Legal and Ethical Issues Concerning Nursing Practice PDF

Based on Morgan (2024) Chapter 5  Understand how nursing intersects with the legal system. Describe issues related to voluntary versus involuntary commitment Recognize patient rights and the nurse's role in protecting these rights. Objectives...

Based on Morgan (2024) Chapter 5  Understand how nursing intersects with the legal system. Describe issues related to voluntary versus involuntary commitment Recognize patient rights and the nurse's role in protecting these rights. Objectives Identify concerns related to the nurse-client relationship Patient Rights Safety Restraints Ethics/Ethical decision-making & Legal issues 10 major Informed consent/confidentiality ideas Patient Advocacy Documentation (C) University of Texas Medical Branch 2024 How Nursing Intersects with the Legal System 1. Professional Regulation: Nursing practice is governed by state laws and regulations, including licensure requirements and scope of practice definitions. 2. Patient Rights: Nurses must understand and uphold patients' legal rights, including informed consent, privacy, and confidentiality. 3. Liability and Malpractice: Nurses can be held legally accountable for negligence or errors in patient care. 4. Documentation: Accurate and timely documentation is crucial for legal protection and can be used as evidence in court. 5. Ethical Dilemmas: Nurses often face situations where legal and ethical considerations intersect, requiring careful navigation. 6. Mandatory Reporting: Nurses are often required by law to report certain situations, such as suspected abuse or neglect. 7. Criminal Law: In some cases, nurses may face criminal charges related to their professional conduct. Understanding these intersections is crucial for nurses to practice safely, ethically, and within legal boundaries while providing optimal patient care (C) University of Texas Medical Branch 2024  (C) University of Texas Medical Branch 2024 Ethical Principles in Psychiatric Nursing Autonomy: Respecting the patient’s right to make their own decisions. Beneficence: Acting in the best interest of the patient. Non-maleficence: Avoiding harm to the patient. Justice: Providing fair and equitable treatment to all patients. Fidelity: Maintaining trust and keeping promises to patients. Veracity: Honesty and truthfulness in communication.  Case: John, a 28-year-old man with a history of major depressive disorder and generalized anxiety, has been struggling with suicidal thoughts. After a recent crisis, he is admitted to a psychiatric hospital. His psychiatrist, Dr. Patel, discusses treatment options, including medication and cognitive behavioral therapy (CBT). (C) University of Texas Medical Branch 2024  Dr. Patel ensures that John is fully informed about the different Autonomy treatment options available, respecting his right to participate in decision-making about his care. John decides he would prefer to try therapy first, without immediately starting medication. Dr. Patel supports John's choice by setting up daily therapy Beneficence sessions with a psychologist and scheduling regular check-ins to monitor his progress, acting in his best interest by offering the care that aligns with John's preferences. Non- Although medication might help, Dr. Patel avoids pushing it, respecting John’s wishes to start with therapy alone, and maleficence preventing any unnecessary distress or side effects associated with medications. (C) University of Texas Medical Branch 2024  John receives the same level of care as other patients, Justice regardless of his financial situation or the complexity of his case. His treatment is equitable, ensuring access to all resources the hospital offers. Dr. Patel assures John that the team is there to support him Fidelity throughout his recovery and follows through by coordinating therapy, ensuring continuity of care and building trust. Dr. Patel is honest with John about his condition and the Veracity potential benefits and risks of both therapy and medication, ensuring that he has the truthful information needed to make an informed decision. (C) University of Texas Medical Branch 2024  Ethical dilemmas are a choice between two equally balanced alternatives Autonomy vs. Privacy vs. Least Restrictive Shared Decision- Environment vs. Making vs. Treatment Beneficence Safety Protection Quality Patient's right to Maintaining patient The principle of Involving patients in make decisions may confidentiality may using the least treatment decisions conflict with the conflict with the restrictive treatment may sometimes nurse's duty to need to protect the may conflict with conflict with provide beneficial patient or others the need to ensure providing evidence- care. from harm. patient and staff based, high-quality Example: A patient Example: A patient safety. care. refusing medication disclosing thoughts Example: