Informed Consent in Nursing

Patient Rights and Informed Consent

• Patients have the right to refuse a procedure or treatment without discontinuing other supportive care.
• Patients may refuse a procedure or treatment even after it has begun.
• Patients must receive an explanation of the procedure, including the names and qualifications of those performing and assisting in the procedure.
• Patients must receive a description of the serious harm, including death, that may occur and the anticipated pain and/or discomfort.

State Statutes Affecting Nursing Practice

• Good Samaritan laws limit liability and offer legal immunity if a nurse helps at the scene of an accident.
• Public health laws are intended to improve the health of people and can affect individuals, populations, and communities.
• Termination of pregnancy laws vary by state and nurses must know the laws in their state before working in this area of practice.
• Physician-assisted suicide laws vary by state and nurses must know their state's laws and ensure their practice falls within the laws' requirements.
• The Uniform Determination of Death Act determines actual death.

Federal Statutes Affecting Nursing Practice

• The Mental Health Parity and Addiction Equity Act requires health insurance companies to provide coverage for mental health and substance use disorder treatment.
• The Patient Self-Determination Act requires health care institutions to provide written information to patients concerning their rights to make decisions about their care, including the right to refuse treatment and to formulate an advance directive.
• The Uniform Anatomical Gift Act provides the foundation for the national organ donation system.
• The Omnibus Budget Reconciliation Act (1986) altered the way in which health care is provided to older adults.

Nursing Workforce Guidelines

• Staffing and nurse-to-patient ratios are important considerations in nursing practice.
• Nursing assignments, patient abandonment, nurse delegation, and nursing students are all important areas of focus in nursing practice.

Legal Implications and Reducing Your Legal Risks

• Torts are civil wrongful acts or omissions of care made against a person or property.
• Quasi-intentional torts are acts in which a person may not intend to cause harm to another but does.
• Unintentional torts arise when a person is harmed and the person inflicting the harm knew, or should have known, that their actions were less than the accepted scope and standard of practice.
• Negligence is conduct that falls below the generally accepted standard of care of a reasonably prudent person.
• Malpractice is a type of negligence, and the person being held liable for malpractice must be a professional.
• Standard of proof is what a reasonably prudent nurse would do under similar circumstances in the geographical area in which the alleged breach occurred.
• Malpractice insurance is a contract between an insurance company and a nurse or employer that is intended to cover costs incurred when a patient sues the employer and/or the nurse.
• Nurse experts often testify about the standards of nursing care as applied to the facts of a case when a case that involves nursing care is filed.
• Reducing legal risks involves being aware of the actions taken at the organizational level by your employer and remaining involved in the nursing profession to reduce your personal legal risk.