Legal Issues in Public Health and Management PDF

Legal Issues in Public Health and Management Dr. Esraa Mohammed Soltan Lecturer of Nursing Administration-Suez Canal University Diploma of Health Professions Education (DHPE) Learning Objectives: By the end of this lecture, the student should be able to: Define law. List fu...

Legal Issues in Public Health and Management Dr. Esraa Mohammed Soltan Lecturer of Nursing Administration-Suez Canal University Diploma of Health Professions Education (DHPE) Learning Objectives: By the end of this lecture, the student should be able to: Define law. List functions of law in nursing. Identify sources of law. Differentiate between the most common types of law. Identify legal issues in nursing. List the most common malpractice situations. Explain health-related legal issues. Apply guidelines for reporting a crime, tort, or unsafe practice. Definition of law: Law: can be defined as those rules made by humans who regulate social conduct in a formally prescribed and legally binding manner. Laws are based upon concerns for fairness and justice. Functions of law in nursing: The law serves a number of functions in nursing: It provides a framework for establishing which nursing actions in the care of clients are legal. It differentiates the nurse's responsibilities from those of other health professionals. It helps establish the boundaries of independent nursing action. It assists in maintaining a standard of nursing practice by making nurses accountable under the law. Sources of Law: The sources of law include constitutions, statutes, administrative agencies, and court decisions. Constitution: A constitution is a system of fundamental laws or principles that govern a nation, society, corporation, or other aggregate of individuals. The purpose of a constitution is to establish the basis of a governing system for the future and the present. Statutes: Laws that govern legislative bodies and make these laws. Statutes are officially enacted (voted on and passed) by the legislative body and are compiled into codes, collections of statutes, and ordinances. Administrative agencies: Administrative agencies are given authority to act by the legislative bodies and create rules and regulations that enforce statutory laws. Administrative laws are valid only to the extent that they are within the scope of the authority granted to them by the legislative body. Court decisions: Judicial or decisional laws are made by the courts to interpret legal issues that are in dispute. Depending on the type of court involved, judicial or decisional law may be made by a single justice, with or without a jury, or by a panel of justices. Generally, initial trial courts have a single judge or magistrate, intermediary appeal courts have three justices, and the highest appeal courts have nine justices. Types of laws and courts: Although most nurses worry primarily about being sued for malpractice, they may actually be involved in three different types of court cases: criminal, civil, and administrative. The court in which each is tried, the burden of proof required for conviction, and the resulting punishment associated with each are different. Criminal cases: In criminal cases, the individual faces charges generally filed by the state or attorney general for crimes committed against an individual or society. In criminal cases, the individual is always presumed to be innocent unless the state can prove his or her guilt beyond a reasonable doubt. Incarceration and even death are possible consequences for being found guilty in criminal matters. Nurses found guilty of intentionally administering fatal doses of drugs to patients would be charged in a criminal court. Civil cases: In civil cases, one individual sues another for money to compensate for a perceived loss. The burden of proof required to be found guilty in a civil case is described as a preponderance of the evidence. In other words, the judge or jury must believe that it was more likely than not that the accused individual was responsible for the injuries of the complainant. The consequences of being found guilty in a civil suit are monetary. Most malpractice cases are tried in civil court. Administrative cases: In administrative cases, an individual is sued by a governmental agency assigned the responsibility of implementing governmental programs. Types of law: Public Law: refers to the body of law that deals with relationships between individuals and governmental agencies. Private Law: is the body of law that deals with relationships between individuals. Criminal law: It is a part of private law. It is categorized as contract law and tort law. Contract Law: It involves the enforcement of agreements among private individuals or the payment of compensation for failure to fulfill the agreements. Tort Law: The word tort means “wrong" or "bad" in Latin. It defines and enforces duties and rights among private individuals that are not based on contractual agreements. Examples of tort law applicable to nursing: Negligence and malpractice Invasion of privacy and assault. Legal issues in nursing: Nursing Practice Act Standard of Practice Nursing Practice Act: Nursing practice act or act for professional Nursing practice regulate the practice of nursing legally define and describe the scope of nursing practice, which the law seeks to regulate, thereby protecting the public as well. It protects the user’s professional capacity. Each country may have different acts but all have a common purpose: