NUM1205 Clinical Application of Law and Ethics in Media - Assessment Answer

A Potential Ethical Dilemma Faced by Mental Health Nurses

Ethical dilemmas are highly common in mental health patients. It often arises because of the presence of mental disorders in which patients might lack the capacity to make any decision for themselves and depend on clinicians to attend to the best interest of law and ethics. There are several situations in which a nurse must decide between competing values and the choices they need to make. In several ethical dilemmas conflicts might arise and the nurse's values or Codes of Ethics might be affected (Ventura et al., 2021). There are mainly three ethical dilemmas that are faced by psychiatric nurses: the patient's autonomy should be maintained and it should be controlled. Other than this a balancing act is needed as it helps to keep distance from a desire to establish therapeutic relationships. The next ethical dilemma which is faced is the balance and the desire to do the right thing. Social stigma is associated with mental health illness, this social stigma should be taken care and nurse should ensure that social stigma is taken care of and patient well-being is not affected due to it (Giannetta et al., 2021).

Utilitarianism and Deontology

Utilitarianism is an important concept that determines morality and it is based on the outcomes of the interventions. The principle of utility which are present states that moral course is required and it helps to maximize the values over disvalues in addition to it, it also seeks the great benefit for great numbers. In this approach, decisions are chosen and it is based on a great amount of benefit which is obtained from a great number of individuals. In the healthcare industry especially among mental health nurses, the pleasure of the patient and the treatment should be provided accordingly. The mental health nurse should take care of it and should work accordingly. Adequate action should be taken to provide the best care to the patient. Other than this happiness of everyone should be maintained (Vearrier & Henderson, 2021).

Deontological ethics needs to be taken into consideration and it is mainly based on rights, duties, and responsibilities. Other than this, the rights of the individual need to be discussed. It put a major focus on the intention of the individual and not on the outcome of any action. All the duties, obligations, and rules need to be followed. The deontology code of nursing states that nurses should not perform or take part in an intervention that aims to cause death even if the patient requests it (Tseng  & Wang, 2021).

Beneficence, Non-Maleficence, Autonomy, Justice

 The principle of beneficence among mental health nurses should be such that nurses should act in the best interest of the patient. The nurses should aim to provide the best care to the patient's health and avoid any harm to the patient. The patient's choice should be respected as to what treatment they require (Bester, 2020).

The principle of Nonmaleficence states that no harm should be done to the patient and balanced care should be provided to the patient. Mental health nurses also need to be taken care of, they should not be involved in any harm to the patient (Ye et al., 2017).

Clinical autonomy among nurses is the authority to take any medical care decision and then take action accordingly. Among mental health nurses, freedom should be present so that nurses can take any decisions and actions based on judgment. Among mental health nurses there are several instances where the mental health patient might not be able to take action, hence, in such cases, the nurse needs to take action on behalf of the patient. This is a highly important concept and it needs to be followed (Wergeland et al., 2022).

Fidelity

This term states that nurses should remain true to their professional promises such as the promise to provide high-quality, safe, and competent patient care. It also implies that support for patient decisions should be provided. It is important to ensure that supportive decisions should be taken. This nurse should follow all the promises which are made to them, this is the only way to ensure that safe and effective care should be provided. Among mental health nurses, this is a highly important concept (Toomey et al., 2020).

The Tort of Negligence/ Components of Negligence/Acts and Omissions

Torts are the wrong act that harms or makes the patient suffer. An act of omission is one in which the patient is not taken care of in the way they should be. An unintentional tort is mainly harm that is caused by failure. Malpractice and negligence are the most common tort in mental health settings. In mental health nurses, there is no scope for negligence as it will directly affect the patient's well-being and health is impacted. Very common example of mental distress tort is sex discrimination, racial insult, conduct that threatens physical security and false imprisonment. There are several elements of negligence: the legal duty of the patient, how the defendant breached the duty, and the proof of the defendant's breach which is caused by the duty (Cheluvappa & Selvendran, 2020).

Duty of Care          

The duty of care of a mental health nurse is to provide the best care to the patient. The role of a mental health nurse while working alongside people with mental illness is to provide recovery, support, and help to the patient. The mental health nurse utilizes psycho-therapeutic and interpersonal intervention to take care of and help consumers and families to recover. The patient should be assessed and talked to about their condition, and the best way to plan and deliver the best care. It also builds relationships with the patient (Joseph et al., 2022).

References

Bester J.C. (2020). Beneficence, interests, and wellbeing in medicine: What it means to provide benefit to patients. The American Journal of Bioethics : AJOB, 20(3), 53–62. https://doi.org/10.1080/15265161.2020.1714793

Cheluvappa, R., & Selvendran, S. (2020). Medical negligence - Key cases and application of legislation. Annals of Medicine and Surgery (2012), 57, 205–211. https://doi.org/10.1016/j.amsu.2020.07.017

Giannetta, N., Villa, G., Pennestrì, F., Sala, R., Mordacci, R., & Manara, D.F. (2021). Ethical problems and moral distress in primary care: A scoping review. International Journal of Environmental Research and Public Health, 18(14), 7565. https://doi.org/10.3390/ijerph18147565

Joseph, B., Plummer, V., & Cross, W. (2022). Mental health nurses perceptions of missed nursing care in acute inpatient units: A multi-method approach. International Journal of Mental Health Nursing, 31(3), 697–707. https://doi.org/10.1111/inm.12990

Toomey, E., Hardeman, W., Hankonen, N., Byrne, M., McSharry, J., Matvienko-Sikar, K., & Lorencatto, F. (2020). Focusing on fidelity: Narrative review and recommendations for improving intervention fidelity within trials of health behaviour change interventions. Health Psychology and Behavioral Medicine, 8(1), 132–151. https://doi.org/10.1080/21642850.2020.1738935

Tseng, P.E., & Wang, Y.H. (2021). Deontological or utilitarian? An eternal ethical dilemma in outbreak. International Journal of Environmental Research and Public Health, 18(16), 8565. https://doi.org/10.3390/ijerph18168565

Vearrier, L., & Henderson, C.M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues, 33(1-2), 45–60. https://doi.org/10.1007/s10730-020-09431-7

Ventura, C. A.A., Austin, W., Carrara, B.S., & de Brito, E.S. (2021). Nursing care in mental health: Human rights and ethical issues. Nursing Ethics, 28(4), 463–480. https://doi.org/10.1177/0969733020952102

Wergeland, N.C., Fause, Å., Weber, A.K., Fause, A. B.O., & Riley, H. (2022). Increased autonomy with capacity-based mental health legislation in Norway: A qualitative study of patient experiences of having come off a community treatment order. BMC Health Services Research, 22(1), 454. https://doi.org/10.1186/s12913-022-07892-9

Ye, J., Xiao, A., Yu, L., Wei, H., Wang, C., & Luo, T. (2017). Physical restraints: An ethical dilemma in mental health services in China. International Journal of Nursing Sciences, 5(1), 68–71. https://doi.org/10.1016/j.ijnss.2017.12.001

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