Legal and Ethical Considerations Flashcards
Patients rights under the law
- right to tx
- right to refuse tx
- right to informed consent
Informed Consent
- Autonomy over body
- ONLY PHYSICIAN/ PROVIDER OF CARE CAN OBTAIN CONSENT ( nurse can sign consent as witness for clients signature )
When can treatment w/o consent be allowed?
- mentally incompetent and need tx to preserve life or avoid serious harm
- Refusal of tx endangers life or health of another
- Emergency in which client in no condition to exercise judgement
- Patient is a child
- Therapeutic Privilege= info about tx maybe withheld if full disclosure would hinder tx, cause severe psych harm, or make pt so upset they cant make rational decisions
What is competence?
DECISION MAKING CAPACITY
- Can change overtime ( will need repeated assessments)
- The is pt. evaluated by psychiatrist
- The COURT DESCIDES IF THE PT IS COMPETENT
What is Guardianship
Appointment of person to make decisions when judgment is impaired or disabled
- Pt cant enter into contracts, consent to sexual activity, or authorize own tx W/O GUARDIAN APPROVAL
- Payee= volunteer or staff that pt agrees to help manage finances via contract
Informal admission
sought out by patient
Voluntary admission
sought out by patient or guardian
Involuntary commitment
w/o patients consent
-mentally ill
- danger to self or others
- unable to acquire basic necessities
Temporary admission
- used for observation dx tx
- generally for 24-96 hrs
- requires court hearing before d/c or next admission
Assisted Outpatient Tx
“PINK SLIP” : application for emergency admission
Allows state to hospitalize individuals w/ mental illness against their will IF
1. hospitalized by court order
2. represents substantial risk of physical harm to self or others if allowed to remain at liberty pending examination
- Must be evaluated by psychiatrist within 24 hrs
Sections of PINK SLIP
- Statement of Belief = can be taken to safe environment ( ED ) holds for 24 hours
- Who can do it?: transporting psychiatrist, clinical psychologist, licensed physician, health officer, police officer, chief of adult parole, parole or probation officer, sheriff
- Statement of observation= detain for further observation
- have to talk to pt for more than 10 mins
- valid for 72 hours ( only monday-friday 9a-430p counts) NO HOLIDAYS OR WEEKENDS
* if signed after business hours day 1 starts the next day - when pink slip expires the patient must be d/c, sign in voluntarily or have court ordered hospitalize the pt
What criteria must be met to force meds?
- Behavior is dangerous to self or others
- Med must have reasonable chance of working
- Client must be judged incompetent to evaluate tx
** NEED A COURT ORDER **
Right to least restrictive environment
- Freedom from restraint / seclusion = false imprisonment
- Restraint= Leather / manual restraint , medication used to restrict freedom of mvt
- Seclusion= type of physical restraint, confined alone to room, unable to leave
Restraints / Seclusion Standards
- D/C earliest possible time
- Inperson evaluation by physician, psychiatrist, or other practitioner within 1 hour of initiating restrint or seclusion
- need continuous monitoring
- Renew order
Adult Q4
Age 9-17: Q2
Age <9: Q1
Confidentiality + Right to privacy
- May release info WITHOUT CONSENT IN LIFE THREATENING SITUATIONS - Document
- DUTY TO WORN - protection of 3rd party = ability to intervene to protect the victim
Malpractice ( applies to only professional )
Instance of negligence or incompetence on part of professional - must prove cause and damages
