If the nurse’s obligation to act beneficently is informed by the patient’s choices and preferences, then the respect for the patient’s autonomy will ultimately override any paternalistic actions on the part of the nurse (Beauchamp & Childress 2009). The remainder of this chapter focuses on health care issues and planning for health decisions. I was glad to see a comprehensive book devoted to this field. Respect for autonomy flows from the recognition that all persons have unconditional worth, each having the capacity to determine his or her own moral destiny. During a one-to-one therapeutic session Anita disclosed that she was having strong urges to self-harm. In encouraging autonomy for Anita involves taking risks on the part of the nurses’ which may go against their principles of nonmaleficence and beneficence. Questions arise about the use of coercion, e.g., when a patient doesn’t want to take his medicine, refuses treatment or … STUDY. Disclaimer: This work has been submitted by a student. In contrast, the correctional nurse may face ethical situations daily. Which can make the nurses ethical dilemma difficult to manage due to balancing the two valid ethical principles of autonomy (respecting and supporting decisions making) and beneficence (relieving or minimising harm in the best interest of the patient) (Hendrick 2004, Beauchamp & Childress 2009). Editors of the book have distinguished academic backgrounds. The main legal and ethical dilemmas that can be extracted from this case study are whether the Anita’s capacity to make decisions about her treatment should be overridden by use of the Mental Capacity Act (GB 2005) and whether Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. As such the therapeutic session concentrated on exploring her feelings surrounding her impulses, alternative coping mechanisms to manage her thoughts of self-harm and strategies to help maintain her safety upon the ward. This decision was reached due to Anita being able to understand the information being given to her, being able to retain the information and weigh it up to make a decision to refuse treatment. This infringement is “supported by the principle of beneficence, which is the argument frequently used to impose treatment on patients whether they want it or not” (Buka 2008: 29). Anita is a young woman with a primary diagnosis of emotionally unstable personality disorder borderline type as defined by the World Health Organisation (WHO 2010). This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Mental health nurses are registered nurses who have gone through training for licensure. Firstly the practitioner needs to ascertain whether the person being assessed has some sort of disturbance of the mind and, if such a disturbance exists then it “must affect their ability to make decisions when they need to” (Department of Constitutional Affairs (DoCA) 2007:45). Legal and Ethical Issues in Behavioral Health in Idaho. Therefore it may need to be considered whether Anita’s is refusal of treatment is something that she feels in control of, thus a way in which she feels empowered. This approach was agreed in collaboration with Anita and the wider team as a way of her taking responsibility for her own decisions and actions. This event is not currently available for purchase. Although this appeared to be an unwise decision, which felt uncomfortable to the team, it was agreed to monitor the wound, keep it clean and dry and continue to talk to Anita about her thoughts and feelings surrounding getting medical treatment for the wound. The mental health practitioner: Demonstrates legal, ethical and accountable mental health practice and ethical decision making that remains open to the scrutiny of people with lived experience, peers and colleagues Participates in professional development relevant to their role and professional interests "right" or "good" Legislation determines what is _____ within a society. Ethics-related issues are gaining complexity and becoming very vital for current-day mental health professionals. The Nursing and Midwifery Council (NMC 2008) stipulates that nurses must respect a patients right to confidentiality at all times and ensure that the patient is informed about how information concerning them is shared. PDF | Ethical issues in Mental Health Nursing | Find, read and cite all the research you need on ResearchGate. Although mental health and substance use disorders are the leading cause of disability worldwide [1], World Health Organization (WHO) statistics from 2014 indicate that the median number of practicing psychiatrists worldwide is 0.1 per 10,000 people [2]. VAT Registration No: 842417633. Efforts to lasso health care costs puts increasing pressure on staff to do more with less. Do you have a 2:1 degree or higher in nursing or healthcare? To address the need for ethical guidelines for working with family caregivers, an analysis of relevant ethical and legal issues is provided within the context of dynamic mental health care and legal systems. The main legal and ethical dilemmas that can be extracted from this case study are whether the Anita’s capacity to make decisions about her treatment should be overridden by use of the Mental Capacity Act (GB 2005) and whether Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Care givers evaluating someone at the request of a school, employer, or court should be sensitive to the possible consequences of their evaluation. Legal And Ethical Issues In Mental Health Nursing Essay. Overall, this is an essential book for students in training as well as for mental health practitioners in academic and clinical settings. In accordance with this the name of the