Child neglect in home care: weighing legal and ethical issues.

Individual cases of child neglect and/or abuse in pediatric home care pose a number of legal and ethical questions for health care providers. Staff members and agencies must carefully consider all legal and ethical issues before arriving at decisions to terminate care due to noncompliance.

Managing your risk of legal liability.

Pediatric practitioners face significant risk of liability and are becoming increasingly conscious of the need to manage their risks of legal liability. Providers must understand what constitutes negligence or malpractice and steps they can take to reduce their risks of legal liability.

Balancing personal risk with professional responsibility: the case of AIDS.

Generally, nurses have an ethical and legal obligation to provide treatment to persons with AIDS. When it is unclear whether nurses are morally required to provide treatment, they should engage in moral analysis, discuss their concerns with their colleagues and administrators, work within their institution's framework to resolve their concerns, seek legal counsel, or as a last resort consider working in another practice setting.

Confronting unsafe practice: ethical and legal issues.

Confronting unsafe practices in the workplace requires careful ethical and legal analysis and a supportive practice environment. Nurses should collaborate with their colleagues to create mechanisms to review and monitor clinical practices, investigate questionable occurrences, and collaborate with licensing boards to respond to infractions.

When parents demand "everything".

Critical care professionals may be faced with requests by parents to continue life-sustaining treatment despite professional recommendations to the contrary. Such cases raise complex moral, legal and social issues that require ongoing ethical dialogue in hopes of achieving a social consensus. Professional standards, a statutory framework, case law and the exercise of professional and parental responsibility will also play a role in this dialogue.

End of life care for infants with AIDS: ethical and legal issues.

Complex cases involving end-of-life care for infants with AIDS raise a variety of ethical and legal concerns. Health care providers should understand the issues involving proper treatment, including adequate relief of pain at the end of life, and a context for examining the suffering of caregivers.

Patient referrals: could nurses be violating federal and state antitrust laws?

A recent Florida court case has clearly signaled that nurses may be increasingly involved in activities that may result in violation of state and federal antitrust laws. Nurses must review their referral practices for patterns similar to the Florida case and modify their practices to reflect the recent court decision.

Inadequate staffing situations: implications for nurses.

Lack of sufficient staff on a nursing unit is a problem frequently encountered by nurses and nurse managers. Nurses should understand the legal implications of staffing problems and resolve situations in a manner that poses minimal risk to themselves.

Liability for premature discharge: an update.

As first reported in the September/October 1988 issue of Pediatric Nursing, payors have taken an active role in the process of making discharge decisions in order to save money. Recent court decisions since the landmark Wickline v. The State of California case in 1987 have addressed this issue of shared liability between payors and providers.

Withholding nutrition and hydration from an incompetent: implications.

In Cruzan v. Director, Missouri Department of Health, the U.S. Supreme Court considered for the first time the circumstances under which nutrition and hydration may be withheld from an incompetent. This important decision is described along with possible implications for pediatric nurses.

Referring patients to organizations in which providers have an ownership interest: legal ramifications.

Self-referral practices by providers have brought them under increasing criticism and legal actions by outside organizations. Nurses who refer patients should be aware of recent legal developments concerning self-referral practices.

The liability of payors and providers in health care treatment decisions.

Who is legally liable for health care treatment decisions--payors or providers? Nurses need to understand the implications of recent court decisions that deal with this question.

What nurses can do to prevent or stop physical violence from patients.

A common misperception is that nurses must tolerate physical violence and possible injury from patients. It is important for nurses to take action to protect both themselves and other patients.

Preparing for depositions: what nurses should know.

With nurses more frequently involved in lawsuits, understanding how to prepare for depositions is extremely important to the success of a case.

Implications of certification--legal considerations.

With certification of specialty nurses here to stay, nurses and certifying organizations must understand several legal issues associated with the process.

Consent for minors.

Consent for minors is an issue health care institutions must deal with frequently. Development of a mature minors policy is a worthwhile ethical and legal undertaking for every institution.

Opportunities for nurses seeking third party reimbursement using existing mechanisms.

Opportunities exist for nurses in advanced practice to successfully seek third party reimbursement by paying close attention to technical details in existing payment mechanisms. One recent case in Oregon yielded positive results when such an approach was used.