最新Legal AspectsAustin Community CollegeStart Here Get There法律方面的问题奥斯汀社区学院从这里到那里..ppt

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1、Legal Aspects,Application to OB/Pediatrics,允归植弦唬墟市防并悟妈幅闺泼枚变仁舍皇嫉腊霄硝午帅掇剂贪航陌惹抱Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Tort Laws,Tort laws offer remedies to individuals harmed by th

2、e unreasonable actions of others.Tort claims are based on the legal premise that individuals are liable for their actions if they result in injury to others.There are two major categories of torts in medical related cases:intentional tort and negligence tort.,砖炊椅壁擞录只盗绊松裁篮屯窿园取靛糟显映闭珠由更侗奠唾佰损呐播擞Legal As

3、pects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Intentional Torts,Intentional torts are usually offenses committed by a person who attempts or intends to do harm.For intent to exist,the individ

4、ual must be aware that injury will result from the act.The RN has knowledge that the act or omission of an act will cause injury to the plaintiff.This is different from“intent to injure”,which is a criminal matter.The distinction is“intent to act without regard”as opposed to the“intent to injure”.Ex

5、amples of Intentional Torts:Assault:Threatening to harm resulting in fear.Battery:Unlawful,unprivileged touching of another person.Deceit:False statement or deceptive practice done with intent to injure another.False imprisonment:Unlawful restraint of a person,whether in prison or otherwise.Defamati

6、on:Wrongful act of injuring anothers reputation by making false statements.Invasion of privacy:Interference with persons right to privacy.Infliction of emotional distress:Intentionally or recklessly causing emotional or mental suffering to others.,账斗臼仆障姥垒考禾宴彪阂图谤毕谍疑咽蝴蠕冗佣赶袱麓簇根漠奋魔累辽Legal Aspects-Austin

7、 Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Negligence&Malpractice,Negligence and malpractice are used synonymously in litigation.The difference is that“malpractice”is a specific type of negligence.Mal

8、practice implies:a violation of professional duty ora failure to meet the standard of care of other prudent professionals in similar circumstances orfailure to use the skills and knowledge of other professionals in similar circumstances.,救升轩苯勋得预挤楚灭坑硒葬狠掠箭故谊讯敢讽酮袭弓己灼地岔输铂誓丫Legal Aspects-Austin Community

9、 College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Nursing Negligence,The elements of negligence are:(1)duty(2)breach of duty(3)causation(4)injury and damages.Without all four elements there will be no malpractice clai

10、m in a court of law.,邪低队狂销手限甸颅讲朋演喀淡订央质卉拌珠赢刹韵剥羌视鞭硒轿倡拦酸Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Negligence Element 1:Duty,The existence of a duty of care exists because of the cont

11、ractual relationship between the patient and the doctor,the hospital,and other health care providers.When the nurse-patient relationship is established,the nurse has a duty to:Possess the nursing knowledge required of a reasonably competent RN engaged in the same specialty,and Possess the skills req

12、uired of a reasonably competent RN engaged in the same specialty,and Exercise the care in the application of that knowledge and skill to be expected of a reasonably competent RN in the same specialty,and Use the nursing judgment in the exercise of that care required of a reasonably competent RN in t

13、he same medical or health care specialty.Generally,a health care professional does not have a duty to someone who is not a patient.,打锹拘毋吨记馆王杯乞两尉嗣灰笋沮聋偿舆骚批客铰蒜伪不填红椿她阜苯Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get T

14、here法律方面的问题-奥斯汀社区学院-从这里到那里,Negligence Element 2:Breach of Duty,Breach of duty is the failure of the nurse to follow the standards of care found in the hospitals unit policies and procedures,authoritative nursing textbooks,Board of Nursing(BON),and the nursing specialty association guidelines/standar

15、ds.To prove that the RN beached his or her duty expert witnesses and nursing literature are used to show a deviation or breach of the standard of care.It involves showing what a reasonably competent health care professional would have done in a similar situation.,糕止凄懊梦酵栈捉寿涡熄咱袒遮宗壹乍很可胆封隙藐绎悸稼乱漠侠苹团筐Lega

16、l Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Negligence Element 3:Damage,This element relates to the damage that was caused as a result of the breach of duty.This injury must an actual p

17、hysical or mental injury.Even in instances where there is negligence,damage suits will not be successful unless there is provable injury.,嗓篷绷辗箩缉会调扩架礁哑偏学荫疥践鞘耿宣璃店干勋份肄崇哪府槛尿沮Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here

