Legal and Ethical Issues for Health Professionals is an important and practical guide to aide in the resolution of ethical dilemmas with legal implications. This comprehensive reference provides both the student and practicing health care professional with an overview of the ethical and legal issues that face healthcare providers today. The reader will better understand ethical dilemmas and learn how to evaluate and distinguish between the rightness and wrongness of alternative courses of action when faced with complicated problems to solve. From the Preface: Legal and Ethical Issues for Health Professionals is a comprehensive reference to the questions of right and wrong for the student and practicing health professional. This text will provide the reader with a strong foundation to build upon to help in the understanding of ethical dilemmas. The reader will learn how to evaluate and determine the rightness or wrongness of alternative courses of action when things are just not always what they seem. Ethics in the health care setting is about doing the right thing. It involves recognizing ethical dilemmas and appropriately addressing them. The purpose of this text is to provide both the student and practicing health care professional with an overview of the ethical and legal issues that face healthcare providers. The text: presents ethical and legal concepts in an easily understood format; reviews the basic principles of ethics and the law; provides insight into how ethics and the law are intertwined; provides an understanding as to how both ethics and the law permeate every aspect of the decision-making process in the health care setting; presents case studies to illustrate real life issues; guides students and caregivers to resources to help them practice more effectively within the boundaries of ethical principles and applicable laws; explores the use of ethics and the law to assist caregivers in resolving ethical conflicts and dilemmas; and, reviews an organization's boundaries as to what is acceptable and unacceptable behavior. This book starts with the premise that to act in an ethical manner, means to engage in conduct according to the acceptable principles of right and wrong. The author's objective is to provide the reader with the background knowledge necessary to understand that ethics is a manner of using integrity based decisions in order to determine what actions need to be taken when faced with common health care dilemmas.

Preface

ix

SECTION I ETHICS

1

(128)

Introduction to Ethics

3

(32)

Introduction

4

(1)

Ethics

4

(5)

Ethical Theories

9

(4)

Code of Hammurabi

13

(1)

Principles of Health Care Ethics

14

(6)

Morality

20

(1)

Virtues and Moral Values

21

(7)

Situational Ethics

28

(1)

The Final Analysis

29

(6)

Contemporary Ethical Dilemmas

35

(38)

Introduction

36

(1)

Abortion

36

(9)

Acquired Immune Deficiency Syndrome

45

(7)

Artificial Insemination

52

(1)

Organ Donations

53

(3)

Research, Experimentation, and Clinical Trials

56

(5)

Sterilization

61

(1)

Wrongful Birth, Wrongful Life, and Wrongful Conception

62

(11)

Health Care Ethics Committee

73

(16)

Introduction

74

(1)

Committee Structure

74

(1)

Goals of the Ethics Committee

74

(1)

Committee Functions

75

(3)

Ethics Consultation

78

(2)

Expanding Role of Ethics Committees

80

(2)

Convening the Ethics Committee

82

(1)

Reasoning and Decision Making

83

(3)

Helpful Hints

86

(3)

End-of-Life Dilemmas

89

(40)

Introduction

90

(1)

Self-Determination: Significant Events

90

(2)

Euthanasia

92

(9)

Physician-Assisted Suicide

101

(3)

Oregon's Death with Dignity Act---1994

104

(1)

Patient Self-Determination Act---1990

105

(1)

Advance Directives

105

(5)

Appointed Decision Makers

110

(4)

Futility of Treatment

114

(2)

Withdrawal of Treatment

116

(13)

SECTION II LAW

129

(90)

Development of Law

131

(16)

Introduction

132

(1)

Sources of Law

133

(4)

Government Organization

137

(4)

Administrative Departments and Agencies

141

(6)

Introduction to Law

147

(34)

Introduction

148

(1)

Tort Law

148

(1)

Negligence

148

(7)

Intentional Torts

155

(2)

Infliction of Mental Distress

157

(2)

Criminal Law

159

(4)

Contracts

163

(3)

Trial Procedures and the Courtroom

166

(15)

