Legal and Ethical Issues - EXAM I Flashcards
Clients who have a mental health disorder diagnoses or who are receiving acute care for mental health disorder are guaranteed the same civil rights as any other citizen. These include the following:
- the right to humane treatment and care, such as medical and dental care
- the right to vote
- the rights related to granting, forfeiture, or denial of a driver’s license
- the right to due process of law, including the right to press legal charges against another person.
specific rights that a client with a mental health diagnoses include the following:
- informed consent and the right to refuse treatment
- confidentiality
- a written care of plan of care/treatment
- communication with people outside the mental health facility
- care provided with respect, dignity, and without discrimination
- freedom from harm related to physical or pharmacological restraint, seclusion, and physical and mental abuse
- psychiatric advance directive in case they are an involuntary admit
- provision of care with the least restrictive intervention necessary
wrongful act or injury committed by an entity or person against another person or another person’s property.
Tort
philosophical ideas regarding right and wrong.
ethical issues
the quality of doing good; can be described as charity.
beneficence
the client’s right to maker her own decisions. But the client must accept the consequences of those decisions. The client must also respect the decisions of others.
autonomy
fair and equal treatment for all
justice
loyalty and faithfulness to the client and to one’s duty.
fidelity
honesty when dealing with a client.
veracity
the client or client’s guardian chooses admission to a mental health facility in order to obtain treatment. A _______ _______ client has the right to apply for release at any time. This client is considered competent, and so has the right to refuse medication and treatment.
Voluntary admission
the client is admitted for emergent mental health care due to the inability to make decisions regarding care. The medical healthcare provider may initiate the admission which is then evaluated by a mental healthcare provider. The length of this type of admission varies by the client’s need and state laws but often is not to exceed 15 days.
temporary emergency admission
the client enters the mental health facility against her will for an indefinite period of time. the admission is based on the client’s need for psychiatric treatment, the risk of harm to self and others, or the inability to provide self care.
Involuntary admission
an involuntary admission is limited to ___ days at which time a psychiatric and legal review of the admission is required.
60
How many physicians ( in most cases) are required to certify that the client’s conditions requires commitment. Which can be imposed by a family member, legal guardian, primary care provider, or a mental health provider
2
are clients committed involuntarily still considered competent, and given the right to refuse treatment, and medications. Once judged incompetent a temporary of a permanent guardian is appointed by the court in which they will provide informed consent for the client. This guardian is expected to consider what the client would want had they been competent.
Yes
a type of admission that is similar to temporary commitment but must be imposed by the courts. Time of commitment varies, but is usually 60 to 180 days. Sometimes, there is no set release date.
Long-term involuntary admission
what are the less restrictive measures taken before seclusion and restraint become an option?
- verbal interventions such as telling the client to calm down
- diversion or redirection
- providing a calm, quiet environment
- offering a PRN medication (chemical restraint but considered less restrictive than a mechanical restraint.
the nurse should never use seclusion or restraint for : ?
- convenience of the staff
- punishment of the client
- clients who are extremely physically or mentally unstable
- clients who cannot tolerate the decreased stimulation of a seclusion room
The provider must prescribe the seclusion or restraint in writing within __ hours of the nurse initiating the emergency treatment.
4 (the book notes within the first hour the treatment was initiated however Hilton states that the general rule of thumb is 4 hours)
confining a client to a specific area, such as a seclusion room, is _____ ________ if the reason for such confinement is for the convenience of the staff.
false imprisonment
making a threat to a client’s person, such as approaching the client in a threatening manner with a syringe in hand.
assault
touching a client in a harmful or offensive way is considered _____. This would occur if the nurse threatening the client with a syringe actually grabbed the client and gave an injection.
battery
What should be documented in the event of a violent or unusual episodes?
- client behavior in a clear and objective manner
- staff response to the behavior (timeline and the extent of the response)
- time the nurse notified the provider (an any prescriptions received.)
what should be included in a mental health assessment?
Psychosocial history Cultural beliefs and practices Spiritual and religious beliefs Mental status examination (MSE) Physical appearance Behavior Cognitive and Intellectual beliefs
a client’s ____ provides information about the emotion that she is feeling.
mood
a clients ____ is an objective expression of mood, such as a flat affect or a lack of facial expression
affect
published by the American Psychiatric Association, and used as a diagnostic tool to identify mental health diagnoses. It is used by mental health professionals for clients who have mental health disorders.
The Diagnostic and Statistical Manual of Mental Disorders
requires outpatient treatment for a specified period to determine the patients adherence with medication protocols, ability to meet basic needs, and ability to reintegrate into the community.
conditional release
…or discharge, is the termination of the patient - institution relationship. This release may be court ordered or administratively ordered by institutional officials.
unconditional release
in some case’s there is a disagreements with mental health care providers and patients.
release against medical advice (AMA)
defendant executed the wrong doing act on purpose or with intent.
intentional tort
direct wrong of a personal nature. Injures the feelings of the person and does not take into account the effect of revealed information on the reputation of the person in the community.
invasion of privacy
communication that is false of made with a careless disregard for the truth, and results in injury to the reputation of the person.
defamation
defamation of character by means of print
libel
defamation of character by spoken word
slander
negligence/professional negligence
unintentional tort
misconduct that is below the standard of what is expected of an ordinary, reasonable and prudent person.
negligence
involves extreme lack of knowledge, skill, or decision making that the person clearly should have known would put others at risk.
gross negligence
“professional negligence” that is negligence that occurs while the person was performing as a professional. Six elements must be present for a case of nursing professional negligence to be proven; duty, breach of duty, forseeability, causation, harm or injury, and damages.
malpractice
lists psychiatric diagnosis/diagnoses (ex. Major Depressive Disorder)
Axis I of DSM IV
personality disorders and intellectual disability (ex. borderline personality disorder)
Axis II of DSM IV
medical conditions that may or may not have influence on mental health diagnoses. (ex. coronary heart disease)
Axis III of DSM IV
Psychosocial stressors (economic, spiritual, environmental stressors) ex. homelessness
Axis IV of DSM IV
Global Assessment of Functioning (GAF) Score, rated from 1-100 and indicated patient’s level of functioning. The higher the score the higher level of functioning.
Axis V of DSM V
what does right of Habeas Corpus mean?
protection from unlawful detention (due process in civil commitment
