Module 3: Cultural, Legal and Ethical Implications

Question 1

Define cultural competence in psychiatric mental health nursing and outline strategies to assist nurses in the development of cultural competence

Answer 1

• culture can be viewed as a blueprint or guiding actions that affect care, health, and well-being
• to develop cultural competence a nurse can either ask the patient/family members questions or go off what they’ve been told by the patient and research in order to be cultural competent and respectful of their beliefs and view points as to not offend them or go against what they believe
• not all cultures view mental health as serious or a real issues so it is important to be understanding of this as patient’s family members may not be willing to come to terms with what the individual is facing

Question 2

Compare and contrast dominant Western beliefs and values with the beliefs and values of non-dominant diverse cultures

Answer 2

• western beliefs: mind and soul are separate entities and are treated by different practitioners, disease has a specific measurable, and observable cause and treatment focuses on curing and eliminating the cause. Time is linear and moving forward and not waiting for anyone, success is obtained by preparing for the future
• others may view family as central to ones identity and family interdependence and group decision making are the norm. Body-mind-spirit seen as one entity

Question 3

Consider the world view and cultural beliefs of the First Nations people in Canada and their relation to mental health and mental illness

Answer 3

• it is important for psychiatric mental health nurses to be aware of how history and context of indigenous peoples and social determinants of mental health have influences mental health and illness for indigenous people
• indigenous world view of mental health acknowledges the connection between an individual and the collective, reflective of the balance achieved between physical, emotional, cognitive and spiritual dimensions

Question 4

Explain the unique mental health and mental illness issues of refugee and immigrant groups in Canada

Answer 4

• refugee families inclusive to their kids may require mental health assistance to adjust to their new surroundings and to feel as sense of safety and security
• many refugees have been traumatized by war, genocide, torture, starvation and other catastrophes
• common mental health problems faced by refugees include anxiety, depression, grief responses and notably a risk for post-traumatic stress disorder related to their experiences.
• Certain factors may predispose immigrants to mental health problems
  
  • during their first 10 yrs in Canada 30% of immigrants live in poverty
  • they may experience acculturative stress in attempt got adapt to a new culture, negotiating new norms and seeking meaningful employment
• immigrant woman are particularly vulnerable to mental illness and mental health problems due to their multiple social roles and limited autonomy
• accessing mental health services may be problematic due to language barriers and stigma

Question 5

autonomy

Answer 5

respecting the rights of others to make their own decisions

Question 6

non-maleficence

Answer 6

doing no wrong to a patient

Question 7

beneficence

Answer 7

the duty to promote good

Question 8

justice

Answer 8

the duty distribute resource or care equally

Question 9

Principle of impossibility

Answer 9

the rights or obligations that cannot be met in the circumstances are no longer obligations

Question 10

fidelity

Answer 10

maintaining loyalty and commitment

Question 11

informed consent

Answer 11

• is based on a person’s right to self-determination and ethical principle of autonomy
  
  • > obtained by the physician or other health care provider before the treatment/procedure and PT must be informed of the following
    • • nature of their problem/condition
    • -nature and purpose of a prosed treatment
    • -the risks and benefits of that treatment
    • -alternative treatment options
    • -probability of success of the prosed treatment
    • -risks of not consenting to treatment

Question 12

Competency

Answer 12

• the capacity to understand the consequences of one’s decisions, PT must be considered legally competent until declared incompetent through a legal process
  - > if declared incompetent a legal guardian or or representative would give consent or decline care

Question 13

Confidentiality

Answer 13

the right to privacy of information

Question 14

Explain the duty to warn and protect

Answer 14

• assessing and predicting the patient’s danger of violence toward another
• identifying the specific persons being threatened
• taking appropriate action to protect the identified potential victims