Psychiatric-Mental Health Nursing Ethics

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Questions and Answers

Psychiatric-mental health nurses frequently encounter ethical dilemmas that necessitate decisions concerning:

Personal relationships with patients and boundary setting.

Financial resource allocation and insurance limitations.

Staff scheduling and managing nurse-patient ratios in acute settings.

Distinguishing between beneficence and non-maleficence, or determining life-sustaining interventions. (correct)

What is the primary function of the American Nurses Association (ANA) Code of Ethics for nurses?

To serve as a guiding framework for nurses in making ethical choices and decisions. (correct)

To provide specific legal statutes for nursing practice in mental health settings.

To dictate hospital policy and procedures related to patient care and resource management.

To offer a rigid set of rules for every ethical challenge encountered in nursing.

According to the ANA Code of Ethics, a psychiatric-mental health nurse's responsibilities extend to whom?

Exclusively to the patient and their immediate family members involved in care decisions.

Primarily to the employing healthcare organization and its financial stability.

Solely to the individual patient under their direct care in a clinical setting.

To the patient (individual, family, group, community, or population), themselves, and all individuals they interact with. (correct)

The ANA Code of Ethics interpretive guidelines emphasize the importance of teamwork and collaboration in healthcare, aligning with recommendations from which organization focused on healthcare improvement?

Institute of Medicine (IOM), now the National Academy of Medicine. (D) Signup and view all the answers

What is the role of 'Psychiatric-Mental Health Nursing: Scope and Standards of Practice' published by the ANA and associated organizations?

To apply the principles of the ANA Code of Ethics specifically to the context of psychiatric-mental health nursing. (A) Signup and view all the answers

Why is knowledge of the 'Code of Ethics for Nurses' and 'Psychiatric-Mental Health Nursing: Scope and Standards of Practice' considered 'essential' for psychiatric-mental health nurses?

To provide clarity and direction regarding the expected professional conduct and responsibilities of nurses in this specialty. (A) Signup and view all the answers

In addition to ethical considerations, what other domain of issues is crucial for psychiatric-mental health nurses to understand in their professional practice?

Legal issues pertaining to patient rights, confidentiality, and involuntary treatment. (A) Signup and view all the answers

The content emphasizes that legislation shapes societal norms of 'right or good'. How does this relate to legal issues in psychiatric-mental health nursing?

Laws define what is legally acceptable within society, influencing what is considered permissible and ethical in psychiatric care. (A) Signup and view all the answers

What is the primary purpose of the SBAR model in healthcare settings?

To ensure effective communication with caregivers (A) Signup and view all the answers

According to the Quality and Safety Education for Nurses standards, what is an essential nursing competency?

Use of best informatics sources (C) Signup and view all the answers

How does the ethical theory of utilitarianism determine what is right and good?

By promoting the most happiness for the most people (C) Signup and view all the answers

What approach is recommended for handling 'suit-prone' patients?

Engagement and problem-solving (C) Signup and view all the answers

Which ethical theory is based on adhering to a sense of duty?

Kantianism (A) Signup and view all the answers

What is a potential consequence for nurses if legal issues arise due to their actions?

Malpractice lawsuits against the nurse and institution (B) Signup and view all the answers

Which of the following is included in civil law protections?

Privacy of individuals (C) Signup and view all the answers

What does the ethical principle of autonomy emphasize?

Patients making their own healthcare decisions (A) Signup and view all the answers

What is the significance of building a rapport with patients in preventing lawsuits?

It influences the likelihood of malpractice considerations (B) Signup and view all the answers

Which ethical principle is concerned with fairness and equality?

Justice (A) Signup and view all the answers

Which ethical theory prioritizes actions that maximize happiness for the greatest number of people?

Utilitarianism (A) Signup and view all the answers

According to Kantianism, the morality of an action is determined by its:

Underlying principle (A) Signup and view all the answers

Which ethical theory is based on the teachings of Jesus Christ?

Divine Command Ethics (A) Signup and view all the answers

Natural Law Theory posits that the knowledge of right and wrong is:

Inherent to human nature (D) Signup and view all the answers

Which ethical theory is primarily concerned with the individual's self-interest?

Ethical Egoism (D) Signup and view all the answers

What is the term for a situation in nursing where a choice must be made between two equally justifiable options?

Ethical dilemma (A) Signup and view all the answers

What is the definition of 'morals'?

