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LEGAL AND ETHICAL ASPECTS IN PSYCHIATRY

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Samjhana Bhattarai

M.Sc. Nursing

Batch 2013

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Unit III: Legal and Ethical aspects in Psychiatry

Objectives:

At the end of the unit, the students should be able to: Describe the legal and ethical aspects in psychiatry

 

THEMES AND TOPICS

Admission and discharge of mentally ill clients Mental health Act and narcotic drug and psychotropic substance Act Criminal and civil responsibilities Rights of mentally ill patients Ethical issues in psychiatry

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content

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Terminologies used in legal and ethical aspects.

Ethics Ethical principles

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Terminologies

and

Basic Concepts

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TERMINOLOGIES

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Law: Rules established by authority for regulating

the behavior of the members of community or

country.

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Law…

Criminal law: It defines certain acts as offences against the state and doing so makes them punishable.

Offence: breaking of a rule or law; crime

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Law…

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Civil law: It defines the rights and duties of

individuals in relation to each other.

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Civil Rights: Right to vote Right to humane care Right to treatment, Right to religious freedom, Right to social interaction etc.

Persons with mental illness are guaranteed the same rights as any other citizen.

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Right

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A valid legally recognized claim or entitlement,

encompassing both freedom from government

interference or discriminatory treatment and

an entitlement to a benefit or service.

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Act :- written document which has been formally passed by government

e.g. Nepal nursing council act at the national level, health act.

Bill:- draft or temporary outline of what the act will be.

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Legal document

Certain written forms used regularly by nurse and doctor on the process of treatment.

These forms can be used as evidence in court if any difficulty arises. These document should contain factual statement and signed by concerned personnel and dated.

E.g. treatment chart and consent papers.

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Other Legal Terminologies…

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Torts

Violation of civil law against a person or a person’s

property.

Types

Unintentional

Intentional

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Unintentional torts

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a. Negligence: involves exposure of person or property of

another to unreasonable risk for injury. Lack of

reasonable conduct or care. Omitting an action

expected of a sensible person in a particular

circumstances is considered negligence.

Eg: during Medication

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Unintentional tort…

Malpractice: Any unreasonable lack of skill

in professional duties or illegal or immoral

conduct that results in injury or to death of the

client.

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Intentional torts:

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Occur when a person does damage to another

person in a willful, intentional way and without just

cause and/or excuse.

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Intentional Tort

a. Assault: Mental or physical threat. Knowingly threatening or attempting to do violence to another person without actually touching the person.

Eg: Forcing the medication or treatment on a person who does not want it but without touching the person.

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Intentional Tort…

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b. Battery: actually touching or wounding the person in

an offensive manner with or without the intent to do

harm.

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Intentional Tort…

C. Fraud: purposeful false presentation of facts

to create deception; includes presenting false

credentials for licensing or employment.

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Intentional Tort…

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D. Invasion of privacy

i. Encroachment or trespass on another’s body:

includes any unwarranted operation, unauthorized

touching, and unnecessary exposure or discussion

of the client’s case unless authorized.

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Intentional Tort…

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ii. False imprisonment: includes intentional

confinement without authorization, as well as the

threat of force or confining structures and/or clothing;

the charge is not false imprisonment if it is necessary

to protect an emotionally disturbed person from

harming self or others.

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Intentional Tort…

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iii. Defamation: involves communication, even if true,

that cause a lowering of opinion of the person,

includes slander (oral) and libel (written, pictured,

telecast), both of which are dependent on

communication to a third party.

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Good Samaritan Laws

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protect the health care professionals who administer

first aid as volunteers in an emergency unless there is

gross negligence or willful misconduct.

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Crimes

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An intentional wrong that violates societal law

punishable by the state; the state is the complainant.

A. Felony: serious crime, such as murder, punishable

by a prison term

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Crimes…

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B. Misdemeanor: less serious crime that is punishable by a fine and/or short-term imprisonment.

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Forensic Psychiatry:

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Part of psychiatry that deals with patients and

problems at the interface of the legal and

psychiatric systems.

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Forensic Nursing

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Application of forensic science combined with the

bio-psychological education of the registered nurse,

in the investigation, evidence collection,

preservation, analysis, prevention and treatment of

trauma and/or death related to medico-legal issues.

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Ethics

Ethics is the core of nursing practice.

It is branch of philosophy that concern the distinction

between right and wrong based on body of knowledge,

not just based on opinion.

It is a discipline of rightness and wrongness of actions.

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Autonomy Benefice

nce

Justice Non – Maleficenc

e

Veracity

ETHICAL PRINCIPLES

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Autonomy

This presumes that individuals are always capable of making independent choices for themselves.

Children, comatose individuals and the seriously mentally ill are examples of clients who are incapable of making informed choices.

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Beneficience

Beneficence refers to one’s duty to benefit or promote the good of others.

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Nonmaleficence

Nonmaleficence is the requirement that health-care providers do no harm to their clients, either intentionally or unintentionally.

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Justice

The concept of justice reflects a duty to treat all individuals equally and fairly.

Right of individuals to be treated equally regardless of race, sex, marital status, medical diagnosis, social standing,

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Veracity

The principle of veracity refers to one’s duty to always be truthful.

Veracity requires that the health-care provider tell the truth and not intentionally deceive or mislead clients.

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References

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Sharma C, Choulagain PS. Essentials of Psychiatric and Mental Health Nursing. 2015. First Edition. Saurav and Awish Publishers.

Stuart GW, Laraia MT. Principles and Practice of Psychiatric Nursing. 2005. Elsevier Publication.

Bhaskararaj DE. Textbook of Mental Health Nursing. First Edition. 2011. Jaypee Brothers Medical Publishers.

Lalith K. Mental Health and Psychiatric Nursing, an Indian Perspective. First edition. 2007. VMG Book House.

Townsend MC. Psychiatric Mental Health Nursing. 2012. 7th Edition. Jaypee Brothers Medical Publishers (P) Ltd.

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Any Queries???

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THANK YOU!!!