Critical care
Chapter 3
Laws: EMTALA: Emergency room law - everyone who comes in ER room must be treated whether they have insurance or
not.
Torts: Doing something legally wrong
Intentional: Assault (Verbal threat
...
Critical care
Chapter 3
Laws: EMTALA: Emergency room law - everyone who comes in ER room must be treated whether they have insurance or
not.
Torts: Doing something legally wrong
Intentional: Assault (Verbal threats), battery (Physical harm, putting your hands on them without permission),
false imprisonment (medical restraint is a necessity) (Haldol to sedate them is chemical restraint)
Unintentional: Negligence (no harm to patient we just didn’t do what we were supposed to), Malpractice
(when harm is done to the patient). ON TEST
Dilemmas: No right or wrong
Principlism is a widely applied ethical approach based on four fundamental moral principles to contemporary ethical
dilemmas: respect for autonomy, beneficence, nonmaleficence, and justice.
Autonomy states that all persons should be free to govern their lives to the greatest degree possible. This
implies a strong sense of self-determination and an acceptance of responsibility for one's own choices and
actions. To respect autonomy of others means to respect their freedom of choice and to allow them to make
their own decisions.
Beneficence is the duty to provide benefits to others when in a position to do so and to help balance harms and
benefits. In other words, the benefits of an action should outweigh the burdens. Actions intended to benefit
the patients or others.
Nonmaleficence is the explicit duty not to inflict harm on others intentionally.
The principle of justice requires that health care resources be distributed fairly and equitably among groups of
people.
Other principals
The principle of veracity states that persons are obligated to tell the truth in their communication with others.
The principle of fidelity requires that one has a moral duty to be faithful to the commitments made to others.
These two principles, along with confidentiality, are the key to the nurse-patient relationship.
Bioethics committees – Address ethical concerns. Typical membership of a bioethics committee includes physicians,
nurses, chaplains, social workers, and, if available, bioethicists.
Informed consent: Three elements must be present.
Informed consent is not a form. It is a process that entails the exchange of information between the health care provider
and the patient or patient's proxy.
1. Competence (or capacity) refers to a person's ability to understand information regarding a proposed medical or
nursing treatment. Patients providing informed consent should be free from severe pain and
depression. Critically ill patients usually do not have the mental capacity to provide informed consent because of
the severe nature of their illness or their treatment (e.g., sedation). If the patient is not mentally capable of
providing consent, informed consent
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