Learned standards of right and wrong (D) Signup and view all the answers

What does the term 'bioethics' refer to?

Ethical principles applied to healthcare (D) Signup and view all the answers

What is "values clarification"?

The process of identifying and ranking personal values (A) Signup and view all the answers

What is the difference between morals and ethics?

Morals are internalized, while ethics are external guidelines. (C) Signup and view all the answers

What are 'rights' in the context of healthcare?

Entitlements based on laws, policies, or ethical principles (C) Signup and view all the answers

What characterizes an 'absolute right'?

A right with no restrictions (B) Signup and view all the answers

What is a 'legal right'?

A right formalized into law by society (A) Signup and view all the answers

Whose guidelines pertain to patients' rights, though not legally binding?

National League for Nursing (NLN) and American Hospital Association (AHA) (C) Signup and view all the answers

What are nurses responsible for upholding, despite their non-legal status?

Patients' rights guidelines (B) Signup and view all the answers

What is the primary function of the Health Insurance Portability and Accountability Act (HIPAA)?

To protect client confidentiality in medical records (D) Signup and view all the answers

Which category of law is derived from decisions made in previous cases?

Common law (D) Signup and view all the answers

What right does an individual have with regard to their mental health-care records?

The right to access the records on request (D) Signup and view all the answers

What is a tort in the context of civil law?

A violation of a civil law where an individual is wronged (A) Signup and view all the answers

Which law provides protection from conduct deemed injurious to public welfare?

Criminal law (A) Signup and view all the answers

What does the Fourth Amendment protect in terms of legal issues in psychiatric-mental health nursing?

The right to privacy (C) Signup and view all the answers

What is an intentional tort in healthcare settings?

Performing a medical procedure without consent (D) Signup and view all the answers

What must a client provide for health information to be shared outside the current treatment team?

Written consent (C) Signup and view all the answers

When must clients be informed of their privacy policies under HIPAA?

Upon entry into the healthcare system (D) Signup and view all the answers

How are civil and criminal components classified within statutory and common law?

As civil and criminal (D) Signup and view all the answers

What is the most common violation of criminal law by nurses?

Failure to renew nursing licenses (D) Signup and view all the answers

What are PHI identifiers under HIPAA intended to protect?

Individually identifiable health information (C) Signup and view all the answers

Upon discharge, what right does a client have regarding referrals to other providers?

The right of referral to other providers (C) Signup and view all the answers

Which amendment of the U.S. Constitution is associated with the protection of privacy in health records?

Fourth Amendment (A) Signup and view all the answers

Under civil law, what type of legal action is brought for breach of a contract?

A contract action (B) Signup and view all the answers

Which ethical perspective supports giving the patient information to respect her autonomy and decrease the chance of pregnancy?

Kantianism (D) Signup and view all the answers

Why might withholding information be considered harmful in this scenario?

It restricts the patient's autonomy (B) Signup and view all the answers

Which ethical principle is primarily concerned with promoting good and doing no harm?

Beneficence (A) Signup and view all the answers

What potential consequence does Alternative 3 have on Kimberly?

Reprimand from supervisor (A) Signup and view all the answers

Which of the following legal considerations are relevant for administering involuntary medication?

Local jurisdiction laws (A) Signup and view all the answers

Which principle emphasizes treating a psychiatric patient with the least restrictive measure?

The right to the least restrictive treatment alternative (B) Signup and view all the answers

What does 'Kendra’s Law' in New York State allow regarding mental health patients?

Mandated outpatient treatment (C) Signup and view all the answers

What does the utilitarian perspective focus on in ethical decision-making?

The greatest good for the greatest number (C) Signup and view all the answers

When selecting an alternative, how is the principle of autonomy respected with Alternative 3?

By providing the patient additional options without coercion (C) Signup and view all the answers

What outcome would indicate an acceptable resolution of Tonja's case?

Tonja keeps her appointment and complies with her medication (A) Signup and view all the answers

What might motivate Kimberly to seek employment elsewhere?

Disagreement with the institution’s philosophy (A) Signup and view all the answers

Which alternative respects the patient's autonomy while aligning with Kimberly’s Christian ethic?

Alternative 3 only (A) Signup and view all the answers

What is the primary purpose of informed consent in medical procedures?

To preserve and protect individual autonomy (D) Signup and view all the answers

What is a common criterion for forcing medication without client consent?

Dangerous behavior to self or others (B) Signup and view all the answers

Which of the following is NOT typically included in the information provided for informed consent?

