Legal and Ethical Issues for Health Professionals

Cover
Title Page
Copyright Page
Dedication
Epigraph
Brief Contents
Contents
Foreword
Preface
Acknowledgments
Chapter 1 Introduction to Ethics
Learning Objectives
Introduction
Ethics
Why Study Ethics
Morality
Code of Conduct
Moral Judgments
Morality Legislated
Moral Dilemmas
Ethical Theories
Meta-Ethics
Normative Ethics
Descriptive Ethics
Applied Ethics
Consequential Ethics
Utilitarian Ethics
Deontological Ethics
Nonconsequential Ethics
Ethical Relativism
Principles of Ethics
Autonomy
Beneficence
Nonmaleficence
Justice
Virtue Ethics and Values
Courage as a Virtue
Wisdom as a Virtue
Temperance as a Virtue
Commitment
Compassion and Empathy
Conscientiousness
Discernment
Fairness
Fidelity
Freedom
Honesty/Trustworthiness/Truth Telling
Integrity
Kindness
Respect
Hopefulness
Tolerance
Cooperation and Teamwork
Forgiveness
Religious Ethics
Judaism
Hinduism
Buddhism
Taoism
Christianity
Islam
Religious Beliefs and Duty Conflict
Secular Ethics
Atheism
Situational Ethics
Reasoning and the Decision-Making Process
Absence of a Moral Compass
Creating a Culture of Ethics
Summary Thoughts
Chapter 2 Contemporary Ethical Dilemmas
Learning Objectives
Introduction
Noteworthy Historical Events
68,000–58,000 BC
AD 1932–1972
1933–1945
1946
1949
1954
1960s
1964
1968
1970
1971
1972
1973
1974
1976
1978
1980
1983
1987
1990
1993
1994
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2009
2010
2013
2017
2018
Abortion
Right to Abortion
Abortion Restrictions
Undue Burden Rule
Funding
Refusal to Fund Abortion Counseling Not Unconstitutional
Spousal Consent
Parental Consent
Informed Consent
States May Protect Fetus
State Abortion Statutes
Law and Morality of Abortion—Conflicting Beliefs
Sterilization
Elective Sterilization
Therapeutic Sterilization
Eugenic Sterilization
Wrongful Birth, Life, and Conception
Wrongful Birth
Wrongful Life
Wrongful Conception
Artificial Insemination
Consent
Confidentiality
Surrogacy
Organ Donations
Who Lives? Who Dies? Who Decides?
Uniform Anatomical Gift Act
Failure to Obtain Consent
Altruism vs. Sale of Organs
Research, Experimentation, and Clinical Trials
Right to Try Experimental Drugs
Office of Research Integrity
Food and Drug Administration
Institutional Review Board
Informed Consent
Experimental Subject’s Bill of Rights
Patient Responsibilities
The Cures Act
Human Genetics
Genetic Markers
Genetic Information Nondiscrimination Act of 2008 (HR493)
Stem Cell Research
Acquired Immune Deficiency Syndrome
Spread of AIDS
Confidentiality
The Right to Treatment
AIDS Education
Chapter 3 End-of-Life Dilemmas
Learning Objectives
Introduction
Where Do Americans Die?
Euthanasia
Active or Passive Euthanasia
Voluntary or Involuntary Euthanasia
Right to Self-Determination
Defining Death
Legislative Response
Assisted Suicide
Physician-Assisted Suicide
Assisted Suicide Versus Refusal or Withdrawal of Treatment
Oregon’s Death with Dignity Act (1994)
Patient Self-Determination Act of 1990
Advance Directives
Living Will
Right to Die Without a Living Will
Durable Power of At torney
Surrogate Decision Making
Futility of Treatment
Withholding and Withdrawal of Treatment
Patient Not in a Persistent Vegetative State
Removal of Life-Support Equipment
Feeding Tubes
Do-Not-Resuscitate Orders
Competent Patients Make Their Own Decisions
A New Beginning and a Better Ending
Chapter 4 Healthcare Ethics Committee
Learning Objectives
Introduction
Committee Structure
Committee Goals
Committee Functions
Policy and Procedure Development
Expanding Role of the Ethics Committee
Internal Ethical Issues
External Ethical Issues
Resolution of Ethical Dilemmas
Making Better Decisions
Chapter 5 Development of Law
Learning Objectives
Introduction
Public Law
Private Law
Sources of Law
Common Law
Statutory Law
Administrative Law
U.S. Government Organization
Separation of Powers
Conflict of Laws
Legislative Branch
Judicial Branch
Executive Branch
Department of Health and Human Services
Administration on Aging
Centers for Medicare and Medicaid Services
Public Health Service
Chapter 6 Introduction to Law
Learning Objectives
Introduction
Tort Law
Negligence
Intentional Torts
Assault and Battery
False Imprisonment
Defamation of Character
Invasion of Privacy
Infliction of Mental Distress
Criminal Law
Criminal Procedure
