prominent legal issues encountered in nursing practice

1. Nursing Ethics &
Legal Aspects in Nursing
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2. Few facts to ponder on..
 Medication errors harm an estimated 1.5 million people
every year
 In India- 52 lakh medical injuries & 98,000 people lose their
lives due to medical negligence every year
 According to Johns Hopkins Hospital, medical malpractice
ranks as the third leading cause of death – behind heart
disease and cancer.
 Medical malpractice causes more than 250,000 every year.
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3. “Human rights are not a privilege conferred by government.
They are every human being’s entitlement by virtue of his
humanity”
……..Mother Teresa
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4. Objectives
 Nursing Ethics
 Definition of law
 Importance of law in nursing
 Liability in Nursing
 Principles of liability
 Torts
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5. Nursing Ethics
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 Ethics:branch of philosophy dealing with values pertaining to
human conduct, considering the rightness and wrongness of
actions and the goodness or badness of the motives of such
actions
 Nursingethics is system of principles governing the conduct of
a nurse. It deals with the relationship of a nurse to the patient,
thepatient's family, associates and fellow nurses, and society at
large.

6. Principles of ethical practice in nursing
NON
MALEFICENC
E
BENEFICENC
E
RESPECT
FOR
AUTONOMY
JUSTICE
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7. Contd….
Veracity Fidelity
Confidentiali
ty
Accountabili
ty
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8. Definition of Law
 It is the sum total of rules & regulations
by which society is governed.
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9. Importance of law in Nursing
 Nurses are expected to function within the legislation, legal
policies, statutes relevant to the profession and practice
setting, and professional standards.
 Law protects patients against deliberate & inadvertent
injury by a nurse
 Law protects the nurses against the suits if she renders
right care.
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10.  Laws provides framework for which nursing actions in client
care are legal
 Laws assist in maintaining standard of nursing practice
by making nurse accountable for their actions
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12. Meaning of Liability
 Liability is anything that is a hindrance & puts an individual
at a disadvantage
 Legal liability is a situation in which a person is liable, &
therefore responsible to pay compensation for any damage
incurred.
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13. Areas of Legal Liability in Nursing
 Informed consent
 Confidentiality
 Refusal of treatment
 Medication administration
 Restraints
 Abusive situations
 Delegation to unlicensed
assistive personnel
 Clients with AIDS & HIV
testing
 Organ & tissue donation &
transplantation
 DAMA
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14. Informed Consent- Nurses’ Role
 Client gives consent voluntarily
 Signature is authentic
 Client appears competent to give consent
 Remind client they have the right to refuse after signature
on form continues after signing consent
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15. Confidentiality
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Disclosure permitted:
 consent by patient
 information necessary for other caregivers to care for
patient;
 if statutes require disclosure (child abuse reporting law)
 if common law exists to protect public interest (safety of
blood supply)
 If duty to warn an identifiable victim in great danger
 If court proceedings require disclosure

16. Legal liabilities in Nursing:Torts
Unintentional
Torts
Negligence
Malpractice
Intentional
Torts
Assault &
Battery
False
Imprisonme
nt
Restraints
Quasi-intentional
Torts
Defamation
Slander &
Libel
Fraud
Invasion of
Privacy
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17. Legal liabilities in Nursing: Torts
 Tort is a civil wrong which produces harm, intentional or
unintentional
 Types: Un-intentional torts; Intentional torts; Quasi
intentional torts
 Quasi intentional torts are voluntary act that causes injury
or distress without intent to injure or cause distress,
situations of communication & often violates a person’s
reputation, personal privacy or civil rights.
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18. 1. Negligence
 Negligence is a conduct that is culpable as it falls short of
what a reasonable person would do to protect another
individual from foreseeable risks of harm.
 Elements :
- The nurse owed a 'duty of care' to the patient, or was
obligated to care for the patient
- The nurse 'breached' that duty of care, or failed to
properly care for the patient
- The breach resulted in 'measurable damage', injury or
harm to the patient
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19.  Common acts of negligence in nursing: burns, falls,
medication errors, failure to observe, use of defective
equipment, loss of patient’s property, patient mix up etc.
 Section 304A of the Indian Penal Code of 1860 states that
whoever causes the death of a person by a rash or
negligent act not amounting to culpable homicide shall be
punished with imprisonment for a term of two years, or
with a fine, or with both
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20. 2. Malpractice
 Medical malpractice is an act or omission by a health care
provider which deviates from accepted standards of
practice in the medical community and which causes injury
to the patient.
 Eg:
Leaving foreign objects inside the body during surgery,
failing to assess or observe the patient as directed, failing
to report change in patient’s condition, failing to select
correct site for injection, failing to obtain proper informed
consent etc.
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21. 3. Assault & Battery
 Assault is a crime of violence against another person, also
includes physical contact with another person without their
consent.
 Battery is an unjustified harmful or offensive touching of
another.
 Battery differs from assault in that it does not require the
victim to be in apprehension of harm.
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22. 4. False Imprisonment
 It is a type of tort wherein a person is
intentionally confined without legal
authority.
 Elements: intent, actual confinement in
boundaries, absence of reasonable
means of escape & absence of legal
authority on the part of person acting to
confine the other.
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23. 5. Restraints
 Physical, chemical or environmental measures used to
control the physical or behavioral activity of a person or a
portion
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24. 6. Defamation
 It is the issuance of a false statement about another
person, which causes that person to suffer harm.
 Also called slander, libel & vilification
 Statements may harm reputation of an individual, business,
product, group, government or nation
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25. Defamation per se…
 Allegations that an unmarried person is unchaste
 Attacks on person’s professional character or standing
 Allegations that a person is infected with STDs
 Allegations that a person has committed a crime of moral
aptitude.
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26. 7. Slander & Libel
 It refers to the spoken communication in which one person
discusses another in terms that harm a third person’s
reputation.
 Libel refers to making of defamatory statements in printed
medium.
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27. 8. Fraud
 Fraud is a crime or offense of deliberately deceiving
another in order to damage another-to obtain property or
services, & is also a civil law violation.
 Civil fraud involves act of intentionally making a false
representation of a material fact, with the intent to deceive,
which is reasonably relied upon by another person to that
person’s detriment.
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28. 9. Invasion of Privacy
 Privacy is the ability of an individual to remain unnoticed
about themselves or information about themselves.
 Invasion of privacy is the intrusion into the personal life of
another, without a just cause, which can give the person
whose privacy has been invaded a right to bring a lawsuit
for damages against the person or entity that intruded.
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29.  Types of invasion
- Intrusion of solitude (spying, opening mails)
- Public disclosure
- False light (false statements about a person)
- Appropriation of name or likeness
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30. References
1. Westrick S J. Essentials of Nursing Law & Ethics. 2nd Ed.
2014; Jones & Bartlett Learning, LLC: ISBN: 978-1-284-
03020-4
2. Griffith R & Tengnah C. Law & Professional Issues in Nursing.
4th ed. 2014; Sage Publications India Pvt. Ltd. ISBN: 978-1-
4739-6942-1
3. Deepak K, Sarath C & Mithun BP. A comprehensive textbook
on Nursing Management. 1st ed, 2nd reprint, 2015.
4. Lucita M. Nursing: Practice & Public Health Administration. 2nd
ed. 2007.Elsevier, New Delhi.
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31. Give to every human being every right that you claim for
yourself”
….Robert Ingersoll
THANK YOU…..
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