Legal And Ethical Flashcards
Seven areas that need to be considered when thinking about clinical scenarios and applying ethical reasoning (Evans et al, 2017, p. 73)
- Rights
- Autonomy
- Beneficence
- Justice
- Fidelity
- Veracity
- Trust and reciprocity
Why do nurses need knowledge about the Mental Health (Compulsory Assessment and Treatment) Act 1992 (MHA92)? How will you use this knowledge in your nursing practice?
- To comprehend and understand their legal and ethical responsibilities when they care for a person who experiences a mental health challenge and could require compulsory treatment or assessment. In practice this knowledge will enable nurses to advocate for a person’s rights and ensure appropriate care and educate the person and their whanau about their rights in regard to their treatment under the act
Find out what the following section numbers mean: Section 30 MHA92
- Impatient orders, compulsory treatment orders that require a person with a mental disorder to receive treatment in a hospital. Orders can be issued by the court after a hearing, which will consider evidence and determine if the person needs compulsory treatment. Orders can last for up to six months.
Find out what the following section numbers mean: Section 8 MHA92
- Anyone can request an assessment of a person that they believe could be experiencing a mental disorder. The assessment is conducted by the Director of Area Mental Health Services and will determine if the person meets the criteria for a mental disorder. The applicant must be over 18 but there is no age restriction on the person that is being assessed
Find out what the following section numbers mean: Section 16 MHA92
- Judges review. At any stage during the first (Section 11) and second (Section 13) periods of assessment and treatment, an application may be made to the Court for a review of the client’s status. The judge will consider all reports, clients and others involved in client care in order to determine if the person subject to the Act must stay on the Act or can be released from it. A RN (usually case manager) is expected to write a second opinion report for this hearing and accompany the client
Find out what the following section numbers mean: Section 2 MHA92
- Defines a “mental disorder” and enables a framework for compulsory assessment and treatment. It outlines what constitutes a mental disorder and when a person may be detained in hospital for assessment and treatment against their own will
Find out what the following section numbers mean: Section 4 MHA92
- Exclusions: The Act cannot be invoked solely by reason of the person’s:
- Political, religious, or personal beliefs
- Sexual preferences
- Criminal or delinquent behaviour
- Substance abuse
- Intellectual Disability
How could a nurse help to minimise feelings of powerlessness for people committed under the Act?
- Respect the autonomy of the person by encouraging them to make decisions that are about their care and enable them to participate in their care and treatment plan, and advocate for the person’s rights. Offer the person a choice or provide different options, demonstrate empathy and understanding to create a safe environment to establish a therapeutic relationship
Can we put someone under the Act who is refusing to take their medication for a physical condition? Explain your answer
No, because the act cannot force someone with a physical condition to take their medication. The act is applied to people who have a mental disorder and who are deemed to be a danger to themselves or others
Alex, a 33-year-old woman under the MHA92 is refusing to have her regular antipsychotic medication, Olanzapine, although she does agree that her symptoms were lessened when taking the medication. She is concerned about her weight as a result of taking the medication and tells you that you do not understand what it is like taking medication with such side effects. As a nurse what plan of action would you consider to manage this situation?
Nursing Intervention:
- Discuss Alex’s concerns about her medication
- Risk assessment
- Discuss healthy lifestyle choices
Rationale:
- To work together to increase her medication adherence, and find alternative or additional strategies around her concern’s.
- To identify Alex’s potential risks that could cause harm of lack of safety for herself or others around her
- Discuss healthy lifestyle choices To work together on developing a plan that will help her to manage her diet, weight, and exercise
Paternalism
- Paternalism is making a decision(s) for the patient based on what is perceived as the patient’s best interest without the consent or autonomy of the patient
Autonomy
- Autonomy is the right of an individual to have self-determination, independence and freedom. It promotes that the individual has the right to make their own decisions and will take responsibility for their decisions
Beneficence
- Beneficence is defined as to “do good”, by performing actions that can lead to an outcome which is regarded as worthwhile and will benefit the patient and their family members
Non - maleficence
- Non-maleficence to do no harm. It also is the avoidance of harm, minimising harm in situations that are deemed unavoidable and prevention of future harm
Justice
- Justice is based on the responsibility to treat all people fairly. A nurse can face a decision which a sense of justice should prevail. For example, under the mental health legislation a person can be detained but justice states that the individual can only be detained if at risk of themselves or other people
Veracity
- Occurs when actions, behaviour and speech ensure communications between an individual and groups are honest and truthful
Informal
When a patient has treatment in a psychiatric hospital voluntarily, and have the right to leave at any time