Healthcare Fraud
Manslaughter
Murder
Theft
Contracts
Elements of a Contract
Employment Contracts
Exclusive Contracts
Trial Procedure and the Courtroom
Pleadings
Discovery
Preparation of Witnesses
The Court
The Jury
Subpoenas
Opening Statements
Burden of Proof
Evidence
Examination of Witnesses
Defense of One’s Actions
Closing Statements
Judge’s Charge to the Jury
Jury Deliberation
Damages
Appeals
Chapter 7 Government Ethics and the Law
Learning Objectives
Introduction
U.S. Office of Government Ethics
House of Representatives Committee On Ethics
Senate Select Committee On Ethics
Office of Congressional Ethics
U.S. Judicial Code of Conduct
State Ethics Committees
Public Policy
Veterans Administration
Fourteenth Amendment to the Constitution
Title VI: Civil Rights Act
Sherman Antitrust Act
Privacy Act
Health Insurance Portability and Accountability Act (HIPAA)
Emergency Medical Treatment and Active Labor Act (EMTALA)
Health Care Quality Improvement Act
Agency for Healthcare Research and Quality
Ethics in Patient Referral Act
Patient Self-Determination Act
Sarbanes-Oxley Act
Patient Protection and Affordable Care Act (2010)
Political Malpractice
Oath of Office
Ethics in Public Service
Chapter 8 Organizational Ethics and the Law
Learning Objectives
Introduction
Corporate Authority
Fiduciary Responsibility
Express Corporate Authority
Implied Corporate Authority
Ultra Vires Acts
Corporate Ethics
Code of Ethics for Organizations
Corporate Compliance Program
Unprofessional Conduct
Trust and Integrity
False Advertising
Concealing Mistakes
Corporate Negligence
Doctrine of Respondeat Superior
Independent Contractor
Corporate Duties and Responsibilities
Appointment of a CEO
CEO Licensure
CEO Responsibilities and Challenges
CEO Code of Ethics
Screen Job Applicants
Credentialing, Appointment, Privileging, and Discipline
Ensure Competency
Discipline of Physicians
Provide Adequate Staff
Provide Adequate Supplies and Equipment
Allocate Scarce Resources
Provide Quality Patient Care
Comply with Rules and Regulations
Provide Timely Treatment
Avoid Conflicts of Interest
Provide a Safe Environment
Prevention of Falls
Protect Patients and Staff from Sexual Harassment and Assault
Decisions that Collide with Professional Ethics
A Life Needlessly Shortened
Financial Incentive Schemes
Restoring Trust
Effective Communication Builds Trust
Improving Organizational Performance and Ethics
Board Education
Policies and Procedures
Search for Best Practices
Reduce Variation
Assure Continuity of Care
Partner with the Community
Develop a Culture of Compassion and Kindness
Chapter 9 Healthcare Professional Legal-Ethical Issues
Learning Objectives
Introduction
Paramedics and First Responders
Emergency Medical Responder
Emergency Medical Technician
Advanced Emergency Medical Technician
Paramedic
Nurses: Ethics and Legal Issues
Registered Nurse
Advanced Practice Nurse
Nurse Practitioner
Clinical Nurse Specialist
Nurse Anesthetist
Nurse Midwife
Special Duty Nurse
Float Nurse
Agency Personnel
Nursing Assistants
Student Nurses
Negligent Acts in Nursing
Chiropractor
Dentistry
Dental Hygienist
Dietary
Incidence and Recognition of Malnutrition
Emergency Department
Timely Response May Require a Phone Call
Laboratory
Ethics and Inaccurate Lab Results
Refusal to Perform HIV Testing
Medical Assistant
Medical Records
Pharmacy
Dispensing and Administration of Drugs
Drug Substitution
Expanding Role of the Pharmacist
Duty to Monitor Patient’s Medications
Warning Patients About Potential for Overdose
Refusal to Honor a Questionable Prescription
Reducing Medication Errors
Physical Therapy
Incorrectly Interpreting Physician’s Orders
Resident Neglect
Physician Assistant
Psychology
Failure to Minimize Harm: Unethical Conduct
Sexual Harassment
Reporting Child Abuse
Radiology
Failure to Restrain Causes Patient Fall
Respiratory Care
Social Work
Certification of Healthcare Professionals
Licensing of Healthcare Professionals
Suspension and Revocation of License
Helpful Advice for Caregivers
Chapter 10 Physicians’ Ethical and Legal Issues
Learning Objectives
Introduction
The Hippocratic Oath
Code of Medical Ethics
Law and Ethics Intertwine
Morally Wrong, Legally Actionable
Hippocratic Oath and AMA Code of Ethics Violated
Principles of Medical Ethics
Compassionate Care