Deciding Example: A patient that would likely of harming whether to use preferring a less improve their themselves or restraints or effective treatment condition. others. seclusion for an option. agitated patient. (C) University of Texas Medical Branch 2024 Legal Status and Rights Voluntary patients generally have more rights than involuntary patients, including: The ability to request discharge (though this may be subject to a short hold period) Greater control over treatment decisions However, the line between voluntary and involuntary status can be blurry. Some "voluntary" patients may feel coerced into admission, while some involuntary patients may be cooperative. (C) University of Texas Medical Branch 2024 When individuals with mental illness behave in erratic or potentially dangerous ways, to either themselves or others, then something must be done. Admission Process Voluntary admission typically requires the patient to sign consent forms Involuntary commitment usually involves a legal process, often initiated by a mental health professional or law enforcement Emergency involuntary holds (EDO) (e.g. 72-hour holds) may precede longer-term commitment Civil Commitment Action involves involuntary commitment in a hospital or mental health facility and is done to protect the individual and express concern over their well-being, much like a parent would do for their child. An individual can voluntarily admit themselves to a mental health facility, and upon doing so, staff will determine whether or not treatment and extended stay are needed. (C) University of Texas Medical Branch 2024 Criteria for Involuntary Commitment Though states vary in the criteria used to establish the need for involuntary commitment, some requirements are common across states. Danger to Self: The individual poses a clear and imminent risk of serious harm to themselves, often evidenced by suicidal behavior or intent. Danger to Others: The individual poses a significant risk of harm to others, demonstrated through threats or violent behavior. Grave Disability: The individual is unable to care for their basic personal needs (e.g., food, clothing, shelter, or personal safety) due to their mental illness, and as a result, their health and well-being are at significant risk. Severe Mental Illness: The individual must be diagnosed with a mental illness that severely impairs their judgment, behavior, or ability to understand reality, contributing to their dangerousness or inability to function. Lack of Insight: The individual is often unaware of their condition (anosognosia) and refuses treatment despite the evident risk to themselves or others. Inadequate Alternatives: Less restrictive interventions, such as outpatient treatment, have been tried or considered, and the individual’s condition requires the structured environment of a hospital. (C) University of Texas Medical Branch 2024 Procedures in Involuntary Commitment Initial Request for Evaluation: A family member, mental health professional, or primary care practitioner can request that the court order an evaluation of an individual. In some states, law enforcement may also initiate this request. If the judge agrees, an initial evaluation can be ordered, often by one or two professionals (mental health professionals or physicians) to assess the individual’s mental state, capacity for self-care, and risk of harm to themselves or others. Professional Assessment: Two professionals (commonly a psychiatrist and a second mental health professional or physician) will evaluate the individual. They will focus on the person's mental condition, ability to care for themselves, and their risk of harming themselves or others. This evaluation determines if the individual meets criteria for involuntary commitment. Formal Hearing: After the evaluation, a formal hearing is usually held. In this hearing, the examiners testify about their findings, and family members, friends, and the individual themselves may also provide testimony. During the hearing, the individual often has the right to legal representation. (C) University of Texas Medical Branch 2024 Involuntary commitment in Texas will typically involve the following steps. Initiation: Emergency Detention: Application for Court- Emergency detention can be The person is taken to an Ordered Treatment: initiated by a peace officer inpatient mental health facility for If longer-term treatment is without a warrant if they believe evaluation. needed, a physician, peace officer, the person is mentally ill and This initial detention can last up or mental health professional poses an immediate threat. to 48 hours. must file an application with the Alternatively, an adult can file an county court. application for emergency detention with the court. *Note: NCLEX will NOT test you on state specific laws. (C) University of Texas Medical Branch 2024 Appointment of Court