Nursing Jurisprudence

LEGAL & ETHICAL issues in instruction for Nursing Etiquette concerned with good principle governing the conduct of concords towards patients, physicians, colleagues, the safekeeping for profession and state-supported ethics part of philosophy that deals with systematic approaches to questions of morality a term for the oeuvre of how we curb judgments regarding duty and do by a system of MORAL PRINCIPLES or moral measurements governing conduct Moral mankind conduct in the application of ethics Concerned with JUDGMENT PRINCIPLES of right and wrong in relation to kind-hearted procedureion at laws and char biter Determinants of the Morality of Human conduct The purpose The END The CIRCUMSTANCES Ethical Principles Ethical Principles INVIOLABILITY OF LIFE All kind-hearted life, from the moment of conception and through all subsequent stages, is SACRED No superstar can violate or destroy life 8 ETHICAL DILEMMAS 1. 2. 3. 4. 5. 6. 7. 8. ARTIFICIAL INSEMINATION IN VITRO F ERTILIZATION HUMAN CLONING contraception ABORTION EUTHANASIA PHYSICIAN ASSISTED SUICIDE HUMAN transplant 9 Argument favoring Euthanasia compassion for the patient and shortening the flowing of suffering of the patientArgument disapproving Euthanasia it is intrinsically wrong since it rejects life. 10 STEWARDSHIP reality has DOMINION over Gods creation himself (life and health), creatures and environment matchless should reasonably, responsibly and respectfully benefit from them for service NOT domination total Parts argon integral, destined to be part of and subordinate to a whole SOLIDARITY One to be with separates to have a unity of interest, righteousness or goal. Based on the common good, love of neighbor, preferential for the more or less proximate and most need SUBSIDIARITYEvery creature should be entrusted with the functions he is fitted of carry outing. It relates to human dignity and recognize soulfulnesss as free and responsible agents able-bodied to feel for and make decisions for them AUTONOMY Self Governance/Self rationale Having the freedom to make choices 4 Basic Elements of Autonomy 1. Respect for sovereign soulfulness 2. Ability to determine soulfulnessal goals 3. Capacity to decide 4. Has freedom to Act CONFIDENTIALITY Requires non-disclosure of occult or secret information Confidentiality of Information ? permit communication ? Based on trust Revealed when a.The patient permits such revelation. b. Medico- reasoned cases/legal proceedings c. Communicable disease /public safety whitethorn be jeopardized. d. Continuity of care JUSTICE refers to the certificate of indebtedness to be fair to new(prenominal) people. Types 1. distrisolelyive justice- fair distribution of responsibilities 2. culpable justice- penalty proportionate to law-breaking 3. rectificatory justice- just compensation in civil law Distributive arbiter To each equally. To each correspond to need. To each according to merit. To each according to sou lfulnesss right. To each according to individual effort.To each as you would have done by. To each according to the greatest good to a greater number Double Effect Principle When an cause has both(prenominal) good and bad pitchs, it is permissible if 1) The direct freely chosen effect is morally good and the indirect foreseen but non desired may be foul, 2) The carryion/object must not be deplorable, 3) The foreseen ripe effect must be greater or equal to the foreseen shabbiness effect 4) The beneficial effect must follow directly from the action or at least as immediate as the harmful effect BENEFICENCE- substance to do good and not to do harm.NON- MALEFICENCE- one ought not to inflict evil or harm. 22 FIDELITY- refers to the obligation to be faithful to the agreements, relegatements and responsibilities that one has made to oneself and others VERACITY- refers to telling the truth or not intentionally deceiving or mis allowing patients 23 RESPECT- treat all human creati ons as persons with rights SHARING AND ALLOCATION OF RESOURCESwho will receive particular extraordinary resources. 24 NURSING ETHICS ? All principles of right conduct in the answer of care for ? Appraisal of rightness or wrongness of an act BIOETHICS item domain of ethics Systemic study of human behavior in the field of life experience and health care in the light of moral values and principles Code of Nursing morality respect for human dignity safeguards the clients right to screen safeguard client and public assumes responsibility and accountability for own actions and judgments maintains competence in care for uses apprised judgment, competence and qualifications in accepting responsibilities and commission nursing activities Contributes to the development of the professions body of noesis utilise and improve standards of care establish and maintain conditions of employment conducive to high-quality nursing care protect the public from misinformation and mi srepresentation and to maintain the integrity of nursing In collaboration with other allied health team members, play off the health care require of the public Patients eyeshade of Rights The patient has the right to 1) considerate and respectful care. 2) relevant, current, and chthonianstandable information concerning diagnosis, treatment, and prognosis. ) make decisions regarding his plan of care in case of refusal, he is entitled to other appropriate care and service or to be transferred to another hospital. 4) grant advance directive (such as living will) concerning treatment or designating a surrogate decision maker. 5) Every friendship of his privacy such as in case discussion, consultation and treatment. 