Responsibility to the Patient Is Paramount
Trust
Failure to Refer for Consultation
Falsification of Records
Justice
Respect for Privacy
Negligence
Patient Assessments and Diagnosis
Patient Diagnosis
Patient Treatment
Discharge and Follow-Up Care
Untimely Discharge
Failure to Provide Follow-Up Care
Failure to Follow-Up on Test Results
Physician–Patient Relationship
Personalized Treatment Versus Assembly-Line Medicine
Treat Caregivers with Respect
Chapter 11 Employee Rights and Responsibilities
Learning Objectives
Introduction
Employee Rights
Fair Treatment and Employment at Will
Refuse to Participate in Patient Care
Question Patient Care
Suggest Changing Physician
Freedom from Disruptive Behavior
Sexual Harassment
Treatment with Dignity and Respect
Freedom from Intimidation
Privacy and Confidentiality
Family Medical Leave
Whistleblowing
Safe Environment
Unemployment Compensation
Employee Responsibilities
Know Your Patient
Educate and Encourage Patients to Ask Questions
Be Compassionate
Comply with State and Federal Regulations
Comply with Hospital Policy
Comply with Assigned Duties
Honor and Respect Patient Rights
Maintain Confidentiality
Adhere to Safe Practices
Admit to Mistakes
Adhere to Professional Standards
Maintain Professional Relationships
Sexual Harassment
Report Unethical Behavior
Protect Patients from Harm
Report Patient Abuse
Stand as a Patient Advocate
Maintain Professional Competence
Encourage Teamwork
Helpful Advice
The Caregiver’s Pledge
Chapter 12 Patient Consent
Learning Objectives
Introduction
Informed Consent
Codes of Ethics
Proof of Consent
Statutory Consent
Capacity to Consent
Adequacy of Consent
Competent Patient
Spouse
Parental Consent
Consent by Minors
Incompetent Patients
Guardian
Right to Refuse Treatment
Refusal of Care Based on Religious Beliefs
Chapter 13 Patient Abuse
Learning Objectives
Introduction
Child Abuse
Reporting Abuse
Detecting Abuse
Good-Faith Reporting
Immunity and Good-Faith Reporting
Senior Abuse
Reporting Senior Abuse
Signs of Abuse
Intimidation of Abusive Resident/Disciplinary Overkill
Abusers Abused
Prevention of Senior Abuse
Look Closer, See Me
Chapter 14 Patient Rights and Responsibilities
Learning Objectives
Introduction
Patient Rights
Right to Know One’s Rights
Right to Explanation of One’s Rights
Right to Exercise Rights
Right to Ask Questions
Right to Complain
Right to Emergency Care
Right to Admission
Right to Examination and Treatment
Right to Know Caregivers
Right to Informed Consent
Right to Refuse Treatment
Right to Execute Advance Directives
Right to Have Special Needs Addressed
Right to Choose Physician(s)
Right to Trust Caregivers
Right to Patient Advocacy Services
Right to Have Spiritual Needs Assessed and Addressed
Right to Ethics Consultation
Right to Choose Treatment
Right to Try Experimental Drugs
Right to Timely Response to Care Needs
Right to Receive Quality Care
Right to Compassionate Care
Right to Respect
Right to Pain Management
Privacy and Confidentiality
Right to Freedom from Abuse and Harassment
Right to Know Hospital’s Adverse Events
Right to Discharge
Right to Transfer
Right to Access Medical Records
Right to Access Lab Reports
Right to Know Third-Party Care Relationships
Right to Know Hospital Charges
Right to Know Medical Errors
Right to a Safe Healing Environment
Right to be Free from Restraints and Seclusion
Which Right is the Greater Good?
Patient Responsibilities
Maintain a Healthy Lifestyle
Keep Appointments
Maintain Current Medication Records
Accurately Describe Symptoms
Provide Full and Honest Disclosure of Medical History
Report Sudden Changes in Health Status
Adhere to the Treatment Plan
When in Doubt, Seek a Second Opinion
Stay Informed
Ask Questions
Follow Discharge Instructions
Treat Caregivers with Respect
Respect the Rights of Other Patients
Show Compassion for Caregivers
Advisory Commission Describes Patient Responsibilities
Teamwork and Professional Relationships
Chapter 15 Summary Case: Search for Truth
Learning Objectives
Introduction
Case: Code of Silence
Characters
Settings
Background
Events of Sunday, October 2
Events of Thursday Morning, October 6
Events of Thursday Luncheon, October 6
Events of Thursday Late Afternoon, October 6
Events of Thursday Evening, October 6
Events of December 27–29 Educational Conference
Glossary
Index