A. Definition of terms:
1.
Law- is a set of rules that a country or community recognizes as
governing the actions of its citizens and that it can enforce through the
imposition of penalties.
2.
Standards of care- is referred to as the level of care or skill that is
expected in a certain situation or function.
3.
Contract- is a written or oral agreement that is meant to be legally
enforceable, especially one involving employment, sales, or tenancy.
4.
Implied contract- is a legally enforceable obligation that arises
from one or more parties to a contract's actions, behaviour, or
circumstances. It has the same legal effect as an express contract, which is
a contract between two or more parties that is willingly entered into and
agreed upon verbally or in writing.
5.
Liability- is referred to as the state of being responsible for
something, especially under the law.
6.
Right- is morally good, justifiable, and acceptable.
7.
Responsibility- defined as the state or fact of having a duty to deal
with something or of having control over someone.
8.
Collective Bargaining- is the negotiation of wages and other
employment conditions by an organized group of employees.
9.
Informed consent- is a communication process between you and
your health care provider that often results in agreement or permission for
care, treatment, or services.
10. Express concern- is to say or demonstrate that you are concerned
about something.
11. Implied consent- defined as the assumption that a person has
granted permission for an action based on his or her actions rather than
expressly or explicitly providing permission.
12. Impaired Nurse- refers to a nurse who is unable to carry out his or
her professional duties due to drug or alcohol addiction or mental illness.
13. Values- refer as the regard that something is held to deserve; the
importance, worth, or usefulness of something.
14. Beliefs- are the acknowledgement of a statement's truth or the
existence of something.
15. Attitudes- are defined as a fixed way of thinking or feeling about
someone or something, which is generally mirrored in a person's behavior.
16. Ethics- is described as the moral rules that guide a person's behavior
or the performance of an activity.
17. Bioethics- is described as the ethics of medical and biological
research.
18. Morality- is described as the rules that govern the distinction
between what is right and wrong, or what is good and bad behavior.
19. Moral development- refers to the process by which children develop
appropriate attitudes and behaviors toward other people in society, which
are based on social and cultural norms, rules, and laws.
20. Code of Ethics- is a set of principles intended to assist professionals
in conducting business honestly and with integrity. A code of ethics
document may define the business's or organization's objective and values,
how professionals are expected to handle problems, the ethical principles
based on the organization's fundamental values, and the standards to
which the professional is held.
21. Moral distress- is the mental state that emerges when a nurse
believes that the ethically correct action to do differs from what he or she
is entrusted with accomplishing.
B.
Law and Nursing
 What are the functions of the Law in Nursing?
- Provides a framework for determining which nursing actions in client care
are legal.
- Distinguishes nurses' responsibilities from those of other health
professionals.
- Assists in establishing the boundaries of independent nursing action.
- Assists in maintaining standards of nursing practice by holding nurses
accountable under the law
 Identify the salient points defined in the Nurse Practice Acts
RA 9173 describing the scope of the nursing practice?
- Using the nursing process, provide nursing care to patients. Traditional
and innovative nursing approaches, therapeutic use of self, executing
health care techniques and procedures, essential primary health care,
comfort measures, health teachings, and administration of written
prescriptions for treatment, therapies, oral topical and parenteral
medications, and internal examination during labor in the absence of
antenatal bleed are all examples of nursing care. Special instruction must
be offered in the case of suturing a perineal laceration according to the
recognized protocol;
- Make connections with community resources and work with the health
team to coordinate;
- Individuals, families, and communities should receive health education;
- Teach, guide, and supervise students in nursing education programs,
including the administration of nursing services in a variety of settings such
as hospitals and clinics; provide consultation services; engage in activities
that necessitate the use of a registered nurse's knowledge and decisionmaking skills; and
- Conduct nursing and health human resource development training and
research, including but not limited to the development of advanced nursing
practice. This clause, however, does not apply to nursing students who
undertake nursing responsibilities under the direct supervision of a certified
teaching member: Furthermore, the nurse is required to follow the Code of
Ethics for Nurses and preserve the norms of safe nursing practice when
practicing nursing in all situations. The nurse must retain competence by
studying on a continuous basis through continuing professional education
given by an accredited professional organization or any recognized
professional nursing organization: Finally, the continuing professional
education program and activities must be submitted to and approved by
the Board.
Identify the rights and associated responsibilities in the legal role of nurses
as:
a.
