R U Reasonable?
-
Upload
nc-association-of-nurse-anesthetists -
Category
Education
-
view
28 -
download
0
Transcript of R U Reasonable?
![Page 1: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/1.jpg)
Basis Behind Medical Legal Issues
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 2: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/2.jpg)
Describe the Reasonable Person Theory of Tort Law
What is required for Appropriate Informed Consent
List Three Charting Pitfalls
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 3: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/3.jpg)
Statutory Law Law is passed (i.e.) Nurse Practice Act
Common Law Legal Precedent
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 4: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/4.jpg)
Criminal
Intentional
Civil Unintentional
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 5: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/5.jpg)
Duty
Medical Legal—Duty to care
Breech
Not acting within your standard of care
Harm
Actual or imagined
Causation
Did the breech cause the harm
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 6: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/6.jpg)
Negligence Law
Each member of society has a duty to behave as to avoid unreasonable risks of harm to others
We Must Act:
As a reasonable person of ordinary prudence in similar circumstances
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 7: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/7.jpg)
Considers Personal Characteristics
Similar age, intelligence, experience
Similar circumstances
▪ Emergencies require less of a standard
Similar physical disabilities
Mental Disabilities do not relieve a person from conforming to Reasonable Person Standard
▪ Same is true of intoxication
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 8: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/8.jpg)
Used as a judgment:
Did a persons conduct fall below this standard…
▪ Was there a breech of Duty?
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 9: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/9.jpg)
Objective for two reasons Hypothetical Person
▪ Ideal attributes
Focused of behavior
▪ Rather than the subjective mental state
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 10: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/10.jpg)
Flexible
Tailored to the facts of the case
▪ Reasonable Foreseeablity
▪ Magnitude
▪ Social Utility
▪ Avoidance
▪ Context
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 11: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/11.jpg)
Could a reasonable person predict the foreseeable risk of harm
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 12: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/12.jpg)
As the seriousness of the risk increases the duty to avoid the behavior increases
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 13: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/13.jpg)
The more valuable the conduct to society, the less likely the breech
Good Samaritan Laws
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 14: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/14.jpg)
Emergencies do not need the same cautiousness and deliberation as planned events
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 15: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/15.jpg)
Diagnosis Purpose of Procedure Risks involved Success Rate Failure to Act Alternative treatments
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 16: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/16.jpg)
Landmark case for informed consent handed sown in US Appeals Court Washington District
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 17: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/17.jpg)
1959 – 19 y/o clerk in DC with back pain sought tx and found to have bulging disc @ T4
Surgeon called and talked to mother in WV. No record of consent during conversation Surgery performed and mom arrived after surgery, consent
signed. On PO day 2 pt assisted OOB to void and was left
unattended and fell in process of voiding Lower extremity paralysis Months later, crutch walking with no bowl or bladder
function
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 18: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/18.jpg)
“every human being of adult years and sound mind has a right to determine what shall be done with his own body”
Right to Self Determination
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 19: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/19.jpg)
Must be able to trace:
Knowledge of options
Risks of each
Magnitude of Risk
Risk of failure to act
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 20: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/20.jpg)
Required to communicate this to the patient
Medical training enables providers to a self-satisfying course of action
Prerogative is of the patient not the physician
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 21: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/21.jpg)
Justices found:
This is doctrinal emphasis not an addition to malpractice law
Settled the rule:
▪ Therapy not authorized equaled a tort –Common Law Battery
▪ Criminal Tort (intentional) not a Civil Tort (unintentional)
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 22: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/22.jpg)
Degree of care which a reasonable prudent person with like training would have experienced under similar circumstances
Physician performs at a higher level than a non-physician
Same of similar location/setting
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 23: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/23.jpg)
Are but an adaptation of general standards Required to act as reasonable men
possessing their medical talents would
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 24: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/24.jpg)
Unwilling to adopt full disclosure
Unrealistic to expect disclosure of every risk no matter how remote
What a reasonable practitioner would bare More importantly:
What a reasonable person would expect
▪ Patient prerogative
▪ Self-determination shapes duty to reveal
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 25: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/25.jpg)
Two exceptions to the rules:
Incapable of consenting and failure to treat would harm▪ Unconscious patient in the ED
Disclosure poses threat to the patients care
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 26: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/26.jpg)
Not Duress but undue influence Duress
Induced by threat
No reasonable alternatives
Undue Influence
A relationship exists
▪ Trust and Confidence
▪ Domination
Unfair persuasion
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 27: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/27.jpg)
Healthcare Insurance Portability Assurance Act
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 28: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/28.jpg)
Too little Too Much Illegible
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD
![Page 29: R U Reasonable?](https://reader030.fdocuments.in/reader030/viewer/2022032421/55a7cbab1a28abe6408b45d9/html5/thumbnails/29.jpg)
NCANA Dist. I & II Mtg. 2015 Jerry Coy, CRNA, PhD