Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Ethical and Legal Foundations of PMHNP Care

Topic: Informed Consent

Considerations regarding informed consent in mental health practice are discussed in the topic. It is ethically and legally required to obtain informed consent before starting psychotherapy with a PMHNP during clinical practice Blease et al., (2020). The adult patient was informed through informed consent about his mental health and the suggested course of treatment. Because informed consent supports patient liberty, the patient is free to reject the proposed therapy. Guardians and parents, however, have the legal authority to refuse the advised treatment in the context of minors or teenagers. Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Summary

The papers discussed every legal and ethical consideration that goes into children’s, adolescents, and adults’ decisions about a particular style of therapy. These articles concentrate mainly on the application of informed consent in psychotherapy procedures. The articles focus on the views of the hospital personnel and nurse practitioner toward moral and legal issues related to informed consent. Before performing any medical operation, justifications and explanations are provided with evidence based on the study (Bipeta, 2019). Darby and Weinstock (2018) examine the boundaries of privacy and ethical problems associated with using informed consent in therapeutic contexts. Davis et al. (2016) evaluate the “Informed assent recall among adolescents in substance use disorder treatment research.” The four publications chosen for this study provide enough information about applying moral and legal requirements for informed consent in mental health psychiatric procedures. The most significant ethical and legal concerns about children, teenagers, and adults are further discussed.

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Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices

For better therapeutic results, adult patients require psychotherapy right away. A PMHNP is granted the legal right of consent by the mental nurse practitioner. After hearing about the therapy strategy, the patient rejects it as ineffectual. The PMHNP is faced with ethical and moral decisions in this situation. Although the doctor believes the course of therapy benefits the patient, the patient’s impaired ability to make decisions makes it challenging to carry out the plan. The ethical principle of informed consent will be violated if the therapist withholds information about all the specifics of the mental treatment (Blease et al., 2020).Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Parents make treatment decisions for adolescents and children receiving psychotherapy. The parents forbid the children or adolescents from learning about the PMHNP’s therapeutic intervention. The opinions and consent of children and teenagers are frequently disregarded by their parents. The parents make the decisions based on their viewpoint. To guarantee the ethical concerns of informed permission, this situation presents ethical challenges for the PMHNP. Making an ill-informed judgment about therapy interventions in children’s and adolescents’ psychotherapeutic approaches is immoral.

Legal Considerations of Informed Consent in Psychiatric Mental Health Practices

A PMHNP faces a dilemma regarding psychotherapy for an adult patient with a significant mental illness. Such patients’ reactions to the suggested medication regimen can occasionally harm the doctors or the patients themselves. This is the legal consideration’s cap since it might prevent the therapy from being delivered generally in some circumstances. However, for PMHNPs in medical care, the legal ramifications of informed consent are inevitable.

In psychotherapy, adolescents and children are frequently viewed as incapable of making decisions. However, due to their legal rights, adolescents receiving psychiatric treatment can make their choices and give informed consent. It is illegal for the practitioner to persist on the same care plan, regardless of how beneficial the therapy is. Even though the doctor is aware of the patient’s history, the adolescent client cannot assess the significance of the suggested treatment. However, the choice cannot be made on behalf of the patient by the practitioner Chenneville and Schwartz-Mette, 2020). Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Application to my Clinical Practices

I would implement the moral and legal requirements of informed consent for such treatment interventions in my clinical environment since I am a mental health nurse practitioner. Likewise, by reading these pieces, I would be better equipped to deal with the ethical questions that arise in my therapeutic practice. It is crucial to obtain the child or adolescent’s agreement for various reasons, including those related to law, morality, and the success of mental therapy.

Major depressive disorder (MDD)

MDD, also called clinical depressive episodes, is an illness that affects several aspects of a human’s life. MDD might have an impact on one’s mood, behavioral patterns, and physical abilities, such as sleep and appetite. People suffering from major depressive disorder frequently lose interest in pleasurable activities. They also have difficulties completing everyday tasks. Major depressive disorder, according to clinical personnel and health scientists, is among the most prevalent forms of depression, negatively impacting millions of individuals living in the United States and being the worldwide leading cause of disability.

FDA-approved drug: according to Rothschild (2021), Escitalopram and fluoxetine are the approved drug by FDA, whereby Escitalopram is for ages between 12 to 17 years while fluoxetine is for children from ages 8 to 17 years.

Off-label drug: Off-label drug use is the technique of recommending a prescription medication for an intent besides what the FDA has endorsed. This is known as “off-label” use since the drug is being utilized in a manner not mentioned in the product description. According to Urits et al. (2019), Fluvoxamine is the preferred off-label drug for children and adolescents.

Nonpharmacological intervention: Nonpharmacological intervention is any form of health treatment that does not depend exclusively on drug therapy. Examples of such interventions for children and adolescents with major depressive disorders are family therapy, interpersonal therapy, and cognitive-behavioral therapy (Krause et al., 2019).

