Legal Issues in Health Care

Afza.Malik GDA

Legal Issues of Nursing and Health care

Legal Issues in Health Care

Legal Issues in nursing includes, Practice license , state license, privacy right , patient rights and legal acts.

Legal Problems In Nursing

    Legal issues in nursing involve licensing, patient rights, and management and employment issues. Each of these issues presents challenges for nurses and leaders. Approval of care the licenses is a credential provided by state law that entitles qualified individuals to perform specific skills and services. 

    In nursing, these statutes are known as Nursing Practice Acts. Each state establishes its own board of nursing, whose members have the authority to establish and enforce rules and regulations related to the practice of nursing, including licensing requirements in that state. The license protects the use of the title of registered nurse, practical nurse, or advanced practice nurse and establishes standards of education, testing, and conduct to protect the health, safety, and welfare of the public.

    Because each state controls and maintains its own licensee database, caregiver mobility is hampered. To practice in a state other than the one where the nurse is already licensed, an RN must apply for a cross license from that state. Although all RNs take the same licensing exam, not all states have the same nursing practice guidelines, e.g. B. the requirements for completing the complementary training.

Uniform License Requirement

    One remedy proposed by the National Council of State Boards of Nursing (NCSBN) is to develop uniform licensing requirements across states that would not only facilitate the mobility of nurses but also ensure public access to qualified professionals (National Council of State Boards of Nursing). Nursing, 2011). .

Multi-State License

    Another NCSBN initiative is multi-state licensing. Multi-state licensing is a similar process to obtaining a driver's license, allowing you to practice in more than one state. As of May 2015, 25 states have signed an interstate compact to allow multistate licensing privilege (National Council of State Boards of Nursing, 2015). The country of residence counts as the country of origin. All other contracting states are distant states. The nurse still has the responsibility to comply with the standards established in the statutes of the nursing practice where she practices. Both home states and distant states can take disciplinary action.

Model Nursing Practice Act

    The NCSBN has also developed a Model Nursing Practice Practice Act (National Council of State Boards of Nursing, 2012). The Nursing Model Law, its Scope, Title, Advanced Practice Nursing Standards, Educational Requirements, Violations and Penalties. Greater consistency across states will be achieved when states adopt the model law

Patient Care Rights

    When people enter the health system, they keep the basic requirements attributed to them by the Constitution and the courts. The additional rights are designed to protect the rights of people at times when they are most vulnerable. These include the right to privacy and confidentiality, the ability to provide informed consent, the right to opt out of treatment, and the right to be free from coercion.

Privacy Rights

    Invasion of privacy in violation of a person's right to be alone, without being the subject of undue or uninvited publicity, and to make personal decisions without interference. The information disclosed by the patient is confidential and as such only accessible to authorized personnel. Patients can sue for invasion of privacy when confidential information is disclosed to unauthorized individuals. Likewise, a patient may sue for invasion of privacy if unauthorized personnel directly or indirectly observe the patient without permission. Authorized personnel are those personnel involved in the diagnosis, treatment and related care of the patient. Generally, these are members of the health team.

    Caregivers, like others, must not use photos, videos, or search data without the express permission of the patient concerned. In addition, the nurse must be discreet when disclosing information about the patient's condition over the phone, since it is difficult, if not impossible, to accurately identify the caller on the phone. The nurse even has to get the patient's permission to share information with family and close friends.

    Other privacy violation cases involve freedom to make decisions without interference. Patients have the right to make informed decisions, such as B. the use of contraception, abortion and the right to refuse treatment. In addition, they must be assured that these decisions will be respected and upheld, even if they are not the same decisions or decisions that the healthcare professional might make. 

    Nurses often act as advocates to uphold these rights.The difficulty arises when nurses' personal beliefs interfere with their care. Some issues raised by nurses are dying with dignity compared to extraordinary life-saving measures, use of medical marijuana and, not surprisingly, abortion of a non-viable fetus. 

    The manager's role is to support caregivers in their personal beliefs while ensuring that all patients receive unbiased care and organizations to take much stricter measures to ensure the privacy of their patients than was previously required: The Communication between providers requires patient clearance. Public health offices and public places must prevent names and identifying information from being heard or seen. Providers must ensure that postal, fax, email, text and voice messages are only accessible to the patient. HIPAA compliance required a major overhaul of most healthcare systems, but protecting patient privacy soon became standard nursing practice (Wielawski, 2009).


 Confidentiality is the right to confidentiality of records. Individuals have the right to believe that information disclosed to healthcare professionals will only be used for diagnostic and treatment purposes and will not be shared with others without the individual's consent. This is considered information protected by the doctrine of privilege. According to this doctrine, people in protected relationships are required to disclose unless the other person in the relationship consents. Confidentiality guarantees have been strengthened with the HIPAA regulation. In certain circumstances, the nurse may lawfully disclose confidential information to the patient, e.g. B. when the well-being of an individual or group is at stake or a claim for personal injury or workers compensation is made.