Hearing: Judge's Decision: Extended Attorney: A hearing must be set within The judge can order Commitment: 14 days of filing the temporary commitment The judge appoints application. for up to 90 days if the If further treatment is needed beyond 90 days, an attorney to The individual has the right criteria are met. to legal representation and an application for represent the Criteria include having a extended commitment to contest the petition. mental illness and being proposed patient Two physician certificates, can be filed. a danger to self or others, within 24 hours of including one from a or unable to provide for This requires another filing the application. psychiatrist, must be on file basic needs. court hearing. before the hearing. Throughout the process, the individual has certain rights, including the right to be informed of the reasons for detention, access to legal representation, and the ability to communicate with others. The goal is to balance the individual's rights with the need for treatment and public safety. (C) University of Texas Medical Branch 2024 Length of Stay (LOS) and Discharge Voluntary patients can theoretically leave at will, but may face a short hold period (e.g. 72 hours) if they request discharge Involuntary patients are held for a set period determined by law, which varies by jurisdiction Extending involuntary commitment usually requires additional legal proceedings (C) University of Texas Medical Branch 2024 (C) University of Texas Medical Branch 2024 Treatment Involuntary patients may be forced to take medications or undergo other treatments against their will. This will require a court order to override the clients' civil rights. Perception and Stigma Involuntary commitment can be stigmatizing and traumatic for patients Balancing patient autonomy with the need to protect individuals and society Concerns about coercion and the use of involuntary treatment Ethical Debate over the effectiveness and potential harm of forced treatment Considerations Understanding these issues is crucial for mental health professionals, as the voluntary/involuntary distinction significantly impacts patient care, rights, and outcomes. (C) University of Texas Medical Branch 2024 Clients who are cared for in Mental Health settings have the same civil rights as any other citizens. Mental health clients have the following rights: To be treated with dignity, respect, and consideration for personal autonomy Freedom from discrimination based on race, ethnicity, age, gender, sexual orientation, disability, or other protected characteristics Protection from physical, sexual, or emotional abuse and inhumane treatment Right to confidentiality of personal information and communications, within legal limits Informed Consent and Refusal Right to give informed consent or refuse any service/treatment Freedom from unnecessary restraint or seclusion Right to be informed of and refuse any unusual or hazardous procedures (C) University of Texas Medical Branch 2024  Laws Applicable to Nursing Nurses are not immune from criminal prosecution if they break the law. Nurses have been prosecuted for crimes, such as negligent homicide, insurance fraud, theft of narcotics, manslaughter, and falsifying medical records. There are many examples of nurses being charged with crimes. Defamation False Invasion of Assault: Battery: (slander and imprisonment: privacy: libel): Making false Causing Touching a Intentional fear or patient Confining or Violating a statements restraining a patient's about a Torts apprehensi without patient patient or right to on of consent or against their disclosing will without privacy and private physical beyond the proper confidentia information harm in a scope of justification lity without patient consent authorization (C) University of Texas Medical Branch 2024 Legal Requirements for Assault in Nursing Awareness of Potential Harm For an assault claim to be valid, the alleged victim must be aware of the potential for harmful or offensive contact Example: An unconscious patient cannot claim assault by a nurse, as they are unaware of potential harm Words alone are not enough and verbal threats by themselves do not constitute assault However, words combined with threatening actions can meet the criteria for assault Example Scenario: Emergency Department Nurse yells at an unruly client Approaches quickly while grasping a key Loudly threatens to lock client in the seclusion room if they don’t “stop it!” This combination of words and actions could potentially be considered assault Key Takeaway: Assault charges require both components 1. The victim's awareness of potential harm 2. Actions that reasonably induce fear of immediate bodily harm (C) University of Texas Medical Branch 2024 Legal Requirements for Battery in Nursing Definition: Intentional, wrongful physical contact without consent Includes injury or offensive