6) Confidentiality of communication and records 7) Review his records concerning his medical care and have these explained to him except when restricted by law. ) Expect that deep down its power and policies, a hospital will make reasonable response to the pass alon g of a patient for appropriate and medically indicated care and services. 9) Be informed of business relationship among hospital, educational institution, health care providers that may puzzle out the patients treatment and care. 10) Consent or decline to participate in data-based research affecting his care. 11) Reasonable continuity of care when appropriate and be informed of other care options when hospital care is no womb-to-tomb appropriate 12) Be informed of hospital policies and uses that relate to patient care.Nurses Bill of Rights Nurses have the right to 1) suffice in a manner that fulfills their obligation to the clubhouse and to those who receive nursing care. 2) Practice in environments that allow them to act in accordance with professional standards and legally sure sphere of nursing. 3) conk out environment that supports and facilitates ethical practice 4) freely and openly advocate for themselves and their patients without forethought of retribution. 5. Fai r compensation for their work consistent with their knowledge, experience, and professional responsibilities. 6.Work environment that is safe for themselves and their patients. 7. Negotiate conditions of employment, in all practice settings. LEGAL ASPECTS OF NURSING Nursing Jurisprudence the philosophy of law, or the science which treats the principles of positive law and legal relations Comprises all laws, rules, doctrines and principles, legal opinions and decisions of fit post regarding governance and regulations of the practice of nursing. Functions of the police force in Nursing 1. Provides a framework for establishing what nursing actions in the care of patients are legal. . Delineates the nurses responsibilities from those of other health practitioners 3. Helps to establish the boundaries of self-governing nursing action 4. Assists in maintaining a standard of nursing practice by making nurses responsible under the law. Philippine Nursing Law Philippine Nursing Act of 2 002 R. A. 9173 (October 21, 2002/ November 20, 2002) regulates Philippine nursing practice at present. The law provides about nursing registration, nursing examination, nursing education, nursing practice, and health human resource production, recitation and development.It is made up of 19 articles and 41 sections. Prohibitions in Practice of Nursing (Section 35) PENALTY Fine a. b. c. d. e. f. g. Php50,000- Php100,000 and/or Imprisonment 1- 6 old age practice nursing without corroboration or special(a) permit use the certificate of others as his own use an invalid certificate extend phoney evidence during registration falsely pose or advertise as a registered nurse illegally append BSN/RN to his/her recognise embolden or assist the illegal practice of a person who is not rule-governedly qualified to practice nursing heedlessness Commission or omission of an act, consistent to a duty, that a reasonably prudent person in the same(p) or similar circumstance would or would not do, and performing or the non-acting of which is the proximate wee-wee of blot to another person or his blank space Elements of Professional Negligence Duty Breach of duty Foreseeability Injury steer relationship between failure to meet standard of care and soil can be proved Res Ipsa Loquitor the thing speaks for itself 3 conditions 1.Accident which usually doesnt occur in the absence of someones negligence 2. Must be caused by an agency or within the goop control of the defendant 3. Must not have been due to unpaid action or contribution on the part of the plaintiff Specific Examples of Negligence Failure to report observations to attention physicians. Failure to exercise the mark of diligence which the circumstances of the particular case demands. Mistaken identity. Wrong medicine, wrong concentration, wrong route, wrong dose. Defects in the equipment such as stretchers and wheelchairs may lead to falls thus injuring the patients. Errors due to family assista nce. Administration of medicine without a makes prescription. Legal Defense in Negligence Provision of standard of care in giving service and that they have movered the care they given in a concise and complete manner. Exercise reasoning(a) judgment assumption of risk MALPRACTICE Stepping beyond ones allowance with serious consequences Reducing The Risk of Malpractice litigation Maintain Good parley Be courteous, show respect, and take time to listen Do not belittle patients or make value judgment Involve patients in decision making Assess clients level of understanding Explain so client understand Clarify and verify Reducing The Risk of Malpractice Litigation Maintain Expertise in Practice Keep up to discover in both knowledge and skills Do not attempt some(prenominal) kidskinbed or give any meds that is unfamiliar Practice within the professional scope of practice Be familiar with standards of care Be attentive of clients changing status Pay besotted attention to details Document objectively, thoroughly and in a well-timed(a) fashionReducing The Risk of Malpractice Litigation Maintain autonomy and vestment Challenge equivocal physician order Seek attention for patient with changing needs Challenge bureaucratic structures that threaten patients welfare annul institutional settings that produce systematic threats to patient welfare Respondeat Superior permit the superior answer for the acts of the subordinate Master and servant are answerable servant is responsible Actions performed by the employee within the scope of his employment. Force Majeure unresisting/ superior force Accident which human prudence can incomplete foresee or prevent Act of God Liability of Nurses Work of Nursing Aides Work of Nursing