NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Sample Answer for NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay Included After Question
Advanced practice nursing in all specialties is guided by codes of ethics that put the care, rights, duty, health, and safety of the patient first and foremost. PMHNP practice is also guided by ethical codes specifically for psychiatry. These ethical codes are frameworks to guide clinical decision making; they are generally not prescriptive. They also represent the aspirational ideals for the profession. Laws, on the other hand, dictate the requirements that must be followed. In this way, legal codes may be thought to represent the minimum standards of care, and ethics represent the highest goals for care.
For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare
- 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
- In the Walden library, 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.
By Day 3 of Week 2
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.
Read a selection of your colleagues’ responses.
By Day 6 of Week 2
Respond to at least two of your colleagues on 2 different days by sharing cultural considerations that may impact the legal or ethical issues present in their articles.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
A Sample Answer For the Assignment: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Title: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Ethical and Legal Foundations of PMHNP Care
Ethical principles are common guidelines that protect the rights of patients and healthcare professionals in the healthcare setting. Advanced practice nursing is guided by codes of ethics that consider care and patient safety the central issues. Informed consent is the decision-making process involving patients being treated, for example, those treated for mental illnesses. This ethical principle requires psychiatric nurses to allow the patients to understand the type of treatment to be offered to patients (Levine et al 2022). Informed consent provides information to adult patients regarding their patients and the recommended treatment plan.
Article Summary
All the articles included in this assignment address all the legal and ethical aspects of informed consent. The main area addressed is the informed consent of children, adolescents and adults in a mental or psychotherapy setup. These articles are focused on the application of informed consent in undertaking PMHNP care (Schulz, 2018). As such, the attitude of the medical staff and the nurse practitioners on these ethical issues related to informed consent are addressed in the selected articles. The reasons and justifications for informed consent on a particular group of patients have also been addressed in the articles.
The articles collectively discuss a wide scope of ethical consent on various populations that had been discussed in class. The informed consent for children is different from that of adolescents (Sherwood& Parsons, 2021). While the parents take charge of the decision involving mental treatment offered to a child, an adolescent who is eighteen years and above can decide on the treatment they would need (Levine et al., 2022). Also, the situation for adults would change as they must know their treatment and agree with the offered treatment through informed consent (Smartt et al., 2019).
NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay References
Levine, S. B., Abbruzzese, E., & Mason, J. W. (2022). Reconsidering informed consent for trans-identified children, adolescents, and young adults. Journal of Sex & Marital Therapy, 48(7), 706-727. https://doi.org/10.1080/0092623X.2022.2046221
Schulz, S. L. (2018). The informed consent model of transgender care: An alternative to the diagnosis of gender dysphoria. Journal of Humanistic Psychology, 58(1), 72-92. https://doi.org/10.1177/0022167817745217
Sherwood, G., & Parsons, S. (2021). Negotiating the practicalities of informed consent in the field with children and young people: learning from social science researchers. Research Ethics, 17(4), 448-463. https://doi.org/10.1177/17470161211014941
Smartt, C., Prince, M., Frissa, S., Eaton, J., Fekadu, A., & Hanlon, C. (2019). Homelessness and severe mental illness in low-and middle-income countries: scoping review. BJPsych Open, 5(4). doi:10.1192/bjo.2019.32
A Sample Answer 2 For the Assignment: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Title: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
PMHNP are often confronted with situations that require sound ethical decision-making ability. As PMHNPs, we are guided by a code of ethics that puts the care, rights, duty, health, and safety of the patient first and foremost. These codes are the framework to guide clinical decision-making; they are generally not oppressive. They also represent ambitious ideas for the profession. On the other hand, laws dictate the one requirement for the domain. In this way, legal codes represent the minimum standards of care, and ethics represent the highest goals for care (Walden, 2022). Informed consent remains among the most critical issues in mental health settings. Informed consent emphasizes respect for persons, which relates to the ethical principle of autonomy (Bester et al., 2016). Bester et al. (2016) say that consent should be used with other bioethical principles, like beneficence and nonmaleficence, in mind. The consideration of informed consent may differ between adults and children. Specifically, children do not have the legal capacity to give informed consent. Therefore, their legal guardians or parents have to make the decisions on their behalf. However, children and adolescents may give informed consent if they are emancipated (Davis & Fang, 2020). The discussion summarizes four articles related to informed consent in adult and pediatric psychiatry.
