if ms. mary refuses treatment which behavior justifies short term involuntary hospital admission?

What are the challenges of involuntary admission of psychiatric patients?

Involuntary admission of psychiatric patients: Referring physicians' perceptions of competence Psychiatric emergency situations are challenging situations not only for patients but also for the involved physicians.

Should psychiatric hospitals accept patients who refuse treatment?

When patients like Thomas refuse treatment, psychiatric hospitals may benefit. When such patients are not admitted, it is probably beneficial for the ward atmosphere: an open ward policy can be maintained, ward statistics on the use of coercion may look better, and stigma related to the institution may be reduced.

Is involuntary detention without treatment a misuse of Psychiatry?

Mental disorder alone without impaired capacity does not justify involuntary treatment, which can be considered a misuse of psychiatry. Involuntary detention without treatment can be justified for short periods for assessment and to offer treatment options.

Can a psychiatric hospital hold a patient involuntarily without any treatment?

Detaining a patient involuntarily in a psychiatric hospital without any treatment requires financial and human resources that might be better used for patients willing to receive treatment.

Why is Abigail admitted to the hospital?

The healthcare provider admits Abigail to the hospital for psychotic depression.

Who must ask Abigail to sign the consent for treatment?

The PN must ask Abigail to sign the consent for treatment.

What is the medication prescribed for Abigail?

The PN reports the elevated blood pressure to the healthcare provider, and Abigail is. prescribed hydrochlorothiazide (Hydro-Chlor) 25 mg daily (a diuretic). The PN. collaborates with the dietician about Abigail's meal plan.

How long to wait to get NPO before ECT?

These are common side effects. (27) Preparation is similar to a brief surgical procedure. NPO for 6 to 8 hours prior to treatment with the exception of receiving cardiac medications or antihypertensive agents. Prostheses should be removed, and the client should void immediately before receiving ECT.

What does the girl say when asked what she prefers to be called?

asked what she prefers to be called, she replies, "I don't care."

How many points are assigned for each category?

categories, and one point is assigned for each applicable category.

Why is involuntary treatment not used?

In some countries, involuntary treatment for mental health is not used to treat a symptom that is present, rather to reduce the risk of symptoms returning through the use prophylactic psychotropic medication.

What are the criticisms of forced treatment orders?

Critics, such as the New York Civil Liberties Union, have denounced the strong racial and socioeconomic biases in forced treatment orders.

What is the meaning of O'Connor v. Donaldson?

In 1975, the U.S. Supreme Court ruled in O'Connor v. Donaldson that involuntary hospitalization and/or treatment violates an individual's civil rights. The individual must be exhibiting behavior that is a danger to themselves or others and a court order must be received for more than a short (e.g. 72-hour) detention. The treatment must take place in the least restrictive setting possible. This ruling has since been watered down through jurisprudence in some respects and strengthened in other respects. Long term "warehousing", through de-institutionalization, declined in the following years, though the number of people receiving involuntary treatment has increased more recently. The statutes vary somewhat from state to state.

What organizations support involuntary treatment?

Supporters of involuntary treatment include organizations such as the National Alliance on Mental Illness (NAMI), the American Psychiatric Association, and the Treatment Advocacy Center.

What is the impact of coercion on mental health?

A minority of narratives from people who had been treated involuntarily talked about the necessity of treatment in retrospect. Studies suggest that coercion in mental health care has a long-lasting psychological effect on individuals leading to reduced engagement and poorer social outcomes , but that this may be reduced by clinicians knowledge of the effects of coercion.

What is the duty to protect in medical ethics?

In medical ethics, involuntary treatment is conceptualized as a form of parens patriae whereby the state takes on the responsibilities of incompetent adults on the basis of the duty to protect and the duty of beneficence, the duty of the state to repair the random harms of nature . The duty to protect is reflected in utilitarianism and communitarianism philosophy, though psychiatrist Paul Chodoff asserted a responsibility to "chasten" this responsibility in light of the political abuse of psychiatry in the Soviet Union. This duty to protect has been criticized on the grounds that psychiatrists are not effective at predicting violence, and tend to overestimate the risk.

