Acknowledgments Introduction BASIC LAW The American Legal System Common law State and federal courts Statutory law Executive orders and agencies Constitutional law Criminal and civil law EXERCISES Chapter 1: Moral Decision Making: Theory and Practice WHAT IS MORALITY? CONSEQUENTIALISM AND DEONTOLOGY Consequentialism Rule consequentialism Kantian Deontology The categorical imperative The respect principle Rule Theory ALTERNATIVE APPROACHES Principlism The Ethic of Care PRACTICE ETHICS: NURSING IS THERE A MORAL OBLIGATION TO OBEY THE LAW? CULTURAL SENSITIVITY The Importance of Cultural Sensitivity Reacting to Patients: Responding to Differences Responding to Patient Biases Cultural Competence and Translation CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 2: Regulation of Nursing LICENSURE, CREDENTIALING, CERTIFICATION, AND ACCREDITATION NURSE PRACTICE ACTS AND NURSING BOARDS LEGAL STANDARDS OF CARE NEGLIGENCE AND MALPRACTICE Requirements of a Negligence Lawsuit Nurses'' Relationship to Other Providers Employee of facility Agent of physician CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 3: Informed Consent THE RIGHT TO INFORMED CONSENT ELEMENTS OF INFORMED CONSENT Disclosure Risk Expected benefits Alternative treatments Absence of treatment WAIVING AND DELEGATING INFORMED CONSENT Proxy Decision Making Advance Directives INFORMED CONSENT: ETHICAL ISSUES Constraints on Informed Consent Coercion Manipulation Offers and rewards Influence Medical paternalism Autonomy versus Beneficence Ethical Evaluation of Informed Consent Informed Consent and Ethics Committees INFORMED CONSENT: LEGAL ISSUES The Scope of Informed Consent Community of physicians standard Reasonable physician standard Objective patient standard Subjective patient standard Hybrid standard Three Exceptions to Informed Consent Incompetency Emergency care The therapeutic privilege Revising Informed Consent False Imprisonment NURSES AND INFORMED CONSENT Ethical and Professional Considerations Legal Duties of Nurses Regarding Informed Consent Exceptions to the General Rule CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 4: End of Life and the Refusal of Treatment THE NURSE''S ROLE IN END-OF-LIFE DECISIONS THE CRITERIA FOR AND MEANING OF DEATH Persistent Vegetative States MEDICAL FUTILITY What Is Medical Futility? Physiological or strict futility Quantitative futility Qualitative futility CASE STUDIES OF MEDICAL FUTILITY AreWanglie andBaby K Cases of Medical Futility? HOW CERTAIN? WHAT IS THE CHANCE OF SUCCESS? POLICIES ON FUTILITY American Medical Association American Thoracic Society The ANA Code DISCONTINUING MEDICAL TREATMENT AND ADVANCE DIRECTIVES Determining whether to Discontinue Treatment Family consent Substituted judgment Best interest standard Mixed standard: Limited objective test Withdrawing versus Withholding Treatment Passive Euthanasia Active Euthanasia and Physician-Assisted Suicide The Law of Assisted Suicide Nurses and Physician-Assisted Suicide ETHICAL AND LEGAL FOUNDATIONS OF INFORMED REFUSAL The Ethics of Informed Refusal Legal Foundations of Informed Refusal Karen Quinlan: Privacy and treatment Nancy Cruzan: Clear and convincing evidence Elizabeth Bouvia: Do motives matter? Removing respirators versus removing feeding tubes Other cases: Schiavo and Borenstein TREATMENT DECISIONS INVOLVING CHILDREN Birth Defects and Treatments Parental Autonomy and Mandated Treatment Refusal of Treatment for Religious Reasons CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 5: Privacy and Confidentiality PRIVACY Moral Support for the Right to Privacy Covert surveillance The Legal Right to Privacy CONFIDENTIALITY: THE NURSE-PATIENT RELATIONSHIP The Nurse''s Obligation of Confidentiality HIPAA Regulations Maintaining Confidentiality Legal Exceptions to Confidentiality Evaluating the Tarasoffcase HIV and the Law Privacy and Adolescents Privacy and Social Media CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 6: Impaired Decisional Capacity ASSESSING CAPACITY The Nurse''s Obligation THE MEANING OF DECISIONAL CAPACITY Ability to Communicate a Decision Ability to Understand Medical Circumstances Ability to Reason about Medical Circumstances Ability to Appreciate Medical Circumstances MENTAL ILLNESS AND CAPACITY TO CONSENT ENHANCING CAPACITY CAPACITY: SPECIAL CONCERNS Capacity: Young and Old Religion and Capacity DOES REJECTION OF TREATMENT INDICATE INCAPACITY? ERRING ON THE SIDE OF AUTONOMY ASSESSING CAPACITY CONCLUSION FOR FURTHER CONSIDERATION EXERCISES Chapter 7: Integrity and Advocacy NURSING AND INTEGRITY Conscientious Objection Compromise and Integrity RELATIONSHIPS AND ADVOCACY Boundary Violations WHEN THE NURSE IS AT RISK UNIONIZATION AND CAREER SATISFACTION CONCLUSION FOR FURTHER CONSIDERATION EXERCISES INDEX INDEX OF COURT CASES INDEX OF STATUTES.