NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
Walden University NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
Whether one passes or fails an academic assignment such as the Walden University NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
The introduction for the Walden University NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
After the introduction, move into the main part of the NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
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
Sample Answer 2 for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
Thank you for your detailed post and summary of articles on informed consent. Your post is easy to understand. I agree that clinicians must make sure patients, parents, or their appointed individuals have the requisite information given to them to make an informed decision on treatment choices. To make informed consent, the individual must be of sound mind, cognitively intact, have received all the necessary information, and not feel pressured to consent. Informed consent affirms the right of autonomy, the right of an individual to accept or decline treatment. It fosters the principle of a shared decision model where practitioners respect their patients’ choices, and a mutual agreement is reached after the patient has freely consented to treatment. Ensuring the individual agreeing to treatment understands treatment is at informed consent’s core (Pietrzykowski & Smilowska, 2021).
The issue of overriding autonomy and informed consent for psychiatric patients to prevent harm and stabilize patient presents an ethical dilemma. The ability to consent or withhold treatment is impaired when a patient is in a psychiatric crisis or has impaired cognition. In this state, clinicians must find a suitable approach to ensure no harm is done. While it is essential to preserve patients’ right to autonomy, there is a need to ensure patient and staff safety in psychiatric emergencies. Establishing guidelines to define psychiatric emergencies, standards of care, and the legal framework in emergencies would be beneficial to ensure such care is provided as defined by law. Establishing a legal framework would help ensure clinicians don’t violate the right to patient autonomy at will (Becker & Forman, 2020).
References
Becker, S. H., & Forman, H. (2020). Implied consent in treating psychiatric emergencies. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00127
Pietrzykowski, T., & Smilowska, K. (2021). The reality of informed consent: Empirical studies on patient comprehension—systematic review. Trials, 22(1). https://doi.org/10.1186/s13063-020-04969-w
Sample Answer 3 for NRNP 6665 Week 2 Discussion: Ethical and Legal Foundations of PMHNP Care
Advanced practice nursing specialties such as mental health nursing (PMHNP) adhere to established codes of ethics that prioritize the care, rights, and responsibilities, as well as the health and safety of patients. Ethical codes serve as a guide for psychiatric-mental health nurse practitioners in making clinical decisions (Aydin & Ersoy, 2017). Laws specify the requirements that they must adhere to in order to practice. The implication is that legal codes reflect minimum standards of care, whereas ethics reflects the highest standards of care. This assignment evaluates significant ethical and legal issues relating to children, adolescents, and adults in psychiatric-mental health practice using informed consent as a case study.
Informed Consent
Informed consent refers to a patient’s right to be informed about and actively involved in their mental health care. The right to make decisions about one’s psychiatric treatment, including the right to decline undesirable therapeutic interventions based on one’s capacity, is fundamental to one’s dignity and autonomy (Dala, 2020). Imperatively, informed consent encompasses both ethical and legal considerations, and psychiatric-mental health nurse practitioners (PMHNPs) must ensure that they adhere to provisions that protect their clients’ autonomy and dignity. Adult patients are informed consented to receive information about their mental health and recommended treatment interventions and plans. If the patient is an adult, he or she has the right to refuse recommended psychotherapy (Darby & Weinstock, 2019). Children and adolescents, on the other hand, are minors, and their informed consent must come from their parents or guardians, who have the legal right to consent to suggested treatment interventions.
Summary of the Articles
Informed consent is critical in psychiatric-mental health, and both codes of ethics and statutes require PMHNPs to obtain consent by adequately informing patients about the benefits and risks of the treatment interventions or plans they recommend. According to Dala’s article (2020), consent entails four critical components: capacity, decision-making, knowledge, and freewill or voluntariness. However, the article notes that consent may take on a different meaning in psychiatry because the decision-making ability aspect can be influenced by the psychiatric illness, which results in deficits in mental abilities as a result of attention, mood, and understanding impairments. The article emphasizes the importance of increased understanding of mental health care provision in light of these distinctions.