protecting the public. It grants the public a mechanism to ensure minimum standards for entry into the profession and to distinguish the unqualified. Standard of Practice: A standard of practice is a means which attempts to ensure that its practitioners are competent and safe to practice through the establishment of standard practice. Establishing and implementing standards of practice are major functions of a professional organization. Standard of Practice (cont.): Standards of nursing practice are to describe the responsibilities for which nurses are accountable. The standards: Reflect the values and practices of the nursing profession Provide direction for professional nursing practice. Provide a framework for the evaluation of nursing practice Defines the profession’s accountability to the public and the client outcomes for which nurses are responsible. Standard of Practice (cont.): When standards of professional practice are implemented, they serve as yardsticks for the measurements used in licensure, certification, accreditations, peer review, and public policy. The profession maintains standards in practice in part through appropriate entry. Credentialing: It is the process of determining and maintaining competence-nursing practice. Credentials include: a. Licensure b. Registration c. Certification d. Accreditation Licensure: It is a legal permit a government agency grants to individuals to engage in the practice of a profession and to use a particular title. It generally meets three criteria: There is a need to protect the public's safety or welfare. The occupation is clearly delineated with a separate, distinct area of work. There is a proper authority to assume the obligation of the licensing process. Registration: It is a listing of an individual's name and other information on the official roster of a governmental agency. Nurses who are registered are permitted to use the title “Registered Nurses" Certification: It is the voluntary practice of validating that an individual nurse met minimum standards of nursing competence in specialty areas such as pediatrics, mental health, gerontology, and school health nursing. Accreditation: It is a process by which a voluntary organization or governmental agency appraises and grants accredited status to institutions and/or programs. Most common malpractice situations: 1. Medication error which resulted from: Failing to read the medication label. Misunderstanding or incorrectly calculating the dose. Failing to identify the client correctly. Administration by the wrong route (e.g. intravenously instead of intramuscularly) some errors are serious and can result in death. Most common malpractice situations (cont.): 2. Sponges or other small items can be left inside a client during an operation. 3. Burning a client 4. Clients often fall accidentally: As a result that a nurse leaves the rails down or leaves a baby unattended on a bath table. 5. Ignoring a client's complaints 6. Incorrectly identifying clients 7. Loss of client’s property: jewelry, money, eye glasses and dentures. Health-related legal issues: Abortion Euthanasia Organ Transplantation Suicide Abortion: The nurse shall assist the physician if she/he is sure that an abortion is performed for the purpose of saving the endangered life or health of women. The nurse shall not attempt or carry out the abortion. It is mandatory for the nurse to treat a patient who is suffering from the effect of a criminal abortion induced by another provided there is no physician in the health institution. The nurse shall report to the concerned authorities of criminal abortion in the absence of physician. Euthanasia: It is the act of pennilessly putting to death persons suffering from incurable or distressing diseases. It is commonly referred as “mercy killing” Types of euthanasia: 1. Active euthanasia: Is a deliberate attempt to end life e.g., deprivation of oxygen supply, administering an agent that would result in death. 2. Passive euthanasia: allowing death by withdrawing or withholding treatment. The nurse shall never assist; or collaborate in taking life as an act of mercy even at the direct request of the patient or patient's relatives. Organ Transplantation: The nurse shall involve in any organ transplantation procedure provided that the donor and recipient have clear written agreement, the donor gives informed consent and he/she is not mentally ill at the time of consent. The nurse shall advocate the declaration of human rights in the organ transplantation procedure. Suicide: A nurse who is taking care of a patient with a suicidal tendency shall remove all items that facilitate suicide such as sharp instruments, ropes, belts, and drugs. The nurse should not leave a suicidal patient alone. Guidelines for reporting a crime, tort or unsafe practices are: Write a clear description of a situation you believe you should report. Make sure that your statements are accurate. Obtain support from at least one trustworthy person before filing the report. Report the matter starting at the lowest possible level in the agency hierarchy Assume responsibility for reporting the individual by being open about it; sign your name to the letter. See the problem through once you have reported it. Summary: Definition of law. Functions of law in nursing. Sources of law. Differences between the most common types of law. Legal issues in nursing. Most common malpractice situations. Health-related legal issues. Guidelines for reporting a crime, tort, or unsafe practice.