A misdemeanor is a crime that is not considered as serious as a crime. An administrative offence remains a serious charge and may warrant the revocation of a care licence. Possession of controlled substances may be a misdemeanor or felony under local, state, or federal law. In addition to publishing the Code of Ethics, the ANA Center for Ethics and Human Rights was established to help nurses manage ethical and value conflicts, as well as life-and-death decisions, many of which are common in everyday practice. The ethical standards of the health profession and the laws of the United States and Canada are carefully designed to protect you and the people you serve. You are responsible for familiarizing yourself with these legal and ethical standards before dealing with customers. As I studied the legal and ethical aspects of nursing practice, I began to realize that nursing is a very responsible job and began to worry about what might happen if I did something wrong in the clinical field. However, it became clear in the lectures that we as nurses work in situations that give us the privilege of working with individuals, including taking care of their physical and emotional needs. The laws define the limits of this privilege and specify the rights and duties of nurses.
I always thought that as long as I kept this in mind and followed them, I would always give clients that I would be the best care in my practice. Ethical values are essential for all health professionals. Ethical practice is a foundation for nurses who deal with ethical issues on a daily basis. Ethical dilemmas arise when nurses care for patients. These dilemmas can sometimes conflict with the nurse`s code of ethics or ethical values. Nurses advocate for patients and must balance patient care. There are four main ethical principles: autonomy, charity, justice and non-malevolence. Ethics refers to standards of moral judgment and professional conduct. Nurses are accountable to patients, the public, employers and the profession as a whole. It is imperative that they have a thorough understanding of the various ethical, legal and professional issues they face during their careers. There are three main duties for nurses, among many others, which are the duty of autonomy, confidentiality and the duty of care to all patients. i These duties are complemented by the principles of charity, i.e.
to promote or do good and act in the best interests of patients, and non-malevolence, i.e. to avoid harm. ii These are professional obligations that become legal obligations if laws or guidelines are violated in the course of practice. In 2001, a study found that there was a need to provide more guidance on ethical dilemmas within the health professions following the increase in the number of legal cases and inquiries from the public.iii As a result, various Clinical Ethics Boards (CECs) and Research Ethics Boards (REBs) have been established in the UK to provide comprehensive ethical support. Ever-changing values in the fields of health, behavioral sciences and society mean that physicians must be aware of new ethical issues for the medical sector and learn how to respond appropriately. As with all other aspects of care, the outcomes of interventions to promote ethical practice are evaluated and measured. The purpose of this chapter is to introduce the registered nurse to certain legal and ethical concepts relevant to the practice of nursing. Although the concepts of nursing ethics are generally universal, the nurse must be aware that the law is different from country to country and may differ from state to state and territory to territory. The place of residence and practice of the nurse determines the necessary legal knowledge. Further reading on these topics is necessary for safe and competent practice. Nurses have legal responsibilities common to all members of the community, as well as responsibilities arising from the nature of their work, which can be defined as responsibilities relating to: The steps in the ethical decision-making process are, like the problem-solving process: The principle that a patient who understands relevant information about his or her medical condition should be able to make a decision about The treatment extends to the duty of doctors and nurses.
It is a duty of confidentiality not to disclose patient information to others without consent. The patient must be considered capable of making decisions, as in other circumstances a breach of trust may be permitted. xxv The principle of autonomy of competent persons implies that confidentiality must be respected. In some circumstances, respecting confidentiality requests may be detrimental to the patient – which is the principle of best interest and non-malevolence that conflicts with the right to autonomy.xxvi Nurses must carefully consider the possible consequences of a breach of confidentiality, taking into account the risk of harm that is not being violated, which must be important, to justify disregard for the concept of autonomy. GMC`s Privacy Policy permits disclosure under Section 27 if: «Disclosure of personal data without consent may be justified in the public interest if otherwise the patient or others may be exposed to the risk of death or serious harm.» xxvii The discussion of confidentiality must be guided by ethical principles in accordance with case law and legislation. In addition to counselling strategies and any on-the-job learning that can be applied to independent cases. Since confidentiality is a combined public interest and an individual assessment of interests, the judicial system does not provide sufficient guidance. This creates a problem for nurses and ethical issues to protect from. The GMC acts to protect practitioners who violate confidentiality rules when it was in the public interest to do so, although this depends on the circumstances. The GMC will not be able to protect caregivers if, despite the assessment of legal and ethical issues, the disclosure constitutes a material violation against the person. viii Although case law often determines the issue of «public interest», practitioners and nurses are still required to exercise their professional judgment and are personally liable for any decision that may violate ethical standards.
ix The current legal framework in the United Kingdom includes legislation and case law. There are also differences in jurisdiction within the United Kingdom, with Scotland and Northern Ireland having different legal systems.xiii For example, a person in Scotland may appoint a welfare lawyer to make decisions about medical treatment if that person becomes incompetent under the Incapacitated Adults (Scotland) Act 2000, but this is not an option in England. There are a number of laws that affect healthcare in the UK, as well as international standards. These include the Abortion Act 1967, the Mental Health Act 1983, the Data Protection Act 1998, the Children Act 1989, various laws only in Scotland and guidelines such as the Department of Health guidelines for access to requests for medical records. These laws include strict control over the disclosure of personal information under the Data Protection Act and the simultaneous application of the Public Interest Disclosure Act 1998 when carers have concerns about privacy decisions made at executive level in organisations. Article 8 of the Human Rights Act also allows individuals to bring actions against authorities who have not respected their right to privacy. xiv In connection with Article 3, it may be implied that there is a fundamental right for every individual to determine his or her own life without government interference, including the right to choose medical treatment – treatment must be either consensual or, if the patient is effectively incapable of giving consent, it must be therapeutically necessary.