18、 Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Negligence Element 4:Causation,The breach in duty must be the cause of harm to the patient.Causation is the key word.Question:If this act had or had not occurred would the results have been the same?Determination of proximate cause is a factual one.This means that th

19、e evidence must show that the results of misconduct were reasonably foreseeable.Proof of causation requires the testimony of an expert witness.Most jurors are not competent to draw their own conclusions from the evidence without the aid of such expert testimony.,接温斥似涣负搐脯哄叶纵讨恋躬挑轮艘吝氏毕滞炬欧喊詹砷篆冗殉则伦似Legal

20、 Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Successful Malpractice Suit,The recoverable damages are the same as in other personal injury/wrongful death actions caused by the negligence o

21、f another.They include:Actual damages easily measured such as medical expenses and lost wagesCompensatory damages that what makes a person whole.Loss of work,grief,mental anguish,loss of wage earning capacity,loss of consortium(spouse,parent,child)Punitive/Exemplary damages-to punish,gross,negligenc

22、e,and reckless disregard for safety,榆谱扔玛四貉见安咋兑贯钦躁烟瓢蹦消姻殊魄舔迟要津峰掌腊冻病暑烃敢Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,爵兔传母苗心赛遂龙伙观舟羞疫辩隋试裹军桅羔脏娟迁简跨棠诲摘扑吼哥Legal Aspects-Austin Community Colleg

23、e-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Respondeat Superior:,The legal concept of vicarious liability and the doctrine of Respondeat Superior occur when the servant(employee)commits a tort or civil wrong within the

24、 scope of employment and the master(employer)is held liable,although the master may have done nothing wrong.For example,a hospital can be held liable for the negligence of a nurse employed by the hospital,even if the hospital itself has not acted negligently.The doctrine of Respondeat Superior belie

25、ves that employers are better able to compensate injured parties than the employees who work for them.Employers can purchase insurance and spread the risk over the entire business.,钵胎弯镣返日袒海查桨均盎貉焙谰厦炉然灿举瘤葡捂稗延肯磨揩彩洗拾搀Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal

26、Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Medical Liability and Insurance Improvement Act,The state of Texas passed The Medical Liability and Insurance Improvement Act in 1977.This act introduced changes to malpractice lawsuits including pre-suit notification,the us

27、e of expert reports,caps on damage awards and a 2-year statute of limitations.Noneconomic damages were limited to$500,000,plus cost-of-living increases.These increases eventually raised the cap to about$1.3 million.(Noneconomic damages include pain and suffering,physical impairment,disfigurement,los

28、s of consortium or companionship,etc.)The Texas Supreme Court in a 1988 ruling made the cap unconstitutional.The size of awards for noneconomic damages soon shot up,as did insurance premiums.Texas legislated another cap on noneconomic liability awards in 2003.$250,000 for physicians and$500,000 for

29、institutions.Texans approved the amendment by a 51%to 49%margin.Soon after,liability insurers reduced their premiums by as much as 33%.,粮持庶忠梨吞垦叛呐馏占胰蜗港童展燕残墒醉起宠槛驮院嘶筒窄窟媳瘟瞎Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here G

30、et There法律方面的问题-奥斯汀社区学院-从这里到那里,Statute of Limitations,Statute of limitations places a limit on time during which lawsuit can be filed.Medical malpractice lawsuit must be filed within 2 years and 75 days.Exceptions to this are:Fraud:The patient was deliberately misled.Evidence was covered up.The stat

31、ue was abused for physicians benefit.Birth-related injury.In cases of birth-related injury in which parents did not file lawsuit,the injured individual may file suit on his/her own behalf after adulthood is reached.At that time they are subject to same statute of limitations.Consequently,medical rec

32、ords of obstetric patients should not be destroyed until the statute has run out for the child.,型肉粒咬乐哗釜瘩梧掏罗呸往待薯炊差诛护呆累野玉曰气括删携整中贼蕾Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Litigious

33、 Medical Areas:OB&Pedi!,Number of lawsuits filed per specialty:Obstetrics 20%Internal Medicine 18%Family Medicine 16%General Surgery 15%Orthopedic Surgery 14%Pediatrics 4%Obstetrics leads in amount of damages paid by specialty followed by pediatrics.Brain damaged infants are the most expensive.The d

34、amages awarded to pediatric cases are high because they are multiplied over many years and have an emotional component.,搂迸祷棋祁诧蚊误帮冷溃孺半永藏孜负填岩祷酷撵蝴孔珐莽箩飞禄韭康数Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-

35、奥斯汀社区学院-从这里到那里,Good Samaritan Act,Nurses have immunity for damage caused when providing emergency care if:Performed during an emergency unless actions are willful/wanton negligent(therefore only covers ordinary negligence);andPerformed without charge/remuneration or with expectation of remuneration.

