Mental Health Fall '12

1. ETHICAL AND LEGAL
ISSUES

2. Key Terms
Ethics
 Bioethics-term given to right vs wrong decisions or actions as
they relate to the scope of the medical field
Morals
 Reflects the way a person interprets respect for other
individuals
Values
 Understanding a patient’s values allows for the nurse to
understand the decisions and actions of the patient
Rights
 A legally recognized entitlement (freedom)

3. Ethical Dilemma
This is a situation that requires an individual to
make a choice between two equally unfavorable
alternatives.
How do you make these choices?
 By utilizing ethical principles, or guidelines to help you examine
the issue and decide on what action (or if an action) should be
taken.

4. Ethical Principles
Autonomy
 Right to determine your own destiny
Beneficence
 Duty to promote the good of others
Nonmaleficence
 Do no harm to others
Justice
 Fairness, equal treatment regardless of race, sex etc.
Veracity
 One’s duty to be truthful

5. Model for Making Decisions vs. Nursing Process
Decision Making Model Nursing Process
 Assess situation  Assessment
 Identify problem  Diagnosis
 Make a plan  Identify outcome wanted
 Implement plan  Planning
 Evaluate  Implementation
 Evaluation

6. Ethical Issues for Psychiatric Nursing
The Right to Refuse Least Restrictive
Medicine Doctrine
 Established in 1992  Health care providers
 The patient has the right must attempt to provide
to refuse medication “to treatment in the manner
the extent permitted by that least restricts the
law” and to be “informed freedom of clients.
of the medical  Including seclusion
consequences of his  Chemical intervention
actions”  Mechanical Restraints

7. Legal Issues
Confidentiality
Privacy
PHI (protected health information)
Informed Consent- this may be challenged
Restraints and Seclusion
Commitment Issues
Nursing Liability
 Malpractice/ Negligence/ Defamation of character/
assault/battery

8. How do I avoid Liability?
Respond to the patient, put their welfare first
Educate the patient
Comply with standard of care
Supervise care
Adhere to the nursing process
Document!!! DOCUMENT
Follow up
Develop a good relationship with client and family