touching Protects freedom from unwanted physical contact Key Points: Can occur through direct touch or contact with extensions (e.g., clothing) Victim awareness not required Contrast: Assault vs. Battery Assault: Victim must be aware of potential harm Battery: Victim awareness not necessary Example: Patient refuses to take medication during scheduled administration Nurse becomes frustrated and grabs patient's arm forcefully Nurse attempts to force open patient's mouth to administer oral medication Nurse threatens to call for restraints if patient doesn't comply Key Takeaway Both assault and battery protect patient rights, but differ in awareness requirements and physical contact (C) University of Texas Medical Branch 2024 Unintentional Torts: Negligence: Failing to exercise ordinary care that a reasonable nurse would use in similar circumstances Malpractice: A specific form of negligence committed by a licensed healthcare professional Other Torts: Fraud: Deceiving a patient for personal gain, such as documenting interventions not performed or altering documentation to cover up errors (C) University of Texas Medical Branch 2024 Psychiatric nurses should be particularly aware of potential torts due to the nature of their work with vulnerable populations. Key areas of concern include: Obtaining proper informed consent for treatments Respecting patient autonomy while ensuring safety Maintaining confidentiality and privacy Properly assessing and monitoring patients at risk of self-harm or harm to others Accurately documenting patient care and communications Following proper procedures for involuntary commitment or use of restraints Administering medications correctly and monitoring for side effects To minimize the risk of becoming involved in these torts, psychiatric nurses should adhere to professional standards of care, maintain clear communication with patients and other healthcare providers, and thoroughly document their observations and actions. Chapter 5 Legal and Ethical Considerations in Mental Health Care - Nursing: Mental Health and Community Concepts - NCBI Bookshelf (nih.gov) (C) University of Texas Medical Branch 2024  Mental status assessment When documenting Appearance, behavior, speech, mood, affect, thought client care in psychiatric process/content, cognition, and mental health insight/judgment settings, nurses should Safety assessment Suicidal/homicidal ideation, self- focus on capturing key harm risk, aggression risk information related to the Symptoms and their severity patient's mental status, Both psychiatric and physical symptoms treatment, and progress. Medications Here are some important Administration, efficacy, side elements that should be effects, patient compliance included in psychiatric Interventions provided Therapeutic communication, de- nursing documentation: escalation techniques, crisis intervention, etc. (C) University of Texas Medical Branch 2024 The documentation should be objective, accurate, and timely. It's important to use psychiatric terminology appropriately and avoid subjective interpretations. Nurses should also ensure they are following their facility's policies and legal requirements for documentation. 1. Patient's response to interventions and treatment 2. Changes in the patient's condition or behavior 3. Patient's level of participation in treatment 4. Interactions with family/support system 5. Progress towards treatment goals 6. Patient education provided 7. Any use of restraints or seclusion (if applicable) 8. Interdisciplinary team communications 9. Discharge planning and follow-up care arrangements 10.Risk assessments and safety plans Remember to maintain patient confidentiality and only include information relevant to the patient's care. Good documentation not only ensures continuity of care but also serves as a legal record of the care provided. Assessment of quality in psychiatric nursing (C) documentation – a clinical University of Texas Medical audit - PMC (nih.gov) Branch 2024 The Nurse-Client Relationship Two concerns are of paramount importance in terms of the therapist-client relationship. These include the following: Confidentiality – Confidentiality guarantees that information about the patient is not disseminated without their consent. Health Insurance Portability and Accountability Act (HIPAA) also guides nurses’ when and who should receive information concerning individuals admitted to a psychiatric treatment facility. See the resource located under “Additional Resources” below. Duty to Warn – In the 1976 Tarasoff v. the Board of Regents of the University of California ruling, the California Supreme Court said that a patient’s right to confidentiality ends when there is a danger to the public, and that if a therapist determines that such a danger exists, there is an obligation to warn the potential victim. Tatiana Tarasoff, a student at UC, was stabbed to death by graduate student, Prosenjit Poddar in 1969, when she rejected his romantic overtures, and despite warnings by Poddar’s therapist that he was an imminent threat. Nurses have a legal and ethical obligation to their clients but, at the same time, a legal obligation to society. The 1980 case of Thompson v. County of Alameda ruled that a therapist does not have a duty to warn if the threat is nonspecific. (C) University of Texas Medical Branch 2024 (C) University of Texas Medical Branch 2024 Key Principles of the Tarasoff Ruling 1. Duty to Protect: Mental health professionals have an obligation to take reasonable steps to protect identifiable individuals threatened by a patient. 