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Introduction
Many key legal concepts are important for nurses to understand. As
nursing practice evolves, these fluid concepts are refined and changed.
The legal concepts are apply to all areas of nursing practice and are not
restricted to any specific segment.
Safe nursing practice includes an understanding of the legal boundaries
with in which nurse practice. As with all aspects of nursing, an
understanding of the implications of the law supports critical thinking on
the nurse part. Nurses need to understand the law to protect themselves
from liability and to protect their clients rights.
ETHICAL COMMITTEE
Hospital Ethics Committee
Introduction
Most Indian hospitals have instituted such a committee principally for the
purpose of checking whether proposals submitted for research meet
established guidelines. Once this has been established, the researcher is
permitted to proceed with his work and the committee turns to
subsequent proposals. This approach makes a very limited usage of the
personnel recruited on such a committee. Much more can be done to
improve not only the quality of research undertaken by the institution but
also the care of patients in the institution.
Mission statement of the committee
The committee must start with an open statement on its aims and
objectives. These should be circulated throughout the institution and
feedback sought on how this can be improved. It is also necessary to
review this mission statement periodically and revise it when necessary.
The following could form the heads under which details can be entered:
Care of the patient in this institution.
Research.
Education of the staff on biomedical ethics.
Functions of the committee
other specimens are being collected. The findings of a survey are totally
at variance with this observation.
3. Multi-center trials require a uniform protocol and a unified assessment
system. There should be unlimited cross talk between IECs of institutions
involved.
4. Periodic follow up should be made by the IEC after an institutional
project has been sanctioned.
5. Use of laboratory animals in research - additional inputs from
physiologist, pharmacologists and pathologists should be sought by the
IEC or a separate committee should be available.
6. Informed consent obtained from volunteers who are to participate in a
field trial must be meticulously executed. The dangers if any spelt out,
what legitimate safeguards as opposed to enticements can be offered?
What sort of compensation will be offered if something goes wrong, how
will confidentially be maintained , can be biological samples obtained
from the person be sent to other laboratories in India and abroad? And
the proper disposal of biological samples.
7. Clinical trials of drugs or therapy conducted by clinicians /research
workers attached to this institution and a collaborating one, should not
only be assessed by the IEC ,but it should have a say in the quantum of
largesse offered for the person's services and the final report should be
made available to the IEC before it is submitted to the sponsoring agency.
The ethics committee minutes of the collaborating institution should be
available with the institutional PI.
8. Stem cell research. Experts and details mandatory.
CODE OF ETHICS
INTRODUCTION
Health care delivery system has undergone notable changes during the
last few decades, including increased client participation, shorter hospital
stays and restructuring services to provide care in settings such as
outpatient clinics, short-stay units and long-term care and in home-care.
For nurses, these changes have contributed to the development of new
clinical environment and expanded practice. Nurses today frequently
encounter difficult situations involving decisions about the best course of
are action. Nurses are obligated to provide ethical and legal client care
that demonstrates respect for others. Both fundamental principles of
health care ethics and laws governing the scope of nursing guide nursing
practice in all situations.
CODE OF ETHICS
Code - A code may be defined as conventionalized set of rules or
expectations devised for a specific purpose.
Ethics-Word ethics is derived from the word Ethos. It is a Greek word
and meaning of this word is customs, character or conduct. It may be
related to a person or a profession or a professional body. When we study
beliefs and assumptions it is moral philosophy and principles of morality
tell us how human beings should behave with each other.
Ethics is the branch of philosophy that examines the difference between
right and wrong. Ethics are meant for holistic development of a
professional.
The term refers to the consideration of standards of conduct or the study
of philosophical ideals of right and wrong behaviour.
-American Heritage Dictionary, 2007
Code of Ethics-A specific set of professional behaviours and values the
professional interpreter must know and must abide by, including
confidentiality, accuracy, privacy, integrity.
What professionals ought or ought not to do, how they ought to comport
themselves, what they, or the profession as a whole, ought to aim at.
-Litchenberg 1996
An ethical code is adopted by an organization in an attempt to assist
those in the organization called upon to make a decision (usually most, if
not all) understand the difference between 'right' and 'wrong' and to
apply this understanding to their decision.
TYPES OF ETHICS
The code of ethics links to and gives rise to a code of conduct for
employees.
