legal and ethical week 13 Flashcards
Failure to exercise the degree of care that a person of ordinary prudence would exercise under the same circumstances
The doing or not doing of an act, pursuant to a duty, that a reasonable person in the same or similar circumstances would do or not do and the acting or failing to act is the proximate cause of the injury to another person or to her property
Negligence
Traditional standards defined by the degree of skill, care, and diligence exercised by nurses commensurate with the individual’s level
Standards of Nursing Care
An offense covered under tort law
A dereliction from professional services resulting in injury, loss, or damages to the recipient of the services
Relies on the judgment that the professional has failed to perform according to the minimum reasonable standards of the profession
Malpractice
***Malpractice laws vary by state, controlled by statute, regulations and case law
the injury or wrongful act for which a civil action is brought
Tort
Requires proven provider-patient relationship
duty
Nurse had a duty to patient but care fell below the acceptable standard
Standards set per diagnostic profile, can be written or unwritten
Breach of duty
failure to provide care within the standard must be the proximate cause of the injury
Example: administering a drug in error but without injury does not meet criteria for malpractice claim
Malpractice Claims: Elements (cont.)
Proximate cause
Must be proof of harm
Damages
T/F: Nurses may offer duty in emergency circumstances without liability
TRUE
T/F: State law is the authority for professional practice.
TRUE
How many elements must the plaintiff introduce for a malpractice claim?
Four Duty Breach of duty Proximate cause Damages
What should you do if you’re served with a lawsuit?
call professional insurer
notify institution/workplace
DONT contact plaintiff
If one event is comparable to another in causing harm, responsibility does not rest with one individual.
Comparative negligence
defendant receives document informing them of suit
Service:
How many days does a defendant have to respond once served with a suit against them?
120 days
T/F: Most cases end up going to trial?
FALSE
Most cases end with negotiation and settlement.
records all malpractice claims.
The National Practitioner Data Bank (NPDB)
Respect for autonomy (self-determination)
Nonmaleficence (do no harm)
Beneficence (act in the best interest of)
Justice (fairness)
Veracity (truthfulness, honesty)
Confidentiality
Fidelity (promise keeping, loyalty)
Ethical principles
Recognize an ethical dilemma exists. (How do you know?)
Analyze available clinical information.
Develop a moral point of view that can be articulated/explained.
Understand that dilemma can be approached from a variety of viewpoints.
Move toward responsible, collaborative action through communication and understanding.
Ethical Decision Making: Five-Step Process
A health care provider has the duty to disclose all significant information that he/she possesses or reasonably should possess that is material to an intelligent decision by the patient.
Doctrine of Informed Consent
What does the doctrine of informed consent include?
Nature of patient’s condition
Nature/probability of risks
Reasonable expectation of benefits
Inability of provider to predict risks/results
Irreversibility of a procedure
Likely result of no treatment
Available alternatives, including risks and benefits
physical ability to make and communicate decisions
Capacity
makes decisions patient would make
Guardian
makes recommendations for patient in court
Guardian ad litem
makes financial decisions for patient
can’t make healthcare decisions
Conservator
can be activated/inactivated to act on behalf of patient as neede
Proxy
Are legal and ethical issues the same thing?
NO
Ethical responsibility to obtain informed consent may be to do no harm but legal responsibility encompasses multiple criteria.
Are the following a legal or ethical issue or both?
Failure to communicate/poor communication with the treatment team:
legal
Failure to follow the chain of command
legal
Failure to understand/master use of equipment:
legal
Failure to follow/understand institutional policies/procedure
legal
Competency issues
legal and ethical
Failure to document appropriately/accurately
legal
branch of philosophy concerned with “doing good” and “right action”
tends to be associated with critical reflection on our values
Personal beliefs and experiences
Societal norms
Professional guidelines
Organizational standards
ethics
tends to be associated with values or habits that reflect our behavior
Religious beliefs
Morals
Self-rule Patients' right to determine what is best for them based on Ability to reason Capacity for personal decision making Knowledge of personal goals Self-knowledge Ability to act on one's choices
Autonomy
T/F: No one is completely autonomous
TRUE
Do no intentional or needless harm
Possess the professional competence that allows you to:
Foresee consequences
Perform actions
Nonmaleficence
Promotion of patients’ good
Most important thing: knowing what is right for the patient
Beneficence
Truthfulness in support of patient autonomy
Obligation to tell the truth
Veracity
Fairness, both to individuals and in allocating resources
No undue burden on people
Justice and Fidelity
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
The relationship between a patient and her health care team is important. The primary care NP should try his or her best to develop a trusting relationship with a patient
Fidelity
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
An alert elderly woman who has breast cancer decides to have a lumpectomy after discussing treatment options with her oncologist. The woman’s daughter tells the NP that she does not want her mother to have the surgery because she thinks her mother is too old. The NP has a duty to respect the patient’s decision.
autonomy
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
the mammogram result of a 64 year old female is highly indicative of breast cancer. The patient’s son does not want his mother to know about the results. The NP has a duty to discuss the mammogram results with the patient and to refer her to a breast surgeon
Veracity
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
A homeless alcoholic man without health insurance presents to the ED with abdominal pain. The patient is triaged and treated in the same manner as the other patients who have insurance.
Justice
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
Educating patient with a new prescription about how to take the medication
encouraging a patient to stop smoking and enroll in a smoking cessation program
calling the surgeon to get a prescription for stronger pain medications for a post-surgical patient who c/o severe pain
Beneficence
Is the following an example of beneficence, non-maleficence, justice, autonomy, fidelity or veracity?
A middle aged woman with osteoporosis wants to be treated with bisphosphonates. The NP advises the patient that she is not a good candidate for these drugs because of her past medical history of GI bleeding and PUD. The NP decides not to prescribe the bisphosphonates
Non-maleficence
Is one of the richest professional codes Guides nurses in daily practice to: Respect persons Help maintain patients' autonomy Promote patients' dignity Ensure patients' safety
ANA Code of Ethics
