1. Nurses in critical care units face many ethical issues, such as obtaining informed consent from critically ill patients, using physical restraints, and determining how long to continue life support. 2. It is important for nurses to consider ethical principles like accountability, reasonability, and justice when providing care. 3. Legally, nurses must avoid intentional torts like assault or battery, and unintentional torts such as negligence, which could include abandonment of a patient or malpractice.

1. ETHICALAND LEGAL
ASPECTS IN CRITICAL
CARE UNIT
MS DRASHTI PATEL
NURSING TUTOR

2. INTRODUCTION
• Ethics explains what is expected from nurses working in ICU. Ethics play
significant role in health care delivery system.
• Nurses at every level experience different ethical issues during their work
life such as:

3. • 1. Patient admitted in CCU is critically ill and are at life threatening
conditions. nurse should convey correct information regarding patient's
heal, condition to their family members.
• 2. Taking informed consent creates ethical problem because patient is
very sick.
• This covers the principal of autonomy.
• Informed consent ensures patient's permission to do diagnostic to
therapeutic procedure.

4. • 3. Nurses need to use critical thinking skill while dealing with medico-legal
cases in CCU.
• For example, road traffic accident, suicide attempt, burn, etc. fall under
medico-legal case.
• 4. Updated and complete nursing documentation is very important.
• 5. A record must be correct, clear, comprehensive, concise and chronological.

5. • 6. Protecting patient's rights and human dignity is very important.
• 7. Use of physical and chemical restrains restricts patient's movements,
thus affect patient's autonomy. So, nurses should use restrains only when
all other alternative interventions are failed.
• 8. Use of advance life support is again ethical dilemma How long it
should be used and what about patient's DNR (do not resuscitate) orders.

6. • 9. At the end of life, communicate frequently with family instead of
conveying bad news suddenly.
• 10. Provide consistent and honest information.
• 11. Although, staffing norm in ICU is 1:1.
• But due to shortage of nurses and equipments in critical care unit,
sometimes patient's nursing care may be neglected.

7. ETHICS AND LEGALASPECTS
• Ethics in ICU
• Definition of ethics
• It is refers to the study of philosophical ideas of right and wrong behavior
• Ethical principles that nurse should must consider when providing care of patient in
ICU are following principles
• Accountability:
• It refers to the ability to answer for one's own action
• Reasonability:
• It refers to the specific accountability or liability associated with the performance of
duties of particular role.

9. • Justices:
• Is often referred to as fairness
• Fidelity:
• Means to be faithful to agreements and promises

10. LEGALASPECTS
• The area of civil law is divided into many categories, two of which
contracts and torts
• The law of contracts contains a set of rules governing the creations and
enforcement of an agreement between two or more parties

11. Intentional torts
• Assault
• Battery
• False imprisonment
• Trespass
• Infliction of
emotional distress

12. Specific torts
• Defamation
Slander
Libel
• Invasion of privacy

13. Unintentional torts
• Negligence
• Medical / nursing treatment torts
• Professional malpractice
• Abandonment

14. Strict liability
• Products liability

15. Intentional torts
• It is an purposely act on patient
• Assault:
• It is the act is a behaviour the place the plaintiff (the one being wronged who
later sues) in fear or apprehension offensive physical contact
• Battery:
• It is the unlawful or offensive touching to the plaintiff
• False imprisonment:
• It is detaining, confining or restraining another against his or her will

16. • Trespass:
• One type involves persons land and the other involves his or her personal
property, handling the another person property
• Infliction of emotional distress:
• It is one of extreme misconduct or outrageous behaviour

17. •Specific torts
• Defamation:
• It is composed of two torts - slander, (oral defamation) and libel (written
defamation).
• Defamation is not mere statement or writing of words that injuries one's
reputation or good name; the words must be communicated to another
• Invasion of privacy:
• It involves the violation of person rights to privacy nurses can invade
another's privacy by revealing confidential information without authorization
or by failing to follow the patient health decision

18. Unintentional torts
• Negligence:
• It is failure to meet an ordinary standard of care, resulting in injury to the
patient or plaintiff.
• Malpractice:
• It is type of professional liability based on negligence and includes
professional misconduct, breach of a duty or standard of care, illegal or
immoral conduct, or failure to exercise reasonable skills, all of which
lead to harm

19. • Abandonment:
• It is a type of negligence in which duty to give care exists, is ignored,
and results in harm to a patient.
• It is the absence of care and the failure to respond to a patient that may
give rise to an allegation of abandonment