Provider of service- a nurse responsibility is to provide a health
care service to the patient.
b.
Employee or contractor for service- is someone who delivers
nursing services through an agency and participates in contractual
agreements pertaining to those services.
c.
Citizen- nurses aim is to strengthen communities in ways that do
not rely on the expert method.
4.
Advance Health Care Directives
a.
What is advanced health care directives- is a written document
that allows a patient to provide explicit instructions for medical treatment
to be delivered when the patient is terminally sick or permanently
unconscious.
b.
Define Living Will- it expands on the principle of consent, which
states that patients must consent to any medical intervention before
doctors may proceed. It enables the patient to direct future health
treatment when he/she is unable to make decisions about his/her own
health. It can be canceled at any time by the patient. For many people,
having a living will allows them to retain personal authority while also
easing the strain of family decision-making.
c.
Define Health Care Proxy- is a legal document that allows
another person to make health care choices for a patient when the patient
is unable or no longer able to do so personally.
d.
Autopsy- is a postmortem examination performed to determine the
cause of death or the extent of disease.
e.
Certification of Death- is a legal document and vital record signed
by a licensed physician or other designated authority that includes the
cause of death, the decedent's name, gender, place of residence, and date
of death; additional information, such as birth date, birth place, and
occupation, may be included; the immediate cause of death is recorded on
the first line of the certificate, followed by the condition(s).
f.
Do-Not-Resuscitate Orders- is a medical order written by the
doctor. It directs health care providers not to perform cardiopulmonary
resuscitation (CPR) if a patient's breathing or heartbeat ceases.
g.
Euthanasia- is the painless killing of a patient who is suffering from
an incurable and painful sickness or is in an irreversible coma. Most
countries consider the practice to be illegal.
h.
Inquest- is a judicial investigation into the circumstances
surrounding an incident, such as a death.
i.
Organ Donor- is someone who provides permission for a part of
their body to be taken while they are alive or after they die and implanted
into someone else's body to replace an organ that is no longer functioning
properly.
5.
Areas of Potential Liability in Nursing
a.
Define the following:
 Crime- defined as any conduct that can result in criminal
proceedings and, as a result, an acquittal or a criminal conviction.
 Felony- is a serious offense punishable by imprisonment for more
than one year or possibly death.
 Manslaughter- defined as the indefensible, inexcusable, and
purposeful death of a human being without thought, planning, or
malice.
 Misdemeanor- is a criminal crime that is less serious than a felony
but more serious than an infraction, according to the law.
Misdemeanors will undoubtedly have an impact on a nurse's nursing
licensure. The degree of the misdemeanor is determined on the type
of offense.
b.
Tort- are civil laws that address patients' legal rights and the nurse's
responsibilities in the nurse-patient interaction. Malpractice, negligence,
and violations of patient confidentiality are examples of torts particular to
nursing and nursing practice.
I. Unintentional Torts
 Negligence- is a tort that is committed unintentionally. When a
nurse fails to follow established policies, procedures, and standards
of care in the same way that another "reasonable" nurse would in
the same situation, this is considered negligence.
 Gross Negligence- defined as a deliberate and voluntary disregard
for the obligation to exercise reasonable care, which is likely to result
in foreseeable serious injury or harm to individuals, property, or
both.
 Malpractice- which is also a nonintentional tort, consists of six
factors. A duty, a breach of duty as a nurse, reasonable
foreseeability that the nurse's act has a connection with the patient
injury that occurred, the patient was harmed, the link that act
directly led to the harm, and the patient has the right to financial
compensation or damages are the elements of malpractice.
 What are the 6 elements for a case of nursing professional
negligence to be proven?
a. Duty- The nurse must establish a relationship with the client that
entails providing care while adhering to an acceptable standard of care.
b. Breach of duty- The standard of care that should have been provided
in the given situation but was not provided by the nurse.
c. Foreseeability- There must be a connection between the nurses'
actions and the injury sustained.
d. Causation- It must be demonstrated that the harm was caused
directly by the nurses' failure to follow the standard of care.
e. Harm or Injury- The client must show that he or she has suffered
some form of harm or injury. Physical, financial, and emotional wellbeing.
f. Damages- The nurse is held responsible for any damages that may be
compensated.
II. Intentional Torts
 Identify 4 intentional torts related to nursing, define, and
give an example on each.