Physician's credentials and experience (C) Signup and view all the answers

Which option indicates an understanding of utilitarian ethical theory?

Make choices that benefit the majority (A) Signup and view all the answers

In what situation can treatment be administered without obtaining informed consent?

During an emergency where the patient cannot make decisions (C) Signup and view all the answers

How does the 'right to the least restrictive treatment alternative' influence psychiatric care planning?

Ensures minimal restriction and effective treatment (C) Signup and view all the answers

Under what condition can a physician withhold information about a treatment according to therapeutic privilege?

If disclosure would hinder necessary treatment (B) Signup and view all the answers

Which element is NOT a major component of informed consent that nurses ensure?

Payment is confirmed (B) Signup and view all the answers

Which type of patient may require consent from a legal guardian due to inability to provide informed consent?

A patient with severe psychiatric illness (B) Signup and view all the answers

What role does a nurse play regarding informed consent?

The nurse acts as a witness to the patient's signature (C) Signup and view all the answers

What legislation protects an individual's right to freedom from restraint except in emergencies?

Patient Self-Determination Act (D) Signup and view all the answers

What is a primary concern about the use of seclusion and restraint?

They may produce trauma and mistrust (A) Signup and view all the answers

What does the term 'restraints' refer to in psychiatric settings?

Any measure that restricts movement (D) Signup and view all the answers

Who bears the legal liability for securing informed consent?

The physician (A) Signup and view all the answers

Which practice is essential when a patient or guardian withdraws consent after treatment begins?

Inform them about the risks of stopping treatment (B) Signup and view all the answers

In what circumstance does a hospital administrator act in the consent process?

When court intervention is not possible in time (D) Signup and view all the answers

What must be considered when using restraint in psychiatric settings?

The potential harms, including injuries or death (D) Signup and view all the answers

Which scenario exemplifies informed consent not being required?

An unconscious patient needing immediate life-saving measures (D) Signup and view all the answers

What must be demonstrated to justify involuntary hospitalization?

Clear and convincing evidence along with probable cause (D) Signup and view all the answers

Which case emphasized that mental illness alone is insufficient for involuntary hospitalization?

O’Connor v. Donaldson (A) Signup and view all the answers

What is a key element of involuntary outpatient commitment (IOC)?

Court-ordered outpatient treatment (A) Signup and view all the answers

Which state enacted legislation known as Kendra's Law?

New York (D) Signup and view all the answers

What are the eligibility criteria for North Carolina's IOC in terms of preventing deterioration?

The person is at risk of disability or deterioration without treatment (D) Signup and view all the answers

How does Kendra's Law in New York choose candidates for IOC?

Based on previous hospitalizations or violent actions (C) Signup and view all the answers

What is a common criticism of IOC legislation?

It potentially infringes on individual rights (B) Signup and view all the answers

What is typically required for legal restoration of competency?

Another court hearing (A) Signup and view all the answers

What does the term 'gravely disabled' refer to?

Inability to manage basic needs due to mental illness (B) Signup and view all the answers

Which of the following outcomes is associated with IOC according to some studies?

Reduce in hospital readmissions (C) Signup and view all the answers

What is a 'preventive approach' in the context of IOC?

Predicting and preventing potential dangerous behavior (C) Signup and view all the answers

How can involuntary treatments ensure respect for individual rights?

Always using the least restrictive intervention first (D) Signup and view all the answers

What is a stated objective of IOC legislation?

Reducing hospital stay lengths and readmissions (C) Signup and view all the answers

What standard is used to measure the adequacy of a therapist's conduct?

Reasonable care under the circumstances (D) Signup and view all the answers

What does research suggest about IOC outcomes?

It decreases crime victimization among mandated individuals (C) Signup and view all the answers

What was the key issue in the Tarasoff v. Regents of University of California case?

The balance between confidentiality and public safety (B) Signup and view all the answers

What is necessary for an individual deemed gravely disabled to receive a guardian?

A court appointment (D) Signup and view all the answers

Which duty was added to therapists' responsibilities in the Tarasoff II ruling?

Duty to protect (A) Signup and view all the answers

Which of the following is NOT a guideline outlined by courts for therapists to assess their obligation to take protective measures?

Assessment of a client's financial status (C) Signup and view all the answers

Which type of restraint is described as confining the client alone in a room from which they cannot leave?

Seclusion (D) Signup and view all the answers

Which of these states does not have a duty to warn according to the content provided?

