Nurses In Correctional Settings Face Ethical Challenges Unique to the Profession

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As recently as 2013, the United States Department of Justice calculated the prison population of the country at over 1.5 million people. Over 31,000 people are in the custody of the Missouri Department of Correction. Meanwhile, over 10,000 are incarcerated in the Kansas Department of Correction. Nurses working in a correctional institution must set aside their personal beliefs about the prisoners, some of whom are serving sentences for ghastly crimes of a violent or sexual nature. In prison, despite controlled environments, a nurse’s own safety is at risk. Nonetheless, nurses must conduct themselves with the highest degree of ethical behavior to provide the requisite level of health care to the incarcerated. Professional licensing attorney Danielle Sanger understands the strain under which correctional nurses toil and will provide zealous legal defense for any nurse whose ethics are questioned.

Nurses are a critical component of our health care system. Adherence to the principles of justice, fidelity, veracity, autonomy, beneficence, and nonmaleficence guide the nurse’s actions in providing health care to the sick or injured. A correctional setting can challenge those ideals. While nurses are “bound” by the “Code of Ethics and Interpretative Statements,” they must also balance “the goals of corrections and the incarcerated person’s rights to appropriate health care.” Thus, the nurse must perform a nurse’s duties without regard for who the person is and what the person did. Said another way, the nurse must view and treat the prisoner as a person.  Notwithstanding the adherence to this lofty standard, the correctional nurse is encouraged to maintain “safe boundaries” in the institution for their own protection and well-being.

The corrections environment completely distinguishes correctional nursing from nursing care in a strictly medical environment. In fact, correctional nurses are prohibited from engaging in behavior that is related to a corrections function; their mandate is to treat the inmates’ health concerns and those alone. Consequently, the nurses are prohibited from participating in any function of capital punishment because capital punishment destroys life and the nurses’ goal is to preserve life. Furthermore, the American Nurses Association (ANA) prohibits nurses from assisting in investigations such as body cavity searches and other court-ordered procedures, like lethal injection, which lack any health care benefit and are performed without regard to the patient’s “informed consent.”  Correctional nurses are further prohibited from performing any function relating to discipline of inmates or serving on any penal committees. Although from a corrections and rehabilitation standpoint having a nurse serving on such boards may provide the board valuable insight into the inmate’s health concerns upon re-entry into society, such advisory roles are not permitted according to ANA standards.

The correctional nurse will confront diverse medical issues when treating inmates. Health issues relating to juvenile care; health issues specific to females, including treating pregnant incarcerated females and their children; geriatric and end-of-life care are also some of challenges a corrections nurse may face. Additionally, the corrections nurse will face public health issues, such as communicative diseases, as well as issues related to substance abuse and withdrawal all while endeavoring to follow the ANA Correctional Nurses Standards by incorporating the patient’s cultural preferences in the health care equation. The corrections nurse is also burdened with the ethical obligation of ensuring inmates’ access to health care in the facility. The nurse, when informed of a medical issue, must promptly and properly evaluate the inmate’s health care needs and take the proper course of action. The nurse must engage the inmate, bearing in mind safety concerns, personally to properly assess the level of health care required.  Failing to do so may cause the inmate to file a malpractice lawsuit or file a complaint against the nurse’s license to practice.

Professional Licensing Attorney Assisting Those Who Assist Others

Kansas Professional Licensing Attorney Danielle Sanger is dedicated to fighting for professional licensees who are facing an ethical complaint in Kansas or Missouri. Attorney Sanger understands the level of dedication and sacrifice nurses make every moment of their careers. That is why Attorney Sanger will vigorously fight for you to defeat ethical complaints.  Call professional licensing attorney Danielle Sanger at 785-979-4353 today for your free consultation.

Kansas Professional Licensing Attorney Summarizes the Ethical Duties of a Physical Therapist

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Physical therapists profess to treat a multitude of common ailments by increasing mobility and motion in lieu of medical intervention. Physical therapy as a healing art is premised on the principle that moving “pain-free” is essential to good health and is a cost-effective alternative to other medical modalities. Physical therapists work with patients to increase strength and flexibility thereby increasing, depending upon individual circumstances,  the quality of one’s daily life.  Because a physical therapist provides a vital medical service to the public, the physical therapist must be duly licensed to practice. In Kansas, the Kansas Board of the Healing Arts (“the Board”) oversees physical therapist licensing and ethical practices.  Kansas professional licensing attorney Danielle Sanger devotes her practice to the representation of licensed professionals, such as physical therapists, who face disciplinary proceedings in both Kansas and Missouri.