- False imprisonment is defined as limiting, detaining, or restricting a
person's freedom of movement. False imprisonment occurs when a
constraint is used without an order. Examples of this are Locking someone
in a room without his permission, taking hostages as part of a robbery,
holding something of great value to a person in order to compel him to
stay in a specific location, detaining a person physically and preventing him
from leaving, detaining an employee for an inordinate period of time due to
suspicion of theft, and medicating someone against his will in order to
restrain him.
- Assault is an intentional tort that involves threatening to touch someone
without their consent. Examples of this are attempting to spit on the
victim, impersonating the act of striking, punching, or kicking the victim,
pointing a gun at the victim, whether loaded or not, and brandishing a
deadly or non-deadly weapon in a way that suggests the victim will be hit
with that thing.
- Another intentional tort is battery, which involves touching someone
without their consent. Examples of this are nursing home abuse, attempted
rape, unwanted touching, and grabbing a person with the intention of
controlling or harming them.
- Breaches of privacy and patient confidentiality happens when a patient's
private information is disclosed to a third party without their agreement.
When a psychiatrist learns from a patient that they intend to conduct a
specific, violent act, this is an example of this.
 What is defamation?
- Defamation is defined as making false remarks about another person,
either in writing or orally, that harms that person's reputation.
 Libel- is the written defamation of a person's character through
untrue statements.
 Slander- is the vocal defamation of a person's character by untrue
statements.
6.
Explain the Good Samaritan Acts. Give Examples
- GSLs are implemented by individual states and may differ from one state
to the next. They typically do not apply to anyone engaged in compensated
employment, while some jurisdictions expand protection to encompass
corporations and charitable organizations responding to catastrophes.
These rules protect those who provide uncompensated aid to those in need
of immediate medical attention, such as at the scene of an accident. While
these rules may offer some protection against claims of ordinary
negligence, they do not provide protection against accusations of severe
negligence or wrongdoing. Someone with chest symptoms or who has
fallen and struck their head on the sidewalk are both examples of this.
C.
Values, Ethics, and Morality
 Identify, explain, and give examples of the essential nursing
values.
- Altruism, autonomy, human dignity, integrity, and social justice are
among the core values of nursing. Altruism involves supporting patients'
and nurses' concerns about their patients' well-being within the scope of
their professional responsibilities. In fact, altruism is defined as the act of
caring for others without expecting anything in return. When nurses must
take care of sanitary issues while also monitoring patient vitals such as
temperature, blood pressure, and more, this is an example of altruism.
Second, autonomy refers to a nurse's ability to assess and carry out
nursing actions for patient care based on competence, professional
expertise, and knowledge. When a nurse administers pain medication on
an as-needed basis, raises the head of the bed when a patient is out of
breath, and seeks out the physical therapist to discuss advancing
ambulation, this is an example of autonomy. Third, human dignity entails
respecting human individuality and treating each person as a distinct
human being. Nurses are responsible for protecting patient dignity, and
there is a legal and ethical obligation to care for the patient as much as
possible. Having pride in oneself or a conscious sense of one's own worth
as a human being living a meaningful life worthy of the respect of others is
an example of human dignity. Fourth, integrity is defined as the quality of
being honest and fair; having strong moral principles. This type of trust
relationship is what makes a successful nurse, and a nurse who has
integrity as one of her core character traits is well suited for patient care
success. An example of integrity is when the medical assistant checks in
with the patient and informs them that the physician is running late and
assures them that the physician will be with them as soon as possible.
Finally, social justice is a fundamental nursing value and the bedrock of
public health nursing. Nursing students must uphold moral, legal, and
humanistic principles related to health as part of their social justice
ideology. Training nurses to advocate for patients is one example of social
justice in health care. Nurses' roles revolve around intervening on patients'
behalf and providing efficient, compassionate medical care.
Define the following moral frameworks:
a.
Consequences-based (teleological) theories- is a form of
ethical theory that considers judgements on the worth of the outcomes of
action to be fundamental. Utilitarianism is the most prominent
consequence-based theory; it accepts only one basic ethical principle, the
principle of utility, which states that we should constantly generate the
maximum balance of positive value over negative consequences.
b.
Principles-based (deontological) theories- is a type of ethical
theory that holds that some characteristics of actions, other than or in
addition to consequences, determine whether the actions are right or
wrong. One central principle is that we may not utilize or mistreat others as
a means to our own or others' happiness. Deontological theories guide
action through a set of moral principles or moral laws, but the actions
themselves and their moral characteristics are the most important. This
theory is sometimes referred to as the Kantian theory because Immanuel
Kant's (1724–1804) work has had a significant influence on its
formulations.
c.
