Legal and Ethical Legal and Ethical Aspects of Nursing Aspects of Nursing

Practice Practice Chapter 13Chapter 13

Principles of Principles of BioethicsBioethics

Autonomy

Beneficence

Fidelity

Justice

Nonmaleficence

Veracity

Ethical GuidelinesEthical Guidelines

Standards for Psychiatric–Mental Health nursing practice published by ANA

ANA Code of Ethics

Ethical DilemmasEthical Dilemmas

The potential stigma of psychiatric diagnostic labels

Psychiatry’s right to control individual freedom

The justification for involuntary treatment

The use of restrictive treatment interventions

The client’s right to suicide

The client’s right to privacy

Stigma Associated with Stigma Associated with Diagnostic LabelsDiagnostic Labels

Stereotypes

Need for diagnostic labels

Nurse’s moral stance

Mental Health Statutes Mental Health Statutes and Regulationsand Regulations

Rules and regulations are set by state governments

Vary considerably

Nurses must know the law of the state in which they practice

Voluntary AdmissionVoluntary Admission

Informed consent

Client retains all rights

Client has a right to demand and obtain release

Involuntary Involuntary CommitmentCommitment

Hospitalization against one’s will

Criteria: Dangerous to self (DTS) Danger to others (DTO) Gravely Disabled (Unable to provide for

basic needs due to Mentally illness)

Involuntary Involuntary Commitment Commitment

5150 - 72 hour-hold (DTS, DTO, GD)

5250 - 14 day hold (DTS, DTO, GD)

Consecutive 14 day hold for DTS

30 day hold (GD)

180 day hold for (DTO)

Temporary Conservatorship - GD

LPS Conservatorship - GD

Legal TermsLegal Terms

Riese Petition (Medication Capacity Hearing)

Probable Cause Hearing

Writ of Habeus Corpus

Psychiatric–Mental Psychiatric–Mental Health Nursing CareHealth Nursing Care

Rights

Dignity

Autonomy

Psychiatric Advance Psychiatric Advance DirectiveDirective

Modeled after advance directives for end-of-life care

Allows competent persons to document their preferences regarding mental health treatment

Determining Determining NegligenceNegligence

Common Sources of Liability Common Sources of Liability in Psychiatric / Mental in Psychiatric / Mental

Health ServicesHealth Services

Potential ProblemsPotential Problems

Poorly funded services

Stigma

Isolation

Denial of rights