NAME OF TEACHER MS RINGKANGMAI

MOBILE NUMBER 9319523398

E MAIL ID ringliangkiuwiliu@gmail.com
DISIGNATION ASST. PROFESSOR
NAME OF IIMT UNIVERSITY
UNIVERSITY
COLLEGE NAME IIMT COLLEGE OF MEDICAL SCIENCES
STREAM NAME NURSING
SUBJECT NAME OBG NURSING
COURSE 3RD YEAR BSC NURSING
COURSE DURATION 4 YEARS
SUB-TOPIC LEGAL & ETHICAL ASPECT IN MIDWIFERY
CONTENT TYPE PDF FILE
SEARCH KEY LEGAL, ETHICS, MALPRACTICE, NEGLEGENCE,
WORDS
 LAW
• The sum total of rules and regulations by
which the society is governed.
 ETHICS
• Ethics is the systematic study of What a
persons conduct ought to be with regard to
him or herself, other human beings and
the environment, it is the justification of
what is right or good and the study of what
a person’s life and relationship ought to
be, not necessarily what they are.
Ethics in midwifery and obstetrics
• To be professional is to be ethical, and to
be ethical is to be professional.
• To be ethical requires an understanding of
ethics, values, moral reasoning and ethical
decision making.
• The goal of ethical midwifery is to do right
thing for the right reason.
 UNIVERSAL MORAL PRINCIPLES
• Autonomy –right of the individuals to govern their
own action
• Freedom- the right of freedom to exempt from
control by others to select and pursue health goals
• Veracity- principle of truth telling requires
professional care givers to provide patients with
accurate ,reality based information about their
health status and care or treatment prospects
• Justice – persons who are alike in morally relevant
aspects be treated alike
 • Non-maleficence – one is morally obliged to
not harming others
• Beneficence – a person is obliged to help
others to advance their legitimate and important
interests
• Right – An entitlement to behave in a certain
way under certain circumstances. These can be
conventional and moral rights
• Fidelity – Fulfilling one’s duties and obligations
• Confidentiality – caregivers should respect a
patient’s need for privacy and use personal
information only to improve care.
FUNDAMENTAL ETHICAL PRINCIPLES
OF HEALTH CARE
• The Principle of Respect for Persons
• The Principle of Justice
• The Principle of Beneficence
 Health as basic right for all
• Women have often lacked basic human rights
because they were viewed as less than human,
less than persons, by many society.
• Maternal deaths and disabilities are the tragic
example of this.
• In order for women to be healthy and valued for
themselves, not as a producer of children or a
sexual playmate, they must be given the same
status as men in society{ICMI1990}
• Women must also demand equal treatment and
equal right to health and well-being.
Code of ethics by American college of
nurse-midwives
1. Nurse-midwifery exists for the good of
women and their families. This good is
safeguarded by practice in accordance
with the ACNM philosophy and standards
for Practice of Nurse-Midwifery.
2. Nurse midwives uphold the belief that
childbearing and maturation are normal life
processes
• 3. Decisions regarding nurse-midwifery care
requires client participation in an ongoing
negotiation process in order to develop a
safe plan of care.
• 4. Nurse midwifes share professional
information with their clients that leads to
informed participation and consent without
coercion and deception.
• 5. Nurse midwives practice competently.
They consult and refer when indicated by
their professional scope of practice or
personal limitation.
• 6. Nurse midwives provide care without
discrimination based on race, religion, life-
style, sexual orientation, socio-economic
status or nature of health problem.
 • 7. Nurse-midwives maintain confidentiality
except when there is clear, serious and
immediate danger or when mandated by law.
• 8. Nurse midwives take appropriate action to
protect clients from harm when endangered
by incompetent or unethical practices.
• 9. Nurse midwives interact respectfully with
the people with whom they work and
practice.
 • 10. Nurse midwives participate in developing
and improving the care of women and families
through supporting the profession of nurse
midwifery, research, and the education of nurse
midwifery students and nurse-midwives.
• 11. Nurse-midwives promote community, state ,
and national efforts such as public education
and legislation, to ensure access to quality care
and to meet the health needs of women and
their families.
 Legal aspects
• Laws and ethics are often seen as
complimentary to each other but at the
same time they are also seen as opposite
sides of a coin.
• Midwifes must follow standards and
regulations that ranges from national level
to the individual area of practice, such as
hospitals, labor and delivery unit.
 National standards of practice
• Various levels of legal regulations and
standards define midwifery practice.
• National standards provide an expectation
of delivery care.
• The educational programs of midwifery
assure that all the nurse midwives can
safely deliver care within the scope of
usual midwifery practice.
 State license
• Midwifery practice is regulated in the state
of practice through license to practice.
• State license is to protect the consumers
by ensuring that the midwife has
appropriate education for profession and
can provide safe care
 Community standards
• It tells that a midwife’s duty must be
evaluated according to the availability of
medical and practice knowledge that
would be used in the treatment of similar
patients under similar circumstances,
by competent midwives,
given the facilities,
resources and options available.
 Institutional policies
• The hospital laws govern midwives
working in the hospital.
• The midwife working in the hospital should
review the policies of the units in which
midwifery care is provided
 Professional negligence
• Medical malpractice is the legal error
committed by medical personnel.
• In legal terms, the errors is tort-a civil
wrong that wrong a person.
• If tort is intentional, it becomes a crime of
assault or battery.
• Negligence, a form of malpractice, is an
unintentional tort.
 To prove a neglect tort occurred, 4
elements must be there
• 1. a duty must exist between the injured party
and the professional accused of wrong doing
• 2. a breach of duty must have occurred. The
midwife must have practiced outside the
standard of care for breach to occur.
• 3. The breach of duty must be proximate
cause of the claimed injury.
• 4. there must be damages or injuries to the
claimant that are recognised by the law and
compensable.
 Legal issues in midwifery and
obstetrics
• Many legal issues are involved in obstetrics and
midwifery. Law suites against the nurses includes
the following:
• 1. problem of medication
• 2. failure in monitoring of client
• 3. failure to report changes in the pateint
• 4. failure in assessing client
• 5. abortions
• 6. nursing care of new born
 Problems in medication
• Nurses provide medications to the client.
• Certain problems that can results into
allegation against nurses are
Improper dosage of medication
Improper client medication
Wrong route of medication
Wrong time of medication
 failure in monitoring of client
• The responsibility of nurse is to monitor
regularly the client depending on their
conditions and with any gynecological
problems.
• During antenatal period, monitoring is
essential to prevent any complications.
• The nurse has to monitor the client during
antenatal, intranatal an d postnatal.
• Failure of this can results into legal issue.
 failure to report changes in the
pateint
• Nurses do the regular monitoring and the
assessment of the client.
• During assessment, any changes she
notice in the client’s condition should be
brought to the notice of physician.
• With this, the precious life can be saved.
 failure in assessing client
• Assessment is the first thing which nurses
have to do.
• Based on assessment care is provided to
patients.
• She is responsible for assessing and
reporting any minute changes in the client’s
conditions.
• Higher levels of assessment skills have to be
maintained by nurses in all speciality areas.
 Abortions
• Many abortions are performed illegally.
• Nurse have the right to refuse to assist in
abortions procedure.
• only if, abortion is performed under act of
medical termination of pregnancy, she can
assist the physician.
• Patient who has undergone abortion needs
care and monitoring.
• It is nurses legal responsibility to care for
such client.
 Nursing of new born
• Nurses have many responsibilities for the
newborn.
• She has to take
• the footprint of the newborn,
• cord is clamped,
• wrist band has to be put for the
identification,
• proper warming is maintained etc.
Thank you