2. Duty to Warn: This may involve warning the potential victim or notifying authorities who can protect the victim. 3. Assessment of Threat: Professionals must evaluate the seriousness and credibility of threats made by patients. 4. Balancing Confidentiality and Public Safety: The ruling emphasizes prioritizing public safety over patient confidentiality when necessary. (C) University of Texas Medical Branch 2024 Implications for Nursing Practice While the original Tarasoff case focused on psychotherapists, its principles have broader implications for healthcare professionals, including nurses: 1. Threat Assessment: Nurses must be vigilant in assessing and documenting potential threats made by patients. 2. Reporting Protocols: Nurses should familiarize themselves with their facility's protocols for reporting threats and concerns. 3. Collaboration: Working closely with the healthcare team, including mental health professionals, is crucial when dealing with potentially dangerous patients. 4. Documentation: Thorough and accurate documentation of patient statements, behaviors, and nurse actions is essential. 5. Ethical Considerations: Nurses must balance patient confidentiality with the duty to protect potential victims. 6. Legal Awareness: Understanding state-specific laws regarding the duty to warn or protect is important, as they can vary by jurisdiction. (C) University of Texas Medical Branch 2024 Restraints: Last resort measure: Restraints should only be used as a last resort after all other de-escalation techniques have failed. Alternatives like verbal de-escalation, offering PRN medications, and environmental modifications should be attempted first. Safety and legal considerations: Restraints can only be used to manage violent or self-destructive behavior that poses an immediate safety risk. You must follow your facility's policies and relevant laws/regulations on restraint use. Physician order required: A physician order is required to initiate restraints, except in emergencies. In MH the nurse can place a client in seclusion/restraint and has 1 hour to get a face to face by a physician In emergencies, restraints can be applied, but a physician order must be obtained as soon as possible. Assessment and monitoring: Conduct a thorough assessment before applying restraints. Frequent monitoring of the patient's physical and psychological status is mandatory while restraints are in use. (C) University of Texas Medical Branch 2024 Key points about applying restraints: Time limitations: Orders for restraints are time-limited and must be renewed based on reassessment. Restraints should be removed as soon as the patient no longer poses an immediate danger. Documentation: Thoroughly document the rationale for restraint use, alternatives attempted, patient's response, and ongoing assessments. Patient rights: Patients have the right to be treated in the least restrictive environment possible. Inform patients of the reasons for restraint use and the criteria for their removal. Debriefing: Participate in post-incident debriefings to review the use of restraints and identify ways to prevent future occurrences. Potential risks: Be aware of the physical and psychological risks associated with restraint use, including potential trauma or injury. Remember, the goal is to maintain a therapeutic environment while ensuring safety for all. Continuous efforts should be made to reduce the use of restraints through preventive strategies and alternative interventions. (C) University of Texas Medical Branch 2024 Patient’s Rights Patients admitted to a psychiatric treatment facility maintain all their civil rights with one exception; if they have been admitted involuntarily, they may not be able to leave the facility. The following are several rights pertaining to patients and mental health treatment settings. See this article (American Psychiatric Association, n.d.) for further reading. A summary of these rights : Right to Information related to treatment options, providers’ qualifications, appeals and grievance procedures Right to Refuse Treatment Right to Least Restrictive Environment to Meet Needs Choice of Providers Confidentiality Nondiscrimination Parity Hold Accountable Professionals and Payers responsible for injury associated with incompetence, negligence, or unjustified decisions Treatment is Determined by Professionals not third-party payers When faced with an ethical or legal situation in psychiatric nursing, nurses should prioritize the following key considerations: Patient rights Respecting the patient's right to self-determination and autonomy as much as possible, while balancing this with safety concerns. This and autonomy includes considering the patient's right to refuse treatment and make decisions about their own care when competent to do so. Safety and duty Assessing if the patient poses a danger to themselves or others, which may necessitate involuntary commitment or other safety measures. of care: Nurses have a duty to protect patients from harm. Least restrictive Using the least restrictive interventions necessary to ensure patient safety and treatment. Avoiding unnecessary use of restraints, environment seclusion, or coercive measures. (C) University of Texas Medical Branch 2024  Ethical Balancing ethical principles like beneficence (doing good), non-maleficence (avoiding harm), justice, and principles respect for persons. Considering how to uphold these principles in complex situations. Legal Understanding and following relevant laws and regulations regarding mental health treatment, requirements involuntary commitment, duty to warn, confidentiality, etc. Informed Ensuring patients are provided adequate information to make informed decisions about their care when consent: possible. (C) University of Texas Medical Branch 2024  Maintaining patient confidentiality except when there is Confidentiality a duty to warn or report. Patient Acting as an advocate for the patient's best interests and advocacy rights. Ethical decision- Using ethical frameworks and consultation to carefully making: consider options in ethically complex situations. Thoroughly documenting the clinical reasoning, ethical Documentation considerations, and decision-making process (C) University of Texas Medical Branch 2024  Table Talk: Nursing Ethics For each scenario, tables should discuss: What questions would you ask to assess immediacy and credibility of the threat? Who are the potential victim(s)? What can be the legal and ethical implications to the nurse? What are the appropriate steps for the nurse to take or consider? How would the team balance client confidentiality with the duty to protect? (C) University of Texas Medical Branch 2024 A high school student confides they're being bullied and have thoughts of bringing a gun to school. What questions would you ask to assess immediacy and credibility of the threat? Who are the potential victim(s)? What can be the legal and ethical implications to the nurse? What are the appropriate steps for the nurse to take or consider? How would the team balance client confidentiality with the duty to protect? (C) University of Texas Medical Branch 2024  Ask specific questions about the student's plans, access to Assessing the weapons, and timeline immediacy and Evaluate the student's emotional state and level of distress Consider any history of violent behavior or previous threats credibility of the threat: Assess the severity and duration of the bullying Identifying potential The bullies are potential specific targets The entire school population could be at risk victims: Consider if the student has named any particular individuals Nurses have both an ethical and often legal duty to report threats of violence Legal and ethical Failure to report could result in harm and potential liability Follow school policies and state laws on threat reporting implications: Consider the ethical principle of non-maleficence (do no harm) to the broader school community (C) University of Texas Medical Branch 2024  Consult with school counselors and administration Appropriate immediately Contact parents/guardian steps for the Arrange for urgent mental health evaluation nurse to take: Document the conversation and assessment thoroughly Balancing Explain limits of confidentiality to the student confidentiality Prioritize school safety over individual confidentiality in this case and duty to Disclose only necessary information to protect: appropriate parties (C) University of Texas Medical Branch 2024 A client discloses they’ve their food has been poisoned by their spouse. What questions would you ask to assess immediacy and credibility of the threat? Who are the potential victim(s)? What can be the legal and ethical implications to the nurse? What are the appropriate steps for the nurse to take or consider? How would the team balance client confidentiality with the duty to protect? (C) University of Texas Medical Branch 2024  Look for specific details about the alleged poisoning (type of poison, Assessing the when/how it's being administered, etc.) immediacy