Legal Liabilities

in Nursing Practice
 Responsibility and Accountability for the
Practice of Professional Nursing

 The license to practice nursing carries with

it certain legal responsibilities and
accountabilities that a nurse should
comply with.
 Responsibility and Accountability for the
Practice of Professional Nursing

 It is incumbent upon the professional

nurse to have the needed competencies
on the legal responsibilities of the practice
of her profession to ensure that she is
practicing within the bounds of existing
statutory laws, policies and standards.
 The Judicial Process

 functions to settle disputes peacefully

and in accordance with the law.
Steps in the Judicial Process
(1)Plaintiff files a complaint

(2) An answer will be made by the

defendant

(3) Discovery

(4)Trial

(5) Decision/Verdict
 Concept of a
Reasonably Prudent Man

 When a person engages in an

activity, he or she has a legal duty to
act as an ordinary prudent reasonable
person would act.
 STANDARD
OF REASONABLENESS

 Doctrine of ‘Res Ipsa Loquitor’

 Doctrine of ‘Respondeat Superior’
 Doctrine of ‘Force Majeure’
Doctrine of ‘Res Ipsa Loquitor’
 ‘the thing speaks for itself’

 the thing causing the accident lies within the

exclusive control of the defendant
Doctrine of ‘Res Ipsa Loquitor’
‘the thing speaks for itself’
 Doctrine of ‘Respondeat
Superior’

 ‘let the superior or principal answer’

 in doing the acts out of which the

accident arose, the servant was
representing the master at the time.
 Test of liability under the doctrine of
‘Respondeat Superior’

 The power of control – if the master cannot

command the alleged servant , then the acts of the
latter are not his, and he is not responsible for them.
 If the principal cannot control and direct the
alleged agent, then he is not his agent.
 Test of liability under the doctrine of
‘Respondeat Superior’

 The rule is when the general employer assigns

his servants to duty for another and
surrenders to the other, direction and control is
hence shifted to that person ( e.g. hospital direction
and control of the surgeon in the operating room)
 Doctrine of ‘Force Majeure’

 Due to ‘an irresistible or superior force’

 No person will be held liable for events

which could not be foreseen, or which
though foreseen, were inevitable.
 LEGAL ROLES OF NURSES

1. Provider of Service
2. Employee or Contractor for Service
3. Citizen
 Areas of Potential Liability in
Nursing
1. Crime
 An act committed in violation of public law and
punishable by a fine and/or imprisonment

Classification:
A. Felony – crime of a serious nature
punishable by a term in prison
B. Misdemeanor – an offense of a less
serious nature and is punishable by a fine or
short-term jail sentence.
 Areas of Potential Liability in
Nursing
2. Tort
 a civil wrong committed against a person
or a person’s property.
 Usually litigated in court by civil action
between individuals and is based on fault.

Classification:
A. Intentional
B. Unintentional
 A. Intentional

1. Fraud – false representation of some fact

with the intention that it will be acted upon
by another person.
 A. Intentional

2. Invasion of privacy – a direct wrong of

personal nature through revealing
information that will affect the person’s
standing in the community or group where
he belongs.

� the patient has the right to be left alone.

 A. Intentional
3. Defamation – communication that is false, or
made with a careless disregard for the truth,
and results in injury to reputation of a person.

4. Libel – defamation by means of printing ,

writing or pictures.
5. Slander – defamation by means of spoken
words, stating unprivileged (not legally
protected) or false words by which someone’s
reputation is damaged.
 Intentional
Assault and Battery

 Assault – an attempt or threat to touch

another person unjustifiably.

 Battery – willful touching of a person that

may or may not cause harm.
 Intentional

 False Imprisonment
– unlawful restraint or detention of
another person against his or her will.
 Unintentional
Negligence
– doing of that thing which a reasonably prudent
person would not have done, or the failure to do a
thing that a reasonably prudent person would have
done in like or similar circumstances.
- Indicates deficiency of perception and lack of
foresight.

Imprudence
- a deficiency of action involving a lack of skill
 Specific Examples of
Negligence
 Failure to report  Mistaken identity
observations to  Errors in medication
attending physician.  Defects in equipment
 Failure to exercise the  Errors due to family
degree of diligence assistance.
which the
circumstances of the  Administration of
particular case medicine without a
demands. doctor’s prescription
 Legal Defense in Negligence

 Know the standards of care

 Comply with the established set of the
standards of care.
 Document actions taken as well as the
outcome of such interventions accurately
and completely.
 Unintentional
Malpractice – any professional misconduct, or
any unreasonable lack of skill or fidelity in the
performance of professional or fiduciary duties.

 it means objectionable practice, or a practice

contrary to established rules.
 loosely to refer to the negligence of a member
of any professional group.
 Potential Malpractice Situations
in Nursing

 medication errors
 sponges or other small things left inside
a patient during surgery
 burning a patient
 fall
 mistaken identity
 failure to observe and take appropriate
action
 ELEMENTS OF MALPRACTICE
1. Duty owed the patient
A. Nature of the duty
- existence of duty + standard of care
that represent minimum requirement for an
acceptable practice.
B. Breach of the duty
- after establishing the standard of care,
show that defendant fall below the
standard of care
 ELEMENTS OF MALPRACTICE
2. Foreseeability
 certain events may reasonably be
expected to cause specific results.

3. Causation
 the nurse’s action or lack of action directly
cause specific results.
 ELEMENTS OF MALPRACTICE
4. Injury
 the resultant harm must be physical, not
merely psychological or transient.

5. Damages
 the plaintiff must show financial harm
before the court will allow a finding of
liability against the defendant nurse or
hospital.
DUE PROCESS OF LAW
AND LEGAL
PROCEDURES
Two Elements of Criminal Offense

 Criminal act

 Evil/criminal intent
Conspiracy to Commit Crime
Principal

 those who take a direct part in the execution

of the act

who directly force or induce others to commit it

Who cooperate in the commission of the crime

without by another act without which it would
not have been accomplished
Conspiracy to Commit Crime
Accomplice

– those who, not being principals cooperate

in the execution of the crime by previous
or simultaneous act
 Conspiracy to Commit Crime
Accessories
- those who, having the knowledge of the commission of
the crime, either as principals or accomplices take part
subsequent to its commission by:
 profiting themselves or assisting the offender to profit
from the effects of the crime
 Conspiracy to Commit Crime
 concealing or destroying the body of the crime, or the
effects or instruments thereof in order to prevent its
discovery or

 harboring , concealing, or assisting in the escape of the

principal of the crime, provided the accessories act with
abuse of their public functions or are known to be
habitually guilty of some other crimes
 Classes of Felonies
A. Based on the degree of the acts of
execution
 Consummated

 Frustrated

 Attempted

B. Based on the degree of punishment

 Grave

 Less grave

 Light
 Classes of Felonies
Based on the Degree of
ACTS OF EXECUTION Based on the Degree
of PUNISHMENT
 Consummated  Grave

 Frustrated  Less grave

 Attempted  Light
 Degree of Execution

1. Consummated – all the elements necessary

for its execution and accomplishment are
present
 Degree of Execution
2. Frustrated – when the offender performs all
the acts or execution of the felony but which
do not produce it by reasons independent of
the will of the perpetrator
 Degree of Execution

3. Attempted – when the offender commences

the commission of the felony by overt acts,
and does not perform all the acts or execution
by reason of some cause or accident other
than his spontaneous desistance.
 Degree of Punishment

1. Grave felonies – those with capital

punishment (death) or penalties which in any of
their periods are afflictive ( imprisonment ranging
from 6 years and one day to life imprisonment or a
fine not exceeding P6,000.00
 Degree of Punishment

2. Less grave felonies – those with penalties

which are correctional (ranging from 1 month and
1 day to 6 years) or a fine not exceeding
P6,000.00 but not less than P200.00

 Light felonies – those with the penalty of

arresto menor (imprisonment for one day to 30
days or a fine not exceeding P200.00
 Degree of Punishment