Relationship-based (caring) theories- is a type of health-care
ethical theory that is built on the two core constructive notions of mutual
interdependence and emotional reaction. The ethics of care is a rejection of
the unbiased, principle-driven, and dispassionate reasoning and judgment
that has frequently dominated bioethics models and paradigms. Its roots
can be found in developmental psychology, moral theory, and feminist
writings. Its moral focus is with the emergence of needs and the related
duty within a relationship. Individual moral responses are driven by private
norms of friendship, love, and caring rather than abstract rights and ideals.
Define the following Moral Principles and how they are related to the
nursing practice
a.
Autonomy- defined as recognizing the individual’s right to selfdetermination and decision-making.
b.
Nonmaleficence- defined as acting in such a way as to avoid or
inflict the least amount of harm on others.
c.
Beneficence- defined as acting for the good and welfare of others,
which includes qualities such as kindness and charity.
d.
Justice- defined as acting fairly toward all individuals, treating
others equally, and treating all individuals with the same level of respect
and regard.
e.
Fidelity- defined as being loyal and trustworthy to those who invest
their trust in the nurse.
f.
Veracity- defined as being truthful, trustworthy, and accurate in all
interactions with others
g.
Accountability- the nurse is the primary caregiver for the patient
and must follow not just the Code of Ethics but also the state nurse
practice act and any legislation or standards of care that pertain to nursing
and healthcare.
h.
Responsibility- refer to as the state or fact of having a duty to deal
with something or having authority over someone. Nurses have a
professional obligation to take personal responsibility for their activities and
to hold themselves accountable for nursing judgment and action or
D.
Nursing codes of Ethics
 What are the four principal elements that outline the
standards of ethical conduct as identified by the ICN Code of
Ethics for Nurses?
- People: The major responsibility of the nurse is to those in need of
care, who must demonstrate respect for diversity and cultural
difference, uphold patients' rights to privacy and confidentiality, and
promote social justice and professional ideals.
- Practice: The nurse must practice responsibly and accept
responsibility for her actions, delegations, personal conduct, and care
provisions.
- Profession: The nurse must uphold and promote the ideals of the
profession.
- Coworkers: The nurse must respect colleagues and work with them
to deliver care, but she must also protect patients from careless or
impaired healthcare providers.
 What is the purpose of the Nursing Code of Ethics?
- The Nursing Code of Ethics serves as the basis for nursing practice.
 Identify 5 criteria in making ethical decisions.
a. Assessment- Check that you have all of the information about
the problem.
b. Alternatives- Consider your options.
c. Analysis- Determine your candidate decision and put it to the
test.
d. Application- Apply ethical principles to your candidate selection
process.
e. Action- Make a choice.
Know the specific ethical issues of the following:
a. AIDS- is a late stage of HIV infection that occurs when the body's
immune system is severely compromised by the virus.
b. Abortion- is defined as the intentional termination of a human
pregnancy, which is most commonly performed during the first 28
weeks of pregnancy.
c. Organ and Tissue Transplantation- is a procedure in which an
organ, tissue, or collection of cells is removed from one person (the
donor) and transplanted into another person (the recipient), or
relocated from one place to another inside the same person. A
common example of a transplant from one portion of a person's body
to another is a skin graft.
d. End of Life Issues- it means that people in a chronic vegetative
state may be kept alive indefinitely. Other patients, while aware,
were incapacitated and in pain, confined to bed and reliant on
machines for weeks, months, or even years.
 Advanced directives- is a document in which a person makes plans
for health-care decisions in the event that he or she becomes unable
to make those decisions in the future.
 Euthanasia and assisted suicide- are terms used to describe
purposeful actions conducted with the intent of ending a life in order
to alleviate persistent suffering. If a doctor is legally permitted to end
a person's life in a painless manner, as long as the patient and their
family agree, this is referred to as euthanasia. However, it is referred
to as assisted suicide when a doctor helps a patient commit suicide if
they wish it.
 Termination of life-sustaining treatment- is a process that
requires the same thorough planning and high standards that
clinicians provide before initiating other operations to commence life
support.