Four unnamed states (D) Signup and view all the answers

What must healthcare workers obtain to maintain a client's rights when involuntary commitment is necessary for protection?

Court intervention (C) Signup and view all the answers

What condition can lead to health-care workers being charged with false imprisonment?

Unauthorized confinement of a competent person (D) Signup and view all the answers

Which health professional group is typically responsible for initiating protective measures under duty to warn?

Psychiatrists (B) Signup and view all the answers

What is the professional implication of failing to report a threat according to the Tarasoff ruling?

Being considered negligent (A) Signup and view all the answers

Which is NOT typically a reason for involuntary hospitalization?

Financial instability (A) Signup and view all the answers

What is a key requirement before implementing seclusion or restraint according to accrediting bodies?

Staff training and competency (A) Signup and view all the answers

How did New Jersey's expansion of the 'duty to warn' law in 2018 affect mental health professionals?

Requirement to notify local authorities of self-harm threats (C) Signup and view all the answers

Why might healthcare professionals hesitate to report suspected abuse?

Concerns over false allegations (B) Signup and view all the answers

Which amendment provides protections against loss of liberty in involuntary hospitalizations?

Fourteenth Amendment (A) Signup and view all the answers

What is the legal result in states where there is no recognition of duty to warn?

Therapists must rely on personal judgment (B) Signup and view all the answers

What must be shown before recommending involuntary hospitalization?

Probable cause of mental illness (A) Signup and view all the answers

What is the primary focus when a nurse acts with beneficence?

Benefiting or promoting the good of patients (B) Signup and view all the answers

In the context of the content, what does the term 'gravely disabled' indicate?

Lack of personal care skills (B) Signup and view all the answers

How is justice defined within the context of health care?

Distributing health-care services equally regardless of social or economic differences (C) Signup and view all the answers

What does the Federal Child Abuse Prevention and Treatment Act (CAPTA) require from states?

To establish procedures for mandatory reporting of child abuse (C) Signup and view all the answers

What might motivate a nurse to report a patient's potential for harm despite state laws?

Professional and ethical obligation (B) Signup and view all the answers

What is the primary focus shared by laws and policies on restraint and seclusion?

Patient safety (A) Signup and view all the answers

In what situation is the autonomy of a patient typically overridden?

When the patient is deemed harmful to themselves or others (C) Signup and view all the answers

What significant change to HIPAA rules was made in 2013 regarding patient information?

Patients can prevent sharing of treatment information with health insurance if paid out of pocket (B) Signup and view all the answers

Under what condition can medical information be released without consent?

In a life-threatening situation (B) Signup and view all the answers

What does the ethical principle of nonmaleficence require from healthcare providers?

To do no harm to patients, intentionally or unintentionally (D) Signup and view all the answers

Which organization is mentioned as setting accrediting standards for restraint and seclusion?

The Joint Commission (C) Signup and view all the answers

In what situation does reporting information about potential harm NOT breach confidentiality?

When reporting to the treatment team (D) Signup and view all the answers

Why might an ethics committee be convened in a healthcare setting?

To explore and analyze complex ethical issues from multiple perspectives (B) Signup and view all the answers

Why are emergency nurses particularly relevant in the context of assessing risks of violence?

They are front-line health-care workers (C) Signup and view all the answers

What type of commitment is usually initiated by police officers or health-care professionals?

Emergency commitment (D) Signup and view all the answers

What information must be documented if patient data is disclosed in an emergency?

Date, person to whom it was disclosed, and specific information released (C) Signup and view all the answers

In voluntary admission, what can prevent a person from leaving the hospital at will?

Risk of harm to self or others (A) Signup and view all the answers

What consequence is generally NOT associated with failing to report child abuse when required?

Revocation of custody rights (A) Signup and view all the answers

What role does patient advocacy play in psychiatric nursing?

Fulfilling patient's needs that might otherwise go unmet due to their illness (D) Signup and view all the answers

What is a key consideration for nurses when documenting medical records?

Objective and nonjudgmental documentation (A) Signup and view all the answers

In which fields does the doctrine of privileged communication mostly apply?

Psychiatry and law (D) Signup and view all the answers

Which process aims to observe mentally ill individuals for longer than emergency commitments?

Involuntary commitment (C) Signup and view all the answers

How does the concept of distributive justice relate to healthcare?

It promotes equal distribution of health-care resources to all people (A) Signup and view all the answers

What is a characteristic feature of ethical dilemmas?