In their report, Katz et al. (2016) provide crucial insights regarding informed consent, parental permission, and childhood assent in pediatric psychiatry. According to the article, it is standard practice in both the medical and legal worlds to get informed consent from legal guardians or parents. The article observes that decision-making depends on legal empowerment and decisional capacity. As such, the reliance on autonomy and individual liberties may be challenging, legally unacceptable, and unrealistic for pediatric patients. Clinicians should assess the capacity of the patient or their surrogate to make informed decisions about the provision of medical interventions. In this regard, parents and legal guardians are positioned appropriately to make the decisions because they understand the unique needs of their children.
In adult psychiatry, different considerations are made regarding informed consent. From an ethical perspective, Bester et al. (2016) address the issue of informed consent when patients are overwhelmed. In such circumstances, the article argues that the clinician should focus on preventing harm and identifying ways of discharging his or her obligations without paternalism. Respecting a patient’s autonomy is important, but there may be times when a clinician needs to override this autonomy. For example, patients may not provide informed consent when their understanding and capacity are overwhelmed. Clinicians should think about information-related factors, patient-related factors, and communication-related factors when it’s hard to get informed consent. In sum, the article argues that the capacity to offer informed consent should be made in relation to patient factors, communication factors, and information factors.
Davis & Fang (2020) provide insights about the legal aspects of informed consent in pediatric settings. Most importantly, the article talks about the legal limits of children and teens giving informed consent. While minors lack the legal capacity to provide informed consent, emancipation offers an opportunity for adolescents to give informed consent. In this case, a minor who is a legally grown adult would be able to give informed consent. Although the legal doctrine of a “mature minor” exists, few states recognize the doctrine. Minors over the age of 12 are thought to have the mental maturity to agree to treatment, but if the child is not emancipated, the clinicians have to limit the child’s power.
Zhang et al. (2021) discuss the issue of informed consent in adult psychiatry. The study observed that informed consent is part of respect for patients’ autonomy. However, the study observes that cultural factors influence the application of bioethics. The study points out that the slow development and adoption of bioethics in China causes ethical problems for clinicians. Comparing China to the US, the study finds that Chinese doctors often ignore the principle of informed consent because of their cultural beliefs. Still, clinicians are required by law to respect the autonomy of their patients, unless they can’t think for themselves.
Overall, the studies show that informed consent may differ in psychiatric and adult mental health settings. Clinicians should understand the legal limits regarding the provision of legal consent. Notably, clinicians should consider the mental capacity of patients before considering their informed consent. As psychiatric nurses, we should have a wide breadth of knowledge to practice responsibly and legally. That means understanding the impacts that laws have on us. We are accountable for our practice according to current laws, regulations, and standards.
References
Bester, J., Cole, C. M., & Kodish, E. (2016). The limits of informed consent for an overwhelmed patient: clinicians’ role in protecting patients and preventing overwhelm. AMA journal of ethics, 18(9),869–886.https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/peer2-1609.pdf
Davis, M., & Fang, A. (2020). Emancipated Minor. StatPearls [Internet]. Treasure Island,
FL: StatPearls Publishing.
Katz, A. L., Webb, S. A., and the Committee on Bioethics (2016) used informed consent in decision-making in pediatric practice. Pediatrics, 138(2). http://dx.doi.org/10.1542/peds.2016-
1485
Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Privacy and autonomy of patients: a comparison of ethical problems in China and the US BMC Medical Ethic, 22(1), 1–8. https://doi.org/10.1186/s12910-021-00579-6
Walden University (2022). Minneapolis Minnesota.
