Legalities In Field Care PDF

Legalities in field care Basic principles Legal Principles concerning on-field care 1. Duty to Act 2. Consent Purpose of informed consent Validity of informed consent 3. Negligence 4. Confidentiality 5. Documentation 6. Insurance Principle 1: Duty to act A...

Legalities in field care Basic principles Legal Principles concerning on-field care 1. Duty to Act 2. Consent Purpose of informed consent Validity of informed consent 3. Negligence 4. Confidentiality 5. Documentation 6. Insurance Principle 1: Duty to act An Athletic Therapist has a duty to give care to an injured athlete – when? If you are a trained medical professional and you are acting with an expectation of compensation you have a duty to act appropriately and within the scope of your training when called to assist with an emergency situation. Appropriate care Duty to act When do you not have a duty to act? What is the scope of practice for an Athletic Therapist? What is your scope of practice today? Work safely and appropriately within your scope of training to avoid litigation Principle 2: Consent For what purpose(s) does an AT need to consider consent? Consent For what purpose(s) does an AT need to consider consent? Personal Information Medical Information Medical Treatment Consent For collecting personal and personal health information As outlined in PIPEDA and specifically in matters related to health care - Ontario Personal Health Information Protection Act For providing treatment As outlined in the Health Care Consent Act PIPEDA Personal Information Protection and Electronic Documents Act PIPEDA is a consent-based Act, meaning that you must have consent to collect, use or disclose information Includes entire private sector May use the information only for the purpose for which it was collected PIPEDA Implementation Act released in stages beginning in 2001 Re-evaluated and amended as needed on a nearly annual basis – technology advances require continual changes Ontario Personal Health Information Protection Act In Ontario, all health information must be protected under PHIPA Relates to protecting an individuals health information mental or physical health; a person's health services, tests and examinations. PHIPA to establish rules for the collection, use and disclosure of personal health information about individuals that protect the confidentiality of that information and the privacy of individuals with respect to that information, while facilitating the effective provision of health care; provide individuals with a right of access to personal health information about themselves  https://www.youtube.com/watch?v=ZJ2msARQsKU Health Care Custodian To collect information, you must be a health care custodian According to the PHIPA, one potential health care custodian is “a person whose primary function is to provide health care for payment” What kind of health information will you expect to collect? Consent for treatment A person has the right to determine what can and cannot be done to his/her body. Required by law for any medical treatment According to the Canadian Red Cross, to obtain consent you must: Identify yourself to the person State your level of training Explain what you think may be wrong Explain what you plan to do As a health care professional… A more defined outline of what is considered consent. Documents you should become familiar with Health Care Consent Act Personal Health Information Protection Act Informed Consent Person received information about: treatment and its expected benefits alternative courses of action risks and side effects consequences of no treatment Informed Consent Health practitioner responded to person’s requests for: other information regarding treatment alternative courses of action material effects risks and side effects consequences of not having the treatment Purpose of Informed Consent for Treatment 3 Main Purposes: 1. Protect individual’s right to “security of the person” (Canadian Charter of Rights and Freedoms) Physical contact with a person without his/her consent constitutes battery Purpose of Informed Consent 2. Enhances communication and trust between caregiver and care recipient 3. Risk management measure, to avoid litigation Clients have a right to refuse treatment or withdraw consent at ANY time after it has been given Continual communication with patients is KEY!!! Informed Consent Validity For consent to be accepted as valid, it must meet 8 criteria… 1. Legally Competent to Consent Presumption is that the person is competent This includes children Age of majority is NOT always the age of consent for treatment Dementia, mental deficiency, inability to comprehend  The Health Care Consent Act does not identify an age at which minors may exercise independent consent for health care because the capacity to exercise independent judgment for health care decisions varies according to the individual and the complexity of the decision at hand. 2. Mental Capacity “The intellectual ability to reach a reasoned choice about treatment” Refers strictly to the person’s ability to make a treatment decision – not “global capacity” Is responsibility of person obtaining consent to assess the individual’s capacity Diagnosis of a psychiatric illness is insufficient to presume incapacity Mental Capacity The person must be “able to understand the information that is relevant to making a decision concerning the treatment and able to appreciate the reasonably foreseeable consequences of a decision or lack of decision” Judgment of incapacity is NOT a permanent verdict Could be competent but incapacitated. 3. Disclosure of Information Information provided must be what a “reasonable person in the client’s position” would want to know to make the decision Nature of the treatment Includes benefits, risks and side effects of treatment Risks must be those that are specific to the particular client, not merely general risks of the treatment Alternative courses of action Consequences of not having the treatment 4. Consent must be specific to treatment to be given Blanket consent signed at beginning of treatment may not be adequate Treatment, as defined by Ontario’s Health Care Consent Act, is “anything that is done for therapeutic, preventative, palliative, diagnostic, cosmetic or other health-related purpose” 5. Opportunity to ask Questions Explain information in lay terms Explain information in language of client’s choice Give client opportunity to ask questions regarding the treatment 6. Consent must be Voluntary Consent must be freely given Cannot be obtained through undue influence or coercion 7. Misrepresentation Professional may NOT slant the information presented to lead the client to any one decision (even if the professional thinks it is in the client’s best interest) Accurate and impartial information on all treatment alternatives must be provided 8. Documentation of Consent Signed consent form is not adequate proof that the consent process was valid Suggested that specific, brief consent notes be created for each client As medical treatment changes, consent needs to reflect changes Documentation of refusal of consent or withdrawal of consent are critical as well Field Consent Is this going to be different? Principle 3: Negligence Defined as the failure to follow a reasonable standard of care. A person could be negligent either by acting wrongly or by failing to act at all. 4 components must be present for a successful negligence lawsuit… Duty of care Breach of duty Cause of harm due to what someone did or failed to do Damage caused Principle 4: Confidentiality An athlete’s personal health information will be kept in your logbook How do you intend to keep this information protected? Use codes, not names Keep logbook in a safe location Sharing Information With whom can you share an athlete’s information? Principle 5: Documentation Your records are legal documents Should you be called to court for any reason, your record will support what you saw, heard, and did at the scene of the emergency Critical to write the record as soon as possible after your actions Correct medical documentation – coming soon Principle 6: Insurance Required as soon as you become certified You have insurance through Sheridan College ONLY while on an approved placement with a signed supporting contract Never agree to coverage without making sure you are adequately covered Reducing Risk Work within your scope of practice Obtain consent Avoid negligence i.e. practice EAP, use common sense, follow procedure, etc. Keep all personal information secure Keep factual and timely records Be sure to always have insurance coverage Summary Lawsuits against Athletic Therapists are unusual but a possibility We are always accountable for our actions