How to prevent someone from leaving a mental hospital?

To prevent someone from leaving voluntarily, staff may use stalling tactics made possible by the fact that all doors are locked. For example, the person may be referred to a member of staff who is rarely on the ward, or made to wait until after lunch or a meeting, behaving as if a person in voluntary treatment does not have the right to leave without permission. When the person is able to talk about leaving, the staff may use vague language to imply that the person is required to stay, relying on the fact that people in voluntary treatment do not understand their legal status.

What happens when patients like Thomas refuse treatment?

When patients like Thomas refuse treatment, psychiatric hospitals may benefit . When such patients are not admitted, it is probably beneficial for the ward atmosphere: an open ward policy can be maintained, ward statistics on the use of coercion may look better, and stigma related to the institution may be reduced.

What is the ethical reasoning that justifies coercive treatment in some cases of dangerous behavior in the absence of mental?

Prevention of this kind of individual harm is the ethical reasoning that justifies coercive treatment in some cases of dangerous behavior in the absence of mental capacity. Treatment—in contrast to detention, seclusion, or restraint—can improve the state that caused the dangerous behavior.

What are the principles of ethics in medicine?

On the basis of an analysis of all historical approaches in medical ethics, Beauchamp and Childress ( 3) identified four equivalent principles: respect for the patient’s autonomy, beneficence, nonmaleficence, and justice. With respect to patient autonomy and therapy, the gold standard is the concept of “informed consent.” The physician’s duty is to enable an autonomous decision by the patient, based on free will and in full knowledge of beneficial and potential adverse aspects of the suggested therapy, ideally consenting in shared decision making. There is evidence that shared decision making is as possible in psychiatry as it is in any other medical disciplines ( 4 ). However, ethical principles are sometimes in conflict, rendering decisions about ethically appropriate actions difficult, particularly when, in the view of others, the patient’s expressed intentions seem unreasonable and in contradiction to his or her best interest. The use of coercion in such cases by definition violates the principle of autonomy. Furthermore, coercive treatment can impose harm on the patient because of short-term and long-term medication side effects and psychological distress. Therefore, the use of coercion can be justified only if the principles of beneficence (acting in the patient’s best interest), nonmaleficence, or justice are in strong contradiction to the patient’s expressed will and if convincing observations indicate that the patient’s autonomy is severely undermined.

Why is coercive treatment important?

This is important for treatment of people with impaired responsibility due to mental illness and dangerous behavior against others.

What are the principles of coercive treatment?

The author discusses a pragmatic approach to decisions about coercive treatment that is based on four principles from principle-based ethics: respect for autonomy, nonmaleficence, beneficence, and justice . This approach can reconcile psychiatry’s perspective with the U.N. Convention on the Rights of Persons With Disabilities.

What is capacity to consent?

The ethical concept of capacity to consent differs from legal competence. Capacity to consent is always related to a concrete situation. Patients must be able to understand relevant information, relate that information to their personal situation, and make a balanced decision ( 5 ). Many instruments have been developed to assess capacity, and it is well known that clinicians tend to overestimate their patients’ capacity ( 6 ). In most European countries, however, such instruments are considered to be inappropriate and are not used in practice. Assessment of capacity is viewed as a complex idiographic, empathic procedure that should take into account the patient’s cognitive capacity, emotional and psychopathological features, history, and personality.

When is coercive treatment justified?

Coercive treatment can be justified only when a patient’s capacity to consent is substantially impaired and severe danger to health or life cannot be prevented by less intrusive means.

Introduction

Materials and Methods

Results

• Participants
  Eleven patients participated in the study. Their mean age was 43 years (25 to 60 years), six were male, 82% had a schizophrenia spectrum disorder, and 18% had an affective disorder. They had an average of 10 hospitalizations (1 to 30). The eight participating family members had a mean …
• Content
  For the evaluation of the overall results, the verbal content of the individual elements of the research paradigm (e.g., “causes”) is compared group by group. An overview of all findings is provided in Table 11.

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Discussion

Limitations

Conclusion

Ethics Statement

Author Contributions

Conflict of Interest Statement

Acknowledgments