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Psych > 4. Ethical and Legal Issues > Flashcards

4. Ethical and Legal Issues Flashcards

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1
Q

5 ethical concepts

A
  • beneficence
  • autonomy
  • justice
  • fidelity
  • veracity
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2
Q

mental health civil rights and due process includes what?

A
  • client consent
  • communication
  • freedom from harm
  • dignity and respect
  • confidentiality
  • participation in their treatment plan
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3
Q

empowerment or having free will to make moral judgements; uses internal motivation; important part of the recovery process

A

self-determinism

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4
Q

key values of self-determinism

A
  • personal autonomy (right to choose own health-related behaviors; even if different from those recommended by health professionals)
  • avoidance of dependence on others
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5
Q

Patient Self-Determination Act provides what?

A
  • information about advance care documents
  • question on admission and document about having advance care documents
  • information about rights to complete advance care documents and to refuse treatment
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6
Q

advanced care documents in mental health

A
  • living will: states what treatment is refused when the person can’t make decisions
  • durable power of attorney: usually relative or trusted friend to make decisions on person’s behalf if they can’t
  • psychiatric advance directives: document their choices about treatment and care; must have 2 witnesses
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7
Q

gives patients with mental health disorders additional protection

A

bill of rights for mental health patients

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8
Q

protection from job discrimination and mandates accommodations for individuals

A

Americans with Disabilities Act (ADA)

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9
Q

mechanisms to combat any violation of patients rights; requires advocacy and investigation of abuse/neglect

A

internal rights protection systems (Public Law 99-319)

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10
Q

organization that operate independently of mental health agencies and advocate for treatment and rights of mental health patients

A

external advocacy systems

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11
Q

degree to which patient can understand and appreciate the info given during the consent process; cognitive ability to process info at a specific time

A

competency

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12
Q

T/F: competency is clearly defined across the US

A

False

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13
Q

Areas of determining competency

A
  • communicate choices
  • understand relevant info
  • appreciate situation and consequences
  • use a logical though process to compare risks and benefits of tx options
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14
Q

legal procedure to ensure pt knows benefits and costs of tx; mandate of state laws

A

informed consent

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15
Q

how is informed consent complicated in mental health tx

A
  • decision-making ability often compromised in mental illness
  • competency necessary to give consent
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16
Q

explain voluntary admission or commitment

A
  • person retains full civil rights

- free to leave any time, even AMA

17
Q

explain involuntary admission

A
  • court ordered and without the person’s consent
  • right to receive treatment; possible right to refuse
  • provisions for emergency short-term hospitalization of 48-92 hours
18
Q

3 common elements of involuntary admission

A
  • mentally disordered
  • dangerous to self or others
  • unable to provide for basic needs (can’t perform ADLs)
19
Q

elements of least restrictive environment

A
  • larger concept underlying pt’s right to refuse tx
  • person can’t be restricted to an institution when he or she can be successfully treated in the community
  • medication can’t be given unnecessarily
  • use of restraints or locked room only if all other “less restrictive” interventions have been tried first
20
Q

steps to promote safety from least restrictive to most restrictive

A
  • observation
  • de-escalation
  • seclusion
  • restraints (chemical then physical)
21
Q

What is needed to physically restrain patients?

A

doctors order (except in emergency situations -> nurse can place restraints and then obtain an order)

22
Q

When should restraints be removed from patients?

A

as soon as they are no longer a danger to themselves or others and can follow directions

23
Q

part of a person’s life not governed by society’s laws and government intrusion

A

privacy

24
Q

ethical duty of nondisclosure (prover has info about pt and should not disclose it); involves 2 people (person who disclosed info and person who info was shared with)

A

confidentiality

25
Q

release of pt info without the pt’s consent in the absence of legal compulsion or authorization

A

breach of confidentiality

26
Q

states that pt authorization is necessary for release of info with exception of that required for tx, payment, and health care administrative operations

A

Health Insurance Portability and Accountability Act (HIPAA)

27
Q

a legal obligation to breach confidentiality

A

mandates to inform

28
Q

What is the “duty to warn”

A
  • judgement that a pt has harmed someone or is about to injure someone
  • mandated to report that to the authorities or person who is threatened
  • only statement about harm can be reported; details of thoughts found in therapist or psychiatrist notes can only be accessed w/ court order
29
Q

5 types of legal liability in psychiatric nursing practice

A
  • assault: threatening to hurt pt
  • battery: harmful or offensive touching of pt
  • medical battery: causing harm or touching pt without medical consent or failing to follow advanced directive
  • false imprisonment: restraining pt without justification (also not discharging voluntary pt at their request)
  • negligence: doing something or failing to do something that a component nurse would or would not do
30
Q

required parts of nursing documentation

A
  • observations of subjective and objective physical, psychological, and social responses
  • interventions implemented and pt responses
  • observations of meds therapeutic and side effects
  • evaluation of outcomes of interventions
31
Q

What is NGRI

A

Not Guilty by Reason of Insanity (involuntarily hospitalized); person deemed unable to control their actions at the time of the crime

32
Q

What is GBMI

A

Guilty but Mentally Ill (goes to jail); mental illness is considered in the crime but not to the extent that the person didn’t know they were doing something wrong or unable to control actions

Psych (17 decks)

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