Declaration of Helsinki (DOH): One of the darkest episodes in the history of medical research – the horrific experiments conducted by doctors on concentration camp victims in Nazi Germany – was discovered at the Nuremberg trials in 1947. The Nuremberg trials resulted in a code of ethics that “sets standards to which physicians must adhere when conducting experiments on humans.” As a result, the DOH created by the World Medical Association (WMA) contains a set of ethical guidelines for physicians and other participants in medical research and has been described as a “foundational” document regarding the ethics of medical research and as “the most widely used source of ethical guidelines for biomedical research” (NCBI). www.wma.net/wp-content/uploads/2016/11/DoH-Oct2013-JAMA.pdf When PWMI escapes from psychiatric hospitals, especially closed wards, it places a huge burden on hospital staff in terms of legal implications. Fugitives may not care about themselves and risk harming themselves, others and property. Although escape from psychiatric hospitals or nursing homes is quite common, Indian data is not available in the published literature, likely for fear that it could have a negative impact on hospital staff and administrators. While this is an unfortunate event, we don`t need to feel inhibited to explore it, as escape is common in any enclosed environment, including maximum-security prisons[12] and general and psychiatric hospitals around the world,[14,15,16] and in India,[17] are no exception. It is interesting to know the socio-demographic variables that determine this disclosure. Gupta et al.[7] conducted a study of transferred psychiatric patients. Younger age, female sex and higher education were more significantly associated with patients` refusal to share their concerns with others. The authors recommend that these factors can be taken into account when making ethical decisions. The Belmont Report: describes 3 key ethical principles for research involving human subjects: respect for people, charity and justice. The three main areas of application are informed consent, risk-benefit assessment, and subject selection.
www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html ANA Code of Ethics consists of 9 provisions that serve the following purposes: a concise statement of the ethical values, obligations and responsibilities of each person entering the nursing profession; serves as the profession`s non-negotiable ethical standard and expresses nurses` own understanding of our commitment to society: diagnosis is paramount to effectively treating psychiatric patients, based on the appropriate history of other important people, as psychiatrists cannot rely solely on mental state examination. When people are admitted against their will to public tertiary hospitals by honorable courts and prisons, there is no proper history. This is more common among people transferred from prisons. We try to talk to the prison doctor and the caregivers. Supervisors cannot be found or do not want to discuss. Due to ignorance of mental disorders, the only medical history obtained from the doctor is that the patient is irritable or has suicide threats. This is not enough to arrive at a diagnosis. Therefore, the lack of adequate medical history is a major problem in a forensic psychiatric setting. The treatment of these patients is therefore generally based on hospital observation. Recently, India has placed greater emphasis on the training of judicial and prison doctors, which is a welcome step. There is also an urgent need for a judicial policy that requires the presence of caregivers and/or family members while they are referred to psychiatric hospitals. Briefly identify the selected topic.
Then summarize the articles you have selected and explain the main ethical and legal issues related to the topic, as they relate to the practice of psychiatric and psychiatric health for children/adolescents and adults. Explain how this information might apply to your clinical practice, including specific implications for practice in your condition. Attach PDFs of your articles. See attached explanation and response. Let me know if you have any questions. Overview of autonomy Introduction ⢠Autonomy refers to the right granted to a healthy patient to make his or her own decisions about his or her health. Several ethicists have promoted the patient`s right to autonomy, believing that each patient is allowed to make his or her personal decision without feeling the influence of a health professional. However, the rights granted to a patient vary from patient to patient, taking into account several elements of thesis statements ⢠This article will analyze some of the articles that talk about the autonomy of a patient and the corresponding legal provisions for paediatric groups and adults. Paragraph I Adult autonomy The first article analyzed is an article that talks about autonomy and shared decision-making between doctors and adults (Ubel et al., 2018).
According to this article, no medical professional should interfere in a patient`s decision-making process. The role of the doctor in this case is to guide the patient through the state of their current health care so that they can make their individual information after receiving all the relevant details about their health. Paragraph II The physician should help the patient understand all available treatment options. The physician must also help the patient understand all the pros and cons associated with an alternative treatment that the patient chooses. Therefore, health care professionals must allow patients to exercise their autonomous rights in the exercise of their ethical responsibilities. Section III Legal Considerations on Adult Autonomy In medical law, patient autonomy has produced several arguments, with many people having conflicting views on how it should be enforced. In the legal system, this article explains that people should have the opportunity to act as autonomous actors, allowing them to act freely without feeling compelled or influenced to make a particular decision. One is considered incapable of making one`s own theoretical decisions if: they cannot understand the decisions. Health care professionals, especially nurses in all disciplines, must follow the codes of ethics that guide their roles and responsibilities. There are also laws that are standards and regulations that must be followed in order to get the best care for patients.
This research will examine the ethical and legal aspects of charity for psychiatric nurses (PNHRDs) to ensure they meet moral obligations and standards when providing mental health services to adults and children in different settings. Charity refers to an act of charity, kindness and mercy manifested by health professionals with a strong connotation of doing good to others. Medical professionals should be charitable, which requires that their actions benefit others, in this case psychiatric patients (Zhang-Jiang & Tredwell, 2020). The Mental Health Care Act, 2017 (MHCA 2017)[1] explicitly addresses the rights of patients with mental illness (PWMI) and defines the ethical and legal responsibilities of mental health professionals and government. PWMI rights are on par with fundamental human rights and must be clearly taken into account, as they belong to a vulnerable group in terms of assessment, treatment and research. These rights are reflected in the ethics of psychiatric care, which refers to respect for autonomy; the principle of non-evil, charity and justice; confidentiality (and disclosure); border offences; informed consent (and involuntary treatment); etc.[2,3] I will discuss ethical, legal and related issues related to the manuscripts published in this issue of the journal. The patient-physician relationship is linked to the moral and ethical nature of confidentiality, particularly in mental health. This is one of the fundamental tasks of the psychiatrist.
[1,6] In clinical practice, however, PWMI itself waives this confidentiality clause in certain situations. In India, PWMs are usually accompanied by nurses. Few PWMIs want their information and diagnoses disclosed to these caregivers. As this was considered implied consent, this disclosure was made until some time ago in the absence of express written informed consent. A typical scenario would be that a woman who has been treated for psychiatric disorders in the past 10 years suddenly comes to the attending psychiatrist and reveals that she got married about a month ago and is now considering getting pregnant. Your spouse also wants to talk about the diagnosis, treatment, necessity and safety of psychotropic medications during pregnancy. Unfortunately, the spouse can use the disclosed information for any purpose (including divorce) and the lady can sue the attending physician for breach of confidentiality. Since the lady herself wants her information shared with her spouse and the confidentiality clause is violated, she must obtain her written consent, including permission to disclose what may be disclosed, and this must be documented in the patient`s notes.
