

93
Q

NIOSH also provides training and education to…

A

Occupational health and safety professionals, including graduate programs for occupational health nurses

94
Q

Occupational Safety and Health Review Commission (OSHRC)

A

An independent regulatory commission authorized by the OSH Act

95
Q

OSHRC members are appointed by

A

The president with senate approval

96
Q

OSHRC is responsible for…

A

Handling appeals filed by employers who have received OSHA citations

97
Q

Employers must file a Notice to Contest within —– of receiving an OSHA citation

A

15 days

98
Q

OSHRC assigns the appeal to an….

A

Administrative appeal judge

99
Q

Appeal of an OSHRC decision is made to a….

A

US Court of Appeals

100
Q

The ADA is….

A

Wide-ranging legislation intended to make American society more accessible to people with disabilities

101
Q

Disability is defined as:

A
  1. A physical or mental impairment that substantially limits one or more major life activities
  2. A record of such impairment
  3. Being regarded as having an impairment
102
Q

Title I of the ADA applies to…..

A

Employers (including public and pirate employers, employment agencies and labor unions) with more than 15 employees

103
Q

Businesses must protect the rights of ———————- in all aspects of employment including the……..

A

Qualified individuals with disabilities

Application process
Hiring
Firing
Compensation and benefits
Training
104
Q

A qualified person with a disability is one who…

A

Can perform the essential functions of the job with or without reasonable accommodation

105
Q

Reasonable accommodation is…..

A

Any modification or adjustment to a job or work environment that will enable a qualified applicant or worker with a disability to participate in the application process or perform essential job functions

106
Q

Reasonable accommodation may include the following:

A
  1. Making existing facilities used by workers readily accessible to and usable by persons wi disabilities
  2. Restructuring the job, modifying work schedules or reassigning the worker to a vacant position
  3. Acquiring or modifying equipment or devices; modifying examinations, training material or policies; or providing qualified readers or interpreters
107
Q

Considerations related to providing reasonable accommodation include the following:

A
  1. Decisions should be made by a multidisciplinary team that includes health and safety professionals, human resources staff and management
  2. The affected worker should be consulted regarding accommodations
  3. Community resources and national agencies can provide information that can assist with the process of accommodation
  4. The “reasonableness” of accommodation is based on cost and impact on business
108
Q

The ADA affects employment inquiries and medical examinations in the following ways:

A
  1. Employers may not ask job applicants about the existence, nature or severity of a disability; however, they may ask about the applicant’s ability to perform specific job functions
  2. A medical examination may be performed after a conditional offer of employment has been made, if examinations are required for all entering workers in similar jobs; the post-offer examination does not have to be job related
  3. There are specific requirements that the employer needs to show if the individual is not hired because of the post offer examination
  4. Post offer examinations may disqualify a person if it is determined the individual poses a “direct threat” in the workplace
  5. After a person is employed, any medical examination or medical inquiry must be job-related and consistent with business necessity
  6. Results of medical examinations must be maintained in a confidential manner in medical files that are separate from other worker information and available under limited conditions
109
Q

The ——- enforces and regulates Title I of the ADA

A

EEOC

110
Q

29CFR825.118

A

Family Medical Leave Act (FMLA) of 1993

111
Q

FMLA entitles eligible workers to take up to — of unpaid, job protected leave in a — period

A

12 weeks

12 month

112
Q

FMLA entitles workers to take leave for the following reasons:

A
  1. The birth and care of the worker’s newborn child
  2. Adoption of foster placement of a child with the worker
  3. The care of a parent, spouse or child with a serious health condition
  4. The worker’s inability to work because of a serious health condition
113
Q

To be eligible for leave under the FMLA, the following conditions must be satisfied:

A
  1. The worker must work for a covered employer in a covered location
  2. The worker must have worked for the employer for a total of 12 months and worked at least 1,250 hours during the 12 months immediately before the leave
114
Q

Under FMLA what constitutes a covered employer in a covered location

A

At least 50 workers employed within 75 miles

115
Q

In some circumstances, workers may take FMLA leave on an ——– basis

A

Intermittent

116
Q

Under FMLA a serious health condition means…

A

An illness, injury impairment or physical or mental condition for various reasons

117
Q

Defined by FMLA a serious health conditon is an illness, injury impairment or physical or mental condition that involves one of the following:

A
  1. Hospital care
  2. Absence plus treatment
  3. Pregnancy
  4. Chronic conditions requiring treatments
  5. Permanent/ long-term conditions requiring supervision
  6. Multiple treatments (non chronic conditions)
118
Q

Common law

A

Body of law formed by court decisions of individual disputes that establishes judicial precedent

► Med Misc 57 (49 decks)

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