Legal and Ethical Issues in Mental Health

 

A  17 year old male client in an inpatient psychiatric unit is being  uncooperative. The client is standing in front of the nursing station,  where the nurse answers incoming phone calls and discusses patient care  with the treatment team. The nurse kindly asks the client to return to  the dayroom and join the rest of patients for group. However the client  says, “No, I am perfectly fine where I am.” A staff member observes the  situation and steps in and states, “you need to go to group now, or we  will have to escort you to the quietroom.” The client looks at the staff  member and says in a calm tone, “you can’t make me move, I am not doing  anything wrong.” The nurse realizes this situation is escalating and is  stuck between a rock and a hard place. Please consider all the details  provided above and answer the following questions:

1. What does the principle of the least restrictive environment have to do with this situation?
2. What role does HIPAA play in this scenario and why does it make the situation more complicated?
3.  Which nurse would be more likely to initiate a restrictive intervention  for this client, a nurse with a utilitarianism view of ethics or a  deontological view of ethics? And why?
4. Finally, how would you resolve this situation?