Académique Documents
Professionnel Documents
Culture Documents
A SEMINAR ON
LEGAL AND ETHICAL
ASPECTS IN NURSING
INDEX
CONTENT
PAGE NO
1. Introduction
2. Law
4. Intentional torts
5. Unintentional torts
6. Liability
10
13
15
16
18
23
24
26
16.Conclusion
33
17.Bibliography
34
CENTRAL OBJECTIVE
On the completion of the seminar ,the group gain knowledge regarding legal and ethic aspect in
nursing and apply this knowledge in their practice with positive attitude.
SPECIFIC OBJECTIVE
At the end of the seminar, the group will be able to
Define law &tips of law
Explain nursing standards of care
Classify international torts &unintentional torts
Explain legal safeguards for nurses
Define ethics & ethical principles
Explain code of ethics and international council for nurses code of ethics
Illustrate various issues related to ethics in nursing
LAW
Law may be defined as the principle and regulations established in a community by some
authority and applicable to it people whether in the form of legislation or of custom and
policies recognized by judicial decision(dictionary.com)
Laws are put in place to preserve public welfare and manage certain relationship wich the
society.
In
India
different
branches
of
the
legal
system are there that the legal system can be divided into 2 branches
Criminal law
Civil law
Criminal law :- Criminal law deals with act like theft,,murder etc. that starts with
lodging of the first information report (FIR) followed for the police investigation and
filing the case in court
Civil law
Civil law deals with cases were harm or injury is caused to right of individuals the
procedure of civil cases starts with filing of a petition in the relevant court by affected
party only. A tort is a civil wrong or Injury for which the court provides or remedy in the
form of money damages(Black,1999).Torts can be classified into two
1. Intentional torts
2. Unintentional torts
The result of tort may be physical harm, psychological harm, harm to livelihood or some
other less tangible value ,such as harm to reputation intentional torts are will acts that
violate another persons right for example battery, assault are Intentional torts
Unintentional torts is an action causing harm to another person or property that was not
intended to happen the most common cause of an Unintentional torts is negligence,
malpractice
INTENTIONAL TORTS
ASSAULT
Assault is any intentional threat to bring about harmful or offensive contact witch another
individual .No actual contact is necessary the low protects pat cut who are afraid of
harmful contest it is considered an assault threaten to restrain a patient. For a x-ray
procedure when the patient has refusal consent.
BATTERY
Battery is an intentional touching without consent the contact is harmful to the patient
and causes an injury, or it is merely oftensive to the patients dignity. A battery always
include an assault which is why the law commonly combines the two terms assault and
battery for eg: If you threatens a patient to give a patient an injection without patient
consents it is assault, if you actively given the injection it is considered a battery another
example is if patient gives consentfor left knee repair but the surgeons performs right
knee surgery a battery has occurred.
FALSE IMPRISONMENT
Making a person stay in place against his whishes is false imprisonment . The person may
be forced to stay either by physical or by verbal means.If proper procedure were not
carried out first restraing a patient or confining a patient to a locked room could
constitute false imprisonment.
FRAUD
Fraud is willful and purposeful misrepresentation that could cause or has caused loss or
harm to a person or property, situations of fraud in nursing are not common, examples
like trying to obtain a better position by giving in correct information or fake certificates
to a prospective employer
INVASION OF PRIVACY
the intrusion into the personal life of another, without just cause, which can give the pers
on whose privacy hasbeen invaded a right to bring a lawsuit for damages against the pers
on or entity that intruded
UNINTENTIONAL TORTS
NEGLIGENCE
Negligence is conduct that falls below the standard of care for eg: If you are driving a car
and fail to stop at a stop sign. Your action is negligent. In general court define negligence
as failure to use that degree of care that a reasonable person would use under the same
circumstances.
MALPRACTICE
LIABILITY
A liability is an obligation or debt that can be enforced by law. A person found guilty of
any tort is considered legally liable, or legally responsible for the outcome. The person
liable usually is required to pay for damages to the other person, these may include actual
costs of care, legal services, loss of earnings and compensation for emotional and
physical stress suffered. Damage may be paid even when the person devices neglignce,
because a court case wolud cost more then paying damages.