Risk assessment to inform treatment decision making

The risks and advantages of the FDA-approved medication include that it is beneficial in combating major depressive disorder in kids and teenagers and has few side effects. According to  Rothschild (2021), Escitalopram raises serotonin levels in the brain, which lessens the signs of anxiety and despair. Despite the benefits associated with the drug, there are some risks associated with it. Escitalopram might cause agitation, irritability, or other unusual behavior in some children and adolescents. It may also result in suicidal thoughts, inclinations in some individuals, and an increase in depression. Rothschild (2021) also indicates that one may start experiencing some headaches, weakness, and long-lasting confusion with frequent muscle cramps. Urits et al. (2019) indicate Fluvoxamine is essential when prescribed as off-label for major depressive disorder (MDD). Fluvoxamine helps to reduce unwanted thoughts and has no risk associated with its use. Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Clinical practice guidelines for major depressive disorder

Detailed assessment and accurate diagnosis are necessary for managing the major depressive disorder. The evaluation should be formulated based on a physical exam, history, and mental state assessment. All sources should be utilized to gather history, particularly the family. The diagnosis should be documented using the most recent diagnostic standards. Clinical practice guidelines identify the phases of sickness or therapy. A psychiatrist may select from a variety of first alternative treatments during the acute phase, such as psychotherapy combination, psychotherapy, pharmacotherapy, a drug, or Electroconvulsive therapy (ECT). Clinical and non-clinical considerations typically impact the choice of an initial therapy technique. Most of the clinics have incorporated the FDA- approved medication, off-label treatments, and nonpharmacological interventions into their guidelines for treating major depressive disorder. Clinical practice guidelines recommend treating severe depression disorders in children and adolescents with FDA-approved medications, off-label treatments, or nonpharmacological interventions since all three are efficient and have few adverse effects (Fabi et al., 2020).

Study plan

Content-area strengths and opportunities for improvement

As I answered the questions, they seemed to go on indefinitely. Still, after the initial thirty, I developed a flow in my thinking and solidified myself by reiterating that each question contains new material integral to the nursing curriculum. Besides, since each case study had its distinct demography, every inquest offered an opportunity to learn. Moreover, the ability to reflect critically constituted the essential strength revealed by the 150 questions. As said before, the practice test questions differ, and the principles used in one question do not extend to the others. Because each topic required additional research, the most significant change was learning to evaluate and acquire data from diverse sources. The challenges furthermore assisted me in improving my problem-solving attributes. Lastly, the ability to deal with many case scenarios has been developed. Although several questions were challenging to answer and took a while, I completed the exam on time. Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

SMART Goal

1. After finishing any reading or tasks for the next class, I will analyze and revisit the chapter we just finished.
2. When I finish all of the tasks for the following class, each day, I will spend a minimum of an hour or so revisiting my notes from the initial course.

• To complete multiple assignments simultaneously, I will use a calendar to generate study schedules and enter all of my individual dates and appointments. Every week, I would review my plans and revise my study schedule and extracurricular activities.

Study Plan and Tasks Needed to Complete Each SMART Goal 

My certification exam preparation is crucial because it will determine my success. The approach I use for practice consists of six phases that I believe are authentic and necessary for my study journey (Guzzetta et al., 2018). The first step is to determine how I best study. Each plan should be tailored to the person’s learning needs and timeframe. Rather than one long cramming session, I will read for more than an hour at a time. I will reserve approximately four to five hours of reading time to ensure appropriateness. The very next step involves picking suitable learning material. To ensure that the information is current, I have to look online for up-to-date and peer-reviewed documents. To complete my first and second SMART goals, I will need to create time to analyze and reread the previous chapters that I might not have understood well (Harber, 2021). This will help in developing an understanding of the earlier chapters. I would not want to get through the insignificant practice tests only to perform poorly on exams. Third, assessing my knowledge is a starting point toward evaluating whether or not my goals are attainable.

The next stage is to give the plan a deadline to be bound to a specific time. For my third SMART goal, I will draft a wall timetable that shall act as a reminder to know the subjects I will need to cover in a day and the times for a break. I will measure my progress by trying some texts or question-and-answer sessions with my colleague to identify if I have developed an understanding (Kaushik & Lipton, 2018). Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay

Weekly Timetable

Resources Used to Accomplish Goals and Tasks

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I will use practical and case-based questions from the National Council Licensure Examination (NCLEX, 2020) to discourage memorization and encourage thinking critically. I recognize the value of the information and facts, but since each person’s situation is different, it is necessary to make decisions using the available evidence. The questions in Chapter 16 of the textbook are challenging since numerous solutions appear to be correct but are not equal. I would employ the knowledge of the literature, sound reasoning, and common sense to support my views. Joining a group discussion is another resource that will help me recall most of the material I learned.

Moreover, when members discuss, they might have the opportunity to learn from one another’s experiences (Troussas et al., 2020). Lastly, although not every aspect of the NCLEX is contained, I will concentrate on it while employing a wide range of methods and resources. Rather than postponing the test until after graduation, I must incorporate it into my certification exam preparation. Ethical Considerations of Informed Consent in Psychiatric Mental Health Practices Essay