36、Does not apply to persons who regularly administer emergency care in a hospital emergency room or to admitting physician in case of a health care liability claims.Unlicensed emergency medical service personnel are not liable for emergency care regardless of remuneration unless care is grossly neglig

37、ent.State law and your level of training determine whether youre legally protected when using your nursing skills in an emergency.Texas Good Samaritan Act(Article 6701d,Vernons Civil Statutes;Chapter 74,Civil Practice and Remedies Code Section 74.001),言认竖毕坍戒撵忙谰谍戴币澈驹蛾影币帚紧苑炳揪酵赞辖乍侧银茅琅切槛Legal Aspects-Au

38、stin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Rights of OB/Pedi PatientsConfidentiality,Minors are considered emancipated for the purposes of consenting to medical treatment if he or she is married,h

39、as obtained court emancipation,served in the armed forces,or is a parent.Adolescents in the labor&delivery area make all decisions for themselves and their infant.Legal exceptions to confidentiality include suspected child abuse and the requirement to report certain kinds of sexually transmitted dis

40、eases.Third party access to the minors personal health is usually controlled by the parents,making confidentiality between the health care provider and the minor difficult.Virtually every state permits a minor to seek treatment for sexually transmitted diseases without parental consent.Any minor,reg

41、ardless of age,can receive confidential care and treatment related to family planning at a federally funded family planning clinic without parental consent.http:/www.cdc.gov/std/stats07/trends.htmhttp:/www.acog.org/from_home/publications/ethics/co390.pdf,翰她谊桃旷斋佩焚解悟秧陈剩腹乱视仕帛哮孝侨税丸块皂滨翁呈沉筋撬豺Legal Aspects

42、-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Rights of OB/Pedi PatientsRefusal of Treatment,Patients can refuse care at any timeRefusal is documented in chart and patient signs AMA form.The wellb

43、eing of the fetus can become the object of court order.When parents refuse life-saving care for their children the court may be petitioned by the healthcare providers.,呵联剩星渔喝调弱墒巨苗洗聚彩三廉卷跃蓟丑棕阿忿槐躺翻城鞠啥庭帜婿Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austi

44、n Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Rights of OB/Pedi PatientsInformed Consent,Without informed consent assault and battery charges can resultDissent in ages 13-17 can be legally bindingEmergency treatment can be given to children without the parents consentElements of inf

45、ormed consent:CompetenceFull disclosure:purpose,risks,benefits,other treatment options.Understanding of informationVoluntary consent,棘怖熬锹酵黍丸颁襟捅辖柄寥拴匹咱歇抬躯非翌宪蜗腕浮台绍础搏幼晌屑Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get

46、There法律方面的问题-奥斯汀社区学院-从这里到那里,Rights of OB/Pedi PatientsRight to Live or Die,The right to die is related to a persons wish that caregivers allow death.For example,by not providing life support or vital medication.Living Wills and Do Not Resuscitate orders are legal instruments that make a patients tre

47、atment decisions known ahead of time.This is not considered to be euthanasia.Usually these patients make it their wish to receive only palliative care to reduce pain and suffering.Medical Durable Power of Attorney(or MDPOA)designates an agent to make decisions in case of incapacity.It is a most powe

48、rful instrument that does not require interpretation on the part of health care providers or even court-appointed guardians.The MDPOA takes the job of interpretation out of the hands of strangers and gives it to a person selected and trusted by the individual.Pedi:“Wrongful Birth”suits based on fail

49、ure to detect severe abnormalities and“Wrongful Life”suits based on resuscitation of micro-premies.,牛厕冰德叹见娜幅熟釉斤妆奏疤迟厦靶冲联押衣靠集棉赠燥裙帚斌世锗华Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里Legal Aspects-Austin Community College-Start Here Get There法律方面的问题-奥斯汀社区学院-从这里到那里,Right

50、s of OB/Pedi PatientsPediatric Patients Bill of Rights,To ensure that all aspects of childrens healthy care are family-centered,psychosocially sound,and developmentally appropriate.Health care systems and practices are most effective when they are planned,coordinated,delivered,and evaluated through