It includes
1.
2.
2.
3.
4.
5.
INFORMED CONSENT
Informed consent is a patients agreement to allow something to happen, such as surgery
based on a full disclosure of risks, benefits alternatives and consequences of refusal
(Black, 1999) Informal consent requires that you give the patient all relevant information
required to make a decision that the patient is capable of understanding the relevant
information and patient actually gives consent.
Informed consent documentation includes
*
Verification that the patient voluntarily signed the consent that patient
discussed the risks benefits alternatives and right to refuse the procedure with physician.
*
Verification that the patient understands te procedure and cleared all his
doubts.
The nurse does not legally assumes the duty of obtaining informed consent the nurses
roles are to confirm that a signed consent form is present patient chart and assess whether
the patient understand. What he or she is signing and report to physician if any problem
or doubt in obtaining a valid consent. parents are normally the legal guardians of
pediatric patient, under 18 years old. When a parent refuses medically necessary
treatment for a child healthcare provides petition the court to intervene on the child
behalf.
DOCUMENTATION
Careful documentation is crucial legal saleguard for the nurse. Documentation must be
accurate complete and entered in a timely fashion. The nurse should be sure that the
nursing the plan of care is part of patients permenent record. the note should include the
current nature of problem, how the nurse intervened the patients response if a condition
the patients needs emergency medical attention and intervention to physician incharge
and he is unavailable the note should document the time the physician was called
response etc.
unless the
physicians or health care providers order is in error. There for the nurse will determine
they are harmful, obtain further clarification from physician, if still you believe that
inappropriate inform the supervisor or nurse manager. Make sure all physician or health
care provider order are in writing and dated and timed appropriatelly verbal order or
10
telephone orders are not recommended becuase they have possibilities for error if a
telephone orders is necessary for emergency read back the order provider writes and
signs it as soon as possible usually 24 hours.
PATIENT EDUCATION
In U.S. Courts affirm the patients right to know and patient education as the legal
duty of the nurse. The nurse should discuss the nursing plan of care with patients and
family members and identity the learning needs. Document the teaching plan a part of
nursing plan of care and also patient response. If a patient refuses health education or
refers the nurse for a family member document patients response.
PRIVILEGED COMMUNICATION
Privileged communication refers to information that is shared by an individual client with
certain professionals but that does not need to be revealed even in a court of law.
Privilege is a limited concept reserved for information given in confidence to the m nurse
within the nurse - patient professional relationship. only a court can determine whether
previlege exists in any specific case. If a court does not determine information is
privileged then you are legally obligated to testify about the communication.
11
Confidentiality are basic concerns in our society, all information regarding a patient
belongs to that patient. A nurse who gives out information without authorization from
the patient or from the legally responsible guardian can be held liable for any harm that
results. Only those professional persons involved in the patients care who have a need to
know about the patient are allow routine access to the patient record, persons not
involved in care may be allowed access to the record only by specific written
authorization of the patient or by court order. Be cautious about what information you
share verbally and with whom and also in social networking. In India the information
technology act deals with the patient privacy and Confidentiality
ADVANCE DIRECTIVE
Advance directives are legal documents stating the wishes of individuals regarding health
care in institutions in which they are no longer capable of giving personal informed
consent. There are several types of advance directives such as living will and durable
power of attorney
A living will provides information on preference regarding end of issues such as
types of care to provide and whether use to various resuscitation measures.
A durable power of attorney for health care is a document that legally designates a
substitutionery decesion maker, should the person be incapacitated. This document
provides individuals with the opportunity to identify a preferred legal decision maker if
they are incapacitated.
If a physician or health are provides has document in the progress notes that the
physician or health care provider and the patient have made the decision not to administer
cardiopulmonary resuscitation, the physician or health care provider should written a do
not resuscitate (DNR) order. A DNR order is written not given verbally.