Government, Ethics, and the Law

181

(14)

Introduction

182

(1)

XIV Amendment to the U.S. Constitution---1868

182

(1)

Public Policy as a Principle of Law

183

(1)

Civil Rights Act---1964

183

(1)

Sherman Antitrust Act---1890

183

(1)

Privacy Act---1974

184

(1)

Emergency Medical Treatment and Active Labor Act---1986

185

(1)

Health Care Quality Improvement Act---1986

186

(2)

Agency for Healthcare Research and Quality

188

(1)

Ethics in Patient Referral Act---1989

188

(1)

Patient Self-Determination Act---1990

188

(1)

Health Insurance Portability and Accountability Act---1996

189

(1)

Political Malpractice

189

(6)

Organizational Ethics and the Law

195

(24)

Introduction

196

(1)

Organizational Conduct under Scrutiny

196

(2)

Organizational Structure

198

(1)

Doctrine of Respondeat Superior

199

(1)

Corporate Negligence

200

(2)

Corporate Duties and Responsibilities

202

(12)

Building and Restoring Trust

214

(5)

SECTION III HEALTH CARE PROFESSIONALS

219

(84)

Health Care Professionals' Ethical and Legal Issues

221

(48)

Introduction

222

(1)

Chiropractor

222

(2)

Dentistry

224

(2)

Dental Hygienist

226

(1)

Dental Assistant

227

(1)

Dietitians and Nutritional Care

228

(1)

Emergency Department

229

(3)

Emergency Medical Technician

232

(2)

Laboratory Technician

234

(2)

Medical Assistant

236

(4)

Medical Records

240

(1)

Nursing

241

(8)

Pharmacist

249

(4)

Physical Therapist

253

(2)

Physician Assistant

255

(1)

Psychologist

256

(3)

Respiratory Therapist

259

(2)

X-Ray Technician

261

(2)

Certification of Health Care Professionals

263

(1)

Licensing Health Care Professionals

263

(1)

Helpful Advice for Caregivers

264

(5)

Physicians' Ethical and Legal Issues

269

(20)

Introduction

270

(1)

Principles of Medical Ethics

270

(2)

Credentialing Professionals

272

(1)

Hospital's Duty to Ensure Competency

273

(1)

Physician Supervision and Monitoring

273

(2)

Honoring a Patient's Right to Autonomy

275

(1)

Abandonment

275

(2)

Aggravation of a Preexisting Condition

277

(1)

Alternative Procedures: Two Schools of Thought

278

(1)

Confidential Communications

278

(1)

Falsification of Records

279

(1)

Failure to Respond: Emergency Department Call

280

(1)

Failure to Provide Informed Consent

280

(1)

Failure to Read Nurses' Notes

280

(2)

Failure to Seek Consultation

282

(1)

Failure to Obtain Adequate History and Physical

282

(2)

Infection Control Issues

284

(1)

Medications

284

(1)

Misdiagnosis

284

(1)

Obstetrics and Gynecology

285

(1)

Physician--Patient Relationship

285

(4)

Employee Rights and Responsibilities

289

(14)

Introduction

290

(1)

Employee Rights

290

(6)

Employee Responsibilities

296

(1)

Responsibility to Be a Patient Advocate

296

(7)

SECTION IV THE PATIENT

303

(50)

Patient Consent

305

(20)

Introduction

306

(1)

Informed Consent

306

(2)

Consent and Ethical Codes

308

(1)

Assessing Decision-Making Capacity

308

(1)

Adequacy of Consent

309

(1)

Proof of Consent

310

(1)

Who May Authorize Consent?

311

(4)

Implied Consent

315

(1)

Right to Refuse Treatment

316

(6)

Statutory Consent

322

(3)

Patient Abuse

325

(14)

Introduction

326

(1)

Elder Abuse

326

(7)

Child Abuse

333

(6)

Patient Rights and Responsibilities

339

(14)

Introduction

340

(1)

Patient Rights

340

(8)

Patient Responsibilities

348

(5)

Glossary

353

(10)

Index

363

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