Lecture 2: Legal and Ethical Concerns

mental health notes Lecture 2: 1/20 Legal and Ethical Concerns Ethical Concepts Six Principles of Bioethics Evolving Ethical Issues in PMH Ethics: The study of philosophical beliefs about what is considered right or wrong in society Autonomy: kespecting the rights of others to maDe their own decisions Bioethics: Used in relation to ethical dilemmas surrounding healthcare BeneNcence: /uty to promote good Ethical dilemma: Con,ict between two or more courses of actionv each with faRorable and unfaRorable results Fustice: /istribute resourcesqcare eMually roluntaSy admission: 'ought by pt or guardian /one if the pt is mentally illv danger to self or othersv confusedqdementedv graRely disabledv or in need of treatment and illness preRents help-seeDing Used for obserRationv diagnosisv and treatment :enerally for 96-xA hours Court hearing before discharge or neWt admission /ue Irocess in GC gtizmatiWation: :enetic testing could preRent an indiRidual from getting a Sob reSacity: /uty to always communicate truthfully Gssue of autonomyE kight to Dnow or not Dnow of genetic tendencies in health :enome scans Discharge Procedures Cnconditional Selease: Termination of the legal patient-institution relationship kight to treatment xonditional Selease: Usually reMuires outpatient tW for a specijed amount of time with follow-through eRaluation kight to refuse treatment Assisted outLatient t : 'imilar to conditional release but court-ordered TaDing the last drastic or restrictiRe action 5 Elements to Prove Negligence /uty reach of duty Cause in fact IroWimate cause Tort Law Fny wrongful act 2intentional or accidental4 that results in an inSury to another Gntentional Tort Oillful or intentional acts that Riolate another person)s rights or property Gnclude assaultv batteryv false imprisonmentv inRasion of priRacyv and defamation of character /amages Standards for Nursing Care UalLSactice: Type of negligence that results in harm Gncompetencev impairmentv or criminal actiRity keport process 2to preRent actual harm4 Gn an emergencyv a nurse may place a pt in seclusionqrestraint but obtains a writtenqRerbal order F'FI thereafter Hrders for restraintqseclusion are neRer written as a IkBqstanding order GIFF IriRacy kule Conjdentiality of professional communications Custom as a 'tandard of Care (Wceptions to the ruleE /uty to warn and protect third parties Documentation of Care Fccurate and complete Child and elder abuse reporting Nailure to protect pts ;eans of interprofessional communication The record belongs to the institution Medical Records as Evidence kecords are used to determineE (Wtent of pt)s damages and su ering in suit Bature and eWtent of inSuries in abuse cases Medical Records and Quality Improvement ketrospectiRe record reRiews areE 'uperRisor interRenesP if unaRailablev you must interRene to protect the pt Used as eRidence Bature and eWtent of physical or mental disability in disability cases Bature and eWtent of inSury and rehabilitatiRe potential in worDers) compensation cases Used for risD management purposes Used to determine insurance reimbursements ;anage data and communication Violence in the Psychiatric Setting Nederal priRacy laws on access Burses must participate in setting policies that create and maintain a safe enRironment Courts assume if it)s not documentedv it didn)t happen Flways documnent pt)s potential for Riolence 'pecijc rules and time frames to jW errors Hrders and documentation Gnstitutional Iolicies and Irocedures Used for Muality improRement keduce errors and facilitate decision maDing kights regarding restraint and seclusion Conjdentiality after death /ocument clearly and accurately jrst Guidelines for Electronic Documentation kights regarding psychiatric adRance directiRes Irofessional Fssociations Begligencev irresponsibilityv or impairment /uty to interRene and duty to report Gmplied consent Conjdentiality and social media It has a right to reRiew record Acting on Questionable Practice Ierson must Roluntarily accept tW 'tate oards of Bursing Unintentional Tort Jelizence: Nailing to meet a standard of care It is informed of risDsv benejtsv and alternatiRes kights regarding conjdentiality 'lander is RerbalP libel is written Unintended acts against another that produce inSuryqharm kight to informed consent Capacity and competency Used when pts jnd they)re held wqo Sust cause veast SestSictiMe alteSnatiMe doctSine: Patients' Right Under the Law kelease against medical adRice 2F;F4 fSit ob hapeas coSLus: Challenges unlawful detention IredictiRe Isychiatry Videlity: ;aintaining loyalty and commitmentP doing no wrong to a pt GnRoluntary Commitment (mergency commitment without pt)s consent 2temporary4 Gssue of nonmalejcence Gf tests are not usefulv then potential harm outweighs benejts JonmaleNcence: /oing no harm to a pt Hospital Admission Procedures Iharmacogenetic Testing Communicate obesrRations to colleagues Bew laws enhance criminal charges and penalties for striDing nurses and other healthcare worDers in the course of duty Forensic Nursing Fpplication of nursing principles in a court of law to assist a decision Burse often educates the court on the science of nursing ;ay proRide opinions using appropriate nursing standards Gssues at staDe may includeE It)s competency GndiRidual)s jtness to stand trial GnRoluntary commitment kesponsibility for a crime