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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
2-13-08 Travis
• 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.