Approaches to Analyzing Ethical Issues

To prepare:

Review literature for moral/ethical issues encountered by a PMHNP.

Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.

Write a 2-page paper in which you do the following:

Summarize the moral/ethical issue in the article (no more than 1 paragraph).

Describe the moral and ethical dilemmas surrounding the issue.

Analyze the ethical issue and compare them to the state health laws and regulations in your state.

Outline the process of ethical decision making you would use to address this ethical dilemma.

Practicum Journal Entry: Analyzing an Ethical Decision

In their advanced practice profession, psychiatric mental health nurse practitioners (PMHNPs) encounter specific dilemmas (American Nurses Association, 2014). Ethical dilemmas may make an individual to feel overwhelmed out and make a poor decision. Ethical dilemmas fall beyond clear-cut rules, by nature. Kaplan (2017) urges clinicians to evaluate the facts and psychological prejudices about the problem at hand when presented with that kind of a dilemma. The PMHNP should adhere to the code of ethics when in uncertainty, which governs the formation of legally sound decisions.

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Summary of article

Pathak and Chou’s (2019) article “Confidential care for adolescents in the U.S. healthcare system” investigates the difficulties of gaining consent and anonymity when coping with adolescents receiving mental health services. Pathak and Chou (2019) stated that federal legislation sets a basic requirement for conservation of confidentiality. As a consequence, each state has its own laws surrounding minor consent and privacy. Confidentiality issues can be a deterrent to pursuing health services for young patients. In teenage health care, maintaining the confidentiality of adolescent patients is an important evidence-based approach.Approaches to Analyzing Ethical Issues

The Healthcare Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA) is addressed by Pathak and Chou (2019) as the two principal federal legislative requirements designed to include a minimum “floor” for the preservation of minors’ confidentiality. h Under HIPAA, parents or carers may access the medical records for children under the age of 18, with various exceptions. nThe exceptions include a juvenile whose care is mandated by the judge, the parents agree that a discreet arrangement will be between the physician and the minor, and if a teenager has agreed to the care services ,the parent’s permission is not needed by state or any relevant legislation.

Moral and Ethical Dilemmas

Concerning the confidentiality of adolescents in health care, the practitioner must recognize and be able to implement both federal and state regulations. The PMHNP will have to comply with the confidentiality limits, particularly for teenage patients whose parents are consenting to care. The health care consent legislation offering teens with the right to discreet care is of great support. Ott (2014) claimed that all 50 states and the District of Columbia have laws allowing juveniles to agree to access care including contraceptive care.

Comparison of Ethical Issue with Texas Health Laws and Regulations

Texas law requires either a parent or an underage patient 16 years of age or older to agree to drug therapy both in-patient and out-patient care (Kerwin et al., 2015). As far as mental health care is concerned, Texas requires minors 16 years of age or older to sign an agreement for in-patient care, although there is no policy on who can sign an agreement for out-patient mental health care for minors.   In this situation, the minor cannot insist that her medical history be not addressed or disclosed to her parents. Nevertheless, the parents of a teenager who agree to care cannot access to the medical records of the patient.

Process of Ethical Decision Addressing Ethical Dilemma/Conclusion

The laws regulating the confidentiality of teenagers in mental health need not be restricted to circumstances of mental health. A dilemma might occur when an expectant teenager presents for mental health treatment with the consent of the parents. The adolescent may be telling the parents not to be told about her situation. However, PMHNP should administer medicines such as Depakote and Lithium that are usually prescribed during pregnancy. The PMHNP will have to analyze the state regulations on the dissemination of such details to parents and whether the dissemination of such information would be in breach of the confidentiality of the teenager.Approaches to Analyzing Ethical Issues

References

American Nurses Association (2014). Psychiatric mental health nursing: Scope and Standards of Practice (2nd ed.). Washington, DC: Author.

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from https://web.archive.org/web/20160416180027/http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx

Kerwin, M. E., Kirby, K. C., Speziali, D., Duggan, M., Mellitz, C., Versek, B., & McNamara, A. (2015). What can parents do? A review of state laws regarding decision making for adolescent drug abuse and mental health treatment. Journal of Child and Adolescent Substance Abuse, 24(3), 166-176. https://doi.org/10.1080/1067828X.2013.777380

Ott, M. A. (2014). Ethical case: Teen pregnancy and confidentiality. American Medical Association Journal of Ethics, 16(11), 884-890. Retrieved from https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/ecas3-1411.pdf

Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the U.S. healthcare system. Journal of Patient-Centered Research and Reviews, 6(1), 46-50. https://doi.org/10.17294/2330-0698.1656 Approaches to Analyzing Ethical Issues