Module Components

• Overview

Topics

• Ethical Health Care Issues
• Basic Concepts of Law in the Healthcare Workplace
• The Legal Environment: Healthcare Law
• Legal & Clinical Incapacity and Informed Consent
• Confidentiality and HIPPA
• Advance Directives
• Labor Relations
• Human Resources: Related Legislation

Nurs 692 Administration of Nursing and Health Care Services

Module 10: The Ethical & Legal Environment and Labor Relations

Overview

Health care professionals practice in an environment that is complex, with many regulations, laws and standards of practice. Performing an abortion is legal but may not be considered ethical by other health care professionals or members of the public at large. Other ethical dilemmas arise at the end of life, when a decision must be made to turn off life-support machines and allow death to occur. Other common ethical issues a health care professional might face are confidentiality, relationships with patients and matters related to consent, especially in the treatment of minors. In this module, we explore some of the legal and ethical issues in health care. To start our discussion, consider the following issues:

1. Confidentiality is both an ethical and a legal issue. Keeping information about a patient confidential is a way of showing respect for the person’s autonomy; releasing information can damage the patient. There are also specific laws regarding the release of information under the Health Insurance Portability and Accountability Act, or HIPAA. The laws define exactly what information can be released and to whom. Insurance companies, for example, may not have the right to certain aspects of a patient’s medical record. However, if there is risk to a third party, an ethical health care professional may need to break confidentiality to prevent harm.
2. Health care practitioners of all sorts face the risk of being sued for malpractice. A lawsuit may be brought from an injury related to surgery, defective equipment or medical products, care that was omitted or a deliberate act that caused harm to a patient. The risk of litigation is such that many health care professionals practice what is called defensive medicine -- for example, ordering a test or performing a procedure primarily to ensure that the patient cannot allege negligence.
3. Patients must provide informed consent for treatment to be legal. A surgery performed without proper consent is generally considered assault, according to a 2009 article in the "Internet Journal of Surgery." When treating an adolescent, the health care professional faces potential conflict between ethics and the law in certain situations. The professional might believe that parents should be kept informed of their child’s health issues. In California, however, a 12-year-old can consent to medical care and counseling related to the treatment of a drug or alcohol problem, the National Center for Youth Law reports. The treating doctor cannot disclose information to the parents without the child’s consent except in very specific circumstances, such as risk to another person.

Objectives

At the end of this module, students will be able to:

1. Explain one ethical issue surrounding health care delivery.
2. Discuss the four main principles of health care delivery.
3. Compare two basic concepts of health care law.