They involve emotional conflict due to equally valid arguments on both sides (D) Signup and view all the answers

What must occur if a voluntarily admitted patient decompensates and restraint or seclusion is deemed necessary?

Court intervention for involuntary commitment (D) Signup and view all the answers

Which element is not considered Protected Health Information (PHI)?

Year of birth (C) Signup and view all the answers

What is the primary focus of the new provision in the Code of Ethics for Nurses regarding social justice?

Applying social justice principles in nursing practice and policy development (A) Signup and view all the answers

What triggered the duty to warn under the Tarasoff rule?

A patient expressed a serious intention to harm another individual (C) Signup and view all the answers

When is it necessary to involve a patient representative in decision-making?

When the patient is incapable of making informed choices (C) Signup and view all the answers

Which agency provides a significant amount of mental health services voluntarily?

Substance Abuse and Mental Health Services Administration (A) Signup and view all the answers

Under what condition might the principle of veracity be limited according to the content?

When the truth would cause harm or impede recovery (B) Signup and view all the answers

What is the primary focus of HIPAA?

Ensuring patient health information safety and privacy (A) Signup and view all the answers

What is often the result when nurses collaborate with ethics committees?

Enhanced critical thinking and clinical judgment skills (D) Signup and view all the answers

Which step of the ethical decision-making model involves evaluating outcomes?

Evaluation (A) Signup and view all the answers

What should be a priority for nurses working in psychiatric-mental health nursing?

Guarding patient privacy diligently (B) Signup and view all the answers

According to the content, which document informs patients of their rights in a hospital setting?

The Patient Care Partnership (A) Signup and view all the answers

What does the principle of veracity in healthcare entail?

Ensuring accurate and honest communication with patients (C) Signup and view all the answers

What legal basis allows patients to refuse treatment unless immediate intervention is needed?

The U.S. Constitution and several amendments (C) Signup and view all the answers

In ethical decision-making, what does autonomy emphasize?

Individuals having the right to make their own choices (C) Signup and view all the answers

Which of these identifiers is considered protected under PHI?

Social Security number (D) Signup and view all the answers

What is a possible negative aspect of taking no action in a healthcare setting?

It signifies a decision has been made by default (D) Signup and view all the answers

Which professionals are generally required to uphold the doctrine of privileged communication?

Attorneys (C) Signup and view all the answers

How might involuntary hospitalization criteria in the U.S. impact individuals with mental illnesses?

It makes it more challenging to receive care, leading to higher detention rates in prisons (C) Signup and view all the answers

In the case study presented, what is the ethical conflict faced by Nurse Kimberly?

To balance providing needed information against institutional policy (D) Signup and view all the answers

How is the principle of beneficence sometimes misunderstood in healthcare?

As always doing what the patient expressly requests (C) Signup and view all the answers

What does the Tarasoff ruling emphasize in terms of a therapist's duty?

A duty to protect those threatened by a client (B) Signup and view all the answers

Why is patient education a key component of advocacy in nursing?

It empowers patients to make informed decisions about their care (C) Signup and view all the answers

What is an example of a situation where veracity may not be maintained?

When telling the truth could cause unnecessary distress during recovery (C) Signup and view all the answers

What did the Tarasoff case primarily highlight about patient confidentiality?

It can be breached in specific situations to protect potential victims (B) Signup and view all the answers

What consideration is necessary during the 'Problem Identification' step in ethical decision-making?

Identifying the conflict between alternative actions (C) Signup and view all the answers

What should nurses keep in mind when documenting psychiatric interventions?

Ensure prescriptive interventions are clearly noted (B) Signup and view all the answers

Which of the following is not considered individually identifiable information under HIPAA?

Country of birth (B) Signup and view all the answers

Which Amendment addresses the right to refuse treatment within its provisions?

First Amendment (A) Signup and view all the answers

Which scenario exemplifies a breach of a psychiatric patient's right to treatment?

Denying appropriate treatment to a hospitalized patient (A) Signup and view all the answers

What does the principle of veracity primarily emphasize in healthcare?

Always being truthful with patients (D) Signup and view all the answers

What is the main focus of the 'Implementation' step in the ethical decision-making process?

Communicating and acting on the decision made (B) Signup and view all the answers

Why might federal health-care laws continue to change over time?

To adapt to the current political climate (B) Signup and view all the answers

What is a recognized right of patients in a hospital according to the AHA?

