Ethically right, legally wrong

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Dec 13, 2010

Easy! A minor is brought into the ER with an injury, say a wrist fracture. His parents "are on their way from out of town." Treating him without parental consent constitutes assault and battery. Hospital policy says we must wait for consent.

Saw essentially same scenario in my EMS days, so I've no problem with it. You have 2 choices, both of which could lead to legal action, and facing a jury. I'd rather face a jury for assault, having given the child my best possible care, than risk making the child wait, and if for some reason there's a poor outcome for the patient (not necessarily negligence), having to face the jury when the child is permanently impaired, disfigured, or handicapped.

qt2168 · Dec 13, 2010

That is a great example! I used this one though, tell me what you think. We get diabetic patients on our unit all the time. When they are in my unit they are prescribe an insulin pen. We are supposed to throw these pens away. This patient had very limited funds so I let her take the pen home. Do you think thats a good example?

Thats awful that you can get in so much trouble for helping a minor!

NurseLoveJoy88, ASN, RN · Dec 13, 2010

Here's one from NS: You are treating a rape victim that threatens to kill or harm her attacker. Do you call the police to report the threat or keep quiet ? In ns we were taught that it is legally correct to report any threat of attack against the rapist to proper authorities.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Dec 13, 2010

I know home health nurses sometimes tell diabetics to re-use their syringes. Before glucometers became a household item, glucose was measured by comparing the color of the test strip with a color chart on the side of the container. It wasn't unusual for patients to cut the test strips in half lengthwise to save money. I am not familiar with the insulin pens, but if they can be used safely by the patients at home, I'd mention the possibility to the patient and leave the insulin pen where the patient could choose to take it home with him/her.

qt2168 · Dec 13, 2010

dthfytr thanks for your help! Thats the one I am going to go with. I appreciate your guidance.

anon456, BSN, RN · Dec 13, 2010

We had a patient who spoke an unusual language and she was going for urgent surgery. Her family member was translating but legally could not translate the doctor telling her about the surgery, and the consent form itself. The policy is that consent forms and doctor consults must be done by official translators. They did not have a translator on site who spoke this language. They brought out the translator phone and it was having technical difficulties (they could not get the thing to dial into the service). It was not a dire emergency, but there she was in pre-op and people waiting behind her. The charge nurse made the decision to allow the family member to translate to the patient. Then the patient was asked to repeat back in her own words what her understanding was, and the family member translated that back to the doctor. Then the consent was signed and she went to surgery. I agree with their decision, they couldn't be messing around with the translater phone, who knows how long it was going to take to fix. And the pt. was extremely scared and nervous and sitting there in that state would be detrimental to her health.

qt2168 · Dec 13, 2010

I wonder what would have happened if something wrong went off in surgery and the patient had tried to take the hospital to court? Do you think the court would have sided with the hospital because they tried, this ethics class is really opening my eyes. Very interesting stuff.