Introduction
Ethics
Outlined by Faculty - Egan's Chapter # 5
Ethics and law help to maintain order in society.
Law sets minimal standards for healthcare practice.
I. Ethical Dilemmas of Practice
A. Codes of Ethics –.
Code
Law a. Ethics is NOT a matter of opinion, or anything one did would
be ethical (right)
1. Moral
1) The Ten Commandments.
2) Ethics are reflections of what is moral. a) Virtue. b) Courage is the highest virtue
“There is a big difference in knowing what is
ethical and doing what is ethical.”
B. Ethical Theories and Principles
Also called Moral principles a . Autonomy –
1. Informed Consent – we must ask consent from patients to give care.
1) We must disclose information necessary for decision
making and be supportive of the decision.
2) As an RCP we have the duty not to deceive or coerce. a) We must be truthful
2. Patients are given self-governance
1) Jehovah’s Witnesses

b. Nonmaleficence – “do no harm” - healthcare provider is
obligated to avoid harming patients.
1. This does not apply to the benefit of a good action
2. We must bring patients into the decision of whether to
utilize technology to maintain life.
3. Confidentiality c. Beneficence – “medicine should benefit patients”
1. the “do no harm” is raised to a higher level as “do good”
2. Advanced directives (2)
1) A living will may create conflict.
2) Power of Attorney d. b.
3. healthcare providers are obligated to report child abuse
Justice – healthcare must be fairly distributed
1. entitlement – healthcare is owed and not as a charity
C. Mini Clinics: See p. 83 a. AHA (American Hospital Association) Patient Bill of Rights
II. Legal Issues Affecting RC
A. Systems of Law a.
1.
Public Law
Criminal Law
1) punishable by fines, imprisonment or both
2. Administrative Law
1) fishing license (fines)
2) RCP license
Civil Law (also Private law) – is concerned with issues:
1. between people,
2. between organizations, or
3. between people and organizations.
B. Legal Terms: a. Plaintiff

b. c. d. e.
Defendant
Tort
Tort Law
Negligence
C. Professional Negligence a. May involve acts of commission or omission. b. The normal standard being “what a reasonable and prudent
person (RCP) should have foreseen and avoided.” c. “Breach of Duty” d. See Box 4-3; P 79; The “Four D’s” of Negligence.
1.
2.
3.
Duty
Derelict
Direct
4. Damages e. “Res Ipsa Loquitur” – (the thing speaks for itself) –
(established in 1863, England in Byrne v. Boadle)
- a claim is supported if three conditions are met:
1. harm
2. action
3. injury
D. Malpractice –.
Three classifications: a. Criminal Malpractice (criminal court) – i.e. assault & battery; euthanasia b. Civil Malpractice (civil court) – i.e. negligence; practice
below a reasonable standard. c. Ethical Malpractice (licensure boards) – i.e. violations of professional ethics
E. Intentional Torts
Includes: a. Assault b. Battery
1. inform patient before initiating procedure
2. physical contact without consent c. Slander - Spoken words can be:
1. false
2. unprivileged (i.e.: release of chart information)

3. breach of confidence d. Libel – printed defamation
F. Liable a.
– obliged under the law; responsible
Strict Liability
G. Breach of Contract
The provider must act only in the patient’s behalf, protect the patient’s life, preserve the patient’s health, relieve suffering, and protect privacy. a. The more vulnerable the patient (neonate, child), the greater the providers duty to protect .
III. Medical Supervision - RCP’s are required to work under medical
(physician) supervision.
A. Respondeat Superior (let the master answer)
IV. Avoiding a malpractice lawsuit
A. Ask your patient for consent.
B. Angry patients sue a. b. take the heat if a patient complains; called venting report a concern to “
Risk Management
”
C. Be careful about what you chart, it is a legal record. a. Avoid inflammatory remarks b. Be complete c. Be honest & accurate (within hospital / department policy)
1. oxygen “on” or “off”
2. incorrect entries on medical record
D. Establish good relationships between patient and family to healthcare provider
V. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
A. known ase
B. treat medical records and information as confidential
C. Goal “protect all individually identifiable health information” aka “protected health information”:
1. individual’s past or future physical or mental health/condition
2. provision of healthcare to the individual
3. past, present, or future payment for the provision of helath care to the individual
D. Any form