Every day, patients, families and healthcare professionals face ethical and lega


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Every day, patients, families and healthcare professionals face ethical and legal decisions. These difficult dilemmas may concern medical treatments, practices, hospital management and other matters that arise in the healthcare industry. Ethical issues in healthcare can require an immediate response, such as making decisions for patients when they are not able to do so, or can involve a prolonged, carefully considered decision, such as the debate over the right to abortion or assisted suicide. The actions taken in ethical issues in healthcare clearly distinguish between what is right and wrong, and often, many of the actions taken today can have lasting effects on healthcare in the future.
There are numerous ethical challenges clinical leaders, health practitioners and patients face in healthcare. Some examples of common medical ethical issues include:
1. Patient Privacy and Confidentiality
The protection of private patient information is one of the most important ethical and legal issues in the field of healthcare. Conversations between a physician and a patient are strictly confidential, as is information about an individual’s medical condition. Specific provisions of the Health Insurance Portability and Accountability Act, or HIPAA, define exactly what information can be released and to whom.
2. Transmission of Diseases
The recent global outbreak of the Ebola virus put a renewed emphasis on the right of healthcare providers to protect themselves from communicable diseases, whether by direct or indirect contact with an infected patient. Ethical and legal questions arise when a patient’s health history is not provided to the medical staff.
3. Relationships
Sexual relationships between medical practitioners and patients or between medical staff are strictly forbidden at a healthcare facility. Sexual harassment can be harmful to all involved, including the facility, so the code of ethics should be explicit about this.
4. End-of-Life Issues
Terminally ill patients may have specific wishes about the way they want their lives to end. Families may struggle with the decision to end life support for a loved one. Healthcare practitioners and clinical leaders need to be prepared to handle end-of-life issues as well as problems encountered in dealing with elderly patients who may not be able to make rational decisions on their own.
The law has a lot to say about personal decision-making. For example, people have the legal right to make their own health care decisions. However, poor health can jeopardize people’s ability to exercise their legal rights.Safeguarding these rights requires advance thinking and planning. Sudden or chronic illness can cause profound weakness and confusion, which makes people vulnerable and can lead to the unwilling loss of control. Conducting personal affairs, making wishes known, and making sure those wishes are respected may be difficult for people who are physically or mentally impaired. Nevertheless, adults of any age can take steps to protect themselves against losing control over their life, and such steps are especially important for older people.
Legal Issues
The legal implications of nursing practice are tied to licensure, state and federal laws, scope of practice and a public expectation that nurses practice at a high professional standard. The nurse’s education, license and nursing standard provide the framework by which nurses are expected to practice. When a nurse’s practice falls below acceptable standards of care and competence, this exposes the nurse to litigation.
The basis for litigation can relate to negligence, failing to exercise the level of care that a reasonable, prudent nurse would under similar circumstances; malpractice; and professional negligence, which means an act of neglect committed in the nurse’s professional role. Acts of omission and commission will also subject the nurse to litigation and professional license review. Both litigation and professional license review can result in reprimand of a nurse’s license or loss of a license.
Legal Terms Related to Health Care
Legal capacity (competency): The right and ability to manage one’s own affairs (bestowed at age 18 in most states).
Legal incapacity (incompetency): The inability to manage one’s own affairs because of injury or disability, as determined by a legal proceeding.
Clinical incapacity to make health care decisions: The inability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health- care decision, as determined by a qualified doctor or other health care practitioner.
Advance directives: Documents or other recordings such as a living will or a health care power of attorney that communicates a person’s wishes about health care decisions.
Living will: A document, sometimes called a medical directive, that expresses a person’s wishes regarding future medical interventions when the person no longer has the capacity to make health care decisions.
Health care power of attorney: A document that legally appoints someone else to make health care decisions on a person’s behalf in the event the person no longer has the capacity to make health care decisions. The person appointed may be called a health care agent or proxy, health care representative, or other name depending on the state.
Discussion topic:
Identify a legal or ethical issue that you encountered during your FNP clinicals. In a 300 word descriiption, discuss how the situations was handled and in your opinion, was it handled the correct way. As a student, did you percieve this situation as stressful? What coping mechanisms did you find helpful?
Include in your discussion the ethical or legal dilemma, how the situation was handled, recommendations, and evidence-based findings to substantiate your discussion and your thoughts.

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