patient has been changed and permission has been sought from the patient to use them in the case study. This text is of immense value, not only for mental health professionals working in the forensic sector, but also for mental health professionals at large. The Gibbs(1988) reflection model will be used to guide the discussion. LEGAL AND ETHICAL ISSUES IN MENTAL HEALTH AND PSYCHIATRIC NURSING BY EUNICE KATUNGWA Legal … They should also restrict their diagnoses to their area of … Together, these legal tools help direct and manage property and health care decisions in accordance with a person’s wishes when the person no longer has the ability (capacity) to make decisions. Course … This relationship is built upon trust as well as purposeful and effective communication (Buka 2008) and is considered to be the cornerstone of nursing care (Lakeman 2009, Pryjmachuk 2011).Therefore the nurses would need to consider future risk as part of the ethical decision making process. Ethics can be seen as the study of human conduct and morality (Buka 2008). At this time Anita, due to her mental state, could not fully appreciate the nature of the wound and felt that she needed to punish herself further by refusing treatment. Enforcing treatment on Anita may produce barriers to the therapeutic relationship such as difficulties in trusting the nurse in the future, disengagement from therapeutic communication, opposition and rejection of future treatment, increased self harming behaviours due to the trauma and hostility towards others (Kettles et al 2007, Byrt 2010), all of which may stop Anita from telling the nursing team when she self-harms in future episodes of distress. Created by. We will look at how, after an episode of self-harm, the patient refused any medical treatment for the wound and how this posed an ethical dilemma for the nursing staff involved in their care. What legal dilemma can be hypothesised as underpinning the decision making process of the mental health professionals in this case? However this may not feel entirely comfortable for the nurse. *You can also browse our support articles here >. Boundary violations have been a major ethics concern in the mental health profession. Journal of the American Academy of Psychiatry and the Law Online … Study for free with our range of nursing lectures! The conflicting principles of autonomy and beneficence that have been presented within this case study would both be ethically and morally correct courses of action to take. These issues are elaborated in the chapters in the section on general principles of ethics. In considering whether Anita needed to make the decision around treatment, we can see that, as the wound was not life threatening, it was decided to allow her time to settle and re-approach the question of treatment. Learn vocabulary, terms, and more with flashcards, games, and other study tools. As the wound could be safely managed in the short term upon the ward the decision to allow Anita time to weigh up the information was the correct one to make. Autonomy is “the freedom and ability to act in a self determined manner” (Butts & Rich 2008: 42) and the right of a rational person to achieve personal decisions without any outside interference. Application of knowledge through assessment and discussion of specific cases. The Commission on Mental Health Law Reform was appointed by then Chief Justice of the Supreme Court of Virginia Leroy Rountree Hassell Sr. in October 2006 and was directed to conduct a comprehensive examination of Virginia’s mental health laws and services. Ethical Concerns For the nurse in a traditional medical setting, ethical decisions occur occasionally and at times the nurse may face ethical dilemmas. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. Where: BOISE, ID When: Friday, March 6, 2020 at 8:00 AM - 3:45 PM. All work is written to order. In deciding that the decision could be made at a later time not only complies with the Act but also promotes Anita’s autonomy. We do not capture any email address. Limited resources force tough choices in quality of care. Multi-User. View Legal -Ethical issues in Mental health.ppt from NURSING 231 at Egerton University. These are important references for students and practitioners. Beauchamp and Childress (2009) devised four basic moral principles which function as guidelines for professional ethical decision making. This month's issue explores critical social, cultural, and ethical dimensions of mental illness. Nurses are constantly faced with the challenge of making difficult decisions regarding good and evil or life and death. The main legal and ethical dilemmas that can be extracted from this case study are whether the Anita’s capacity to make decisions about her treatment should be overridden by use of the Mental Capacity Act (GB 2005) and whether Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. Enter multiple addresses on separate lines or separate them with commas. Finally, a clear and compelling presentation of the most critical legal and ethical issues practitioners need to know—updated in 2020! This raises the principle of Nonmaleficence (doing no harm), in this instance to the therapeutic relationship, wellbeing and care of Anita. The decision to covertly administer the medication will be critically assessed in this assignment. You can view samples of our professional work here. In 2013, the cost for treating mental illness in the US topped the list for all medical conditions. Ethical Issues in Mental Health Nursing. Being a sound mental health professional entails that the individual be competent, practice her profession with integrity, be aware of her limitations, respect the