3. Light felonies – those with the penalty of

arresto menor (imprisonment for one day to 30
days or a fine not exceeding P200.00
Circumstances Affecting
Criminal Liability
 Justifying Circumstances
 Exempting circumstances
 Mitigating Circumstances
 Aggravating Circumstances
 Alternative Circumstances
 Justifying Circumstances- those
circumstances which make the act of a person
to be legal and not criminal , so he is deemed
not to have violated the law and is free from
both criminal and civil liability.
1. Self defense
 Unlawful aggression on the part of the
offender
 Reasonable necessity for the means employed
by the person to defend himself
 Lack of sufficient provocation
 Justifying Circumstances
2. In defense of family members/relatives.
3. In defense of strangers/rights of
strangers.
4.Avoidance of Greater Evil or Injury– evil
exist, injury feared is greater or no other
practical or less harmful way to prevent it.
5. Acts in fulfillment of Duty, or Lawful
Exercise of Right or Office.
6. Obedience to a Lawful Order.
 Exempting Circumstances
 Imbecility or insanity
 Being nine years of age or less of age.
 Over 9 yrs. and under 15 yrs. unless has not acted
with discernment.
 Performing a lawful act with due care but caused
an injury by mere accident.
 Under the compulsion of irresistible force.
 Under an impulse of an uncontrollable fear of an
equal or greater than injury.
 Failed to perform an act required by law, when
prevented by some lawful cause.
 Mitigating Circumstances
 Incomplete Justifying or Exempting
Circumstances
 No intention to commit so grave a wrong
as the one committed.
 Being under 18 years old or over 70 years
old
 With sufficient provocation or threat on
the part of the offender
 Mitigating Circumstances
 Immediate vindication of a grave offense
 Acts upon impulse so powerful as naturally to
have produced passion or obsfuscation
 Voluntary surrender or confession of his guilt
 With physical defect, deaf or dumb, blind which
restricts his means of action, defense or
communication with his fellow beings.
 Illness of the offender that diminishes the
exercise of his will power.
 Similar and analogous Circumstances – as
impulse of jealousy, and extreme poverty and
necessity.
 Aggravating Circumstances
 Taking advantage of public position
 Contempt of or insult to public authorities
 Committed with disregard of Rank, Age or Sex.
 Committed in the dwelling of the offended party
 Committed with abuse of confidence
 Obvious ungratefulness
 Palace of the Chief Executive of the country
 In the presence of the Chief Executive
 Committed in place of worship
 Committed on the occasion of calamity or
misfortune.
 Aggravating Circumstances
 Committed in consideration of a price, reward,
promise or fortune.
 Committed by means of inundation, fire, poison,
explosions, intentional damage, etc.
 Committed with evident premeditation or after an
unlawful entry
 When craft, fraud or disguise is employed
 Where public authorities are engaged in the
discharge of their duties
 Wrong done in the commission of the crime is
deliberately augmented by doing other wrongs
not necessary for its commission
 Nighttime or during period of darkness
 In an uninhabited place
 By a band or cuadricilla or a group of more than
3 armed men
 With the aid of armed men
 Recidivism – when one who at the time of his
trial for 1 crime shall have been previously
convicted of another crime by final judgment
 Habituality – have been previously punished
with an equal or greater penalty or with a lighter
penalty.
 Utilization of the offender’s superior strength
 When means to weaken defense are
employed
 Treachery
 Add Ignominy to the natural effects of
the felony ( make the effects more humiliating
/ shameful)
 Breaking a wall, roof, floor, door or window as a
means
 With the aid of minors or by means of motor
vehicles, airships or other similar means.
 Cruelty
 Alternative Circumstances
 Those which must be taken into
consideration as aggravating or mitigating
according to nature and effects of the
crime and other conditions attending its
commission.
 Relationships, intoxication, degree of
instruction and education of offender
 Penalties
 Is the suffering being inflicted by the State for
the commission of the crime.
 Theories Justifying Penalty :
1. Prevention – penalty prevents the danger to society that
may arise from crimes.
2. Self- defense – penalty is a measure of self defense
intended to protect society from the threat and wrong
inflicted by the criminal.
3. Reformation- penalty is intended to correct and reform
the offender.
4. Exemplarity- the criminal is penalized as an example to
deter others from committing crimes.
5. Justice – penalty is imposed as an act of retributive
justice / or vindication of right and moral law violated by
the criminal.
 Causes of Total Extinction Of Criminal Liability
 Death of the Convict
 Service of the Sentence
 Amnesty – general pardon of a class of persons who are
guilty of high political crimes.
 Absolute Pardon- an act of grace which exempts the convict
from the punishment of his crime without any condition.
 Prescription of the Crime – forfeiture or loss of the right of
the State to prosecute the offender after the lapse of a
certain time
 Prescription of the Penalty – the forfeiture or loss of the
right of the State to execute the final sentence after the
lapse of a certain time
 Marriage of the Offended Woman or the marriage of the
offender, in good faith, with the offended woman after the
commission of the crime of Rape, Acts of Lasciviousness,
Seduction or Abduction
 Some Crimes or Felonies
 Crimes against Persons
 Parricide – killing of a persons father, mother or child
 Murder- an unlawful killing by a person of another committed
due to the ff. circumstances – treachery, reward, promise,
inundation, fire, poison etc.
 Homicide –unlawful killing by a person of another without the
presence of the circumstances qualifying it as murder
 Giving assistance to suicide
 Infanticide – killing of a child less than 3 days of age
 Abortion
 Dispensing of abortives
 Mutilation
 Physical Injuries
 Rape
 Crimes Against Personal Liberty

