Legal Considerations Flashcards
The law influences many aspects of the professional practice of nurses. For example, the law:
o Regulates the profession.
o Clarifies the rights of patients, and nurses.
o Outlines the civil and criminal consequences when the law is breached and when professional standards are not met.
o Requires provincial oversight and management of some legislation related to negligence and the associated disciplinary outcomes
Nurses must understand the Legal System in Canada and understand the following:
o The system and fundamentals of law that apply in their setting
o How the legislative process and how laws are established and introduced
o How the law is interpreted and applied
o The Canadian Constitution and the Charter of Rights and Freedoms
Four Pillars of Nursing
- Serve and protect the public
- Advance the profession and improve health
- Advance education and represent nursing programs
- Support the nurse and strengthen working conditions
- Civil Code in Quebec
o Based on French civil law
o Laws codified in document known as “civil code”
o Code is the chief source of rules and principles that establish rights and responsibilities
- Civil Law (tort law)
o applies to private disputes between two sets of individuals
o describes the legal system in Canada
- Criminal Law
o Concerned with relations between the individual and the state
- English common law
o is the foundation of the Canadian legal system outside of Quebec
o is not written down or codified
o is guided by precedent (case law)
- Statute law
o All Legislation exists in both systems as “Statute Law”
Documentation in Legal Proceedings
- Documentation is submitted as evidence in legal proceedings
o Court wants documentation to understand sequence of events in a court case - Meticulous, clear, and well-organized records assist the court in determining how events took place (sequence and circumstances)
- Inadequate or missing documentation can have serious consequences in legal actions
- Nursing testimony is strengthened/validated by an accurate health record
- MAR
- Evidentiary Use
- In order for notes to be used as evidence, the court must be satisfied that:
o the notes were made by the person testifying
o it was part of that person’s duty to make notes
o the notes were made contemporaneously with the event (or reasonably so)
o there have been no alterations, additions, or deletions to the notes
Guidelines for Proper Documentation
- Legally proper documentation is
Contemporaneous and continuous
in chronological order
clear and concise
accurate
legible - Corrections are made clearly (not white out)
- Late entries are noted as such (have to write late-entry). Documentation itself should reflect correct date and time.
Legal Liability Issues in Nursing Practice
- CIVIL (Tort)
o Civil wrong committed against a person or property.
Intentional tort – willful acts that violate another person’s rights. - Assaults
- Battery
- Invasion of Privacy
- False Imprisonment (serves to protect individual liberty and basic rights)
Unintentional tort – when nurses are sued, most often the proceedings against them are for the tort of negligence or malpractice.
- Informed Consent
o Person’s agreement to allow a medical action to happen, such as surgery or an invasive procedure, based on full disclosure of the likely risks and benefits of the action.
o Creates a legal duty for the physician or other healthcare provider to disclose material facts in terms that the patient can reasonably understand in order to make an informed decision.
o Relationship between health care providers and patients – nurse is not legally responsible for obtaining informed consent for a medical procedure
o Nursing procedure not doctor’s procedures
Informed Consent. The nurse needs to confirm the following:
* Need to ensure patient consent is voluntary,
* Informed about entire procedure by the doctor,
* Ensure patient has capacity to consent
o Legal significance of risk and benefits of consent.
o First thing a nurse would do if patient doesn’t want survey:
Stop the procedure even after the consent has been given.
Patient has right to withdraw consent at any moment and then educate the patient about the rights and then you document everything.
Implied Consent
o Emergency situations. Assumed. A minor is not allowed to give out a consent.
- Personal Directives: Legal documents outlining a patient’s healthcare wishes.
o A Personal Directive is a document that names someone chosen by the patient who will make personal decisions on their behalf if they become Incapable due to illness or injury in the future.
o This is a legal document that anyone 18+ years and older can make ahead of time that identifies who will make decisions for them should they lack the ability to do so.
o It is optional and voluntary and created prior to illness or injury
o Can be registered with the Office of the Public Guardian & Trustee (OPGT) if the persons wish to have it included in the provincial registry
o Makes decisions about the types of medical care/treatments, where to live and with whom, choices about personal activities and other personal decision
Guardianship:
o Makes the Healthcare decisions.
o A Guardian is a person who can make decisions for an adult (18+ years of age) who is unable to safely make personal decisions on their own due to:
o Lacks capacity to make sound decisions due to intellectual or cognitive alterations.
o May have a permanent or temporary disability/illness
o Lacks an immediate family member to become Guardian
o Can be appointed by the court
