Week 8 NURS 6675 LEGAL AND ETHICAL ISSUES RELATED TO PSYCHIATRIC EMERGENCIES ESSAY
Week 8 NURS 6675 LEGAL AND ETHICAL ISSUES RELATED TO PSYCHIATRIC EMERGENCIES ESSAY
Legal and Ethical Issues Related to Psychiatric Emergencies
Laws guide the practice of nurses when providing care to patients with mental health illnesses. The laws also apply to patients requiring voluntary and involuntary care. Therefore, this paper explores the different laws that relate to involuntary psychiatric holds in the state of Florida.
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State of Florida Laws for Involuntary Psychiatric Holds
The involuntary commitment law in Florida is referred as the Baker Act. According to this act, any individual that remains in a treatment facility for at least 12 hours must be given a physical examination by a healthcare practitioner as stated by the law within 24 hours. Patients should receive individualized treatment which they have been involved in its development before implementation. Treatment facilities hold patients for involuntary treatment based on their assessments. The holds apply if the patient is a risk to self and others. Patients entering involuntary treatment should give informed and express consent for the admission or treatment. Patient’s guardian should be sought if the patient is incapacitated to give informed and express consent. Parents or guardians should give and express informed consent if the patient is minor. The patient should be given information such as the reason for the treatment or admission, proposed treatment plan, need for the treatment, common benefits and risks, and side effects, dosage range, and alternative modalities before they express and give their consent. The same also applies to cases where medical procedures involving electroconvulsive treatment or general anesthesia should be given. Patients can petition their involuntary holds via writ of habeas where the court gives a determination. The people that should be informed and pick patients upon discharge are mainly the patient’s representatives (Florida, n.d.). They include their spouses, an adult child, parent, adult next kin, or an adult friend of the patient.
Differences among Hospitalizations
The state of Florida uses emergency hospitalization for psychiatric hold or evaluation, outpatient commitment, and inpatient commitment to help patients suffering from psychiatric illnesses. Emergency hospitalization for psychiatric hold or evaluation and inpatient commitment are involuntary in nature. Outpatient commitment is voluntary. Inpatient commitment is largely used for patients who have been hospitalized recently and have not demonstrated any improvement in symptoms. Emergency hospitalization for psychiatric hold and evaluation applies when the patient is at a risk of harm to self and others (Rodrigues et al., 2019). A healthcare practitioner applies for court determination while the patient is in a treatment facility undergoing treatment.
Difference between Capacity and Competency
Capacity differs from competency. Capacity entails the individual’s ability to make informed decisions. Capacity depends largely on baseline patient’s abilities to consider the current situation and consequences of the potential solutions they should embrace for their health. Competence relates to the individual’s ability to engage in actions that implement the selected decision. Competency also refers to the individual’s ability to take part in legal proceedings that relate to their health (Libby et al., 2022). Practitioners must present evidence to show that patients are incompetent to implement actions needed for their recovery from mental health problems.
Patient Autonomy
The selected practice issue is patient autonomy. Patient autonomy entails ensuring that healthcare providers seek informed consent before initiating any treatment. Competent patients should give consent to the healthcare providers before the administration of any intervention. One ethical issue related to patient’s autonomy is whether the consent by patient’s significant others such as guardians may predispose patients to unintended harm. The legal issue associated with it is the need for healthcare providers to always seek informed consent before any treatment to safeguard patient’s interests and rights (Abbasinia et al., 2020). An example of a suicide risk assessment tool that I may use to screen patients is Ask Suicide Screening Questions (ASQ) tool. An evidence-based tool that I may use to screen patients for violence is the Broset Violence Checklist.
Conclusion
In summary, each state has laws that guide involuntary holds for psychiatric patients. Differences exist between different emergency hospitalizations for psychiatric patients. Nurses and other healthcare providers should assess the competency and capacity of their patients to make informed decisions and actions. Practitioners must ensure that patient’s autonomy is respected in their practice.
References
Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151. https://doi.org/10.1177/0969733019832950
Florida, C. (n.d.). Involuntary Commitment Law in Florida. Citizens Commission on Human Rights, CCHR. Retrieved January 20, 2023, from https://www.cchrflorida.org/involuntary-commitment-law-in-florida/
Libby, C., Wojahn, A., Nicolini, J. R., & Gillette, G. (2022). Competency and Capacity. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK532862/
Rodrigues, R., MacDougall, A. G., Zou, G., Lebenbaum, M., Kurdyak, P., Li, L., Shariff, S. Z., & Anderson, K. K. (2019). Involuntary hospitalization among young people with early psychosis: A population-based study using health administrative data. Schizophrenia Research, 208, 276–284. https://doi.org/10.1016/j.schres.2019.01.043
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Week 8 NURS 6675 class insructions
LEGAL AND ETHICAL ISSUES RELATED TO PSYCHIATRIC EMERGENCIES
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
THE ASSIGNMENT
In 2 pages, address the following:
- Explain your state laws for the state of FLORIDA for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
- Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
- Explain the difference between capacity and competency in mental health contexts.
- Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
- Identify one evidence-based suicide risk assessment that you could use to screen patients.
- Identify one evidence-based violence risk assessment that you could use to screen patients.
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