Legal and Ethical

Question 1

what seven areas need to be considered when thinking about clinical scenarios

Answer 1

1. rights
2. autonomy
3. beneficence and non-maleficence
4. justice
5. fidelity
6. veracity
7. trust and reciprocity

Question 2

Rights

Answer 2

right form the basis of most profession, codes, legal judgement and consider ideas such as self-determination rights, rights and cultural relativism the right to health care and right to privacy and confidentiality

Question 3

Automony

Answer 3

people are free to choose, maker their own decisions and act on their own preference so long as they dont impinge on the moral interest of others,

Question 4

Beneficence

Answer 4

“above all, do good” a positive obligation on nurses to act in the benefit of others clients and whanau

Question 5

Justice

Answer 5

can be considered as fairness, nurses frequently face decisions in which a sense of justice should prevail (mental health act), facilitating what is due and owed to a consumer e.g. their rights.

Question 6

Fidelity

Answer 6

being faithful to agreements and responsibilities one has undertaken.

Question 7

Veracity

Answer 7

telling the truth, consumers expect nurses to be truthful in matters such as planned treatment/ any limits to autonomy

Question 8

Trust and Reciprocity

Answer 8

trust that colleagues will act in a way that is mutually supportive and do not harm each other. Essential of building trust in working relationships.

Question 9

Section 30 MHA92 (mental disorder)

Answer 9

inpatient order every patient order shall require the continued detention of the patient in the hospital specified in the order or where the patient is being detained. the admission of the patient and his/her detention in the hospital soufl be specified for the purpose of treatment and shall require the patient to accept treatment

Question 10

Section 8 MHA92

Answer 10

Any person may fill out an application form. Anyone who believed that a person may be suffering from a mental disorder may at any time fill out an application form asking the director of Area mental health services for an assessment of the person , if at anytime the patient during current inpatient oder responsible clinician patient and continue treatment outside notice in writing is required.

Question 11

Section 16 MHA92

Answer 11

judges review. at any stage during the first (section 11) and second (section 13) periods of assessment and treatment, an application may be made by the court for a review if the clients status. The judge will consider all reports , client and others involved in client care in order to determine the person is subject to the act, must stay in the act or can be released from the act. A RN (usually case manager) is expected to write a second opinion report for this hearing and accompany the client.

Question 12

Section 2 MHA92

Answer 12

interpretation, in this act unless the context otherwise requires. Biometric information, clinical means, court means, deputy director means, district inspector means, duty authosior means, first period means, fit to be released from compulsory status means, health practitioners hospital means… ect.

Question 13

Section 4 MHA92 (exceptions)

Answer 13

exclusions: the act cannot be invoked solely by reason o the person’s
- political, religious or personal beliefs
- persons sexual preference
- person’s criminal or delinquent behaviour
- substance abuse
- intellectual disability

Question 14

how could a nurse help to minimise feelings of powerlessness for people committed under the act?

Answer 14

communication, involvement and some authority over care and care planning, therapeutic communication

Question 15

can we put someone under the act who is refusing to take their medication for a physical condition?

Answer 15

no, someone can only be placed under the mental health act if they are a danger to themselves or others.

Question 16

non-maleficence

Answer 16

“above all, do no harm” in providing care it obligated nurses to remain fro acts that unnecessarily cause injury or harm of suffering

Question 17

paternalism

Answer 17

when nurse believe they know what’s best for the consumer (i.e in their best interest) and that they are most qualified to speak on the consumers behalf.

Question 18

What is the MHA 1992

Answer 18

legislation that sets out the circumstances for treating service users with a mental illness/ disorder

• it protects service rights
• a tool to protect people from harming themselves and also the public
• allows for review and judicial enquiries
• can force people to have treatment and assessment

Question 19

Service user rights

Answer 19

right one: the right to information
right two: respect for cultural identity
right three: the right to an interpreter
right four: the right to appropriate treatment
right five: the right to be informed about care
TREATMENT
right six: the right refuse video recording
right seven: the right to independent
PSYCHIATRIC ADVICE
right eight: the right to legal advice
right nine: the right to company
right ten: the right to have visitor and make phone calls
right eleven: the right to send and receive mail

Question 20

Services in the community

Answer 20

the mental health services in the community, sector bases, hereford centre, support groups

• doctors/ GP- SPOE
• crisis resolution, emergency department
• police

Question 21

What is a serious danger

Answer 21

• serious danger has a wide meaning and includes danger to your physical or mental health or safety, or danger to the physical or mental health or safety of any other person

Question 22

Exceptions Sec 4 MHA 92

Answer 22

you cannot be placed under the MHA because of your

• political, religious or cultural beliefs or sexual preference
• criminal or delinquent behaviour
• substance abuse
• intellectual disability

Question 23

Ethics as a nurse

Answer 23

• privacy
• beneficence
• professional behaviour
• autonomy versus making decisions over someone
• consent not needed
• family not included

Question 24

role as an RN MHA

Answer 24

• assists in keeping family informed
• contribute to assessments and nursing care plans
• ensure service users are aware of their rights
• maintain safety of service users and others
• be aware of their legal status
• section 111 of the MHA
• assess for any cultural or spiritual considerations

Question 25

Sections of MHA

Answer 25

section 8 a and b: application for assessment/ medical certificate
section 9: notice to attend an examination
section 10: cert if prelim
section 11/12: assessment for up to 5 days
section 13: further assessment for 14 days
section 14: cert for final assessment
section 15: further assessment for 14 days
section 16: review of condition by judge
section 29: community treatment order
section 30: inpatient treatment order
section 31 : leave for patient
section 111: powers of the nurse