Module 4 Ethico Moral and Legal Considerations in The Practice of Nursing

MODULE 4
Ethico-Moral and Legal Considerations

in the Practice of Nursing
LESSON 1- Legal and ethical aspects in nursing
https://www.slideshare.net/salmanhabeebek/legal-and-ethical-aspects-in-nursing2.
Law may be defined as “the principles and regulations established in a community by

some authority and applicable to its people whether in the form of legislation or of
custom and policies recognized by judicial decision
 CRIMINAL LAW
 CIVIL LAW
 A tort is a civil wrong or injury for which the court provides a remedy in the form of
money damages (black ,1999)
 Intentional torts
 Unintentional torts
 Nursing standards of care are the legal guidelines for minimally safe and adequate
nursing practice
 Written policies and procedures of an employing institution defines the standards of

care for nurses at that institution
 ASSAULT
 BATTERY
 FALSE IMPRISONMENT
 FRAUD
 Assault is any intentional threat to bring about harmful or offensive contact with
another individual, no actual contact is necessary
 Eg. threatening a patient to give an injection  Restrain a patient for an x-ray
procedure when the patient has refused consent
 Battery is an intentional touching without consent, the contact is harmful to the patient
and causes an injury, or it is merely offensive to the patient dignity
 Eg. Giving an injection without patient consent  A patient gives consent for left knee
repair but the surgeon performs right knee surgery
 Making a person stay in pace against is wishes is false imprisonment

 Eg. Restraining or confining a patient to a locked room without proper consent could
constitute false imprisonment
 Fraud is a willful and purposeful misrepresentation that could cause or caused harm
to a person or property
 Eg. giving incorrect information to obtain a better positon or job
 NEGLIGENCE
 MALPRACTICE
 Negligence is conduct that falls below the standard of care
 Malpractice is one type of negligence called professional negligence
 Medication errors that result injury to patient
 Burns caused by equipment or spills of hot liquids
 Falls resulting in injury to patients
 Errors in sponge, instrument, needle, count in surgery cases
 Failure to give adequate report, notify physician, adequate monitoring the patient
 INFORMED CONSENT
Informed consent is a patient’s agreement to allow something to happen, such as

surgery based on a full disclosure of risks, benefits alternatives and consequences of
refusal (Black, 1999)
 DOCUMENTATION
 EXECUTING PHYSICIANS ORDER
 GOOD SAMARITAN LAW
 PATIENT EDUCATION
 PRIVILEGED COMMUNICATION
 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 types; living wills durable power of attorny 
AUTOPSIES
ORGAN AND TISSUE DONATION 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 10 lakh people suffer from corneal blindness and await transplant (Times
of india) Types; live donation cedaveric donation
 The transplantation of human organs act, 1994 an act to provide for the regulation of
removal, storage and transplantation of human organs for therapeutic purposes and for
the prevention of commercial dealings in human organs and for matter connected with
it.  transplantation of human organs bill 2013
 Medical termination of pregnancy act -1971  The prenatal diagnostic techniques act
and rules
 Narcotics drugs and psychotropic substances act 1985  Mental health act ,1987
 Consumer protection act  Prohibition of sexual harassment of women at workplace
bill,2010  Biomedical waste (management and handling) rules,1998
 The word ethics derived from the Greek term ethos, which means ‘customs`  Ethics
can be defined as a branch of philosophy that involves systematizing , defending and
recommending concepts of right and wrong conduct, often addressing deputes of moral
diversity(wikipedia)
1. Autonomy
2. Beneficence
3. Nonmaleficence
4. Fidelity
5. Justice
6. veracity
 It involves the right of self-determination or choice, independence and freedom 

Eg;the purposes of the preoperative consent is to assure in writing that the health care
team respects the patients independence by obtaining permission to proceed
 This principle promotes taking positive, active steps to help others

 Eg; a child immunisation causes discomfort during administration but the benefits of
protection from disease both individual and for society, outweigh the temporary
discomforts
 It refers to the fundamental agreement to do no harm  Eg;
 It refers to the agreement to keep promises, commitments, responsibilities that one

has made oneself and others
 Eg; if you assess a patient for pain and then offer a plan to manage it, this principle
encourages you to do your best to keep the promise to improve the patients comfort
 Telling the truth or intentionally deceiving or misleading patient
 Eg; should you tell the truth when you know that it might cause harm to the client?
 Families go to great lengthens to protect a dying patient from the harsh truth of his
prognosis, and the patient himself may not wish to know
 It refers principle of fairness  It implies equal treatment of all clients