AUTOPSIES
Autopsy is a medical procedure invloving the examination of the body of a dead
person to determine the cause and manner of death and to assess any disease or injury
that way be present.
The prime aim is to determine of the cause of death the condition of health of the perslon
before he or she died, whether medical diagnosis treatment before death was appropriate
it also used in medical or research teaching
12
For medical teaching research the person has given permission in advance of their
death, where a doctor is not able to write a death certificate or when death is believed to
result from an unnatural cause,warrant autopsy, such autopsy is legal and performed
under a legal authority, the consent of relatives of the deceased is not required.
procedure can help in saving lives of people who whould die because of their
dysfunctional organ. In India 5,00,000 people die because of non availability of organs
per year and 1,50,000 people await a kidney transplant but only 5,000 get one h10 lakh
people suffer from corneal blindness and await transplant (Times of India) Asigned
consent is necessary before donating a patients body, tissues or organs. It is important
that before transplantation conducted several related laws should be kept into
consideration.
In earlier times illegal organ trafficking is a major problem because of corrupt and
inefficient health care system for stopping illegal organ transplant the Government of
India had come up with certain laws in 1994 that made organ sale a crime the human
organs transplant Act 1994 laid down certain rules and regulations that were to be
followed while conducting organ transplant. According to organ transplant law no money
exchange between the donor and the recipient was allowed no foreigner could get a local
donor, close relatives of the recipient like sublivings, parents, children and spouse could
donate the organ without clear once from the Government. However they were required
to appear before authorization committee for clearance and approval.
Later The transplantation of Human Organs Bill 2009 passed. It was made
necessary that the medical staff looking forward a request to the relatives of the brain
dead person from donations of organs. The transplantation of Human organs Bill 2013
passed in this bill now along with an authorization Committee there will be a verification
committee ,as well in every block for verification of the details that are offered by the
donor recepient
There are mainly 2 types of donation
6. 1.
Live Donation : Where organ transplant takes place between the patient and his
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3. Cadaveric Donation : Where a person pledges his organs for harvesting and donated
after his death. For cadaveric donation the person need to register with any NGO who
will arrange an organ donation card for him.
EUTHANASIA
The term euthanasia comes from the Greek word euthanatos ,which means good
death.it refers to the deliberate ending of someone suffering from a terminal or incurable
illness.it can be classified as two
1.active euthanasia
2.passive euthanasia
In active euthanasia occurs in a situation in which the physician prescribes ,supplies or
administers an agent that results in death.
In passive euthanasia occurs as a result of lack of action like withholding the life supports
or medication.
Passive euthanasia is legal in India.On 7 March 2011 the Supreme Court of
India legalised passive euthanasia by means of the withdrawal of life support to patients
in a permanent vegetative state. The decision was made as part of the verdict in a case
involving Aruna Shanbaug, who has been in a vegetative state for 37 years at King
Edward Memorial Hospital. The high court rejected active euthanasia by means of lethal
injection. In the absence of a law regulating euthanasia in India, the court stated that its
decision becomes the law of the land until the Indian parliament enacts a suitable
law. Active euthanasia, including the administration of lethal compounds for the purpose
of ending life, is still illegal in India, and in most countries.
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2.
3.
The Right to choose: - Right to have asscess variety of products and services at a
complete price
4.
nomic policy
5.
6.
The Right to basic needs:- Availability of articles which are basic needs of every
consumer
must be ensured.
15
An Act to consolidate and amend the law relating to narcotic drugs to make stringent
provisions for the control and regulation of operations relating to narcotic drugs and
psychotropic substances
16
a nation of different cultures you will find yourself faced with complicated situations that
arise from these differences with the support of professional code of practice and a
commitment to critical thinking skills, you will contribute a vital and unique voice to the
process of health care delivery
ETHICS
Ethics has been defined a branch of philosophy that involves systematizing, defending
and recommending concepts of right and wrong conduct, often addressing disputes of
moral diversity (Wikipedia. The word ethics is derived from the Greek term ethos, which
means customs Ethics offers a forward process for answering the question about that
one ought to
guideliness assists us in making logical and appropriate decisions. It helps us identify the
motives for action and define relationships between human beings.