The articles by Bipeta (2019), Blease et al. (2020), and Darby and Weinstock (2019) emphasize the importance of informed consent in adhering to legal and ethical obligations and mandates for psychiatric nurses. The articles agree that patients, whether adults or minors, should be informed about their mental health condition and potential solutions or therapeutic interventions by mental health professionals. The three articles discuss the attitudes that medical staff and nurse practitioners should have when it comes to ethical and legal issues surrounding informed consent. The authors provide reasons and justifications for considering informed consent prior to any medical procedures being performed on a mental health practitioner. The articles provide psychiatric mental health practitioners with sufficient knowledge and critical information on the subject in order to improve care delivery and ensure compliance with existing provisions.
Legal Aspects of Informed Consent in Psychiatric Mental Health Practice
Making decisions about therapeutic interventions for adult patients with severe mental illness presents difficulties for psychiatric mental health nurse practitioners. Patients’ reactions to suggested treatment interventions and plans can have a detrimental effect on providers, third parties, and even the patient and their family. This restricts the legal consideration because it impairs the delivery of treatment and the parties’ ability to interact effectively. Regardless of the occurrence of such events, nurse practitioners in mental health must adhere to legal requirements.
Due to their limited capacity, children and adolescents are incompetent decision makers. Legal rights confer on parents the ability to make decisions and obtain informed consent regarding psychiatric treatment plans. It is illegal and unethical for mental nurse practitioners to continue treatment plans, regardless of how effective they are, when adolescents refuse psychiatric treatment or request plan modifications. The implication is that the psychiatric nurse cannot make treatment decisions on behalf of the patient, even if they understand that the client is incapable of evaluating the significance of the suggested treatment (Bipeta, 2019). As such, informed consent has legal and ethical implications because it prevents the mental health nurse from continuing the treatment and gives the patient the option to reject or accept the intervention.
Application to Clinical Practice
As a mental health practitioner, PMHNP, working in a clinical setting in a mental health facility, the importance of these components of informed consent cannot be overstated. I am capable of implementing both the legal and ethical aspects of informed consent in clinical practice when it comes to treatment interventions for children and adults. I can address ethical dilemmas that may arise in my practice by reviewing the articles in order to provide more informed care and develop effective interactions with patients. Informed consent is a legal and ethical issue for both adults and minor patients. As a nurse practitioner, this implies that I am required to adhere to these provisions.
References
Aydin, R. & Ersoy, N. (2017). Ethical Problems Experienced by Nurses Who Work in
Psychiatry Clinics in Turkey. Journal of Psychiatric Nursing, 8(2)77-85. Doi: 10.14744/phd.2017.97720
Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian Journal of
Psychological Medicine, 41(2), 108–112. doi: 10.4103/ijpsym.ijpsym_59_19
Blease, C. R., Arnott, T., Kelley, J. M., Proctor, G., Kube, T., Gaab, J., &Locher, C. (2020).
Attitudes About Informed Consent: An Exploratory Qualitative Analysis of UK
Psychotherapy Trainees. Frontiers in Psychiatry, 11. doi:10.3389/fpsyt.2020.00183
Dala, P. K. (2020). Consent in psychiatry – concept, application & implications. Indian Journal
of Medical Research, 151:6-9. DOI: 10.4103/ijmr.IJMR_1518_19
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent and
Psychotherapy. FOCUS, 16(4), 395–401. doi: 10.1176/appi.focus.20180020
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.
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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.
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 “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Also Read: NRNP 6665 Week 3 Assignment 1: Prescribing for Children and Adolescents
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
Week 2 Discussion
Name: Discussion Rubric
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
0–69 |
|||
| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
||
| Main Posting:
Writing |
6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
||
| Main Posting:
Timely and full participation |
9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
7 (7%) – 7 (7%)
Posts main Discussion by due date. |
0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
||
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| First Response:
Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| First Response:
Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
||
| Second Response: Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
| Second Response: Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
||
| Total Points: 100 | ||||||
Name: Discussion Rubric