Ethical and legal Issues – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Ethical and legal Issues
The term ethics derives from the Ancient Greek word ‘ethikos’, which is derived from the word ethos (habit, “custom”). Ethics can be defined as “a set of concepts and principles that guide us in determining what behavior helps or harms sentient creatures”.
Or,
Ethics or moral philosophy is a branch of philosophy that involves systematizing, defending, and recommending concepts of right and wrong conduct. Ethics seeks to resolve questions of human morality by defining concepts such as good and evil, right and wrong, virtue and vice, justice and crime.
Nurses code of ethics:
1. The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
2. The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.
3. The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.
5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
6. The nurse participates in establishing. maintaining. and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.
7. The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
8. The nurse collaborates with other health professionals and the public in promoting community, national and international efforts to meet health needs.
9. The profession of nursing value, for maintaining the integrity of the possession and its practice, and for shaping social policy.
[Ref: American Nursing Association, ANA]
Pathological jealousy:
Pathological jealousy, also known as morbid jealousy, delusional jealousy, or Othello’s Syndrome (which was suggested from (Shakespeare’s play “Othello”), is an abnormal form of an OCD (obsessive [compulsive disorder) and arises in romantic relationships.
[Ref-www.freethoughtlebanon.net/]
Some symptoms of pathological jealousy include:
- Accusing partner of looking or giving attention to other people.
- Questioning of the partner’s behavior.
- Interrogation of phone calls, including wrong numbers or accidental phone calls, and all other forms of communication.
- Not allowing any social media accounts, Facebook, Twitter etc.
- Going through the partner’s belongings.
- Always asking where the partner is and who they are with.
- Isolating partner from their family and friends.
- Not letting the partner have personal interests or hobbies outside the house.
- Controlling the partner’s social circle.
- Claiming the partner is having an affair when they withdraw or tries to escape abuse.
- Accusing the partner of holding affairs when the marriage’s sexual activity stops because of the abuse.
- Verbal and/or physical violence towards the partner, the individual who is considered to be the rival, or both.
- Blaming the partner and establishing an excuse for jealous behavior.
- Denying the jealous behavior unless cornered.
Threatening to harm others or themselves
Legal aspects of psychiatry:
1. Crime and psychiatric disorders.
2. Criminal responsibility.
3. Civil responsibility.
4. Laws relating to psychiatric disorders.
5. Admission procedures of patients in a psychiatric hospital.
6. Nursing responsibility.
[Ref: S Nambi/2/2291]
Concept of legal issue:
Nurses, therapist and other health care workers are expected to make inform effective patient care by utilizing rational problem-solving skills.
(Ref: Ross, 19841)
Legal issues/accountability in nursing:
1. A practitioner is accountable for her actions (and, in certain circumstances, omissions), when caring for a patient. She is accountable to her patient, her professional body, her peers, her employer and society generally. This briefing is concerned with an understanding of legal accountability only.
2. There is no concept in law of team negligence in the sense that each individual member of a health care team is required to observe the standards demanded of the unit as a whole.
3. Once she assumes responsibility for the patient or undertakes to exercise her professional skills on the patient’s behalf, the practitioner owes the patient a legal duty of care. She holds herself out as possessing qualifications, skills and competence that can ordinarily be expected of members of her profession. When evaluating the standard of care to be expected of the practitioner the Courts look to the profession to identify what the standard of the ordinary competent practitioner should be.
4. The legal standard was set more than 40 years ago in an English High Court judgement in what became known as the Bolam case. The Scottish Courts in Hunter v Hanley had taken a comparable decision.
It was held that a professional must show that she followed a course regarded as proper by a responsible body of [nursing] professionals. The House of Lords recently affirmed this test, although it is emphasized that it has to be a competent reasonable body of opinion.
5. The critical question therefore is what is professionally approved practice? This gives rise to a number of secondary issues, such as inexperience, specialization, keeping up-to-date, and innovative treatment which I will deal with briefly.
6. Inexperience is no defense to a claim of professional negligence. The standard of care required is that of the ordinary skilled practitioner exercising and professing to have that particular skill.
7. Obviously the practitioner must keep up to date in her field of practice if she is going to act in accordance with the standards of a responsible body of relevant nursing opinion. However, the failure to read a particular article will not necessarily constitute a breach of the standard of care.
8. The standard of the specialist practitioner is simply the standard of the ordinary competent specialist practitioner. However, there is authority for the view that the specialist should be judged by the standard of general expertise in the particular post which is occupied or the particular procedure which has been undertaken.
9. A departure from normal treatment may not necessarily constitute professional negligence, provided that the practitioner can demonstrate that the deviation was one of which a person of ordinary skill would have undertaken when acting with ordinary care.
10. The legal standard in clinical negligence has been subject to considerable academic criticism over the years, as representing an inappropriate degree of deference (or transfer of power) to the health professionals (sometimes described as confusion of what is done, with what ought to be done). The courts must, so it is argued, exercise a sufficient degree of independence in shaping standards of care in health.
[Ref: www.rcn.org.uk]
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