ETHICAL PRINCIPLES
Practioners in health care delivery agree to set of ethical principles that guide professions
practice and decision making. These principles are common to all professions in health
care. There are mainly 6 principles are.
1.
Autonomy
2.
Beneficence
3.
Nonmaleficence
4.
Fidelity
5.
Justice
6.
Veracity
Autonomy
Autonomy
freedom. It comes from the latin auto, meaning self and nomy which means control it
represents an agreement to respect the patients right to determine a course of action. For
17
example, the purpose of the preoperative consent is to assure in writing that the health
care team respect the patients independence by obtaining permission to proceed. The
consent process implies that if a patient refuses treatment, in most cases the health care
team will agree to abide by the patients refusal.
Beneficence
The principle of beneficence promotes taking positive, active steps to help others. it
encourages you to do good for the patient. It help to guide decisions in which the benefits
well being. A child immunization causes discomfort during administration but the
benefits of protection from disease both for the individual and for society, outweigh the
temporary discomforts.
Nonmaleficence
It refers to the fundamental agreement to do no harm. It is closely related to the priciple
of beneficence. This principle will be helpful in guiding your discussions about new or
controversial technologies for example a new bone narrow transplant procedure promises
a chance at care, but the long term prognosis in uncertain. The principle promotes a
continuing effort to consider the potential for harm even when it is necessary to promote
health.
Nurses are obligated not to harm patients. This is the principal of
nonmaleficence. Nurses often do have to perform procedures which make patients feel
uncomfortable. An example is administering an injection. A patient needs medication to
relieve a symptom, however, in order to relieve a symptom, the nurse may cause
discomfort. Nonmaleficence must be balanced by beneficence, while providing care. The
intent of the nurse provides a treatment which benefits the patient must outweigh the
discomfort caused. The nurses intent must be to help, not harm.
Fidelity
Fidelity refers to the agreement to keep promises, commitments, responsibilities that one
has made to oneself and others, both implicity and explicity. The principle of fidelity also
18
promotes your obligation as a nurse to follow through with the care offered to patients.
eg: If you assess a patient for pain and then otter a plan to manage the pain the principle
of fidelity encourages you to do best to keep the promise to improve the patients
comfort.
Veracity
Veracity refers to telling the truth or not intentionally deceiving or misleading patient.
For eg: do you tell the truth when you know the truth will cause harm to an individual?
Do you tell a lie when it would make some one makes anxious and afraid?
JusticeDerived from the work of John Rawls, this principle refers to an equal and fair
distribution of resources, based on analysis of benefits and burdens of decision. Justice
implies that all citizens have an equal right to the goods distributed, regardless of what
they have contributed or who they are
ETHICAL THEORIES
UTILITARIAN THEORY
Utilitarianism, developed by Jeremy Bentham and John Stuart Mill, defines the moral
goodness of actions by their consequences
with particular emphasis on the happiness generated by the consequences. Those acts are
right that produce greatest happiness for the greatest number. Utilitarianism, at times,
requires that some good be sacrificed. For example, a baby born with an impairment and
a less than "optimal" life would create a great burden for the parents and society. In this
case, it would be best that the child die.
DENTOLOGICAL THEORY
Deontologic theories (theories of duties), developed under the inspiration of Immanuel
Kant, distinguish right from wrong and emphasize adherence to duty as the primary
degree of moral rightness .Right action is determined not by outcomes but by intentions.
Instead of examining the consequences of actions, the choice is examined. The principle
of respect for another is deeply imbedded in this theory and leads to the idea that respect
19
for another includes respect for autonomous decisions. Informed consent is an application
of this respect principle.
FEMINIST THEORY
This theory supports ethical relativism in that it does not support universal acts.
Feminist theory requires examination of context of the situation in order to come to a
moral conclusion. It asks how an action affects the person, the family, and those
depending upon one another (e.g. community).