Involvement in their own care (B) Signup and view all the answers

What is the main difference between negligence and malpractice?

Negligence is done by any individual; malpractice is by professionals. (A) Signup and view all the answers

What must be proven for a malpractice claim to succeed?

A breach of duty caused an injury that was linked to the standard of care. (B) Signup and view all the answers

Which of the following are considered forms of defamation?

Slander and libel (B) Signup and view all the answers

Why might a nurse be charged with false imprisonment?

Confining a competent patient against their wishes outside an emergency. (D) Signup and view all the answers

What is required for a body search of a mentally ill patient?

A physician’s order and written rationale. (C) Signup and view all the answers

Which legal principle underlies most negligence decisions in professional settings?

Common law (A) Signup and view all the answers

When may a nurse be liable for invasion of privacy?

When a patient is searched without probable cause. (B) Signup and view all the answers

Which action would NOT typically result in a malpractice lawsuit?

Adhering to recognized standards of care at all times. (A) Signup and view all the answers

Which statement is true about sexual predator laws in the United States?

They allow indefinite hospitalization beyond prison sentences. (A) Signup and view all the answers

What is a key aspect of avoiding malpractice litigation?

Effective communication with patients and caregivers. (A) Signup and view all the answers

Which factor mostly helps a jury in malpractice cases?

Testimony from expert witnesses. (B) Signup and view all the answers

What is defamation of character when information is shared orally?

Slander (D) Signup and view all the answers

Why might a psychiatric nurse be charged with breach of confidentiality?

For sharing patient information unnecessarily. (D) Signup and view all the answers

What must a plaintiff prove in a negligence claim?

There was a deviation from a reasonable standard of care. (B) Signup and view all the answers

Which of the following describes battery in the context of nursing?

Nonconsensual touching without emergency justification. (D) Signup and view all the answers

What was the significance of the case O'Connor v. Donaldson (1976)?

It concluded that mentally ill individuals must be considered dangerous to be confined against their will. (D) Signup and view all the answers

According to the Patient Self-Determination Act, what fundamental right must healthcare facilities provide to patients?

Legal rights to make healthcare decisions, including accepting or refusing treatment. (D) Signup and view all the answers

What is a key consideration when treating patients with mental illness according to Boland and Verduin?

The notion of restrictiveness is subjective and fraught with personal bias. (C) Signup and view all the answers

Which principle regarding patient treatment is emphasized in the Patient Self-Determination Act?

Patients have the right to decline any treatment offered. (C) Signup and view all the answers

What is an important element contained in the rights under the Patient Self-Determination Act related to treatment plans?

Patients have the right to an individualized, written treatment or service plan. (A) Signup and view all the answers

How does the case of Roger v. Oken (1981) impact the treatment of mentally ill patients?

It allows for a legal guardian to authorize treatment if a patient refuses. (A) Signup and view all the answers

Under nurse practice acts, what is included in the definition?

Broad statements describing the scope of practice for different nursing levels. (A) Signup and view all the answers

Which of the following rights is granted to mental health service recipients under the Patient Self-Determination Act?

The right to informed participation in the planning of their mental health services. (A) Signup and view all the answers

What does a nurse's participation in their profession generally require based on nurse practice acts?

Meeting education and licensing requirements set by the state. (B) Signup and view all the answers

How does the Patient Self-Determination Act impact patient participation in experimental treatments?

Patients must provide informed, voluntary, written consent before participating. (C) Signup and view all the answers

What should be taken into account when determining the restrictiveness of a patient's treatment setting?

The individual needs and safety conditions of the patient. (C) Signup and view all the answers

What is a recognized right under the Patient Self-Determination Act in cases involving restraints?

The use of restraints only during an emergency with a mental health professional's written order. (C) Signup and view all the answers

Which of the following indicates the correct handling of a treatment plan under the Patient Self-Determination Act?

Plans should be periodically reviewed and revised as necessary. (B) Signup and view all the answers

Under the Patient Self-Determination Act, what should patients be informed about regarding their condition?

The objectives, nature, and potential adverse effects of their treatment. (C) Signup and view all the answers

Which of the following illustrates a key concern addressed by the Patient Self-Determination Act regarding mental health service delivery?

Services should support personal liberty and restrict it only as necessary to meet treatment needs. (A) Signup and view all the answers

Study Notes

Ethical and Legal Concepts in Psychiatric-Mental Health Nursing

Nurses face complex ethical and legal decisions in psychiatric care, requiring a strong understanding of ethical principles and legal frameworks.

