Ethics Transform

Ethics Transform ▪ ▪ Legislation determines what is “right” or “good” within a society. Ethics: A branch of philosophy that deals with distinguishing right from wrong- What should I do? • Requires the individual to think about what is right or wrong and come to a decision. • Ethical Dilemmas ‒ ‒ Situations that require individuals to make a choice between two equally unfavorable alternatives. Taking no action is considered an action taken. • Bioethics: Term applied to ethics when they refer to concepts within the scope of medicine, nursing, and allied health • Generally, the process of the formation of morals is unconscious • Morality can be applied without having to think; can follow instructions from those with Moral Authority. ▪ Values: Personal beliefs about what is important and desirable • Values clarification: A process of self-exploration by which people identify and rank their own personal values ▪ Right: A valid, legally recognized claim or entitlement, encompassing both freedom from government interference or discriminatory treatment and entitlement to a benefit or service • Absolute right: When there is no restriction whatsoever on the individual’s entitlement • Legal right: A right in which society has agreed and formalized into law ______________________________________________________________________________________________ Theoretical perspectives ▪ Utilitarianism: An ethical theory that promotes action based on the end result that produces the most good (happiness) for the most people ▪ Kantianism: Suggests that decisions and actions are bound by a sense of duty ▪ Christian ethics: Do unto others as you would have them do unto you. ▪ Natural law theories: Do good and avoid evil. Human knowledge of the difference between good and evil directs decision-making. ▪ Ethical egoism: Decisions are based on what is best for the individual making the decision. ____________________________________________________________________________________________. Ethical Principles ▪ Autonomy: emphasizes the status of persons as autonomous moral agents whose rights to determine their destinies should always be respected. ▪ Beneficence: refers to one’s duty to benefit or promote the good of others. ▪ Nonmaleficence: Abstaining from negative acts toward another; includes acting carefully to avoid harm. ▪ Justice: Principle based on the notion of a hypothetical social contract between free, equal, and rational persons. The concept of justice reflects a duty to treat all individuals equally and fairly. ▪ Veracity: Principle that refers to one’s duty to always be truthful. ________________________________________________________________________ Ethical Issues in Psychiatric/Mental Health Nursing All clients that a nurse attends to has the following rights: ▪ The right to treatment ▪ The right to refuse treatment (including medication) ▪ The right to the least restrictive treatment alternative ▪ Confidentiality and right to privacy • Health Insurance Portability and Accountability Act • Exception: A duty to warn- requires a clinician who has reasonable grounds to believe that a patient may be in imminent danger of harming himself or others to warn possible victims. • Exception: Suspected child or elder abuse ▪ Informed consent- permission granted once the patient has been informed about potential risks and benefits. ▪ Restraints and seclusion Types of restraints: ‒ Physical- vest, belt, mitton ‒ Chemical- sedative/antipsychotic • Prior to using a restraint you always want to try alternatives: ‒ reorientation, supervision, diversion • An order from a physician needs to be attained within 1 hour of applying them. • The physician will have to rewrite the prescription every 24 hours ▪ False imprisonment • Restriction of movement within an area without legal authority ______________________________________________________________________________________________ Commitment issues • Voluntary admissions- patient checks in on his or her own accord; consent for admission attained • Involuntary commitments ‒ Emergency commitments ‒ The mentally ill person in need of treatment ‒ Involuntary outpatient commitment ‒ The gravely disabled client Legal Considerations: ● The Nurse Practice Act defines the legal parameters of professional and practical nursing. ○ Statutory law- come from legislation ● ○ Common law- come from previous judgments Civil law: Protects the private and property rights of individuals and businesses (money, defendants don’t go to jail) ○ Torts- often is a lawsuit seen in the medical field when a patient is seeking damages ○ Contracts- a contract (consent) has been agreed upon between two parties ● Criminal law: Provides protection from conduct deemed injurious to the public welfare ○ Nursing liability ■ Malpractice- physicians (“a professional”) ● ■ negligence- others Types of lawsuits that occur in psychiatric nursing ○ Breach of confidentiality ○ Defamation of character ■ Libel- written defamation (act of damaging an individual’s reputation) ■ Slander- spoken defamation (act of damaging an individual’s reputation) ○ Invasion of privacy ○ Assault and battery ■ Assault- the threat of harm made against an individual ■ Battery- the act of harm made against an individual ○ False imprisonment- Restriction of movement within an area without legal authority Avoid Liability: ▪ Respond to the patient ▪ Educate the patient ▪ Comply with the standard of care ▪ Supervise care ▪ Adhere to the nursing process ▪ Document carefully ▪ Follow up as required ▪ Develop and maintain a good interpersonal relationship with client and family Worst Possible/Most Likely Complications/Assessments to Identify/Interventions to Rescue: Patient Education/Health Promotion Priorities: Active Learning Strategy to Contextualize Content: