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Ethical Legal Issues in
        PMHN
          NUR 682




                      S
Major Concepts


S Patient Rights

S Scope and Standards of Psychiatric Mental Health
  Nursing

S Florida Mental Health Act

S Major Legal Decisions
Patient Rights-Civil


S   Vote                              S   Human care and treatment-
                                          medical , dental, psychiatric
S   Civil service ranking
                                      S   Religious freedom
S   Driver’s license
                                      S   Social interaction
S   Enter contractual relationships
                                      S   Recreational opportunities
S   Press charges
Inpatient Rights


S Confidentiality

S Informed consent

S Least restrictive setting

S Visitation

S Communication

S Privacy
Scope and Standards
              ARNP

S Psychotherapy

S Psychopharmacological Interventions

S Case Management

S Consultation-Liaison

S Clinical Supervision
Areas of Practices


S   Crisis                       S   Community-based care

S   Acute in-patient             S   Assertive Community
                                     Treatment
S   Intermediate and long term
    setting                      S   Tele-health

S   Residential                  S   Collaborative practice

S   Partial hospitalization      S   Self-employment
Florida Mental Health Act
          (Baker Act)

S Involuntary Admission

S Children
Major Legal Decisions


S Right to Refuse Treatment

S Right to Treatment

S Duty to Warn & to Protect
Involuntary Admission


S Ex parte order by a judge following petition from family or
  health care professional

S Law enforcement officer deems behavior falls under
  danger to self and/or others

S Psychiatric mental health care professional certifies need
  for admission due to danger to self or others

S Law enforcement takes person to a Baker Act Facility
Involuntary Admission


S Patient may be kept for observation for 72 hours
  excluding weekends and holidays

S After 72 hours, patient is released or placed in front of
  court under Habeas Corpus

S Judge makes decision on least restrictive setting
Right to Refuse Treatment


S O’Connor v. Donaldson (1976)
  S Supreme court ruling that harmlessly mentally ill cannot be
     confined against their will if they can survive outside.
     RIGHT TO LIBERTY

  S Confined 15 years in Florida for paranoid delusions


  S Involuntary confinement must be based on danger to self or
     others
Rennie v. Klein (1979) New Jersey Supreme Court
decision
   Right to refuse medication
   RIGHT TO PRIVACY

Roger v. Okin (1981) Massachusetts Supreme Court
  Right to refuse medication
  RIGHT TO GUARDIANSHIP
Right to Treatment


S Rouse v. Cameron (1966) Washington D.C.
  S Treatment must be offered and in the
      LEAST RESTRICTIVE SETTING

  S Wyatt v. Stickney (1971) Alabama
      Treatment must be offered

  * Most states a court order needed to administer medications
  and or electroconvulsive therapy
Duty to Warn and to Protect


S Tarasoff 1 (1976)
  S Tarasoff v. Regents of University of California. California
     Supreme Court A potential victim must be warned.

S Tarasoff 2 (1982)
  S Tarasoff v. Regents of University of California. California
     Supreme Court A dangerous person must be reported to
     police.

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Unit2 ethicallegalonline2

  • 1. Ethical Legal Issues in PMHN NUR 682 S
  • 2. Major Concepts S Patient Rights S Scope and Standards of Psychiatric Mental Health Nursing S Florida Mental Health Act S Major Legal Decisions
  • 3. Patient Rights-Civil S Vote S Human care and treatment- medical , dental, psychiatric S Civil service ranking S Religious freedom S Driver’s license S Social interaction S Enter contractual relationships S Recreational opportunities S Press charges
  • 4. Inpatient Rights S Confidentiality S Informed consent S Least restrictive setting S Visitation S Communication S Privacy
  • 5. Scope and Standards ARNP S Psychotherapy S Psychopharmacological Interventions S Case Management S Consultation-Liaison S Clinical Supervision
  • 6. Areas of Practices S Crisis S Community-based care S Acute in-patient S Assertive Community Treatment S Intermediate and long term setting S Tele-health S Residential S Collaborative practice S Partial hospitalization S Self-employment
  • 7. Florida Mental Health Act (Baker Act) S Involuntary Admission S Children
  • 8. Major Legal Decisions S Right to Refuse Treatment S Right to Treatment S Duty to Warn & to Protect
  • 9. Involuntary Admission S Ex parte order by a judge following petition from family or health care professional S Law enforcement officer deems behavior falls under danger to self and/or others S Psychiatric mental health care professional certifies need for admission due to danger to self or others S Law enforcement takes person to a Baker Act Facility
  • 10. Involuntary Admission S Patient may be kept for observation for 72 hours excluding weekends and holidays S After 72 hours, patient is released or placed in front of court under Habeas Corpus S Judge makes decision on least restrictive setting
  • 11. Right to Refuse Treatment S O’Connor v. Donaldson (1976) S Supreme court ruling that harmlessly mentally ill cannot be confined against their will if they can survive outside. RIGHT TO LIBERTY S Confined 15 years in Florida for paranoid delusions S Involuntary confinement must be based on danger to self or others
  • 12. Rennie v. Klein (1979) New Jersey Supreme Court decision Right to refuse medication RIGHT TO PRIVACY Roger v. Okin (1981) Massachusetts Supreme Court Right to refuse medication RIGHT TO GUARDIANSHIP
  • 13. Right to Treatment S Rouse v. Cameron (1966) Washington D.C. S Treatment must be offered and in the LEAST RESTRICTIVE SETTING S Wyatt v. Stickney (1971) Alabama Treatment must be offered * Most states a court order needed to administer medications and or electroconvulsive therapy
  • 14. Duty to Warn and to Protect S Tarasoff 1 (1976) S Tarasoff v. Regents of University of California. California Supreme Court A potential victim must be warned. S Tarasoff 2 (1982) S Tarasoff v. Regents of University of California. California Supreme Court A dangerous person must be reported to police.