Ethical Theories

Ethics: A branch of philosophy that systematically distinguishes right from wrong behavior.
Bioethics: Application of ethical principles to medicine, nursing, and allied health.
Morals: Fundamental standards of right and wrong, learned and internalized. Moral behavior involves critical thinking about how to treat others, respecting autonomy, freedom, justice, honesty, and confidentiality.
Values: Personal beliefs about what's important and desirable. Values clarification helps individuals understand their motivations and how values affect actions.
Rights: Expectations individuals are entitled to via law, policy, or ethical principles. Legal rights are formalized in law.
Utilitarianism: Actions are right if they maximize happiness for the greatest number of people.
Kantianism (Deontology): Actions are judged by their principles, not outcomes. Duty and moral law guide decisions.
Divine Command Ethics: Ethical decisions align with God's commands. Different religions have different perspectives.
Natural Law Theory: Good and evil are self-evident based on human nature and inherent knowledge from God.
Ethical Egoism: Actions are right if they benefit the individual making the decision.

Ethical Dilemmas

Ethical Dilemma: A situation where two or more equally balanced alternatives present compelling arguments for and against a choice, creating internal conflict.
Not all ethical situations are dilemmas.
Ethics committees are valuable resources.

Ethical Principles

Autonomy: Respecting an individual's right to self-determination. It may be limited in certain situations.
Beneficence: Acting to promote the well-being of others; serving the client's best interests. Patient's autonomy may be overridden in cases of harm to themselves or others
Nonmaleficence: Avoiding harm to clients, intentionally or unintentionally.
Justice: Treating all individuals fairly and equally, regardless of background.
Veracity: Truthfulness and honesty in interactions. Limitations exist in cases where truth could cause harm.

Ethical Decision-Making Model

Five-step model (Assessment, Problem Identification, Planning, Implementation, Evaluation) analogous to the nursing process.

Legal Issues in Psychiatric Nursing

Right to Treatment: Hospitalized psychiatric patients have the right to appropriate treatment.
Right to Refuse Treatment (Medication): Patients can refuse treatment unless urgent intervention is needed to prevent harm. Involuntary hospitalization criteria vary.
Least Restrictive Treatment Alternative: Clients are treated in the least restrictive setting possible.
Patient Self-Determination Act (1991): Legal documents for healthcare decisions; includes the right to refuse treatment.
Nurse Practice Acts: State laws that define nursing practice, education, licensure, and scope of practice.
Types of Law: Statutory law (legislature) and common law (court decisions). Categories: Civil (torts, contracts) and criminal.

Confidentiality and Privacy

Confidentiality: Patient records and communications must be protected. Informed consent is required for sharing information.
HIPAA: Federal law protecting protected health information (PHI).
Duty to Warn: Therapists and (in some states) nurses have a duty to protect potential victims from harm.
Child/Elder Abuse Reporting: Nurses have legal obligations to report suspected abuse.

Necessary for treatment procedures.
Includes risks, benefits, alternatives.
Circumstances allowing treatment without consent exist (e.g., emergencies, incompetence, harm to others)
Nurses are advocates ensuring all elements of informed consent are met (knowledge, competency, free will).

Restraints and Seclusion

Used as a last resort, short term, and under specific criteria
Careful monitoring, training, and documentation required.

Hospitalization (Voluntary/Involuntary)

Voluntary: Individual applies for services and stays voluntarily. Withdrawal of consent/discharge is possible..
Involuntary: Criteria vary by state. Includes risk to self/others or inability to meet basic needs. Emergency commitments are time-limited; formal court hearings follow.
Gravely Disabled: Unable to care for basic needs due to mental illness.

Nursing Liability

Malpractice/Negligence: Failure to meet the standard of care, resulting in patient harm.
Avoiding Nursing Malpractice: Effective communication, accurate records, adhering to standards of care, developing rapport with patients, and practicing to the scope of competence.

Clinical Pearl

Patient's rights and welfare are paramount.

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Description

This quiz explores the ethical dilemmas frequently faced by psychiatric-mental health nurses and the essential guidelines set by the American Nurses Association (ANA). It covers the primary functions of the ANA Code of Ethics, the responsibilities of nurses, and the importance of teamwork in healthcare. Perfect for nursing students and professionals looking to enhance their understanding of ethical standards in psychiatric nursing.