Unit I (E) (Ethical And
Legal Issues In
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Copyright © 2017 by Tanzeel Ul Rahman
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Tanzeel Ul Rahman Nursing Instructor
BSN, RN, M.Phil Public health Mr.Tanxeel@Gmail.com
Ethics in Critical Care
• “Ethics” can be defined as a set of principles of right conduct or a system of moral values .
• Critical care nurses face ethical issues every day – Informed consent
– Withholding or withdrawal of treatment – Organ and tissue transplantation
– Confidentiality
– Distribution of health care resources
– Advanced technology for life-sustaining treatments
• Greater frequency in critical care
Ethical Issues
Bioethics
Bioethical Principles
• Non maleficence :
Never harm anyone
Not to intentionally inflict harm
• Beneficence:
Maximize benefit and minimum harm .
Duty to prevent harm, remove harm, and promote the good of another person
• Autonomy :
Respect and not to interfere the choice and action of an autonomous individual.
CONT…
• Justice :
Fair distribution of benefits and burdens . ( health care Resources )
• Veracity:
An obligation to tell truth .
• Fidelity:
To keep promise and fulfill commitments .
• Confidentiality
The Nurse’s Ethical
Responsibilities
• The nursing profession is guided by the American Nurses Association (ANA) Code of Ethics for Nurses With Interpretive Statements
Ethics Committees and Consultation
Services
• Many healthcare organizations have an ethics committee or an ethics consultation service
• Ethical committees are usually multidisciplinary and include representatives from various patient care professions and disciplines (eg, nursing, medicine, social work, spiritual care)
• Committee members may also consult at the bedside, providing education, clarification, or dialogue necessary to assist decision makers in resolving an ethical problem
• Advocacy
– Open communication of patient’s wishes and ethical concerns – True collaboration with health care team members
• Dilemmas can result in moral distress
• Formal mechanisms
– Bioethics committees – Ethics consultation
• Opportunities for critical care nurses
– Institutional Ethics Committee membership – Ethics forums and rounds
– Peer review
– Quality improvement committee membership – Institutional review boards (research)
Nurse Involvement in Ethical
Decision Making
Ethical Dilemmas in Critical
Care
• Withholding and withdrawing treatment
– Patient or surrogate decision in best interest – Nurse can refuse on moral grounds
• Limits to treatment and medical futility • Allocation decisions
– Allocation of organs for transplantation.
Common Legal Issues in
Critical Care
• Negligence (Breach of Duty):
Common Legal Issues in
Critical Care
Vicarious Liability: In some cases, a person or facility can be held liable for the conduct of another. This is called vicarious liability.
Types:
• Respondeat superior: (“let the master
answer for the sins of the servant”) is the
major legal theory under which hospitals are held liable for the negligence of their
employees.
Common Legal Issues in
Critical Care
• Corporate liability: Occurs when a
Common Legal Issues in
Critical Care
• Negligent supervision: is claimed when
a supervisor fails to reasonably supervise people under his or her direction. For example, if a nurse is rotated to an unfamiliar unit and informs the charge nurse that she has never worked in critical care, it would be unreasonable for the charge nurse to ask her to perform invasive monitoring.
Common Legal Issues in
Critical Care
• Rule of personal liability: Liability—that
Legal risk areas
• Assault :
Act not performed but develop a fear related to touch and gives threat verbally or non verbally .
• Battery :
Cont…
• Invasion of privacy :
Intrusion into an individual's private and confidential matters .
• False imprisonment :
CONT…
• Defamation :
The action of damaging the good reputation of someone;
It two types are :
1. Slander; damaging reputation verbally 2. Libel ; damaging reputation in written
form .