Physical therapy provides the opportunity for patients suffering from pain or lack of mobility to reverse those ailments without prescription drugs or surgery.  For example, the American Physical Therapy Association (“APTA”) explains that freedom of movement will help reduce obesity, reduce the risk of heart attack and stroke as well as fracture and arthritis risk. The APTA further explains that increased mobility—one of the primary benefits of physical therapy—decreases the risk of falling by encouraging consistent movement to benefit our sense of balance. In addition to increased mobility, decreased pain is another perceived benefit of physical therapy.  The APTA cites a Journal of the American Medical Association study that concluded that back-pain is “over-treated” by physicians ordering costly diagnostics and treatment, such as “imaging” and surgery.  According to the APTA, physical therapy is a “cost-effective” alternative to “surgery and injections” to treat back-pain and other ailments, such as torn rotator cuffs, meniscus tears, and degenerative disc disease.

To ensure that physical therapy is practiced ethically, the APTA promulgated the “Code of Ethics for the Physical Therapist.”  The Code of Ethics establishes an industry standard of the physical therapists’ role in treating a patient, minimum standards of care, while promoting a patient-centric approach to health care. The APTA delineated 10 principles of physical therapy to guide the practitioner in providing health care in the Code of Ethics. Accordingly, physical therapists are implored to respect their patients and communicate well with them; practice with integrity; avoid misrepresenting their credentials and potential outcomes of treatment; and use sound professional judgment that is in the best interest of the patient at all times. Specifically, the Code of Ethics obligates practitioners to obey federal and state laws and regulations.

In Kansas, the Board of Healing Arts is the licensing authority for physical therapists. The Board of Healing Arts (“the Board”), by authority conveyed by statute, may deny licensure, renewal, or may take adverse action against a physical therapist’s license for conduct including but not limited to alcohol or drug dependency, felony conviction, or unprofessional conduct as defined by the Board’s rules and regulations. The regulations are consistent with, although more specific than, the APTA’s Code of Ethics. In Kansas, unprofessional conduct is defined as, for instance, failing to practice skillfully due to alcoholism or drug dependency and/or mental illness; committing gross or ordinary negligence; demonstrative incompetence; “advertising a guarantee” relating to physical therapy; making false or misleading claims in advertisements, including misrepresenting one’s own credentials; continuing unwarranted treatment or ordering useless tests or procedures; and charging excessive fees.

What To Do If You Are A Physical Therapist Facing An Ethical Investigation

If you are a physical therapist facing an investigation or complaint for unethical practices, contact Kansas Professional Licensing Attorney Danielle Sanger immediately at 785-979-4353 to discuss your options and defenses. Attorney Sanger has vast experience defending professional licensees in Kansas and Missouri against alleged ethical violations. Attorney Sanger is a zealous and tireless advocate who will pursue every available defense on your behalf. Call Attorney Sanger today for your free consultation.  

Practitioners of the Chiropractic Arts Must Maintain Highest Ethical Standards in Missouri

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Chiropractic care continues to suffer from an image problem. Some believe that the chiropractic arts are a bit of witchcraft or voodoo because they are skeptical of its benefits as a healing art. Notwithstanding, given the proliferation of chiropractors in the United States, and in Missouri in particular, chiropractic care continues to grow as a legitimate health care alternative, despite its image problem. Chiropractors must be vigilant to uphold the highest duty of care to their patients as well as their ethical duties so the credibility of the healing art may progress. Any deviation from that high standard can have disastrous consequences for the practitioner. The potentially disastrous consequences is why Professional licensing attorney Danielle Sanger is committed to defending actions against chiropractor’s licenses.

In 2011, the Missouri Bar Association published an article relating to the proper evaluation of chiropractic malpractice relating to strokes purportedly caused by neck manipulation. The risk of stroke, incidentally, the existence of which is conceded by chiropractors, is caused by the twisting of the neck, or cervical spine, which can create a shearing of the major blood vessels leading to the brain. The shearing deprives the brain of necessary blood resulting in a stroke. The article cites a study conducted by medical doctors concluding that manipulation of the neck causes stroke in nearly 1 out of every 40,000 manipulations. By stark contrast, studies advanced by chiropractors conclude the risk of stroke by neck manipulation is 1 in 5.85 million.

The article cautions the legal practitioner on properly evaluating whether the chiropractor committed malpractice causing a stroke. In fact, the article discusses how a plaintiff’s potential expert at trial, i.e., a neurologist, has a natural bias against chiropractic care, which diminishes their credibility as an expert.  That’s on the one hand. On the other, the author instructs the case evaluator to consider the promises and rhetoric a chiropractor uses to convince a potential patient that there is a dire need for chiropractic care vis-a-vis traditional medical care. The author advises that a chiropractor’s website and advertisements are filled with information that can be used against the practitioner.

Ensuring the ethical practice of chiropractic care can only serve to advance the public perception and benefit of chiropractic care. Thus, a chiropractor who truly believes in the healing arts will benefit from closely following the ethical guidelines delineated by the Missouri State Regulations as well as the American Chiropractic Association Code of Ethics. The Missouri State Regulations (“the Regulations”) require a chiropractor to inform the patient of the patient’s “abnormalities” and provide an honest assessment of whether chiropractic care will benefit the patient. Similarly, the American Chiropractic Association Code of Ethics (“Code of Ethics”) mandates a chiropractor to build “trust” in a clinician–patient relationship. Consistent with the Regulations, the Code of Ethics instructs the chiropractor to be completely honest with the patient about the causes of the ailments for which treatment is sought and the possible outcomes as well as the chiropractor’s skill and education.