Students Delegation A branch of transferring selected Nursing tasks to an individual who is competent. Any nursing intervention that requires independent special nursing knowledge, skill or judgment CANNOT b e delegated. Tasks that involve the assessment, grooming and evaluation phases of the nursing process cannot be delegated. Delegation involves Responsibility an obligation to accomplish a task Accountability acceptance of responsibility for the expiry of a duty Authority right to act or empower Principles of delegation A nurse can only delegate those tasks for which that nurse is responsible, according to the specific states nurse practice act The delegator remains accountable for the task Along with responsibility for a task, the nurse who delegates must in addition transfer the authority necessary to complete the task The delegator knows well the task to be delegated Delegation is a contractual agreement that is entered into voluntarily mobilise Orders Only in an extreme emergency and when no other resident physician or intern is available. Nurse should read back the order to the physician. subscribe by the physician within 24 hours. Nurse should sign the name of p hysician per her own and note the time the order was received. take CONSENT Free and rational act that presupposes knowledge of the thing to which consent is being given by a person who is legally capable to give consent. Authorization, by a patient or a person authorized by law to give the consent on the patients behalf.Informed Consent a) The diagnosis and explanation of the condition. b) A fair explanation of the procedures to be done and used and the consequences. c) A description of alternative treatments or procedures. d) A description of the benefits to be expected. e) Material rights if any. f) The prognosis. Things to Remember Patient is the one who gives the consent. Person who is authorized to give the consent in behalf of the patient. Parents of minors. Minors are allowed if liberate or married. Parents or legal guardians for mentally ill patients. Emergency status entails implied consent. Patient has the right to refuse. MEDICAL RECORDS ? Legal protection for the hospital, doctor, and nurse ? If it was not charted, it was not observed or done. ? Nurses are expected to fully, accurately, legibly, and promptly document their observations. ? Subpoena duces tecum ? When a nurse or clinical instructor countersigns the charting of a nursing student, he/she attests that he/she has personal knowledge of information and that such is accurate and authentic. CRIME ?An act commit or omitted in entrancement of the law. Elements a) nefarious act b)Evil/criminal intent TORTS ?A legal wrong, committed against a person or property. 1. Assault and Battery 2. False Imprisonment or Illegal Detention 3. Invasion of Right to Privacy and Breach of Confidentiality 4. aspersion Criminal Actions a. Misdemeanor General name for a criminal abomination which does not amount to felony Punishment is usually a beauteous or imprisonment less than 1 year. b. Felony Public offense presumable to be sentenced to death or penitentiary imprisonment. Deceit (do lo) ? deliberate intent crack (culpa)? rongful acts result from imprudence , negligence, or lack of skill or foresight Classes of Felonies pointedness of the Acts of Execution Attempted offender commences the commission of the act and does not perform all the acts or doing by reason of some cause or accident other than his own spontaneous desistance Frustrated fulfil offender performs all when all the elements acts or execution of felony necessary for its execution but never produce it and accomplishment are because of causes present independent of the will of the perpetrator Degree of Punishment gruelling Less Grave Light capital punishment (death) or penalties which any of their periods are irritating (imprisonment ranging from 6 yrs to 1 solar day to life improsnment or a beauteous not exceeding P6000. 00) penalties which in penalty of arresto their maximum period menor (imprisonment are correctional for 1 day to 30 days or a (imprisonment ranging fine not exceeding from 1 month and 1 day P200. 00 or both to 30 days or a fine not exceeding P6000. 00 but not less than P200. 00) CRIMINAL NEGLIGENCE a. Reckless Imprudence Person does an act or fails to do it voluntarily but without malice, from which material damage results immediately.Person did not use precaution and the damage was not immediate or the impending danger was not evident b. unsubdivided Imprudence CRIMINAL objective State of mind of a person at the time the criminal act is committed Knowledge that the act was flagitious Requisites There must be FREEDOM There must be INTELLIGENCE Requisites of Criminal Intent Freedom Intelligence Freedom is scatterbrained in the 1. An imbecile or demented (unless following circumstances acting during lucid of 1. Under compulsion of an interval). irresistible force. 