1. Employee Ethics
2. Professional Ethics
A code of ethics often focuses on social issues. It may set out general
principles about an organization's beliefs on matters such as mission,
quality, privacy or the environment. It may delineate proper procedures
LEGAL SYSTEM
MEANING OF LAW
a) Legal
- Established by or founded upon law or official or accepted rules
b) Law
- The term law is derived from its tentoric root lag which means
something which lies fixed or events
- Law means a body of rules to guide human action
- Law means that which is laid down or fixed.
DEFINITIONS
1) The law us a system of rights and obligations which the state enforces.
-Green
2) The law constitutes body of principles recognized or enforced by public
and regular tribunals have the administration of justice.
-Pound
3) The law is the body of principles recognized and applied by the state
and the administration of justice.
-Salmaind
4) Law is a rule or standard of human conduct established & enforced by
authority, society or custom
SOURCES OF LAW
a) Constitutional law: - it is a judgmental law. Law that governs the
state. It determines structure of state, power and duties.
b) Common law : - it is a body of legal principles that evolved from
court decisions
c) Administrative law: - rules and regulations established by
administrative agencies made by executives of government.
PURPOSES
To help the nurse to understand that they do have legal
responsibilities in nursing practice.
To make them understand by which authority these legal
responsibilities can be enforced.
To make them understand what areas of nursing practice can mostly
create legal problems.
To describe and protect the rights of clients and nurses
Law is there for the protection of nursing practice
Law is there for the identification of the risk of liability
Law is there to assist in the decision-making process involved in
nursing practice
Nurses have more responsibility another important purposes are
a) Safeguarding the public
b) Safeguarding the nurse
a) SAFEGUARDING THE PUBLIC
1) The public safety is guaranteed because the practice of nursing is
restricted to those accredited practitioners who would seek to
provide highest possible level of comprehensive care for the
individual and the community taking in to account the total need
2) The individual is secure to the event of sickness or disability with
no fear of anxiety of being cared for by a competent person
b) SAFEGUARDING THE NURSE
1) Licensure:- All nurses who are in nursing practice have to
possess a valid licensure, issued by the respective state nursing
council/Indian nursing council
2) Good Samaritan laws:- In response to health professionals,
fear of malpractice claims, most states enacted Good Samaritan
Laws that exempt doctors and nurses from liability when they render
first during emergency. These laws limit liability and offer legal
immunity for people helping in an emergency
TYPES OF LAW
There are many ways in which a body of law, or the principles of lawmaking, can be divided into categories for the purposes of simplification.
Comparative Law: The comparative lawyer works with international
relations in trade and commerce, travel, government business, and many
other areas depending upon the breadth of his/her knowledge and the
needs of his/her employer. The field of comparative law is one in which
there is a great deal of opportunity for advancement and challenging
work.
Public law: Public law is the body of law that governs the relationship
between the individual and the state, as distinct from civil law (or
`private' law) which governs the relationships between individuals. Public
law is often taken to be divided into `criminal', `constitutional' and
`administrative' branches, although these are not distinct in all
jurisdictions.
Family law: Family law attorneys deal specifically with laws having to do
with family matters. There are multiple facets to each instance of
representation required and knowledge of individuals and their family
histories are necessary. Family law lawyers must interview each family
member involved, or mediates for families so agreements can be made in
an amiable or restructuring way. The most common family law attorneys
are the divorce lawyers, but other aspects of family law are represented
as well. Child support claims and those stipulations, custody and who
gets custody, visitation and length of visitation. Adoption proceedings,
who can adopt, the rights of fathers, mothers, and the different statutes
of each state, paternity and how it is determined, domestic abuse
charges, who was abused, spousal abuse, child abuse, sexual abuse and
the court's rulings, annulments of marriages and what are considered
avoidable marriages, are all represented by the family law attorney. How
these cases are decided by the courts and for what reasons are
Categories of torts
Torts may be categorised in a number of ways: one such way is to divide
them into
Negligence Torts and Intentional Torts.
1. Negligence Torts
Negligence is a tort which depends on the existence of a breaking of the
duty of care owed by one person to another. The tort of negligence
provides a cause of action leading to damages, or to relief, in each case
designed to protect legal rights, including those of personal safety,
property and, in some cases, intangible economic interests. Negligence
actions include claims coming primarily from car accidents and personal
injury accidents of many kinds, including clinical negligence, workers
negligence and so forth. Product liability (warranty stuff) cases may also
be considered negligence actions, but there is frequently a significant
overlay of additional lawful content. The elements of negligence are:
Duty of care
Breach of duty in English law Breach of that duty
Breach being a proximate cause or not too remote a cause in law
Causation law Breach causing harm in fact
2. Intentional Torts
Among intentional torts may be certain torts coming out of the
occupation or use of land.
