Legal and Ethical Issues in Disaster Response

Legal and Ethical Issues in Disaster Response

• Law refers to the rules and regulations guiding nursing practice. It can originate from various sources, including statutes, which are commonly known as "laws."
• Laws can require nurses to perform specific actions, like reporting diseases to health authorities. Failure to comply may result in criminal penalties.
• Laws may also authorize government officials to direct nurses' actions in certain situations.
• Nurses can face civil liability for providing inadequate care, which may involve paying monetary damages.
• Good Samaritan Law protects nurses and healthcare providers from legal liability for assisting in emergencies, but may not always apply during disasters.
• Ethics explores moral principles, while morality encompasses the norms individuals adopt to guide right and wrong conduct.
• The ANA Code of Ethics for Nurses outlines ethical obligations and reflects the profession's commitment to society.
• Common disaster-related ethical and legal challenges include privacy issues related to reporting diseases, maintaining confidentiality, and potential quarantines.
• Mandatory vaccinations, treatment refusal, resource allocation, and duty to treat pose ethical and legal dilemmas for nurses in disaster situations.
• Privacy refers to an individual's right to control access to personal information.
• Confidentiality focuses on preserving trust in a relationship, like the one between a healthcare provider and patient.
• Disclosure of health information, particularly identifiable details, raises privacy and confidentiality concerns.
• Exceptions to confidentiality requirements include:
  • Disclosure directly to the individual
  • Disclosure to immediate family or representatives
  • Disclosure to appropriate federal agencies
  • Disclosure under court order to prevent harm
  • Disclosure for deceased identification or death determination
• Quarantine restricts the activities of healthy individuals exposed to a communicable disease for the duration of the incubation period.
• Isolation separates individuals with communicable diseases to prevent further spread.
• Civil Commitment is used in mental healthcare to forcibly confine individuals deemed a danger to themselves or others. In public health, it refers to confining individuals for treatment purposes.
• Vaccination is mandated by states to protect public health, based on their police powers.
• States have the authority to require vaccinations even when individuals object.
• Treatment refusal is recognized as a right for adults.
• State intervention to mandate treatment, even against parental objections, is upheld by courts when children are involved.
• Screening and testing are distinct but intertwined: testing evaluates individual disease presence, while screening tests a larger population.
• Professional Licensing mandates individuals to obtain licenses to practice nursing within a specific state.
• Licenses restrict geographical practice and define the scope of nursing practice.
• Resource allocation in disaster situations often involves prioritizing limited resources, such as medical supplies, medications, and personnel.
• Distributive justice concerns fair and equitable distribution of resources.
• Triage, a French word for "to sort," is a mechanism for prioritizing treatment in emergencies based on medical need and urgency.
• Triage levels categorize patients:
  • Triage Level 1: Those with life-threatening injuries requiring immediate attention.
  • Triage Level 2: Those whose treatment can be delayed without harm.
  • Triage Level 3: Those with minor injuries.
  • Triage Level 4: Those for whom treatment is ineffective.
• Professional liability applies to all healthcare professionals for providing substandard care.
• Nurses can be held liable for negligent care that falls below accepted standards.
• Good Samaritan Laws might provide immunity from civil liability for those providing emergency care, but not always.
• Adequate staffing is a legal and ethical concern. Hospitals can be held liable for insufficient staffing that leads to patient harm.
• Employment relationships between nurses and hospitals are generally considered at-will contracts, allowing either party to terminate the relationship for any reason without specific cause.
• Nurse administrators need legal advice on staffing requirements and potential liability during public health crises.
• Ethics raises concerns for both nurses and institutions when nurses call in sick during a public health crisis. There are legal and ethical considerations to account for in such situations.
• Mandatory work requirements and contractual obligations related to employment conditions are essential to review in cases of staffing shortages.
• Liability for inadequate staffing during public health crises is a complex legal issue, particularly considering the need for flexibility in an emergency situation.