Ethical and Legal Foundations of PMHNP Care
Patients seeking healthcare services have a right to be actively involved and provided with all the pertinent information about their care. The right to decide on psychiatry treatment is fundamental to a patient’s autonomy and dignity. Patients have a right to accept or refuse treatment, provided they have a decision-making capacity. Thus, psychiatry and mental health nurse practitioners (PMNHPs) must know the ethical underpinnings and legal requirements linked with informed consent. However, informed consent may change depending on different circumstances and conditions.
Summary of Articles
Legal Issues of Informed Consent
The benefits of informed consent in psychotherapy may be overlooked, especially when there are uncertainties about adverse events or the success of treatment (Darby & Weinstock, 2018). There are significant risks for psychotherapy treatment. Occasionally, PMNHPs must breach doctor-patient confidentiality due to mandated reporting in situations of possible harm to patients or other persons (Darby & Weinstock, 2018). Some psychotherapists argue that patients have a right to know the limits of confidentiality at the beginning of any treatment. For example, the information revealed could be utilized to infringe on the patient’s freedom, resulting in gun prohibition, occupation problems, involuntary hospitalization, and personal problems (Darby & Weinstock, 2018). Even though patient autonomy is critical in healthcare, PMNHP should be aware of situations where patient safety or others may be at risk. PMNHPs are legally mandated to report cases in which patients may be a risk to themselves or others. Accordingly, this will require them to breach the principle of informed consent by not providing complete information on the limits of patient-doctor confidentiality.
To avoid legal liabilities, healthcare professionals should seek informed consent before initiating treatment by disclosing all information related to treatment that may affect the patient’s decision. Minors are incompetent to make legal decisions compared to adults. Most states assume children cannot give informed consent and require parental approval before treatment (Chen, 2021). Parents are legally obligated to provide informed consent on behalf of their children. Even though many states require a child’s support for mental health treatment, some states only require parental consent (Chen, 2021). State laws also give children more decision-making authority for outpatient treatment due to the low risks compared to inpatient hospitalization. In California, children older than 12 can consent to psychiatric health treatment or counselling services (Chen, 2021). The minor’s ability to give informed consent must be based on an attending professional’s opinion. States have different laws guiding informed consent for children, so healthcare professionals should be aware of these laws in the states they practice.
Ethical Issues of Informed Consent
Capacity and comprehension of consent are part of the informed consent process. Healthcare professionals must assess the decision-making capacity to determine patients who can give informed consent (Deshpande et al., 2018). Accordingly, considering the patient’s competence is essential in the consent process. The primary role of the healthcare professional is to ensure the patient understands the information provided to them in research or treatment (Deshpande et al., 2018). However, individuals with mental conditions may have impairments that affect their understanding ability.
With few exceptions, minors under 18 years cannot consent to psychiatric care. Parents and legal guardians are given the authority to make decisions in their children’s best interest (Bieber et al., 2020). Even though parental autonomy is considered an ethical value when providing care for minors, parental decision-making capacity is a critical lens. Decisional capacity includes an accurate understanding of the proposed treatment, an understanding of the information provided, and rationale manipulation. Since parents have the legal and ethical obligation to make decisions on behalf of their parents, healthcare professionals should assess their decision-making capacity.
Application to Clinical Practice
I am practising as a PMNHP in the state of Virginia. I will apply the ethical and legal considerations of informed consent when implementing care for children and adults. After reviewing these articles, I am better placed to address legal issues and moral dilemmas that may arise in my practice. The Virginia law requires healthcare professionals to seek informed consent from patients or their medical proxies. I will abide by this law to ensure I do not present a