Ethics Flashcards
a disability severe enough to warrant hospitalization cont. treatment on monitoring
mental illness
process by which a person suffering from a mental illness, who is unable to care for self, or who is deemed a danger to self or others, maybe temporarily detained & committed to a hospital or outpatient treatment on a compulsory basis. Governed by individual states.
Involuntary Commitment
Danger to self &/ or others:, inability to attend basic needs, gravely disabled, refuses hospitalization, or incompetent to consent
Civil or judical: Long term.
Emergency: risk of harm to self or others. Short term
Criteria for involuntary commitment
Balance person’s right to freedom with protection of the MI person who is unable to care for self & the protection of society.
Due process in civil commitment
it is the responsibility of a treating mental health professional to notify an intended, identifiable victim.
Tarasoff Duty to Warm
Definite current plan to harm a specific, identifiable person, resources & ability to carry out, history of violence, impulsivity, extreme emotional changes, depression
Assessing intent to harm
regarding treatment and research participation. Must have adequate information for consent. Inform of treatment benefits and risks. Must be capable of consenting or refusing.
Ex. ECT-requires informed consent.
Informed Consent
right to due process in matters of hospitalization do not apply to minors.
Parents/guardians make decisions for minor children.
Nursing Interventions; Support child’s best interest, treat fairly, inform & involve in treatment.
Legal Rights of Children
One to one interaction
Separating the patient from the area/stimulus
Redirecting the patient.
Limit setting
Voluntary med. Administration
Quiet room/time out “staff show of determination”
Involuntary med administration
Least to Most Restrictive Alternative
Seclusion-Involuntary confinement in a specifically constructed, locked room with a security window or camera for protection of others. Provides decreased stimulation. Requires constant monitoring, nursing assessment & care, doctors order.
Restraints-Ankles & wrist devices fastened to bed from to curtail physical aggression to self/others. Must have 1:1 For safety of patient
Nurse can put pt in seclusion or restraints according to hospital policy but must get doctor’s order ASAP & doctor must assess within 1 hour. Discontinue ASAP. Careful Documentation.
Most Restrictive Alernatives
All MI are assumed competent until declared incompetent in court of law or a minor.
Legal Incompetency
Lacks the capacity to appreciate the criminality or conform to law.
Refers to persons state of mind at the time of the offense.
To be found guilty, person must be able to form intent.
If unable to form intent, person is not found guilty
If not guilty, person is usually evaluated for commitment to a hospital for treatment.
M’Naghten Rule-Insanity Defense
Not guilty by reason of insanity
Newer, possible plea in some states.
Person found guilty, but mental illness caused commission of offense.
Sent to prison & treated for mental illness.
Court commitment in DE-Mitchell @ DPC for treatment of MI, determine fitness to stand trial. dept of corrections.
~has intent but mentally ill.
Guilty But Mentally ill (GBMI)
is a branch of philosophy that deals with systematic approaches to distinguishing right from wrong behavior
ethics
is the term applied to these principles when they refer to concepts with in the scope of medicine, nursing and allied health.
bioethics