By Day 6 of Week 2
Respond?to at least?two?of your colleagues on?2 different days?by sharing cultural considerations that may impact the legal or ethical issues present in their articles.
Robertha Charles Compere-Initial Discussion Post
The selected topic for the discussion is beneficence. The principle of beneficence is the obligation of the provider to act for the benefit of the patient (Varkey, 2021). It supports several moral rules to protect and defend the right of others, prevent harm, remove conditions that will cause damage, help persons with disabilities, and rescue persons in danger (Varkey, 2021). The work of mental health nurse practitioner aid in improving the health and well-being of the public mental health.
Furthermore, the mental health nurse practitioner has the ethical and professional obligation to play a leading role in improving child and adolescent mental health(Kumar et al., 2020). The provider must do the right thing for the patient regardless of the circumstances. One of the best examples of beneficence I have witnessed from a provider as the provider goes above and beyond to help a patient during a difficult time and calls insurance companies to intervene for them, so they pay for a medication that she needs. With the achievement of development and emotional milestones, healthy social development, and practical coping skills, mentally healthy children have a positive quality of life. They can function well at home, in school, and in their communities (Kumar et al., 2020).
The need to choose diagnostic and therapeutic procedures in the light of uncertain prognosis and consideration of the principles of patient beneficence (Toney-Butler & Martin, 2022). The Nurse Practice Act, enacted by the Florida Legislature, provides a framework for delivering safe, professional nursing care and offers a layer of protection to the individuals seeking such care (Toney-Butler & Martin, 2022). Board rules must follow the laws enacted by the legislature and adopted in the Nurse Practice Act. As a nurse, my main goal is to put the patients first and do the right thing for them. The same mentality goes when I start to practice as a practitioner; the point is to keep the patient rather and do the right thing for them, mainly because of the lack of mental health care facilities.
Kumar, A., Kearney, A., Hoskins, K., & Iyengar, A. (2020, October). The role of psychiatric mental health nurse practitioners in improving mental and behavioral health care delivery for children and adolescents in multiple settings. Archives of psychiatric nursing. Retrieved March 7, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547148/
Toney-Butler TJ, Martin RL. (2022, Jan 5). Florida Nurse Practice Act Laws and Rules. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; from: https://www.ncbi.nlm.nih.gov/books/NBK532859
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical principles and practice : international journal of the Kuwait University, Health Science Centre. Retrieved March 5, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/
Ethical and Legal Foundations of PMHNP Care
This week’s discussion summarizes four articles related to informed consent in adult psychiatry and pediatric psychiatry. Informed consent to medical treatment is fundamental in ethics and law and emphasizes respect for the patient and their ethical principle of autonomy (Bester et al., 2016). Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about their care. Therapeutic patient-physician communication fosters trust, support, and shared decision-making and, in most cases, differs between adults and children (Bester et al., 2016).
The process of informed consent occurs when communication between a patient and the PMHNP results in the patient’s authorization or agreement to undergo a specific medical intervention.
In adult psychiatry, the principle of beneficence backs the care provided by the physicians. This principle argues that the PMHNP should prevent harm and identify ways of discharging their obligations without restrictions. At the same time, respect the patient’s autonomy. The PMHNP should also bear in mind the patient’s capacity to make such a decision. For example, the patient’s age, mental status, and communication factors. Whatever the case may be, the clinician should provide non-biased, best, and quality care to the patient with or without good mental capacity (Bester et al., 2016).
In general, children and adolescents do not have the legal capacity to give informed consent. For that reason, their legal guardians or parents must decide on their behalf. At the same time, PMHNP should respect the child’s fundamental rights. And ethical principles such as beneficence, nonmaleficence, and justice. However, emancipated children and adolescents may provide informed consent (Davis & Fang, 2020). However, according to Katz et al. (2016), seeking a patient’s informed consent either directly from the patient or the legal guidance/surrogate is an ethical and acceptable legal procedure in mental health practice. In doing so, the PMHNP should assess the following:
1. – Patient’s ability to understand relevant medical information, the implications of treatment alternatives, and make an independent, voluntary decision
1. – Present relevant information accurately and sensitively, keeping with the patient’s preferences for receiving medical information (Katz et al., 2016).
Legal law mandates PMHNP to uphold patients’ autonomy unless there are limitations in cognitive capacity. Notably, informed consent is viewed as a means of respect to older patients, allowing them to pilot their health affairs. Making the decision, however, differs between cultural orientation and beliefs. Therefore, PMHNPs should understand the legal limits of providing legal consent. Notably, PMHNPs should consider the mental capacity of their older patients before considering their informed consent. Zhang et al. (2021) described that patient is motivated when they make decisions related to their care.
As stated above, about children and adolescents’ legal capacity to give informed consent, there are legal backups for their freedom to decide their mental health needs. According to Davis & Fang (2020), the law of emancipation or marriage offers adolescents an opportunity to consent for their mental health needs. In Florida law, though 18 is the legal adult age, minors can take responsibility for their welfare and make the major decisions that parents typically would handle through emancipation. Therefore, minors will generally need to establish their ability to independently live and support themselves before a court grants them emancipation (Reuters, 2021).
Bester, J., Cole, C. M., & Kodish, E. (2016). The limits of informed consent for an overwhelmed patient: clinicians’ role in protecting patients and preventing overwhelm. AMA journal of ethics, 18(9), 869-886. https://journalofethics.amaassn.org/sites/journalofethics.ama-assn.org/files/2018-05/peer2-1609.pdf
Davis, M., & Fang, A. (2020). Emancipated Minor. StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Ethical Principles of Psychologists And Code of Conduct. (2017). American Psychology Association, 1-16. https://www.apa.org/ethics/code/ethics-code-2017.pdf
Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2). http://dx.doi.org/10.1542/peds.2016- 1485
Reuters, T. (2021). Emancipation of Minors. FindLaw. https://www.findlaw.com/family/emancipation-of-minors.htm
Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: a comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics, 22(1), 1-8. https://doi.org/10.1186/s12910-021-00579-6
AMA Journal of Ethics 2016.pdf
Principles and ethics-code-2017.pdf Principles and ethics-code-2017.pdf