dignity of the client, and understand the do’s and don’ts of practice from an ethics perspective. Copyright © 2020 by The American Academy of Psychiatry and the Law, Sign In to Email Alerts with your Email Address. Legal and Ethical Issues for Mental Health Professionals: Revised 2020. Free resources to assist you with your nursing studies! This section also discusses professionals’ responsibilities in maintaining patients’ records. The contributors include professionals from the mental health and legal fields. To help determine whether Anita has capacity, The Mental Capacity Act (2005) sets out a two stage functional approach. In mental health nursing, autonomy is sometimes overridden in the interests of promoting the principle of beneficence (Lakeman 2009). Disclaimer: This work has been submitted by a student. This course will strengthen your clinical decision-making, build your confidence and help minimize the likelihood of board complaints and malpractice litigation. Spell. Every decision that a nurse makes concerning the care of a patient needs to be considered from an ethical base. The ethical issues experienced by mental health nurses in administering antipsychotic depot and long‐acting intramuscular injections (LAI) were explored in the present study. This may indicate that Anita was under a great deal of distress at the time, which could have affected her capacity to make sound decisions; however her later decision of continuing to refuse treatment was based on her own morals and values towards her body that may have included these thoughts of self-loathing and the need to be punished. with the challenge of making difficult decisions regarding good and evil or life and death. Conflicting moral principles may create difficult ethical dilemmas for nurses by having to contravene one moral obligation to uphold another (Beauchamp & Childress 2009). While all of the above effect both telehealth and tele mental health, there are additional ethical challenges to consider when using tele mental health. It will explore how ethical decisions are reached and how they can directly influence patient care. Anita initially made her decision to refuse treatment shortly after self-harming. The book includes as appendices two professional codes: The American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct (2002) and the Code of Ethics of the National Association of Social Workers (1999). The Mental Capacity Act (GB 2005) is clear in expressing that capacity is time and decision specific. (Adshead 2010). The nurses on duty cleaned and bandaged the wound and allowed Anita time to consider the implications of her decision further. Of particular importance are ethical and legal issues that affect counseling, along with professional considerations such as community counselor identity, relationships with other mental health professionals, credentialing of mental health professionals, and managed care and third-party reimbursement. mental health: ETHICAL AND LEGAL ISSUES. In response to a students question regarding choosing a psychiatric specialty, a charge nurse states, Mentally ill clients need special care. This course provides an opportunity for in-depth study of these areas. Matters of ethics that arise in the different stages of the study, ranging from the decision to conduct the study, to the design of the study, data collection, and analysis are discussed. Start studying Mental Health Chapter 3- Ethical and Legal Issues. This article will examine some of the ethical and legal issues correctional nurses must address in their practice. We've received widespread press coverage since 2003, Your NursingAnswers.net purchase is secure and we're rated 4.4/5 on reviews.co.uk. It may be that Anita is already feeling a loss of autonomy or disempowerment by the very nature of being a patient upon a secure ward and being under the Mental Health Act (GB 2007) and the restriction of her basic autonomous decisions such as when to eat, sleep or who she resides with. Staff explained to Anita that the wound was deep enough to require stitching although not life threatening and advised her that she would need to attend the minor injuries unit of the local general hospital for assessment of the wound. You can view samples of our professional work here. Binghamton, NY: The Haworth Maltreatment and Trauma Press, 2005. This is not an example of the work produced by our Nursing Essay Writing Service. Even with changes, legal and ethical challenges remain for those practicing in this area. To answer the question we need to examine how the dilemma sits within an ethical theory and the principles that apply. When Anita had calmed the nurse had a discussion surrounding the implications of not having the wound sutured such as infection, Anita’s possible need to attack the wound in the future and pain relief issues, However Anita maintained her decision not to have the wound sutured. 11th Feb 2020 Write. (Example: a study of volunteer soldiers who were injected with blood infected with the virus that transmits yellow fever.) Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. The chapter on privacy and confidentiality discusses situations in which communication must be disclosed and instances in which information may be disclosed to third parties. The next chapter focuses more specifically on the ethics of publication. Presentation PDF Available. Nursing Essay Morality requires not only that we treat persons autonomously and refrain from harming them, but also that we contribute to their welfare… and …[is therefore]… a moral obligation to act for the benefit of others. These beneficial actions fall under the heading of beneficence. Copyright © 2003 - 2020 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. Buy Now. T. G. Sriram . As Anita was still refusing to have the wound sutured the RC decided that an assessment would need to be carried out to ascertain whether Anita had the capacity to decide to refuse treatment. The APA code is frequently referenced in the book and used as a yardstick for discussions. Also, as a psychiatrist, I would have liked to see a separate chapter pertaining to problems in ethics that arise from the psychiatric profession’s relationship with the pharmaceutical industry. ETHICAL AND LEGAL ISSUES 2 Nurses are faced with ethical and legal issues in their nursing practice on a regular basis related to nursing shortages, general inadequate staffing, cost control measures, and ineffective leadership. From this we can surmise that a morally correct course of action may involve two opposing principles being applicable in any one situation. Solo Practitioner. She was taken to the clinic room where the wound could be cleaned and assessed. Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards Edited by Steven F. Bucky, PhD, Joanne E. Callan, PhD, and George Stricker, PhD. Test. Ethical decision-making model (s) Nuances of rural ethics. Therefore the principle of respecting autonomy concerns the nurse’s acknowledgement of, and obligation in respecting, Anita’s decision over her own life. Self-harm has been strongly associated with borderline personality disorder (Motz 2008) where thoughts of self-loathing and self-punishment are common precipitators; the act of self harm can be seen as a symptom of internal turmoil, an expression of internal pain or as controlling factor to maintain a level of care (Grocutt 2009). The chapter on ethics in research, an important inclusion in the book, is very informative. Gravity. A large proportion of moral and ethical dilemmas that are faced by nurses stem from the conflicting principles of autonomy and beneficence. Learn. Ethical Issues in Mental Health Nursing Pages: 8 (1835 words) Ethical Principles in Nursing Pages: 3 (721 words) Legal and Ethical Issues for Mental Health Professionals Pages: 11 (2560 words) Legal and Ethical issues in nursing Pages: 13 (3092 words) In considering Anita’s wishes and agreeing a management plan to care for the wound incorporates both principles of Anita’s autonomy and the nurse’s obligation towards beneficence. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We're here to answer any questions you have about our services. bernikitty. Beauchamp & Childress (2009: 103) after Kant. Later in the shift Anita approached staff and stated that she had overwhelming urges to self-harm and that she had acted upon them. The ethics and legal implications of boundary violations (sexual contact with patients, misuse of professional influence) are discussed in the section on general ethics standards in practice. Yet, these issues are inadequately addressed in the traditional teaching curriculum of mental health professionals and in day-to-day practice. Legislation determines what is right or good within a society. From this we can surmise that ethics is a complex system of reflective thinking, which is used in the search for a standard that can be used to judge your own actions, or the actions of others, within your own moral code. Should the decision to treat Anita for her self harm regardless of her wishes have gone ahead, there may have been a risk of impacting on the nurse-patient therapeutic relationship. Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NursingAnswers.net. It is about people reasoning, thinking and applying a process of reflection (Adshead 2010); however these people may have opposing views, values and experiences on which to base their moral judgements to define what is the right and wrong course of action (Hendrick 2009) and the principles used to decide this, not only by the individual but also within social groups and societies. The chapter on Tarasoff and duty to protect provides an excellent description of the Tarasoff cases (Tarasoff I and Tarasoff II) and a discussion of their implications for mental health professionals. As a mental health counselor, you will hear intimate details of clients’ lives that may spark ethical concerns. Company Registration No: 4964706. However with collaborative working practices this case study has shown that solutions can be found in even the most complicated of nursing dilemmas. Legal and Ethical Issues for Mental Health Professionals: Revised 2020. 433 pp. Flashcards. However, the nurse’s ability to critically appraise risks and benefits will help them to make decisions that are beneficial to the patient involved. Beneficence could be interpreted to incorporate the patient’s autonomous choice as “the best interests of the patient are intimately linked with their preferences … [from which]… “are derived our primary duties towards them” (Beauchamp & Childress 2009:207). Major ethical/legal issues encountered in practice; Eight major areas of focus; Ethical and Legal Issues; The five moral-ethical principles; Outline Part Two. No plagiarism, guaranteed! Mental Health Nursing ESSAY Help. This is not an example of the work produced by our Nursing Essay Writing Service. Lakeman (2009) points out that an ethical dilemma occurs when there are a multitude of alternative courses of action to deal with a particular situation. Terms in this set (33) Nurses are constantly faced . Ethical and Legal Issues in Psychiatric/Mental Health Nursing ; 2 Introduction. A paternalistic approach is frequently used to infringe upon a person’s right to autonomy. PLAY. Legal & Ethical Issues for Mental Health Professionals, Volume 