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51 Cards in this Set
- Front
- Back
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patient confidentiality
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information that the patient shares with physicians cannot be released to third parties without the patients authorization, except in certain situations
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exceptions to patient confidentiality
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1. sharing relevant information with other staff members of the same facility who are treating the same patient
2. the patient has a communicable disease that state requires be reported to the department of health 3. child or elder abuse is suspected 4. if imminent danger or suicide is present 5. patient is unable to provide basic self care |
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Court order
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issued by a judge
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what if you receive a subpoena from a lawyer for privileged information
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this would be issued by an attorney and is not constitute an exception to conifidentiality
patients permission must be obtained before releasing records |
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Privilege
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term used to describe a patients rights to prevent a physician from testifying about professionally obtained material in legal matters
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Tarasoff vs. Regents of California
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college student in counseling disclosed to his therapist a serious threat to kill a young woman. Psychologist tried to have patient committed to psychiatric facility and reported to the police both verbally and written. The patient dropped out of treatment, later killed intended victim.
Court ruled that mental health professionals and physicians have duty to warn and protect intended victims of violence |
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What indicates a risk of violence?
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history of violence
specific threat with a plan psychiatric diagnosis history of impulsive behavior history of victimization gang membership, history of delinquent behavior |
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HOlding a person against there will in a psychiatric inpatient facility. Who is this used for?
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patients who:
present imminent risk to their own safety or the safety of others , and refuse voluntary admission or lack capacity to consent to voluntary admission Are unable to care for own basic needs due to mental health disorder |
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Procedures for involuntary admissions
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police ma take person into protective custody and transport to psychiatric facility, or if patient is in hospital setting, may be detained by administrative order of detention
once patient is in emergency order of detention status, his case must be reviewed by court within 72 hours A decision is made to release or retain the patient for treatment |
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Do patients hospitalized involuntarily have the right to refuse treatment?
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Yes
unless court order for treatment emergency treatment is deemed necessary to protect the patient or others from harm |
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what is the definition of person requiring treatment in Oklahoma
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only individuals meeting the definition of a person requiring treatment is subject to emergency detention or civil involuntary commitment:
- mentally ill or alcohol or drug dependent - pose a risk of harm to self or others as a result of that mental illness or drug or alcohol dependence |
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what does the definition of a person requiring treatment exclude?
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a person whose mental processes have been weakened or impaired by reasons of advanced ages, dementia, or Alzheimer's disease
a mentally retarded or developmentally disabled person a person with a seizure disorder a person with a traumatic brain injury |
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Oklahoma law about inpatient treatment of minors
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Oklahoma states " a minor may be admitted to inpatient mental health treatment on a voluntary or involuntary basis only if the minor meets the definition of a minor in need of treatment
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minor in need of treatment
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a demonstrable mental illness or who is drug/alcohol dependent and as a result of that illness or dependency can be expected within the near future to inflict or attempt to inflict serious bodily harm to him/herself or another person and has engaged in one or more recent overt acts or made significant recent threats which substantially support that expectation
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minor in need of treatment
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a demonstrable mental illness or is alcohol or drug dependent of sufficient severity to cause substantial impairment or disability in at least two of the following major areas of functioning in the life of the child:
family relations school performance social interactions ability to perform independently the basic tasks of personal hygiene, hydration, and nutrition self protection |
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Minor in need of treatment excludes:
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those afflicted with epilepsy, a developmental disability, organic brain syndrome, physical handicaps, brief period of intoxication caused by such substances as alcohol or drugs who is truant or sexually active unless the minor also meets the criteria for minor in need of treatment
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Minors 16 and older
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right to consent to voluntarily admit themselves for inpatient mental health or substance abuse treatment
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Involuntary admissions of minor
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parent who originally applied for inpatient treatment or minor later revokes his or her consent
when a minor is 16+ revokes consent for inpatient treatment and a parent or guardian refuse consent for inpatient therapy when a minor presents at a facility and appears to need inpatient treatment, but the minor cannot or will not consent and parent canot be located to give consent |
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rights of patients in mental health facilities
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refuse treatment
privacy, visitors, manage own finances, communicates with others outside facility informed consent |
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informed consent
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process by which patients receive relevant information and voluntarily agree to treatment or procedures
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required elements of informed consent
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diagnosis/nature of illness
name and purpose of treatment recommended treatment and alternatives potential risk and benefits likely outcomes without treatment absence of coercion or undue influence can withdraw consent at any time |
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exceptions to informed consent
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implied consent: emergency situations in which patient unable to give consent
therapeutic privilege: physician allowed to withhold information from the patient that could cause harm to the patient patient waives consent patient is a minor |
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what are the exceptions to informed consent considering a minor?
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emergency medical care may be administered if attempts to contact parents/legal guardians are unsuccessful and delaying treatment could endanger patients life or health
parents refuse treatment for child who has life-threatening condition |
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Competence
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legal term determined by courts that refers to an individuals ability to provide informed consent for medical treatment
all individuals except for minors are presumed competent unless the court determines otherwise |
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emancipated minors
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presumed competent unless court determines otherwise
- live independently and are self-supporting, are married, have served in the military, or have dependent children |
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T/F
presence of psychiatric illness does not necessarily mean that patient lacks competence to provide informed consent |
True
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Capacity
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clinical term refers to individuals ability to make treatment decisions
can be assessed by physician/mental health professional |
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T/F any physician can determine capacity of decision making
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true
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Capacity can be task specific and fluctuate based over time. What criteria is this based on?
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1. ability to communicate a choice or preference
2. understands and can explain purpose, risks, benefits, and alternatives of treatment 3. Appreciates situation and potential consequences of accepting and refusing treatment 4. Can logically manipulate information regarding the situation and reach rational conclusions |
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Competence to stand trial
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understand the charges and possible penalties
assist his/her attorney in preparation of defense not guilty by reason of insanity |
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M'Naghten standard
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Criteria vary across state
in general individual must meet the following criteria at time act was committed: have a mental illness not understand right from wrong not understand consequences of actions |
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Malpractice
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performance of medical duties by a physician at a level below or in conflict with the community standard of care that results in patient harm
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what are the four criteria for malpractice
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dereliction/negligence of a duty/responsibility to a patient that directly caused damage to the patient
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is malpractice a crime?
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NO
- tort or civil wrong |
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Personality
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consists of ones habits, attitudes, and expectations that lie along a continuum from trait to disorder
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Personality traits
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are the ways in which individuals perceive, think, and relate to their environment
traits are normal characteristics that make humans beings distinct individuals |
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Personality disorders
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traits that have become so inflexible and pervasive that they have become maladaptive
they cause functional impairment and/or emotional distress |
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when do personality traits/disorders have onset?
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early onset
they begin by at least adolescence or early adulthood |
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Cluster A disorders
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odd, eccentric behavior
- paranoid - schizoid - schizotypal |
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paranoid
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distrust and suspiciousness to the extent that the motives of others are interpreted as malevolent
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schizoid
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detachement from social relationships and a restricted range of emotional expression
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schizoptypal
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acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior
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Cluster B disorders
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antisocial
borderline histrionic narcissitic |
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Antisocial
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disregard for and violation of the rights of others
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borderline
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instability in interpersonal relationships, self-image, affects, and marked impulsivity
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Histrionic
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excessive emotionality and attention seeking
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Narcissistic
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grandiosity, need for admiration, and lack of empathy
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Cluster C personalities
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Avoidant
Dependent Obsessive-Compulsive |
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Avoidant
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social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluations
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Dependent
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submissive and clinging behavior related to an excessive need to be taken care of
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Obsessive compulsive
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preoccupation with orderliness, perfectionism, and control
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