and Note any symptoms or lab results consistent with poisoning Consider the patient's mental state and reliability as a reporter credibility of the threat: Look for any physical evidence of poisoning attempts The spouse is the primary potential victim Identifying potential Consider if there are children or other family victims: members who may also be at risk Nurses have both an ethical and legal duty to report suspected abuse Legal and ethical Failure to report could result in harm to the patient and potential implications: liability Consult hospital ethics committee if unsure how to proceed (C) University of Texas Medical Branch 2024  Document all relevant information thoroughly Appropriate in the medical record steps for the Consult with the attending physician and treatment team nurse Contact hospital social work/case management Balancing Explain limits of confidentiality to the patient confidentiality Only disclose minimum necessary information and duty to to appropriate parties Follow hospital policies on mandated reporting protect: (C) University of Texas Medical Branch 2024 A patient with paranoid delusions believes their neighbor is spying on them and plans to "stop" them. What questions would you ask to assess immediacy and credibility of the threat? Who are the potential victim(s)? What can be the legal and ethical implications to the nurse? What are the appropriate steps for the nurse to take or consider? How would the team balance client confidentiality with the duty to protect? (C) University of Texas Medical Branch 2024  Assessing the Explore the patient's specific plans to "stop" the neighbor Evaluate the patient's access to weapons or means to harm others immediacy and Assess the intensity and persistence of the delusions credibility of the Consider any history of acting on delusions or previous violent behavior Determine if the patient has made any direct threats or taken preparatory threat: actions The neighbor is the primary potential victim Identifying potential Consider if there are other individuals the patient believes are involved in the "spying" victims: Assess if the patient's delusions extend to others in the community Nurses have a duty to warn/protect potential victims (Tarasoff principle) Follow state laws and facility policies regarding duty to warn Legal and ethical Consider the ethical principles of beneficence (doing good) and non- implications: maleficence (preventing harm) Balance the patient's right to privacy with the safety of others Document all decision-making processes and actions taken (C) University of Texas Medical Branch 2024  Appropriate Document the assessment and conversation in detail Consult with the treating psychiatrist or mental health team steps for the immediately Consider the need for increased level of care or hospitalization nurse to take: Evaluate the need for medication adjustment or additional treatment Determine if involuntary commitment criteria are met Balancing Explain limits of confidentiality to the patient confidentiality Prioritize public safety over individual confidentiality in cases of credible threat and duty to Disclose only necessary information to appropriate protect: parties (e.g., treatment team, law enforcement) (C) University of Texas Medical Branch 2024 References American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. https://www.nursingworld.org/our-certifications/code-of-ethics/ Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press. Brent, N. J. (2001). Other Torts And Civil Rights. In N. J. Brent (Ed.), Nurses And The Law: A Guide To Principles And Applications (2nd ed., pp. 114-115, 127-128). W.B. Saunders Company. Furlong, E. (2018). Legal and Ethical Issues in Nursing. In J. R. McKinney & H. J. S. Hurst (Eds.), Nursing Ethics: Across the Curriculum and Into Practice (3rd ed.). Jones & Bartlett Learning. Legal Issues Relating to Mental Health Nursing - Psychiatric-Mental Health Nursing | OpenStax National Alliance on Mental Illness. (2018). Mental Health Bill of Rights. https://www.nami.org/Advocacy/Policy- Platform Raines, D. A. (2012). Ethical Considerations in Mental Health Nursing. In J. R. McKinney & H. J. S. Hurst (Eds.), Nursing Ethics: Across the Curriculum and Into Practice (3rd ed.). Jones & Bartlett Learning. (C) University of Texas Medical Branch 2024 References Singh, G. P. (2021). Ethical and legal issues in Psychiatric Nursing. International Journal of Advances in Nursing Management, 9(1), 91-93. https://doi.org/10.5958/2454-2652.2021.00023.8 Smith, M. C., & Parker, M. E. (2021). Nursing Theories and Nursing Practice (6th ed.). Jones & Bartlett Learning. Tingle, J., & Cribb, A. (2013). Nursing Law and Ethics (3rd ed.). Bailliere Tindall. World Health Organization. (2013). Mental Health Action Plan 2013-2020. https://www.who.int/publications/i/item/9789241506021 (C) University of Texas Medical Branch 2024