Ethical and Legal Foundations of Patient Education

Chapter 2
Ethical and Legal

Foundations of Patient
Education
• Why do you think ethical and legal
foundations of health education is very
important?
• There are scenarios in the clinical area that
can result to a lot of danger , or may result to
aggravated patient condition specially if it is
not properly explained to the patient and
family, same is true to the nursing student
who will go on clinical duty…
• Patient education , student nurses education
generally falls to the nurse / CI.
• The role of the nurse in this education process is
essential in providing safe, high quality as
mandated in the standards and scope of nursing
practice.
• Consumers are aware of and demand recognition
of their constitutional rights regarding freedom
of choice and self determination.
Nursing Law - Republic Act (RA) No. 9173
• Also called as Philippine Nursing Act of 2002

• The bill seeks to institute reforms to further
protect and develop the nursing profession.
• It delineates the scope of work of Registered
Filipino nurse.
• Establishes linkages with community resources
and requires the updating of professional
knowledge in the nursing field, patient care,
levels of nursing practice and development of
nursing education
• This is an recognition of the vital role of
nurses in the delivery of quality services not
only in the country, but all over the world.
R.A. 4704 – Creation of Board of Nursing
• An act to amend certain sections of R.A. 877
• Name and composition of the Board
• Qualifications of Board members
• Term of office
• Compensation of the Board Members
• Clinical and public health nursing
• Qualifications of faculty members
• General entrance requirements to schools, colleges
and universities of nursing
• Scope of practice of nursing
• Holding of examination
• Qualifications of applicants
• Scope of examination
• Ratings in the examination
• Report of results of examination
• Fees for examination and registration
DEPARTMENT OF HEALTH (DOH)
• 1944
• E.O. No. 94
• Principal Health Agency
• Ensures access to basic public health services
by all Filipinos
• Provision of quality health care
• Regulation of all health services and products.
BOARD OF NURSING (BON)
• Under the PRC (Professional Regulation
Commission)
• Regulates the practice of nursing in the
Philippines.
PRIMARY PURPOSE OF BON
1. To provide regulatory standards in the practice of
Nursing by implementing the Nurse Practice Act and by
lobbying to Congress any proposed amendment to any
laws with direct relationship to the practice of nursing.
2. To ensure public safety by administering the
Philippine Nursing Licensure Exam (PNLE) to graduates
of nursing schools prior to practice of Registered Nursing
in the Philippines.
3. To maintain high standards of nursing education by
auditing the performance of Philippine Nursing Schools.
COMMISSION ON HIGHER EDUCATION (CHED)
• 1997
• R.A. No. 8292
• To establish a complete, adequate and
integrated system of higher education.
CHED MANDATE
A. Promote relevant and quality higher education
B. Ensure that quality higher education is accessible to all who
seek it particularly those who may not be able to afford it;
C. Guarantee and protect academic freedom for continuing
intellectual growth, advancement of learning and research,
development of responsible and effective leadership,
education of high level professionals, and enrichment of
historical and cultural heritages; and
D. Commit to moral ascendancy that eradicates corrupt
practices, institutionalizes transparency and accountability and
encourages participatory governance in the Commission and
the sub-sector.
JCAHO
• Means Joint Commission on Accreditation of
Healthcare Organizations
• It is the oldest and largest standard-setting
accrediting body in health care
• JCAHO evaluates and accredits more than
19,000 health care organizations
• They are the leader in developing the highest
standards for quality and safety in delivery of
healthcare
• The Joint Commission was created to set
standards in health care
• Standards help guide organizations to
administer care and continuously improve the
performance of health care
• JCAHO is the only organization with the
capability and experience to evaluate
healthcare across the continuum of care.
JCAHO accredits other facilities, such as;
• Ambulatory care
• Mental health institutions
• Long-term care centers
• Home health care agencies
• Laboratory services
• Office based surgery
• General, children’s, rehabilitation and specialty
hospitals
• Critical access hospitals
• JCAHO Accreditation Benefits
• Patient safety is improved
• Advertising that the institution is accredited
may bring in more patients
• By showing that the institution is committed
to quality health care, liability insurance
premiums may decrease
• Insurance reimbursement are larger if
accredited
Ethical Principles to Patient Education
AUTONOMY
• Greek words “auto” (self), “nomos” (law)

• Right to self-determination
• Allows an individual to decide on his own
VERACITY
• “Truth telling”
• Helps patient to use autonomy
• Nurse must always tell the truth;
• patient is entitled to truth
4 ELEMENTS MAKING UP THE NOTION
OF INFORMED CONSENT
1. Competence
2. Disclosure of Information
3. Comprehension
4. Voluntariness
• Important in patient education

• Related to medical treatment
CONFIDENTIALITY
• Personal information entrusted and protected

as privileged information via social contract,
healthcare standard/code, or legal covenant.
NONMALEFICENCE
• “Do no harm”
• The ethics of legal determination involving
• negligence and malpractice
NEGLIGENCE VS. MALPRACTICE
• Does not involve intent; • Intentional
caused by carelessness • A type of negligence
• Improper and wrongful called
conduct by anyone arising
from any activity “professional negligence”
• Conduct which falls below
the standard established
by the law for
• the protection of others
against unreasonable risk
of harm.
Most Common Causes of Malpractice
• Failure to follow standards of care

• Failure to use equipment in responsible
manner
• Failure to communicate
• Failure to assess and monitor
• Failure to act as patient advocate
• Failure to delegate tasks properly
BENEFICENCE
• “Doing good” for the benefit of others.

• Legalized through properly carrying out tasks
• Effort to save lives and relieve human suffering
is a duty to do what is right within reasonable
limits.
JUSTICE
• Equal distribution of goods andservices.

• Fairness
• Equality
• Equitable treatment
ACCOUNTABILITY
• Accepting responsibilities and consequences

for one’s own actions.
• FIDELITY
• Being true to one’s professional promise

DOCUMENTATION
• Initial assessment, progress notes, nursing care
plans, stagg notes, and discharge planning forms
• Can provide information about the learning

needs of patients
• Documentation by other members of the

healthcare team, can yield valuable insights with
respect to the needs of the learner
• Vehicle of communication that provides
critical information to other health
professionals
• Failure = renders other staff potentially liable,
also renders the facility liable and in jeopardy
of losing its HC accreditation
The Ethics of Education in Classroom and
Clinical Practice
Criteria
1. Risk of harm to the student (patient) or to
the student-teacher (patient –teacher)
relationship
2. Presence of coercion or exploitation
3. Potential benefit to the student or to the
student –teacher relationship
4. Balance of interest and teacher’s interest.
5. Presence of professional ideals.
Legality of Patient Education and Information
• The patient’s right to adequate information

regarding his or her physical condition ,
medications, risks and access to information
regarding alternative treatments.
Thank You!

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Chapter 2

Ethical and Legal

• Also called as Philippine Nursing Act of 2002

• Greek words “auto” (self), “nomos” (law)

• Important in patient education

• Personal information entrusted and protected

• Failure to follow standards of care

• “Doing good” for the benefit of others.

• Equal distribution of goods andservices.

• Accepting responsibilities and consequences

• Being true to one’s professional promise

• Can provide information about the learning

• Documentation by other members of the

• The patient’s right to adequate information

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