One such is the tort of nuisance, which involves strict liability for a
neighbour who interferes with another's enjoyment of his real property.
Trespass allows owners to sue for entrances by a person (or his structure,
for example an overhanging building) on their land. There is a tort of false
imprisonment, and a tort of defamation, where someone makes an
unsupportable reason for arrest or their speech is not represented to be
factual which damages the reputation of another.
3. Statutory torts
A statutory tort is like any other, in that it imposes duties on private or
public parties; however they are created by the legislature, not the
courts. Liability for bad or not working products is strict in most
jurisdictions. The theory of risk spreading provides support for this
being liable for the harm caused by another, because of some legally
relevant relationship.
4. Public liability
Public liability is part of the law of tort which focuses on civil wrongs. An
applicant (the injured party) usually sues the respondent (the owner or
occupier) under common law based on negligence and/or damages.
Claims are usually successful when it can be shown that the
owner/occupier was responsible for an injury, therefore they breached
their duty of care. The duty of care is very complex, but in basic terms it
is the standard by which one would expect to be treated whilst one is in
the care of another.
Once a breach of duty of care has been established, an action brought in
a common law court would most likely be successful. Based on the
injuries and the losses of the applicant the court would award a financial
compensation package.
Classification of accounting liabilities
1. Current liabilities
These liabilities are reasonably expected to be liquidated within a year.
They usually include payables such as wages, accounts, taxes, and
accounts payables, unearned revenue when adjusting entries, portions of
long-term bonds to be paid this year, short-term obligations (Eg: From
purchase of equipment). Current liabilities are the financial obligations
payable within a short period of time, normally within one year. It is a
balance sheet item, which is equal to the sum of dues within one year
and all the money indebted to the establishment. Current liabilities are
the short-term financial obligations.
Some of the distinguishable examples of current liabilities include
accrued expenses as wages, taxes and due interest payments.
2. Long-term liabilities
Long-term liabilities these liabilities are reasonably expected not to be
liquidated within a year. They usually include issued long-term bonds,
notes payables, long-term leases, pension obligations, and long-term
product warranties. Long-term liabilities are liabilities with a future
benefit over one year, such as notes payable that mature longer than one
year. In accounting, the long-term liabilities are shown on the right wing
of the balance-sheet representing the sources of funds, which are
generally bounded in form of capital assets.
standards.
CODE OF ETHICS
Within any given profession, a code of ethics serves as a means of selfregulation and a
source of guidelines for individual behaviour and responsibility.
I.C.N CODE OF ETHICS FOR NURSES(1993)
Ethical concepts applied to nursing:The fundamental responsibility of the nurses is of four fold: to promote
health, to prevent
illness, to restore health and to alleviate suffering.
Elements of the code:Nurses and people
h The nurses primary responsibility is the those people who require
nursing care
h The nurses provides care, promotes an environment in which the
values customs and
spiritual beliefs of the individual are respected
h The nurses holds confidence, personal information and uses judgment
in sharing their
information
Nurses and practice
h The nurse carries personal responsibility for nursing practice and for
maintaining
competence by continuous learning
h The nurses maintains the higher standards of nursing care possible
within the reality of a
specific situation
h The nurses assess judgment in relation to individual competence when
accepting and
delegating responsibilities
h The nurse when acting in a professional capacity should at all times
maintain standards of
personal conduct which reflect created upon the profession
PROFESSIONAL CONDUCT
Code of professional conduct (for nurses in India)
1. Professional responsibility and accountability
To maintain professional responsibility and accountability, the
nurse
Appreciates a sense of self-worth and nurtures.
Maintains standards of personal conduct, reflecting credit upon the
profession.
Carriers out responsibilities within the framework of the professional
boundaries
is accountable for maintaining practice standards set by the Indian
Nursing
Council.
Is accountable for his/her own decisions and actions.
Is compassionate.
Is responsible for the continuous improvement of current practices
Provides adequate information to individuals these allows them to
make informed
choices.
Practices healthful behavior.
2. Nursing Practice