- Select one of the following ethical/legal topics:
- Autonomy
- Beneficence
- Justice
- Fidelity
- Veracity
- Involuntary hospitalization and due process of civil commitment
- Informed assent/consent and capacity
- Duty to warn
- Restraints
- HIPPA
- Child and elder abuse reporting
- Tort law
- Negligence/malpractice
- Locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents.
Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.
Ethical and Legal Foundations of PMHNP Care
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Ethical and Legal Foundations of PMHNP Care
Ethics and legal issues are core necessities in the provision of quality healthcare across the globe. One of the defining responsibilities of a healthcare provider is to make decisions on patient care in different settings (Varkey, 2021). Patient autonomy tends to be a dilemma when working with patients, especially children. Patient autonomy represents the freedom of choice. Patient autonomy is the right given to the patients in sound mind to make decisions about their health (Varkey, 2021). The purpose of this paper is to analyze four articles about patient autonomy concerning children and adults.
Legal Aspect for Autonomy of Adult Patients
As stated above, autonomy for an adult takes both ethical and legal aspects. This section will discuss the legal aspect of patient autonomy in adults across health care settings. According to Varkey (2021), the philosophical basis of autonomy is that everyone has an intrinsic and unconditional value, hence, should have the power to make rational decisions. Patient autonomy was affirmed in a court decision by Justice Cardozo in 1914. The judge acknowledged that every human being who is an adult and has a sound mind has a right to determine what shall be done with his own body. U.S. laws provide procedures for accessing one’s ability to make a rational decision (Varkey, 2021). The principle of autonomy does not extend to persons who cannot make rational decisions.
Ethical Aspect for Autonomy of Adult Patients
The second article to be analyzed is by Ubel et al. (2018) which talked about the ethical basis of patient autonomy in adults. According to the authors, ethics have promoted patient autonomy to allow patients to make decisions about their medical care. Healthcare providers are bound to uphold the idea of shared decision-making processes. Shared decision-making processes promote health care choices for a given patient. Ubel et al. (2018) state further that physicians (healthcare providers) are not to tell patients what to do when patient preferences ought to determine treatment choice. Before making decisions, patients must be informed of alternative treatments, as well as patients recognize the broad set of interests relevant to their choice (Ubel et al., 2018). After making a decision, patients must understand the pros and cons of their choices.
Legal Aspect for Autonomy of Children
Regarding the legal aspect of the autonomy of children, Thompson (2020), reiterates that children are not deemed autonomous to the same extent as adults. People who deal with minors have the authority to negotiate while respecting children’s rights and liberty, as well as protecting them from harm. Doctors are advised to look at the problem from different angles and distinguish actions to apply (Thompson, 2020). Doctors have the legal authority to deem a child unable to make a rational decision, especially those below 18 years (this may be based on a country or region) based on legal rights. U.S. law provides 18 years as the minimum age when one is deemed fit to make a rational decision. The US laws assume that the parent or guardian’s decision will consistently trump the minors. The laws do not require involvement from the minor in the decision-making process (Thompson, 2020). To the authors, this is a flaw in the legal aspect of patient autonomy among children in the U.S.
Ethical Aspect for Autonomy of Children
The last article to analyze that talks about the ethical aspect of patient autonomy concerning children was published by Sawyer & Rosenberg (2020). Patient autonomy may become more complex when dealing with children and adolescents who may not be in a position to make rational decisions. Children rely on their parents to make decisions for them. However, the authors feel that children and adolescents should also be allowed to participate in the decision processes when possible. According to Sawyer & Rosenberg (2020), adolescents of age 14 can understand medical information and make a reasoned decisions similar to those of young adults. However, they are less likely to make rational decisions, which is why parents and guardians are important.
References
Sawyer, K., & Rosenberg, A. R. (2020). How Should Adolescent Health Decision-Making Authority Be Shared?. AMA Journal of Ethics, 22(5), 372-379. https://journalofethics.ama-assn.org/article/how-should-adolescent-health-decision-making-authority-be-shared/2020-05
Thompson, H. (2020). Children’s Autonomy and Medical Decision Making. Honor Scholar Theses. 164. https://scholarship.depauw.edu/cgi/viewcontent.cgi?article=1164&context=studentresearch
Ubel, P. A., Scherr, K. A., & Fagerlin, A. (2018). Autonomy: What’s shared decision making have to do with it?. The American journal of bioethics: AJOB, 18(2), W11. https://doi.org/10.1080/15265161.2017.1409844
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119