3. Legal Aspects in Nursing.pdf

Legal Aspects in Nursing
Prof.Dr. RS Mehta 1

2
In law a man is guilty when he
violates the rights of others. In
ethics he is guilty if he only thinks
of doing so.
-Immanuel Kant
Prof.Dr. RS Mehta

Medico-legal Issues are those in which victim who
are seeking medical help but are related to legal
issues.
Medico-legal is something that involves both
medical and legal aspects.
Medico Legal Issues
Prof.Dr. RS Mehta 3

TERMINOLOGIES
Prof.Dr. RS Mehta 4

BILL
• Drafts or temporary outline of what the act will be.
• VIDEYAK in Nepali
Prof.Dr. RS Mehta 5

• A written document which has been formally passed
by Government.
• Ain In Nepali
Prof.Dr. RS Mehta 6

LAW
• Defined as the sum total of rules and regulations by
which a society is governed. As such, law is created
by people and exists to regulate all persons.
• Kanun
Prof.Dr. RS Mehta 7

Constitution
• It is a system of laws and principles according to which a
state or other organization is governed.
• It indicates how the government is created and given
authority.
• It states the principles and provisions for establishing
specific laws i.e. constitutional laws.
Prof.Dr. RS Mehta 8

•It involves all those cases where there is involvement of
law enforcement agencies like police, lawyer and court
of law besides the health care providers including nurse
to provide treatment and justice to victim and
punishment to the culprit.
Cont.….Medico Legal Issues
Prof.Dr. RS Mehta 9

•Legal event generally occur already out side the hospital
area.
•Victim will come to hospital for the purpose of
investigation and treatment.
• They should provide special attention while caring and
documentation.
Prof.Dr. RS Mehta 10

Laws and Acts applicable in nursing practice
• Nepal Health Service Act 2053 with second amendment in 2058
• Muluki Ain (Civil Code)
• Drugs Administration Act
• Nepal Nursing Council Act
• ICN & NAN – code for Nurses
• Consumers Protection Act
• Abortion Law
• Organ Transplant Act

1.Deliberate self harm
2.Accidents
3.Criminal cases
Common Medico Legal cases

Deliberate self harm

Accidents

Criminal cases

1. All cases of injuries.
2. All cases of burn.
3. Alleged cases of assault.
4. All cases of suspected or evident of poisoning or intoxication.
5. Case referred from court.
6. Victims of Animal ferocity
6. Suspected or evident criminal abortion.
7. Unconscious or comatose where the cause is not natural or clear.
8. Brought dead/ dead on arrival/ sudden unexpected death
9. Cases of suspected self-inflicted injuries or attempted suicides.
Common Medico Legal Cases in Emergency

Common Medico Legal cases in BPKIHS
6
98
55
9
7
4
25
25
Rape RTA Physical Assault Fall injury Hanging Burn Injury Poisioning 0thers
17

1. Rape cases- 5-7 years of imprisonment.????
2. Attempt to rape- 2-3 years of imprisonment.???
3. Murder- 10-12 years of imprisonment.???
4. Attempt to murder- 5-8 years of imprisonment.
5. Accident- if one possess driving license – 35 days of imprisonment, if
not- 11 years of imprisonment.
LEGAL PROVISION IN NEPAL

TERMINOLOGIES

A legal wrong committed against a person, his/her
rights or property, intentionally or willfully committed
without just cause.
The person who commits a tort is liable for damage in
civil.
TORT

Unintentional
•Negligence:
•Malpractice

Omitting an action expected of a sensible person
in a particular circumstances is considered
negligence.
Negligence

Failure to maintain accepted ethical standard.
 Any unreasonable lack of skills in professional
duties or illegal or immoral conduct that result in
injury. E.g.: Untrained nurse conducting
abortion.
Malpractice

1. Assault
2. Battery
3. Crime
4. Defamation libel
5. Defamation slander
6. Crime
7. Euthanasia
8. Invasion of privacy
Intentional Tort

Assault: Assault occurs when a person puts another
person in fear of harm or offensive contact. The victim
fears and believes that harm will be caused as a result
of threat.
Battery: An intentional touching of another’s body
without other’s consent.
Cont.…Intentional Tort.

Defamation slander: Something untrue was said to ruin
the reputation of a person.
Defamation liable: Something untrue was written to
ruin the reputation of a person.

Invasion of privacy:
It is the release of a patient’s medical information to an
unauthorized person such as a member of press, the
patients employer, or the patient’s family.

Provides a frame work for establishing which nursing
actions in the care of client are legal.
Differentiates the nurse’s responsibility from those of
other health professionals.
FUNCTION OF LAW (public and civil) IN NURSING

Establish the boundaries of independent nursing
actions.
Assists in maintaining a standard of nursing practice by
making nurses accountable under the law.
Cont.….Function of Law in Nursing

1. Overlooked sponges, instruments and needles during surgery.
2. Burn with hot water bag.
3. Fall from bed.
4. Assault/ battery.
5. Failure to report and negligence.
6. Failure in close monitoring such as B.P., FHS.
7. Forced to do abortion.
8. Exchange of new born babies. (tags, m/f).
9. Handing over of dead body without postmortem.
10. Discharging MLC without informing police.
SOME LEGAL ISSUE IN NURSING PRACTICE
11. Failure to maintain
records of MLC.
12. Poor recording and
reporting ( GCS, DEATH).
13. Identification of patient
and parts.
14. Loss of client property.
15. Medication error or
wrong medication

1. Overflow of patients.
2. Poor information system
3. Poor lab report
4. Inadequate supplies
5. Poor security and inadequate knowledge of MLC.
REASON FOR LEGAL PROBLEMS

LEGAL SAFEGUARD IN NURSING PRACTICE
1.Informed consent
2. Communication
3. Competence in practice

LEGAL SAFEGUARD……
4. Licensure
5. Patient education
6. Executing physician’s order
7. Documentation

8. Professional liability insurance
9. Good Samaritan law
10. Adequate staffing
11. Patient’s bill of rights

12. Licensure
13. Good rapport
14. Standards of care
15. Standing order

16. Don’t accept gifts
17. Don’t give legal advice
1.Correct identity
1.Maintenance of drugs

LEGAL PROCEEDING FOR MLC CASES IN BPKIHS
1. Registration in MLC record book as well as in admission book.
2. Put stamp of MLC in the document
3. Injury form filled in ER
4. Inform to the police.
5. Maintain confidentiality
6. Collection of samples.
7. 2-3 reports collected.
8. After forensic examination, report collected and sent to court.
9. Identified as accident or intention.
• 10. If accident, no further
proceeding.
• 11. If intention, proceeding as per
the law.
• 12. Sent for postmortem if dead.
• 13. Inform police during discharge

FOR ABANDONED OR LAWARIS DEAD BODY
1. Dead body is kept in mortuary for 35 days
2. In that period police in that area is reported and information
disseminated via media
3. If no one claims for that duration, the body is handed over to
municipality office for funeral.

IN CASE OF DISCHARGE OF MLC CASES
1. The culprit as well as victim may be MLC cases.
2. In culprit – taken under the control of the police and submitted to
district police for further proceeding.
3. If victim- victim report of events taken.
4. MLC cases if dead- sent for post mortem
5. All MLC cases registered in MLC book
6. Accidental cases is open for 2 years for investigation then the case is
closed.

RECENT TRENDS IN MEDICO-LEGAL ASPECTS
1. Age estimation.
2. Dental identification.
3. Bite marks.
4. Photography
5. DNA analysis :- hair/ blood.
6. Crime evidence.
7. Forensic medicine/nursing.
8. Finger prints.

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