BIOETHICS :
a discipline dealing with the ethical implications of biological research and applications
especially in medicine(MERRIAM WEBSTER)
Bioethics" has been used in the last twenty years to describe the investigation
and a study of ways in which decisions in medicine and science touch upon our health
and lives and upon our society and environment.
Bioethics is concerned with questions about basic human values such as the
rights to life and health, and the rightness or wrongness of certain developments in
healthcare institutions, life technology, medicine, the health professions and about
society's responsibility for the life and health of its members.
BIOETHICAL ISSUES
ABORTION
The matter of abortion, the quintessential bioethics topic, raises intensely personal
issues for many people. It is a polarising and divisive issue that raises discussions about
morals, science, medicine, sexuality, autonomy, religion, and politics. A central matter is
deciding what we can say about unborn children, initially known as embryos and later,
foetuses. What is their moral status how much do they matter, and what are our
obligations towards them? The matter of 'personhood' arises, as a philosophical and legal
discussion about what rights to grant them.
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REPRODUTIVE TECHNOLOGY
Assisted reproductive technology (ART) is a medical intervention developed to improve
an infertile couples chance of pregnancy. Infertility is clinically accepted as the
inability to conceive after 12 months of actively trying to conceive. The means of ART
involves separating procreation from sexual intercourse - the importance of this
association is addressed in bioethics.
21
ORGAN DONATION
Modern surgical techniques have made it possible for someone to have diseased or
damaged organs or tissues replaced with healthy ones from a living or dead donor. Major
organs taken from a dead donor include the heart, lungs, kidneys, and liver, and tissues
include bone, corneas, skin, and heart valves. One of the central ethical questions is the
determination of death. People who are on life support may be eligible for organ
donation and important questions arise about correctly determining when they are
actually dead before organ procurement can proceed. Other important ethical questions
include who is eligible to receive an organ; how organ waiting lists are structured; should
payment be permitted for organs and tissues; should reproductive organs and tissues be
permitted for transplant; should face transplants be permitted; how religious and cultural
sensitivities should be handled; confidentiality and privacy of donor and recipient;
ensuring genuine informed consent; and, how should family conflicts about donation be
handled?
EUTHANASIA
Euthanasia is the intentional and painless taking of the life of another person, by act or
omission, for compassionate motives. The word euthanasia is derived from the Ancient
Greek language and can be literally interpreted as good death. Despite its etymology,
the question whether or not euthanasia is in fact a good death is highly controversial.
The fundamental ethical issue in these situation is the right to self determination.in
almost every other health care situation ,a client who is mentally competent can make
decisions about what care to accept and what care to refuse , yet when it comes to the
termination of life ,this right become controversial.
DISABILITY
Here is a significant controversy over whether one ought to speak of "disability" as
a deficit compared to the norm, or whether it is simply a part of the natural diversity
among people. Is disability a biological reality, or is it socially constructed. Is every
biological 'abnormality' a disability, or does a disability necessarily entail some kind of
disadvantage in comparison to most other people? These two different ways of
22
conceptualising disability are known as the medical model and the minority group model
(on which disability rights movements are based). Deciding between these perspectives
has important implications for public policy debates, and social and medical approaches
to disability
Therefore many ethical questions confront us in relation to people with
disabilities, and those who care for them. Is a life with disability worth less? How
should we respond to a request for euthanasia from a person with a disability? Late-term
abortion meets with disapproval by the majority of people, except in the case of severe
fetal abnormality why, and is this right? Should newborns with a disability be killed or
allowed to die? How much healthcare and assistance should we provide to people with a
disability? How do we respond to those whose disability prevents them from
communicating or from making their own decisions for example cognitive and other
mental disabilities?
CODE OF ETHICS
A code of ethics is a set of ethical principles that all members of a profession generally
accept. It is defined as
professional interpreter must know and must abide by including confidentiality, accuracy,
privacy, integrity.
An ethical code is adopted by an organization in an attempt to assist those in the
organization called upon to make a decisions understand the difference between right
and wrong and to apply this understanding to their decision.