2. Under nine years old. 2. Under the impulse of 3.Over nine under fifteen uncontrollable fear or an equal (unless he had acted with or greater injury. discernment). Persons Crimina lly Liable Principals Those who take direct part in the execution of the act (principal by direct participation) Those who directly force or induce others to commit it (principal by inducement) Those who cooperate in the commission of the offense by another act without which it would not have been accomplished (principal by cooperation) Accomplices The person who have a common criminal purpose with the criminal. Have the intention to help and knowledge about the curse.Accessories Have the knowledge but did not participate in the act. a. By profiting themselves. b. By concealing or destroying body of the crime, or instrument thereof, in order to prevent its discovery. c. By harboring, concealing or assisting in escape of the principal. Circumstances Affecting Criminal Liability JUSTIFYING ? Does not commit crime in the eye of the law a. In defense of his person or rights b. In defense of the rights of his family c. In order to avoid an evil or injury d. In the fulfillment of a duty e. In obedience to an order by some superior for some true(a) purposesEXEMPTING ? There is crime committed but there is no criminal on account of absence of freewill and voluntariness to act. a. An imbecile or insane (unless acted on lucid interval) b. Under 9 yrs c. Over 9 and under 15 (unless acted on discernment) d. While performing a lawful act with due care, cause an injury by mere accident without defect or intention of causing it e. Act under the compulsion of an irresistible force f. Acts under impulse of uncontrollable fear of an equal injury g. Who fails to perform an act required by law, when prevented by some lawful or insuperable cause. MITIGATING ? which lessen the penalty a. b. c. d. e. f. g. h. Under 18 or over 70 yrs old No intention to commit so grave There was sufficient innervation Acted on impulse so powerful to have produced obfuscation Voluntarily surrendered Deaf or dumb, ruse or suffering from defect. Illness that diminish will power prompt vindication of grave offense to the one committing the felony, his/her spouse, ascendants, descendants, legitimate, natural or adoptive brothers or sisters, or relative by affinity within the number 1 degree Lack of education is not Mitigating in 1. Rape 2. lively abduction 3. Arson 4. Treason 5.In crimes against chastity like seduction and acts of lasciviousness and 6. Those acts committed in a merciless or heinous manner alter ? which increases the penalty a. Public position b. In contempt of public authority c. Committed with insult or in disregard of the respect of the offended party on account of his/her rank, age, or sex or that it is committed in the dwelling of the offended party, if the latter has not given provocation d. With abuse or confidence or obvious ungratefulness e. in a place of worship f. Conflagration, shipwreck, earthquake, epidemic or other calamity or misfortune g.Price, reward, or promise h. Committed by means of fire, poison, explosion, i. With evident premeditati on or after unlawful entry j. Craft, fraud, or disguise is employed k. Causing other wrongs not necessary for its commission ? ALTERNATIVE ? Those which must be taken into consideration as alter or mitigating according to the nature effects of the crime and other conditions attending its commission ? Alternative circumstance of relationship should be taken into consideration Points to Observe in Order to Avoid Criminal Liability a. Be very familiar with the nursing law. b. Beware of the laws affecting nursing practice. . At the start of employment, get a copy of your job description, the agencys rules, regulations and policies. d. Upgrade your skills and competence. e. Accept only such responsibility that is within the scope of your employment and your job description. f. Do not delegate your responsibility to others. g. realise whether your subordinates are competent in the work you are assigning them. h. disclose good interpersonal relationships with your coworkers, whether the y be your supervisors, peers or subordinates. i. Consult your superiors for problems that may be too big for you to handle. . Verify orders that are not clear to you or those that seem to be erroneous. k. The doctors should be informed about the patients condition. l. Keep in mind the value and necessity of keeping accurate and adequate records. m. Patients are entitled to an informed consent. Moral Turpitude An act of baseness, vileness or depravity in social or private duties which a man owes to hi fellow man or society in general, an act contrary to the accepted and customary rule of right and duty between men Murder ? Unlawful killing a human being WITH INTENT to kill. ? A very serious crimeEx. Criminal Abortion Euthanasia Homicide ? Killing of a human being WITHOUT CRIMAL INTENT by a person other than his father, mother or churl or any of his ascendants or descendants, or his spouse Abortion ? projection of the product of conceptus earlier the age of viability ? In the law, any person who, with the intention pr prematurely ending a pregnancy, willfully and unlawfully does any act to cause the same is guilty of procuring abortion ? Art. II Sec. 15 of Phil. Constitution protects the life of the unborn Infanticide ? Killing of a child less than three (3) days of age ?Mother who committed this crime shall be imprisoned for two (2) years, four (4) months and one (1) day to sestet (6) years Parricide ? Crime committed by one who kills his/her father, mother or child whether legitimate or illegitimate, or any of his ascedants or descedants or his spouse. ? Convicted with this crime, shall be imposed a penalty of life imprisonment (Reclusion Perpetua) to death Robbery ? Crime against a person or property ? The fetching of personal property of another person from him or in his charge Common Legal Terms R. Ns should know Affidavit is a compose statement made under oath efore a notary public or other person duly authorized Civil Law concerned with legal rig hts and duties of private persons Criminal Law deals with conduct that is considered to be offensive to a society as a whole day in Court the right of a person to appear in court and be heard concerning his complaint/defense Defendant the person being accused of wrongdoing therefore needs to defend himself certification an oral interrogation answering all manner of questions relating to the transaction at issue, given under oath and taken in writing before a judicial officer or attorney