Download s12910-021-00579-6.pdf
Download 12910_2021_Article_579.pdf
A Sample Answer 3 For the Assignment: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Title: NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
Undoubtedly, mental health practitioners encounter different situations where they are supposed to make ethical and legal based decisions. I cannot agree more that informed consent is one of the critical aspects of mental health treatment as it attracts different medical ethics and legal interpretations. The PMHNPs ethical framework poses the guidelines under which they should obtain informed consent when dealing with their patients, whether adults or pediatrics (Lepping, 2018). As you have highlighted, informed consent in pediatric patients is critical as they are not in the capacity to give consent. Legally, pediatric patients are not in a position to consent due to their age and thus require their parents or caregivers to consent. However, their parents may not be in the capacity to give consent with the legal doctrine recognizing mature minors. Ethical issues arise when obtaining consent conflicts with the ethical principles of autonomy and beneficence (Katz et al., 2016). As such, obtaining informed consent among pediatrics shouldn’t override the objective of preventing harm and acting to the patient’s interests.
As articulated, informed consent among adult patients also should be in line with the legal and ethical doctrines. When dealing with older adults, PMHNPs should adhere to the ethical objective of preventing harm and letting the patients make informed choices. However, patients’ self-determined will may be overlooked if they are not in the capacity to give informed consent. PMHNPs should act based on their professional competence to determine the capacity of their patients to provide informed consent, which includes considering factors like culture and religion (Lepping, 2018). Further, legal issues arise when obtaining informed consent from adults, with determinants like decisional capacity and legal empowerment being critical. As such, strategies deployed to obtain consent should consider the patient’s ability (Lepping, 2018). For instance, a legally accepted consent form should be well-written in a language the patient comprehends.
References
Katz, A. L., Webb, S. A., Macauley, R. C., Mercurio, M. R., Moon, M. R., Okun, A. L., … & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2). PDF: https://doi.org/10.1542/peds.2016-1485
Lepping, P. (2018). Consent in psychiatry–an ethical review. Psychiatric Bulletin, 27(8), 285-289. https://doi.org/10.1192/pb.27.8.285
In your role as a PMHNP, you will regularly encounter situations that require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidence-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their background or worldview. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action.
Learning Objectives
Students will:
- Analyze salient ethical and legal issues in psychiatric-mental health practice
- Analyze the impact of cultural considerations on ethical/legal decision making in advanced practice nursing
- Evaluate mastery of nurse practitioner knowledge in preparation for the nurse practitioner national certification examination*
NRNP 6665 Ethical and Legal Foundations of PMHNP Care Across the Lifespan Essay
*Assessed in Week 3 Assignment
Learning Resources
Required Readings (click to expand/reduce)
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/
American Psychological Association. (2017). Ethical principles of psychologists and diagnostic formulation. http://www.apa.org/ethics/code/
American Academy of Child & Adolescent Psychiatry. (2014). Code of ethics. https://www.aacap.org/App_Themes/AACAP/docs/about_us/transparency_portal/aacap_code_of_ethics_2012.pdf
American Psychiatric Nurses Association. (2020). APRN psychiatric-mental health nursing practice. https://www.apna.org/i4a/pages/index.cfm?pageID=3846
Anderson, S. L. (2012). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. American Academy of Child and Adolescent Psychiatry, 51(9). 957–974. https://www.jaacap.org/action/showPdf?pii=S0890-8567%2812%2900500-X
Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.
- Chapter 2, “Addressing Behavioral and Mental Problems in Community Settings”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
- Chapter 19, “Legal Issues in the Care and Treatment of Children with Mental Health Problems”
Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.
- Chapter 1, “Preparing to Pass the Psychiatric-Mental Health Nurse Practitioner Certification Exam”
Reminder: Keep Your Library of Advanced Practice Nursing Texts at Your Fingertips
Several textbooks are assigned in multiple courses in your program. That is, you will see reading assignments from the books assigned in the Learning Resources of more than one course. You should, however, keep all prior textbooks—not just the ones explicitly assigned—readily accessible. The expectation is that you will independently consult these prior textbooks to synthesize information needed to complete your final courses. This is your time to “put it all together” and to more fully embrace the advanced practice nursing role. Part of the responsibility of advanced practice is developing information literacy skills to know where to locate needed information for your clinical practice.
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Important information for writing discussion questions and participation
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Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource