Adults and Children/Adolescent Informed Consent’s

Adults and Children/Adolescent Informed Consent’s Ethical and Legal Aspects in Mental Health
 
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Adults and Children/Adolescent Informed Consent’s Ethical and Legal Aspects in Mental Health
Several ethical and legal aspects guide PMHNP practices. Negligence is one of the most sensitive and salient factors of these features. Informed consent’s ethical ideals and legal requirements are critical in PMHNP practices of both children and adolescents, and adults. However, an assessment of existing literature illustrates different patterns of application of informed consent’s ethical and legal considerations between these groups.
Ethical Considerations
In the “Ethical Considerations for the Participation of Children of Minor Parents in Clinical Trials” study, for example, Ott et al. (2018) paint a picture that informed consent carries more sensitive and significant implication. The study attributed this factor to minor’s underrepresentation in clinical trials. Meanwhile, Ott et al. highlight that minors have an ethical right to have decisions in their favour or best interest besides the right to the highest attainable standard of health. According to these researchers, drawing from neuroscience research, minors have an adult-level capacity to make 12–14 years, minors have adult-level capacity to make research decisions in situations with low emotion and low distraction. As such, the ethical codes of conduct of the mental health profession compel PMHNPs to involve them in PMHNP practices, seeking out their informed consent even in areas of slightest and most obvious outcomes.
All the same, informed consent is also a very important ethical consideration for adults. Neilson and Chaimowitz (2017) illustrate that all clients boast a right for PMHNPs to inform them and involve them actively in their health care. According to the authors, essential to a client’s autonomy and dignity is the right to decide about their psychiatric intervention and treatment options inclusive of the right to refuse undesirable or unfavourable treatments, provided the rebuttal is a justifiable one. Accordingly, Neilson and Chaimowitz (2017) affirm that it is imperative that psychiatrists understand the ethical bedrocks of consent and the decreed necessities related to consent, among them precedent cases. The authors argue that consent will always change over time, and for different circumstances and reasons; hence, it must always be a continuous process.
Legal Considerations
Similar to the informed consent ethics surrounding PMHNP practices, the profession’s legal considerations are also slightly sensitive and strict on children and adolescent issues. For example, in New York, according to Santana (2016), the law requires parents or guardians’ for minor’s outpatient mental health treatment. The New York state defines minors as persons below 18 years old. However, the author details that children and adolescents can access mental health services without informed consent if parents or guardians are unavailable, if parental involvement would be detrimental to the minor’s treatment course and or under a court’s order. Otherwise, any negative consequences of practitioners’ choices without informed consent would draw legal implications upon them.
Informed consent legal considerations also hold key for adults in PMHNP practices. Becker and Forman (2020) backdates when informed consent was invaluable in mental and general healthcare. According to them, before the informed consent’s laws, the society and the judiciary considered legitimate for psychiatrists to treat patients against their will. As such, the courts even held psychiatrists accountable for failing to treat patients against their will. Becker and Forman cite a New York court decision in 1968 case where the court awarded a patient $300,000 in damages due to a hospital’s failure to treat a patient against his will as an example. Nonetheless, the authors acknowledge that the informed consent legal status has since reversed such that what is against the law today is treating patients against their own will. According to this Becker ad Forman, this legal consideration dates back as to the Schoendorff v. Society of New York Hosp. case. In this case, Justice Cordoza, the judge ruled, “Every human being of adult years and sound mind has a right to determine what shall be done with his own body.” Informed consent refers to this process, in which we honour patients’ autonomy, wherein the psychiatry explains the treatment procedure, and risks and benefits of either accepting or refusing a given intervention, and then allowing the patient to choose whether to proceed or not.
Conclusion
Ethical and legal considerations are PMHNP’s crucial aspects in today’s liberal society. Informed consent is one of the ethical and legal considerations topic with extensive scholarly attention for both children and adolescents and adults, PMHNP codes of practices and laws provide that psychiatrists should treat patients according to their will. Any deviations brings about ethical and legal consequences.
 
References
Becker, S. H., & Forman, H. (2020). Implied consent in treating psychiatric emergencies. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00127
Ott, M. A., Crawley, F. P., Sáez-Llorens, X., Owusu-Agyei, S., Neubauer, D., Dubin, G., Poplazarova, T., Begg, N., & Rosenthal, S. L. (2018). Ethical considerations for the participation of children of minor parents in clinical trials. Pediatric Drugs, 20(3), 215-222. https://doi.org/10.1007/s40272-017-0280-y
Neilson, G., & Chaimowitz, G. (2017). Informed Consent to Treatment in Psychiatry. NCBI, 60(4), 1-11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459249/#:~:text=Patie
Santana, B. I. (2016). Mental Health Practitioners’ Understanding of Informed Consent with Adolescents [Doctoral dissertation]. https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=2371&context=gc_etds
 

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