week 5 conceptual basis of nursing practice (ethical and legal consideration)_without video version

7/29/2019 Week 5 Conceptual Basis of Nursing Practice (Ethical and Legal Consideration)_without Video Version

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CCN 2258Fundamental Concepts of Health

and NursingThe Conceptual basis of Nursingpractice

Ethical and legal consideration

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Ethical and legal consideration

After completing this lecture, you will be ableto:

Describe the purpose and essential elements of

informed consent Understand the privacy, organ donation and legal

termination of pregnancy briefly

Identify the code of ethics for nurses in Hong

Kong

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Informed consent

Purpose Provides client with complete information prior to

obtaining agreement by client to accept a course oftreatment or procedure

Express Consent Oral or written agreement

Implied Consent

Individuals nonverbal behavior indicates agreement

Medical emergency when a person cannot expresscontent because of physical condition

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Informed consent

Three major elements must be given voluntary

must be given by client or individual with capacityto understand

must be given enough information to be theultimate decision maker

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Informed consent

Three groups of people cannot provideinformed consent a person 18 years or younger (provided by a parent or

guardian)

the unconscious or person injured in such as way that they

are unable to consent (by provided necessary care for theclients emergency condition)

a mentally ill person judged by professionals to beincompetent (by an appointed guardian)

Hong KongStatutory law

Section 59ZB(2) Part IVC of Mental Health Ordinance (Cap136)

A mentally incapacitated person is incapable of givingsuch consent if that person is incapable of understandingthe general nature and effect of the treatment or specialtreatment. Statute (Hong Kong)5


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Informed consent

Important to consider the problem of illiteracy andother language barriers

The consent must be read to the client or aninterpreter appropriately used to be certain client

understands Nurses Role

Client gave consent voluntarily

Signature is authentic

Client appears competent to give consent Remind client they have the right to refuse after

signature on form continues after signing consent

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Privacy

Hold in confidence personal information obtained ina professional capacity

The nurse ensures that the information given by theclients in confidence will only be used for the purposes for

which it was given The nurse protects the information obtained in the course

of professional practice and discloses only with thepatients/clients consent, or in exceptional circumstances,

such as where a court is made for disclosure

When personal information is required for teaching,research or quality assurance procedures, the nurse takescare to protect the patients/clients anonymity and privacy

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Some examples of laws of HK related

to nursing practice

Antibiotics Ordinance

Births and Deaths RegistrationOrdinance

Coroners () Ordinance

Dangerous Drug Ordinance

Defamation () Ordinance

Hong Kong Bill of RightsOrdinance

Hospital Authority Ordinance

Hospitals, Nursing Homes andMaternity Homes RegistrationOrdinance

Human Organ TransplantOrdinance

Interpretation and GeneralClauses Ordinance

Medical (Therapy, Education andResearch) Ordinance

Mental Health Ordinance

Midwives Registration Ordinance

Nurses Registration Ordinance

Occupational Safety and Health

Ordinance Offences Against the Person

Ordinance

Personal Data (Privacy)Ordinance

Pharmacy and Poisons Ordinance

Prevention of Bribery Ordinance

Quarantine () and Preventionof Disease Ordinance

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Organ donation

Number of organ / tissue donation & patient waiting fortransplantation under H.K. Hospital Authority (1994 2011)

(Department of Health, Hong Kong, 2012)9


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(Apple daily, 2013)10


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Organ donation policy

Opting-in (

) Require individuals to sign the consent to indicate the

individuals wishes

The consent of the relatives has to be secured before theorgan can be retrieved for transplantation

United Kingdom, United State, Australia, Taiwan, Japan,Hong Kong

Opting-out () Require individuals to sign to indicate objection to the

taking of organs by others after death Austria, France, Brazil, Spain, Singapore

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Applying for legal Termination of

Pregnancy

Section 47 of the Offences Against the Person Ordinance Termination of pregnancy requires two registered medical

practitioners to concur that:

continuing the pregnancy would involve risk to the life of the pregnantwoman or of injury to the physical or mental health of the pregnant

woman greater than if the pregnancy were terminated; or

there is a substantial risk that if the child were born, it would sufferfrom such physical or mental abnormality as to be seriouslyhandicapped; or

the woman is with child before attaining the age of 16; or

the woman is the victim of incest, rape, drug rape, intercourse bythreats, or intercourse by false pretences, and has made a report tothe police within 3 months after the date of such offences