 Eg; a national multidisciplinary committee strives for fairness by ranking recipients
according to need, rather than resorting to selling organs.
 Code of ethics is defined as `a specific set of professional behavior’s and values the
professional interpreter must know and abide by including confidentiality, accuracy,
privacy, integrity.
 An ethical dilemma is a situation in which a choice must be made between two equally
undesirable actions
1. STAFF SHORTAGE
2. CULTURAL AND RELGIOUS SENSITIVITY
3. DELEGATION
4. TRUTH TELLING VS DECEPTION
 Knowledge of staff nurses regarding legal and ethical responsibilities in the field of
psychiatric nursing
 A study to assess knowledge ,attitude and practice of nurses regarding legal and
ethical concepts of nursing care of children in nicu and picu of selected hospitals in
chennai.
 Nurses responses to ethical dilemmas in nursing practice; meta-analysis
LESSON 2 - SCOPE OF NURSING PRACTICE
file:///D:/Downloads/SCOPE%20OF%20NURSING%20PRACTIC1%20(2).pdf
(stipulated in Article VI Sec. 28 of R.A. 9173, otherwise known as
“The Philippine Nursing Act of 2002.”) Republic Act No. 9173 October 21, 2002 AN ACT
PROVIDING FOR A MORE RESPONSIVE NURSING PROFESSION, REPEALING
FOR THE PURPOSE REPUBLIC ACT NO. 7164, OTHERWISE KNOWN AS "THE
PHILIPPINE NURSING ACT OF 1991" AND FOR OTHER PURPOSES ARTICLE VI
Nursing Practice
Section 28. Scope of Nursing. - A person shall be deemed to be practicing nursing

within the meaning of this Act when he/she singly or in collaboration with another,
initiates and performs nursing services to individuals, families and communities in any
health care setting. It includes, but not limited to, nursing care during conception, labor,
delivery, infancy, childhood, toddler, preschool, school age, adolescence, adulthood,
and old age. As independent practitioners, nurses are primarily responsible for the
promotion of health and prevention of illness. As members of the health team, nurses
shall collaborate with other health care providers for the curative, preventive, and
rehabilitative aspects of care, restoration of health, alleviation of suffering, and when
recovery is not possible, towards a peaceful death. It shall be the duty of the nurse to:
(a) Provide nursing care through the utilization of the nursing process. Nursing care
includes, but not limited to, traditional and innovative approaches, therapeutic use of
self, executing health care techniques and procedures, essential primary health care,
comfort measures, health teachings, and administration of written prescription for
treatment, therapies, oral topical and parenteral medications, internal examination
during labor in the absence of antenatal bleeding and delivery. In case of suturing of
perineal laceration, special training shall be provided according to protocol established;
(b) Establish linkages with community resources and coordination with the health team;
(c) Provide health education to individuals, families and communities;
(d) Teach, guide and supervise students in nursing education programs including the
administration of nursing services in varied settings such as hospitals and clinics;
undertake consultation services; engage in such activities that require the utilization of
knowledge and decision-making skills of a registered nurse; and
(e) Undertake nursing and health human resource development training and research,
which shall include, but not limited to, the development of advance nursing practice;
Provided, that this section shall not apply to nursing students who perform nursing
functions under the direct supervision of a qualified faculty:
Provided, further, That in the practice of nursing in all settings, the nurse is duty-bound
to observe the Code of Ethics for nurses and uphold the standards of safe nursing
practice. The nurse is required to maintain competence by continual learning through
continuing professional education to be provided by the accredited professional
organization or any recognized professional nursing organization: Provided, finally, That
the program and activity for the continuing professional education shall be submitted to
and approved by the Board. Source:
http://www.lawphil.net/statutes/repacts/ra2002/ra_9173_2002.html
http://www.pna-ph.org/the-company/pna-roadmap-2030

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MODULE 4

Ethico-Moral and Legal Considerations

Law may be defined as “the principles and regulations established in a community by

 Written policies and procedures of an employing institution defines the standards of

 Making a person stay in pace against is wishes is false imprisonment

Informed consent is a patient’s agreement to allow something to happen, such as

 It involves the right of self-determination or choice, independence and freedom 

 This principle promotes taking positive, active steps to help others

 It refers to the fundamental agreement to do no harm  Eg;

 It refers to the agreement to keep promises, commitments, responsibilities that one

 It refers principle of fairness  It implies equal treatment of all clients

LESSON 2 - SCOPE OF NURSING PRACTICE

Section 28. Scope of Nursing. - A person shall be deemed to be practicing nursing

(c) Provide health education to individuals, families and communities;

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