1: Revised 2020 by Stephen Feldman Finally, a video program to fulfill your legal and ethical CE requirements that is not only indispensable for daily practice but also engaging, entertaining and informative. The necessity of performing clinical evaluations raises important ethical issues as well. Mental health nurses face ethically‐difficult situations when administering these medications. From which ethical framework is the charge nurse operating? Any decision made from this ethical viewpoint has a higher probability of producing the best outcome under any given circumstance. Chapter 5. For more information: Call (800) 844-8260 × Close. The discussion will also consider the legal, ethical and professional issues surrounding covert medication. Ethics are defined as a set of moral principles that are related to the particular group, high educational status, and female gender that is significantly related to the patient’s willingness to disclose the concern with others. Upon completion of the assessment it was decided that Anita did have capacity to make decisions surrounding treatment at that time, within the framework of the Mental Capacity Act (GB 2005). The principles of autonomy (freedom to act on your own belief), Nonmaleficence (obligation to avoid doing harm), Beneficence (providing benefits and help) and Justice (fair distribution of benefits, risk and cost) which are derived from a duty based theory of Emmanuel Kant (1724-1804) (Beauchamp & Childress 2009). Patient safety may be compromised, resulting in injury and lawsuits. Title: Ethical and Legal Issues in PsychiatricMental Health Nursing 1 Chapter 5. If this is not the case then the person cannot be seen as lacking capacity under the Act (GB 2005, DoCA 2007). to mental health. The book includes 20 chapters neatly organized into four sections: general principles of ethics, confidentiality and privilege, ethics standards in clinical practice, and ethics in teaching, which also incorporates chapters on ethics in research and publication. Using the application of the Mental Capacity Act (MCA) (Great Britain (GB) 2005) and an established model for ethical decision making, we will look at how the decision of whether or not to enforce treatment for the wound was formulated and implemented. This statement clearly incorporates the principle of beneficence and shows that the nurses in the case study are considering whether Anita should have medical treatment for the wound enforced upon her due to the principle of beneficence as described due to the worries of the wound becoming infected if not sutured. The contributors have done a marvelous job of presenting updated information. Ethical and Legal Issues for Mental Health Professionals attempts to accomplish this difficult task in quite a comprehensive manner. Mental health nurses work with people from all backgrounds to assess and treat psychiatric issues through work in the hospital and the community 1. Finally, a video program to fulfill your legal and ethical CE requirements that is not only indispensable for daily practice, but also engaging, entertaining and informative. The more obvious as well as the more subtle ways in which research studies can lend themselves to manipulation are discussed. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Updated 2020 to include changes in laws, use of technology, and more! Match. The practitioner has the onus, not only of providing relevant information about treatments and procedures, but also of disclosing his own limitations, with regard to his training and expertise, and his value systems. As the wound was neither life threatening or of such a degree that it could not be safety managed upon the ward enabled the staff to consider the possibility of enabling Anita to make an autonomous choice. Mental Health Nursing. Anita presented with a laceration to the inside of her thigh which was deep enough to expose the adipose tissue beneath, however was not deemed by the medical staff to be life threatening. Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards, Journal of the American Academy of Psychiatry and the Law Online, Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment, Assessment of Malingered Neuropsychological Deficits, Trials of a Forensic Psychologist: A Casebook, by The American Academy of Psychiatry and the Law, American Academy of Psychiatry and the Law. The decision to manage the wound on the ward and allow Anita time to calm and consider her options is, in the author’s opinion, the correct course of action to take. This assignment aims to critically appraise an ethical conflict in relation to the care provided to a patient. Beneficence can be seen as actions to benefit and promote the welfare of others (Butts & Rich 2008). Reference this. I noticed some overlap of content across chapters. When nurses experience the ethical dilemma of having to enforce treatment irrespective of a patient’s right to autonomy, they can be seen as working in a paternalistic manner (Butts & Rich 2008). To achieve this aim the author will examine a case study of a patient whose care he was involved with whilst in placement. The practice of paternalism is now generally discouraged in health care (Butts & Rich 2008) and is considered unjustifiable in cases where the patient has capacity to make a decision (Edwards 2009, Beauchamp & Childress 2009). The high costs of care and prejudices against persons with mental illness also create ethical problems. The author cites some examples of early research, which by current ethics standards would be viewed with horror.

ethical and legal issues in mental health

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