Legal termination of pregnancy must not be performed after

the 24th week of pregnancy12


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Several Examples of ethical

principles

Respect for autonomy Right to choose

Beneficence

Acting in the patients best interest

Nonmaleficence Doing no harm to patients

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Code of Ethics for Nurses in Hong

Kong

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Organized around four broad valuestatements and seventeen provisions ()

that represent the morals and ideals of theprofession and are regarded as central to

ethical nursing practice The four broad value statements are:

1. Respect life, and improve quality of life

2. Respect individual rights and dignity

3. Be responsive to societys needs, and work towardsa healthy community through partnership

4. Strive for excellence, and assure quality of care


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Code of Ethics for Nurses in Hong

Kong

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The provisions articulated in each value statementare ethical responsibilities that nurses should actupon in order to enact the broad values in practicesituations

For each of these statements, the scope ofresponsibilities identified extends beyondindividuals to include families, communities andsociety

By upholding these values in practice, it isenvisaged that nurses can improve their personalquality, provide quality nursing care and earn thetrust of those under their care

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The 4 value statements are based on

the following general principles :

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People's needs are universal. Nursing service isprovided for people throughout their life span

Inherent in nursing is the respect for life, dignity andrights of individuals, and improvement in the quality of

life Nurses should serve all people irrespective of race,

nationality, creed, colour, age, gender, politics orsocial status

The fundamental responsibilities of nurses are topromote health, prevent illness, restore health, andalleviate suffering caused by ill health


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1. Respect Life, and Improve Quality

of Life

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1.1 Nurses should encourage the individual, the family andthe community to improve the quality of life

1.2 Nurses should ensure patient/client safety whendelivering nursing services

1.3 Nurses should provide information and consultation inaccordance with and adjustable to patients'/clients' andtheir families capacity and needs

1.4 Nurses should respect the wishes of the dyingpatients/clients, and ensure that they have peace anddignity at the time of death


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2. Respect Individual Rights and

Dignity

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2.1 Nurses should respect the individuals spiritualbeliefs, values and customs.

2.2 Nurses should hold in confidence patients'/clients'information and be prudent in their use of theinformation.

2.3 Nurses should respect patients'/clients' and theirfamilies wishes, encouraging them to participate in

planning and implementing nursing care.

2.4 Nurses should take appropriate action to safeguardthe individuals rights and dignity.

2.5 Nurses should value truthfulness and integrity andput oneself in the place of another.

3 Be Responsive to Societys Needs and Work


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3. Be Responsive to Societys Needs, and Work

towards a Healthy Community Through

Partnership

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3.1 Nurses should share the responsibility in raising thehealth consciousness of the community

3.2 Nurses should collaborate with others in initiatingand supporting actions that work towards the goal ofhealth for all

3.3 Nurses should use health care resources efficientlyand effectively through partnerships with thecommunity

3.4 Nurses should coordinate their services with those ofmedical and social groups in rendering healthservices to individuals, families and the community,as appropriate


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4. Strive for Excellence, and Assure

Quality of Care

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4.1 Nurses should seek truth from facts, and usescientific evidence in finding the best possible waysto provide nursing services for the wellbeing ofpatients/clients.

4.2 Nurses should maintain the highest standards of

nursing care possible, actually seekingimprovement on the existing service.

4.3 Nurses should exercise professional judgment inaccepting responsibilities and delegating nursing

activities to others.

4.4 Nurses should value research and development forthe promotion of nursing knowledge and skills.


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References Department of Health, Hong Kong. (2012). Statistics ( Milestones of

Hong Kong Organ Transplantation ). Retrieved fromhttp://www.organdonation.gov.hk/eng/statistics.html

Kozier, B., Berman, A. & Snyder, S. (2012). Kozier & Erb'sfundamentals of nursing : concepts, process, and practice(9th ed.).Upper Saddle River, N.J. : Pearson.

Legislative Council of the Hong Kong Special Administrative Region of

the Peoples Republic of China. (2000). Mental health ordinance

(chapter 136). Retrieved from http://www.legco.gov.hk/yr99-00/english/bc/bill_81/general/81_brf.pdf

The Family Planning Association of Hong Kong. (2013). Unplannedpregnancy. Retrieved fromhttp://www.famplan.org.hk/fpahk/en/template1.asp?style=template1.asp&content=sexual/what.asp

The Nursing Council of Hong Kong. (2002). Code of professionalconduct and code of ethics for nurses in Hong Kong. Retrieved fromhttp://www.nchk.org.hk/filemanager/en/pdf/conduct eng.pdf21

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