Forensic Nursing and the Law

Forensic Nursing and the Law
Forensic Nursing Practice
A. Regulated and influenced by
?? State law
?? Federal law
?? International law; applies when a forensic nurse is assisting in investigation of war crimes and human rights violations
B. Laws passed by state legislatures or U.S. Congress called statutes
C. Administrative rule development
?? Guidelines for writing federal and legislative rules and regulations
?? Guidelines written to protect the rights of citizens
D. Rules and regulations often govern details that may be modified/ changes
?? State nurse practice act
?? State and federal courts interpret existing law, create case laws, make decisions in appellate cases
E. Nurse practice act: First legal responsibility
F. Patient confidentiality
1. Patient confidentiality is the most basic concept in nursing education, practice, and ethics.
2. Failure to follow mandatory policies and laws related to patient confidentiality is considered a misdemeanor criminal offense.
3. According to individual state laws and statutes, patient confidentiality may be breached when reporting abuse, neglect, infectious disease, or when a threat exists that may cause harm, injury, or death to another person.
4. Health Insurance Portability and Accountability Act (HIPAA)
?? Passed by Congress in 1996
?? Mandates the creation of privacy regulations for personal health care information
?? All patients required to receive a written copy of their privacy rights

Temporary or permanent cognitive status alteration as a result of
1. Medications (e.g., narcotics, intravenous benzodiazepines for immediate relief of disruptive or injurious behavior, medications that result in severe extrapyramidal symptoms, above normal blood alcohol level/s, illegal drugs, anesthesia, benzodiazepines as a sedative agent prior to a medical or interventional procedure, long-term sedation to decrease oxygen demand in those suffering from trauma resulting in severe life-threatening injuries)
2. Physical disease processes (e.g., dementia, Alzheimer’s disease, short- or long-term amnesia, cognitive genetic anomalies)
3. Mental illness (e.g., Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision [DSM-IV-TR] diagnosis of psychosis presenting with symptoms such as hallucinations, dystonia not associated with medications, delusions, anhedonia, severe symptoms of depression)