As the article referenced above indicates, the competition for chiropractic patients is greater than that of a medical doctor’s. Accordingly, chiropractors who choose to advertise must do so without being false or misleading. For instance, promising or guaranteeing certain results will be reached is strictly prohibited by both the Regulations and the Code of Ethics. Preying upon a vulnerable population, such as people suffering from chronic pain, or solicitation of business in the immediate aftermath of an accident, is also prohibited.

Missouri Professional Licensing Attorney Danielle Sanger has devoted her career to defending professional licensees, such as chiropractors, in both Missouri and Kansas. Attorney Sanger, with her experience as an assistant attorney general, will represent you with zeal to protect your license from discipline should you be accused of violating an ethical rule. Call Missouri professional licensing attorney Danielle Sanger at 785-979-4353 to schedule your free consultation and learn what a difference dedication and experience can make for you.

Decisions in 2015 by the Missouri Board of Healing Arts Lead to a Number of Physicians Losing Their License to Practice Medicine

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The Missouri Board of Registration for the Healing Arts has disciplined several medical doctors in 2015 for ethical violations. Most disciplinary actions resulted in a public reprimand or probation, while others have led to suspensions from practice for a given period of time. Some physicians have suffered catastrophic outcomes. To this point in 2015, five physicians have lost their license to practice medicine in Missouri. While the reasons for license revocation vary, the transgressions the Board of Registration for the Healing Arts (“the Board”) found that the physician committed were extremely serious and warranted license revocation. The potential for severe, career and potentially life-altering disciplinary action requires hiring an experienced professional licensing attorney to defend you in disciplinary investigations and hearings.  Missouri professional licensing attorney Danielle Sanger has the experience to vigorously protect you from potentially irreparable disciplinary action.

Physicians, as well as all other licensees who are investigated for unethical conduct by the Board, enjoy certain rights if the investigation leads to a formal disciplinary hearing. The rights granted to physicians facing a disciplinary action ensure that the physician is protected by due process of law before adverse action is taken against the physician’s license. Accordingly, physicians have the right to be present and hear evidence presented at a hearing, to be represented by counsel, to have the allegations proven by “competent and substantial evidence,” the right to confront and cross-examine witnesses present in support of the allegations, the right to present evidence in the physician’s own behalf, as well as the right to a fair and impartial hearing conducted by an administrative hearings commissioner.  The rights are personal to the physician. Accordingly, the physician may waive the enumerated rights and enter an agreement with the Board. The physician may wish to challenge the Board’s evidence and contest the allegations levied at a hearing.  Failure to appear and defend will result in a default judgment against the physician and the Board will conclude that all of the allegations are true.

The Board has the statutory authority to discipline a physician licensed in Missouri for disciplinary action occurring in another state. Thus, the Board revoked the license of a Missouri physician for seven years based upon disciplinary action in Tennessee. Tennessee’s disciplinary tribunal revoked the physician’s license for a period of not less than two but no more than seven years.  Similarly, the Board revoked a Missouri physician’s license for seven years who voluntarily and permanently surrendered his medical license to the Texas Medical Board. This physician was found responsible for unethically dispensing controlled substances to seven patients in Texas.

Three additional investigations by the Board resulted in the revocation of Missouri physicians’ licenses. One physician voluntarily surrendered his license in lieu of other discipline for positive drug screens. The physician admitted to taking morphine pills that were not prescribed for him. This positive test caused the physician to voluntarily surrender his rights to prescribe controlled substances monitored by the State of Missouri and the U.S. Drug Enforcement Administration (“DEA”). Surrender of his privileges to the DEA constitutes “final action” giving the Board grounds to seek disciplinary action. Another physician voluntarily surrendered his “controlled substance privileges” to the DEA during the Board’s investigation. This physician also voluntarily surrendered his license in lieu of other discipline. In another case, the Board, after a full hearing, found that the physician failed to comply with his terms of probation on his license resulting from previous disciplinary action for substance abuse. The Board ruled that to preserve the public safety, the physician’s license must be revoked for seven years.

Professional Licensing Attorney Will Fight To Protect You And Your Livelihood

Kansas Professional Licensing Attorney Danielle Sanger is a zealous advocate for professional licensees, including physicians. Attorney Sanger’s experience as an assistant attorney general, coupled with her extensive accomplishments in private practice, provide her with the knowledge to zealously defend against any disciplinary action or investigation. Call Missouri professional licensing attorney Danielle Sanger at 785-979-4353 to learn how experience and determination can preserve your career and your livelihood.