 Kidnapping – when you deprive somebody of

his liberty
 Abandonment of Persons in Danger
 Abandonment of One’s victim
 Threats
 Grave coercion
 Crimes Against Property

 Robbery
 Theft
 Swindling or estafa
 Destructive arson
 Malicious mischief
 Crimes Against Chastity

 Adultery – committed by a married woman

who has sexual intercourse with a man not
her husband
 Concubinage – cohabits with a woman not his
wife in any other place.
 Acts of Lasciviousness
 Seduction
 Abduction
 Crimes Against the Civil Status of the
Person
 Simulation of birth
 Substitution of one child for another
 Concealment or abandonment of a legitimate
child
 Usurpation of another’s civil status
 Bigamy
 Marriage contracted against the provisions of
Law
 Crimes Against Honor

 Libel – written public or malicious act to

discredit or dishonor a person
 Slander – oral defamation
 Slander by Deed – one who performs an act
to dishonor or discredit someone
 PROFESSIONAL LIABILITY
INSURANCE

 Defrays legal fees,

settlement made out of
court

 Covers all costs

incurred by the nurse
up to the face value of
the policy.
 GOOD SAMARITAN LAW
 Designed to protect healthcare providers
who provide assistance at the scene of the
emergency against claims of malpractice.

 Unless it can be shown that there was a

gross departure from the normal standard
of care or willful wrongdoing.
 Things to Remember in being a
Good Samaritan
 Make decision quickly as to whether or not you will stay and
help. Remember there is no common law or duty to stop and
render aid.
 Ask the injured person for permission to help. Don’t force
your services.
 Care for the injured party where you can do safely. Move the
injured party ONLY if you must do so without causing further
harm, and as needed to prevent further harm.
 Apply rules of first aid; assess for and prevent bleeding ;
assess for the need to initiate CPR, cover patient with blanket
 Continuously assess and reassess then person for additional
injuries and communicate findings to patient/relatives.
 Things to Remember in being a
Good Samaritan
 Have someone call or go for additional help while
you stay with the injured party.
 Stay with the person until equally or more
qualified help arrives.
 Give as complete a description as possible of the
care you have rendered to the police and
emergency medical personnel so that continuity of
care exists.
 Do not accept any compensation.
 Should you choose not to stop and render aid;
stop at the nearest phone and report the incident
to proper authorities.