Ethical and Legal Foundations of PMHNP Care Essay

Ethical and Legal Foundations of PMHNP Care Essay

Ethical and Legal Foundations of PMHNP Care Essay

Healthcare decisions and practices are guided by ethical and legal issues that safeguard patient safety and quality of care. On such an issue is patient autonomy. Patient autonomy is the patient’s right to make an informed decision regarding treatment options and other issues pertaining to his/her health (Basri, 2019). Thus, healthcare professionals provide patients with sufficient information regarding treatment options, risks, and benefits and give them the chance to evaluate such information and make an informed choice. Subsequently, the clinicians must respect the patient’s preference of a treatment option even if they disagree with the choice. Autonomy in healthcare has both legal and ethical implications. Failure to observe patient autonomy is not only a violation of ethical principles but can amount to negligence or medical malpractice.

According to Scharf et al. (2021),a patient’s autonomy is an essential principle in ethical and legal considerations giving patients the authority to choose treatment options. At the same time, clinicians encounter multiple issues that may compromise the ability to apply autonomy, such as language and cultural barriers. In some cases, the families insist on making medical decisions on behalf of a competent patient, undermining equitable treatment. Family members may also ask the physician to hide some information from the patient. According to Scharf et al. (2021), identity, culture, needs, and interests influence a patient’s decision. Hence, it is vital to ask the patient how they want to make decisions and whom to involve, an aspect known as relational autonomy. Above all, patients have the right to know, and healthcare professionals must maintain truth-telling without hiding information from the patient. While adult patients are free to make health decisions as long as they are competent, the case of children is different. Sabatello et al. (2018) assert that while children and adolescents have autonomy to some extent in medical decision-making, parents have the exclusive authority to refuse or consent to medical treatments on behalf of their children.


Regarding patient autonomy in children, the law provides an exemption where the court may override the parent’s decision. Sabatello et al. (2019) explain that the right to make a medical decision on behalf of a child is not a parent’s autonomy but a responsibility to be the child’s advocate and expert in making medical decisions. When the parents’ decision is questionable on its benefits to the child, the court enforces an option that serves a child’s best interest and prevents harm. For example, parents may opt for spiritual healing instead of operations or resuscitation. On the other hand, adult autonomy cannot be overruled as the law protectsthe patient’s right to self-determination. Basri (2019) notes that the right to patient autonomy is absolute and providing treatment against a patient’s witness is a criminal offense. However, an important consideration is that the physician must provide the patient with the necessary information to make an informed choice.

Implications for Practice

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Nurses must understand the legal and ethical environment within the clinical practice. Most professions and health organizations have codes of conduct and ethics that guide ethically and legally responsible behaviors. More so, clinicians often face ethical dilemmas caused by the competing interest of one or more ethical principles, for example, respect for autonomy vs. non-maleficence (Basri, 2019). Thus, understanding these issues’ legal and ethical backgrounds is essential to guide decisions in such cases. Additionally, barriers to the right to health care equity threaten these legal and ethical principles, such as cultural norms that require other members of the family to make health decisions on behalf of the patient (Sabatello et al., 2019). Finally, nurses must understand the legal and ethical considerations of these principles concerning state regulations. Knowledge of the ethical and legal factors in health enables nurses to promote patient safety and avoid cases of negligence and malpractice.


Basri, N. (2019). The coherence of the principle of patient autonomy in the English medical Law: A Re-evaluation. LSE Law Review, 5, pp.31–48.

Sabatello, M., Janvier, A., Verhagen, E., Morrison, W., & Lantos, J. (2018). Pediatric participation in medical decision-making: Optimized or personalized? Am J Bioeth, 18(3), 1–3. https:/doi.10.1080/15265161.2017.1418931.

Sabatello, M., Janvier, A., Verhagen, E., Morrison, W., & Lantos, J. (2019). Pediatric participation in medical decision-making: Optimized or Personalied? Am J Bioeth, 18(3), 1–3. doi:10.1080/15265161.2017.1418931.

Scharf, A., Voigt, L., Vardhana, S., Matsoukas, K., Wall, L., Arevalo, M., & Diamond, L. (2021). What should clinicians do when a patient’s autonomy undermines her being treated equitably? AMA journal of ethics, 23 2, E97-108. https:/doi.10.1001/amajethics.2021.97.


Discussion: Ethical and Legal Foundations of PMHNP Care
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:
Involuntary hospitalization and due process of civil commitment
Informed assent/consent and capacity
Duty to warn
Child and elder abuse reporting
Tort law
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.

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