 Withdrawing or withholding food and fluid- is a decision that
enables the disease to run its natural course. It is not a decision to
seek death and end one's life.
e. Advocacy- is defined as public support for or recommendation of a
specific cause or policy.
f. The advocate’s Role- to provide unbiased support to persons who
believe they are not being heard, as well as to guarantee that their
concerns are taken seriously and that their rights are protected. It
also helps individuals find and understand relevant information and
services.
 Advocacy in home care- By paying attention to a range of
conditions and settings, family members, friends, and professional
senior advocates can assist make aging in place safer for elders.
Family members and caregivers face distinct hurdles when providing
patient care in the home. Family members and caregivers might face
great physical, emotional, mental, and financial obligations.
 Professional and Public Advocacy- Professional advocacy
activities include those aimed at promoting the counseling profession
positively. Public advocacy, on the other hand, include litigation,
lobbying, and public education. It can also include capacity
development, relationship building, network formation, and
leadership development.
g. Health-related laws affecting nursing and health- the healthrelated laws affecting nursing and health are as follows: Health
Insurance Portability and Accountability Act (1966), Emergency
Medical Treatment and Active Labor Act (EMTALA), Occupational
Safety and Health Act, Patient Self Determination Act, Volunteer
Protection Act (1997), and Good Samaritan Laws.
h. Various Rights of the Clients- These are the client's various
rights, namely confidentiality and privacy, informed consent, service
access, service plans, alternative service options and referrals, the
right to deny services, service termination, access to documents,
procedures for handling grievances, as well as evaluation and
research.
E.
Jurisprudence Doctrines in Nursing Practice
Explain the following doctrines:
1.
Bonus pater familias and respondeat superior- The term
"bonus pater familias" (good family father) refers to a standard of care
analogous to the "reasonable man" in English law. Furthermore, the
doctrine of respondeat superior permits the law to hold an employer
liable for an employee's actions.
2.
Doctrine of negligent conduct- this form of negligence is
associated with statutory violations. For example, if a nurse fails to take
activities required by legislation or regulations, or breaches statutes or
rules, and the patient suffers harm/injury as a result, the nurse may be
considered negligent. If a nurse delegated inappropriately, this can
result in negligence.
3.
Doctrine of res ipsa loquitor and common knowledge- in a
medical malpractice case, the doctrine of res ipsa loquitur demands that
laypeople realize, based on common knowledge or experience, that the
cause of plaintiff's injury does not typically exist absent the doctor's
negligence.
4.
Doctrine of damnum absque injuria- means to "harm without
wrongdoing." It signifies that a loss or suffering suffered as a result of
something other than an unlawful act does not deserve legal recourse.
For example, in exercising his right, a person may do harm to another.
The harmed individual, on the other hand, cannot sue the person who
exercised his rights.
5.
Doctrine of force majeure- according to this doctrine, a
contract will be null and void if its core purpose is destroyed. If this occurs,
the contract's parties are released from their obligations to perform the
contract.
6.
Doctrine of stare decisis- stare decisis encourages the
evenhanded, predictable, and consistent development of legal principles,
develops reliance on judicial decisions, and contributes to the judicial
process's actual and perceived integrity.
7.
Principle of nolo contender- one possible plea to a criminal
case is nolo contendere, also known as "no contest." A plea of “no contest”
is remarkably similar to a guilty plea. The distinction here is that a
defendant who takes a nolo contendere plea accepts to be convicted and
punished for a crime without actually admitting guilt.
8.
Malfeasance, misfeasance, and nonfeasance- Malfeasance is
defined as a wrongdoing or illegal act committed by a public official or
other person in authority. Malfeasance is done on purpose, despite the fact
that the activity is ethically or legally wrong and will cause harm to
someone. Misfeasance is defined as a permissible act that is carried out in
an unauthorized, illegal, or damaging manner. Misfeasance differs from
malfeasance in that the actor does not intend to hurt, but the harm is
caused by the actor's irresponsibility or negligence. Nonfeasance is the
failing to do anything for which one is legally obligated. Nonfeasance is the
deliberate failure to fulfill one's legal or moral duty in a certain scenario, or
the reluctance to fulfill one's duty.
9.
Doctrine of informed consent- is a legal notion that has been
evolved over time by the courts. According to the Informed Consent
Doctrine, medical physicians must give a patient with all relevant
information regarding a proposed procedure or treatment before getting
the patient's consent to carry out the process or treatment.