2-13-08 Travis

Legal/Ethical
Mental Health Laws

• Civil rights

o All civil rights remain intact unless the patient has been declared
incompetent

o Committed patients still have same rights except to leave the hospital

• Specific client rights (been admitted to the hospital but has not been
declared incompetent)

o Consent

 Right to signs informed consent

o Communication

 Patients have the right to communicate with family and friends,

but there are limitations. There are certain times they are
allowed to do this

o Freedom from harm

o Dignity and respect

o Confidentiality

o Participation in plan of care

o Advanced directives

o Restraints and seclusion

 Nurse can restrain a patient in emergencies, and then call the

MD

 Patient must meet specific criteria

• Harm to self or others

 Order must specify type of restraints and have specific time

frame

 Must have checks every 15 to 30 minutes depending on your

facility and must document what you observed
Hospital Admissions

• Voluntary

o Comes in willingly

• Involuntary

o Commitment

o File affidavit stating the person is a threat to themselves or others

o Elopement-when a client leaves facility, without consent from facility

• Release

o Conditional release-required outpatient treatment for specified period

to determine client compliance with medications, protocols, ability to
meet basic needs, and ability to reintegrate into the community.

• Discharge or unconditional release-termination of a client-institutional

relationship. May be court ordered or administratively ordered

Ethical Consideration

• Elder and child abuse reporting

• Exceptions to the rule

o Duty to warn and protect third parties of potential life threats

Common Liability Issues

• Protection of clients

o 1:1, not leaving suicidal client alone or where they can hurt themselves

• Defamation of character

o Slander

o Harming patients reputations

• Supervisory liability

o What duties you can delegate

• Short-staffing issues
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• Assault and battery

o Assault-threatening to harm

o Battery-harmful or offensive touching

• False imprisonment

o Confining person to specific area that is not in the best interest of the
patient

• Punitive damages

o Monetary damages for wrongdoings

• Negligence

o Act of omission

o Breach of duty-don’t give medicine, etc.

• Abandonment

• Person leaves assigned duty without giving report, etc.