The code of ethics serve as guidelines to assist nurses and other professional groups
when conflict or disagreement arises about correct practice or behavior. It will give
guidelines how should they behave with each other, with the public and with
Governments, with the patients. Ethics also tell the public that what they can expect from
a professional and till the professional that what the public expects from them.
Different nursing councils are set code for the nurse, ICN (International Council Nurses)
and Indian Nursing Council (INC) also set codes.
23
24
The Nurse sustain co-operative relationship with co-workers. In nursing and other fields.
The nurse taken appropriate action to safeguard the individual when his care is
endangered by a co-worker.
NURSES AND PROFESSION
The nurse plays the major role in determine and implementry desirable standards of
nursing practice and nursing education.
The nurse acting through the professional organization participates in establishing and
maintaining equitable social and economic working condition in using
ETHICAL DILEMMA
An ethical dilemma (choice between two undesirable alternatives) occurs when
individual values and conflict. This is especially true in relation to health care.ethical
dilemmas usually have no perfect solution and those making disicion may found
themselves in direct conflict with another.
Most health care institution have an institutional ethical committee process
ethical dilemma, it includes doctors ,nurses, social workers etc,this committee help
the nurse who feels confused in presence of ethicl dilemma. Occasionally nurse final
themselves in situations that are legal but are personally unethical, ethical but illegal.
Eg: Abortion is legal, some believe it is unethical, Assisted suicide is illegal, but
some believe it is ethical
Eg. A client went to a surgery for a laproscopic biopsy of an abdominal mass .after
laproscope was inserted ,the physician notised that the mass had metastasized to the
liver,pancreas and colon,and even before the result of the tissue biopsy returned from
laboratory ,the physician diagnosed metastatic cancer with apoor prognosis .when
the client was returned to room ,the physician told the nurse about diagnosis but
warned that under no circumstances were tell the client about the cancer .
When the client awoke ,the first question that he asked the nurse was
do I have cancer? this posed an ethical dilemma for the nurses .if they were tell the
truth to the client would violates the principle of fidelity to the physician . if they lied
to the client to the client ,they would violates the principle of veracity.
25
26
It is the patients right not only to have informed consent but to have his or her wishes
followed .if the patient wishes to have a living will or to be considered do not
resucitateand he is hopelessly ill ,these wishes should be honoured and carried out
according to health care policy.
Social Norms
Local customs can define the ethical behavior of those living within that culture. What
isconsidered normal in one culture can be completely unnatural in another; what is
ethicalin one culture can be unethical in another.
Religious Beliefs
Many believe in life after death. Most religions have a common theme of judgment in the
after life. In the afterlife, many believe good deeds during natural life are rewarded and
bad deeds can be punished. In defining good deeds, religions have developed moral codes
to live by, such as the Ten Commandments, which forbid theft, killing and other
unethical behaviors. How devoutly a person adheres to these moral codes is a factor
defining overall ethical behavior.
Laws
Laws, and a person abiding by them, influence ethical behavior. Fear of prosecution
andpunishment is a great deterrent, and as such, many do not break the law. In the
UnitedStates, ethical behavior is defined by law, such as not stealing or not causing
propertydamage. The level of punishment is roughly tied to the level of crime.
Disease process
Which disease process are affecting the patient ,whether it is irreversible or terminal
according to this affect disicion making
27
Arrange meetings with nursing department managers or head nurses to discuss ethical
issues that arise in the various units
achieving them.
9 .Invite members of another local ethics committee to help evaluate the institution's
ethics committee meetings.
10 .Conduct a self-evaluation in which individual members evaluate their own
contributions to the ethics committee and reflect on their hopes for its future.
28
Abstract
BACKGROUND:
The paper explores the diverse ethical issues in the care of persons with dementia, in the
Netherlands and Kerala, India. These cross-cultural data are used to suggest newer ways
for addressing the ethical issues in a mutually enhancing manner.
METHODS:
A thorough review of the literature focusing on ethical aspects of the care for persons
with dementia.
RESULTS:
The medical paradigm is dominant in the Netherlands and awareness of dementia as an
organic brain disease is low in Kerala. Institutionalized care is more common in the
Netherlands and home-based care is the norm in Kerala. Institutional care is costly,
whereas home-based care is stressful for caregivers. The advanced directive plays an
influential role in the Netherlands, but this mechanism is yet to evolve in Kerala.
The legal and social setting of the Netherlands has a strong influence on physician
decision-making concerning end of life issues. In Kerala, discussion of these matters is
nearly unknown.
CONCLUSION:
Limited awareness of dementia in Kerala should be addressed in public forums, which
can then be used to garner governmental support. The predominantly institutional model
of care-giving in the Netherlands and home-based care-giving in Kerala, each have their
strengths; policy makers in both societies can usefully apply the values and merits
inherent in both models. A culturally appropriate implementation of the advanced
directive will have beneficial medical, social, and economic impacts in Kerala. The
remarkable disparity between the Netherlands and Kerala in dealing with end-of-life
issues will allow more philosophically and socially informed ways of addressing
the ethical questions that arise in those situations.
29
Abstract
Introduction: The enactment of various legal provisions like Consumer
Protection Act, Right to Information Act and standardization of procedures
and practices have brought nursing care under legal ambit. Needless to say,
the level of legal awareness amidst nursing staff in India is abysmally low.
Present study was undertaken to assess the level of legal awareness and
responsibilities of nursing staff in administration of patient care at a trust
hospital.
Methods: An open ended questionnaire was prepared to assess the level of
legal awareness among the nursing staff. The GNM and ANM nursing staff
deployed at the nursing home and general wards only were randomly
screened and specialty nurses were exempted.
Results: The knowledge on various legal provisions, as was applicable to
nursing, across all categories of nurses which were under review, was found
to be poor. The nursing staff had poor knowledge on patients rights and also
on their legal obligations towards patients. The GNM nurses fared better
than ANM nurses. However, 46.67 % of nurses were found to be aware
about cases of omission or commission.
Conclusion: This study substantiated the fact that nurses had poor
knowledge on the law that governed their profession and that in days to
come, it would become increasingly difficult for them to avoid law suits
which were prepared against them, unless remedial actions were taken.
Keywords: Negligence, Consumer protection act, Immunity
3.KNOWLEDGE OF STAFF NURSES REGARDING LEGAL AND
ETHICAL RESPONSIBILITIES IN THE FIELD OF PSYCHIATRIC NURSING
30
USING
DEMOGRAPHIC
SHEETAND
STRUCTURED
STATUS,
EXPERIENCE
AND
QUALIFICATION
DESIGNATION
IN-SERVICE
AND
THEIR
OF
NURSES,
EDUCATION
TOTAL
WHILE
PSYCHIATRIC
CLINICAL
PROFESSIONAL
EXPERIENCE
WAS
KEY WORDS :
LEGAL AND ETHICAL ISSUES, PSYCHIATRY
NURSING, NURSES
31
32
Methods. metaanalysis method for data collection in four countries (n= 1592 RN)
Conclusion. was conformist practice (following conventions rather than pursing good
for the patient) constitutes a major barrier for nurses to take the appropriate ethical
actions, as creativity and critical reflection are absent.. There is an urgent need to find
ways to promote nurses ethical development from conventional to post conventional
ethical practice.
33
CONCLUSION
Legal and ethical issues in nursing continue to increase in scope and importance as the
profession struggles with complex technology, impacts of nursing shortages in all
practice setting and increasing demands of consumers. Thus the need for relevant and
current infromation remains critical. In the research studies conducted indicates that the
nurses need more strengthening their knowledge and practice in legal and ethical aspects.
34
BIBLIOGRAPHY
1.
Potter Perry Basic Nursing 6th edition - Elsevier publication Page No. 53 - 76
5.
6.
7.
8.
www.bioethics,org/resourcetopics
9, Health ethics committee,the next generation Judith wlison roson, American hospital
publication
10. Nursing now ;todays issues ,tomorrows trends ,joseph t ,catalano
Page no 115-135 jaypee publications
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