Legal & Ethical

Legal provisions set up by individual state nurse practice acts

- Scope of Practice
- Minimal levels of acceptable performance

- State nurse practice acts

- Legal responsibility
- Fail to meet the standard of care
- Actual or potential harm to a patient

- Damaging one’s reputation
- Information being shared without the patient’s permission

render services with the degree of care, diligence and precaution that another member of the same profession under similar circumstances would render to prevent injury to someone else

- Sexual health
- STIs
- Mental health
- Perinatal
- Immunizations
- SUD
- Rape/assault

- Respect for Persons; self-reliance or self-determination
- addressed in pediatrics through process of “assent” by minors

- Clinician decides what is best for the patient
- appropriate when patient is incapacitated and legal guardian is unreachable – must provide life-saving services

- Taking positive actions to help others
- Interest of the patient above self-interest
- e.g. selecting appropriate meds with most benefit to patient – not necessarily med in stock

- Doing no harm or as LITTLE harm as possible
- e.g. giving pain meds before procedures

doing or causing harm

having or showing a desire to cause harm to another person

- Following through; faithfulness; commitment to keep promises, building rapport
- e.g. when meeting with young patients, explain what can/can’t be talked about in terms of confidentiality

- Telling the truth
- may have to adjust the way you say things to pediatric patients; e.g. not saying a shot is painless but assuring them it’s temporary

- Equal distribution of goods, services, benefits, and burden
- Impartiality- being aware of bias

An ethically “right” and ethically “wrong” choice exists

- Two ethically “right” choices exist
- Values among parties are discrepant

Issued by the state board of nursing after verifying graduation from credited program; must
provide evidence that you have met minimum requirements and standards to practice safely

Non-governmental agency that validates an individual has met certain predetermined standards
set by the individual’s profession (e.g. PNCB—certifying body; does not = licensure, must submit
this certification to board of nursing to get licensure to practice)

Process of validation of required education, license, and certification; usually carried out by
hospital or clinical practice site (e.g. individual facility that hires you will validate your degree
(MSN/DNP), license from your state BON, and certification)

Authorizing a HCP scope and content of patient care services, granted by place of employment

- Public protection and safety
- Public.
- state boards or other government agencies

a person has reached the age of majority and has the full and accurate information needed to make a decision.

- nature of condition, nature of diagnostic steps/treatment, probability of success, risks and benefits, consequence of no treatment (must assess consenting person’s understanding) (assumed to have mental capacity)
**Informed consent can be waived in medical emergencies, public health emergencies, parents cannot be reached**

- self-determination
- participates in decision-making

- Help patient achieve developmentally appropriate awareness to their condition.
- Explain what they can expect from test or treatment.
- Assess if child understands and if they are feeling pressured to make a certain
decision.
- Determine if patient accepts proposed care.

- granted autonomy from their parent or legal guardian, make their own health care decisions (state laws regulate this status)
- Can be granted due to pregnancy, having children of their own, suffer from STIs,
marriage, abusive home life, or are granted “mature minor” ~ process varies state to state.

- literature review, critical appraisal of the quality of research, application of the findings from strongest studies to clinical practice, evaluation of the outcome of implementation
- Levels strongest (1)Systematic Review to weakest (7)Expert Opinion

medical management rather than underlying disease

failure of planned intervention, inappropriate use of intervention

cause harm that is not permanent or life-threatening

death, permanent injury, life-threatening harm

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