Legal Concepts, Risk Management, and Ethical Issues

To leave a patient alone who is still in need of care or observation

Process whereby businesses, educational institutions and programs, and health care organizations are determined to meet standards and performance criteria as established by an accrediting agency

Written instructions expressing the patient’s wishes concerning the types and amount of medical treatment to be rendered in the event the patient can no longer make those types of decisions

Voluntary statement of facts sworn before an authority to be true

Guidelines, usually expressed in a series of statements, that provide ethical standards of conduct for a profession

Process by which an agency or organization establishes a minimum knowledge base for a given health care profession and awards a credential to individuals who meet the minimum knowledge level

Branch of philosophy dealing with good conduct and moral values

Mechanism for reporting an incident, usually by completing a document describing what happened, related to any adverse patient occurrence

A situation in which a patient gives voluntary permission to another party (i.e., surgeon or anesthesia provider) to perform the procedures that have been explained; includes the risks, benefits, possible complications, and alternative treatment options

(1)An obligation to do or not do something; (2)An obligation potentially or actually incurred as a result of a negligent act

Professional misconduct that results in harm to another; negligence of a health care professional

Guides for ethical decision making that include the concern individuals have for the well-being of others, respect for individual autonomy, basic justice, prevention of harm to others, and refusal to take unfair advantage

Omission or commission of an act that a reasonable or prudent person would not do under the same conditions

Replacing the AHA’s Patients’ Bill of Rights, this plain-language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities

The efforts of a health care provider organization to collect and utilize data to decrease the chance of harm to patients or staff or damage to property

Established in 1990, this act requires medical device users to report to the manufacturer and/or FDA incidents that reasonably suggest that there is a probability that a medical device has caused or contributed to the death, serious injury, or illness of a patient

Professional duty limits based on state and federal law and on an individual’s education and experience

The basis for the practice of strict adherence to sterile technique by all surgical team members; involves a level of honesty and moral integrity that must be upheld

Obligation to disclose details for evaluation; commonly used to mean “to be held responsible for”

Voluntary statement of facts sworn to be true before an authority

Statement one expects to prove true

In good faith or innocently

All legal decisions reported on a given legal subject

First pleading filled by plaintiff’s attorney in a negligence action

In criminal cases, the person accused of the crime; in civil matters, the person or organization being sued.

Method of pretrial discovery in which questions are answered under oath

Jurisdiction is given to federal courts in cases involving the interpretation and application of the U.S. Constitution, acts of Congress, and treaties

Court-appointed protector for an individual incapable of making his or her own decisions

Injury resulting from the activity of health care professionals

Formal written accusation from a grand jury

Group of citizens who decide the outcome of a criminal or civil trial

Taking another’s property without consent

Principles that have evolved and continue to evolve on the basis of court decisions

Any law prescribed by the action of a legislature

Obligation to do or not do something

Obligation to do or not do something that is the responsibility of the corporate body

Obligation by the individual to do or not do something

Professional misconduct that results in har to another; negligence of a professional

Omission (not doing) or comission (doing) of an act that a reasonable and prudent individual would not do under the same conditions; may be associated with the phase “departure from the standard of care”

Reckless disregard for the safety of another; willful indifference

Intentionally providing false testimony under oath

Person who initiates a lawsuit

Legal principle, created by a court decision, that provides an example or authority for judges deciding similar issues later

Description of conduct that is expected of an individual or professional in a given circumstance

State statutes, regulations, principles, and rules having the force of law

Court order to appear and testify or produce required documents

Civil wrong may be intentional or unintentional

When parties to a dispute present evidence in a court of law in order to achieve a resolution or, in a criminal act, to determine a person’s innocence or guilt

“The Patient First” (motto of the AST)

Health institution may be found negligent for failing to ensure that an acceptable level of patient care was provided. This means that potential employees and medical staff should be carefully screened and that competent staff should be maintained and monitored for proper performance.

One who is controlling or directing the employee has greater responsibility than the one who is paying the employee. Courts frequently found that the surgeon was liable for any negligent at committed in his or her presence in the operating room under the captain of the ship doctrine. However, some rulings have found that the surgeon, under the borrowed servant rule, is not always responsible if a surgical technologist or registered nurse on the surgical team fails to carry out a routine procedure that he or she was properly educated to perform.

Foreseeability is the ability to see or know in advance; the ability to reasonably anticipate that harm or injury may result because of certain acts of omissions. The courts expect you to anticipate risks to patients. In other words, health care providers can be held liable for failure to recognize and/or failure to act on a critical event that was foreseeable.

Each person is responsible for his or her own conduct, even though others may be liable as well. For example, an authority figure such as a physician assures the medical professional that he or she will take responsibility for an action; however, the health professional is still responsible.

Persons should perform an action as would any reasonable person of ordinary prudence. In law, the reasonable person is not a typical person but a collection of the community’s judgement as tohow the typical community member should behave in situations that might pose a threat of harm to the public. A standard of conduct is not established simply because the majority of people in the community behave in a certain way.

“Above all, do no harm.”

“The thing speaks for istself;” harm obviously came from a given act or thing of which the defendant had sole control.

“Let the master answer”: employer is responsible for the actions of his or her employess.

Describes any civil wrong independent of a contract. Provides a remedy in the form of an action for damages. Most actions against operating room personnel are civil actions rather than criminal and may be either intentional or unintentional.

Act that causes another person to fear that he or she will be touched in an offensive, insulting, or physically injurious manner without consent or authority to do so.

Actual act of harmful or unwarranted contact with a person, including contact without proper consent.

Slander (oral statement) or libel (written statement) that damages a person’s reputation or good name.

Illegal detention of a person without consent (e.g., use of restraints), or forcing a person to stay in an area by not allowing him or her to leave.

Disparaging remarks made about a patient that result in emotional distress.

Disclosure of private information concerning a patient or photographing a patient without consent.