Informed Consent

 There are three basic requirements for consent plans and training. Individual expression of opinion is demoralized by age and competition. In general, you have to be of legal age to be able to consent to treatment. The legal age of majority is established by state law and varies from state to state. Under state law, minors have access to certain types of treatment, such as abortion or substance abuse. Adults are considered competent when they can make decisions and understand the consequences of their decisions. 

    People act voluntarily when they exercise their agency without forced fraud, deception, coercion, or any other form of coercion. Limit-enforced consent or fraud-enforced consent is legally considered no consent at all. Because patients are particularly vulnerable when they need medical care, they may believe or be led to believe that they must follow medical staff recommendations. Patients often believe that if they do not comply, they will receive inadequate care or no care at all. 

    Nurses and other health professionals all too often assume that because a patient is in their care, they will accept whatever care they deem necessary. Caregivers have a duty to create an atmosphere that avoids any suggestion of coercion or manipulation. Providing treatment without the patient's consent, except in an emergency situation, may result in liability for unauthorized contact or assault. The third element of informed consent is information. Information must be made available to patients in a way that they can understand. Lay terminology is the preferred technical language. The information must include:

    An explanation of the treatment to be performed and the expected results A description of the risks and inconveniences to be expected A list of possible benefits A disclosure of possible alternatives An offer to answer the patient's questions A statement that the patient can withdraw consent at any time

    The legal responsibility for providing the necessary information for informed con go lies with the person performing the treatment. When a nurse asks a patient to sign a consent form, the nurse is merely testifying to the fact that there is a Mason who believes the patient is aware of the upcoming treatment and witnesses the signing. If the nurse asks the patient to sign a consent form, knowing that the patient has not previously been informed about the treatment, the consent is invalid.

Right To Refuse Treatment

    Just as competent adults have the right to consent to treatment, they also have the right to refuse treatment. Guardians of disabled adults also have the right to refuse treatment for them. The right of competent adults to refuse treatment is guaranteed by the Constitution and has been tested in court in several landmark cases (Cruz Director, Missouri Department of Health 1990, Quinlan New Jersey, 1976, Schindler and Schiavo, 2005). Most states have statutes in place to protect these rights and to protect a healthcare provider who agrees not to treat even when the treatment could be considered medically indicated. 

    The legal documents that comply with these laws and protect people are known as living wills, living wills, and permanent powers of attorney. As a direct result of Cruncase, Congress enacted the Patient Self-Determination Act in 1990 (Koch, 1992). This federal law requires all healthcare facilities receiving Medicare or Medicaid funds to provide written notice to adult patients of their right to make healthcare decisions. These choices include the right to accept or refuse treatment and the right to make living wills.

    A living will is a document that allows a competent patient to make advance decisions about the need for medical treatment. Examples include decisions such as refusing food, putting on a ventilator, or stopping treatment. The two most common living wills are living wills and powers of attorney.

    With a living will, the dependent adult signs a form that indicates what medical care the person wants and does not want in the event of a terminal illness. A person may want all life-saving measures to continue, no matter how bad the prognosis, or a person may simply want comfort measures should the need arise. These decisions are maintained when that adult's ability to make decisions is lost. Both Case Study 7-1 and Bedside Leadership: Respecting Patient Policies emphasize the importance of nurses respecting patient wishes as expressed in these legal documents.

    A Durable Power of Attorney for Health Care Decisions allows a competent adult to appoint a power of attorney or proxy to make decisions if the person is no longer able to do so. The service provider must comply with the wishes expressed in these documents. Difficulties arise when the patient is unconscious and does not have an advance directive or the advance directive is vague. In these cases, the health care provider often relies on family members to make these decisions. However, in most states, family members do not have the authority to make such decisions unless they are legal guardians or parents.

Teeth Freedom

    Another potential area of liability is the use of constraints. The Omnibus Budget Reconciliation Act (OBRA) of 1987 gives patients the right to be free from any physical or chemical restraints imposed for reasons of discipline or convenience and are not required to treat medical symptoms. These regulations apply to nursing homes, state and federal agencies, and other health care organizations that receive Medicare and Medicaid funds. Under these rules, health professionals have an obligation to assess the need for restraint and consider the use of alternative measures. If restrictions are deemed necessary, a medical order detailing the duration and circumstances is required. 

    Order restrictions on request (PRN) is not allowed. If restraints are used, the patient should be closely monitored and periodically reassessed to determine if restraints are still required. In addition to state regulations, most states have laws governing the use of restrictive devices. Federal mandates also require the prudent use of psychotropic drugs, which are often used as chemical coercive agents. Psychotropic drugs may no longer be used to control behavior; they can only be prescribed for diagnostic diseases. The intent is to prevent the indiscriminate use of psychotropic drugs, which often results in patients feeling sedated, restless, and combined.


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