When providing care to patients with mental disorders, psychiatric health practitioners encounter ethical challenges. These ethical concerns require morally effective responses since they involve tough decision-making. Understanding the various types of ethical challenges that might arise gives the psychiatric/mental health practitioner (PMHP) the opportunities to resolve the ethical problems that they will encounter in the profession (Aydin & Ersoy, 2017). A morally unprepared institution is unprepared to take action on an existing psychological, emotional, or educational ethical crisis. For example, controlling negative feelings towards patients might prove difficult for PMHP while providing care to them, resulting in moral blindness, focusing on clinical and technical problems instead of moral issues. These ethical problems have significant influences on patients, and nurse practitioners. Aydin and Ersoy (2017) conducted a study on the ethical challenges facing medical practitioners who work in psychiatry clinics through self-administered questionnaires prepared and distributed among 109 nurses at a psychiatric nursing congress. The study revealed serious ethical problems regarding respect to the autonomy of patients.
Ethical Concerns
The most significant ethical concern is respect for patient autonomy. Psychiatric/mental health practitioners are faced with instances when patients refuse medication (Finley, 2020). In these cases, they reported that ethical concerns arise when one is unsure whether to respect the patient's decisions or embrace beneficence as a moral obligation to the patients' welfare. Secondly, psychiatric patient's privacy has resulted in numerous debates on its ethical components. PMHP may be compelled by certain situations to consciously or unconsciously produce confidential information on the psychiatric patient to their relatives without the patient's consent (Bruun, 2018). It also becomes a moral concern when institutions hold patients that need discharge without their permission. Dealing with psychiatric patients may result in restraints and seclusion, unethical procedures against the medical code of preventing harm to patients. Other ethical concerns involved include hospitalizing patients with the primary objective of conducting research on them and carrying out the research without patient consent.
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Ethical Concerns and Policy
To ensure the autonomy and privacy of psychiatric patients, legislation such as the Mental Health Care Act 2017 recognized the impact of mental disorders on individuals. They withdrew the legal punishment that was previously handed to victims of attempted suicide. On the other hand, mental health's national policy suggests that mental disorders influence decision-making capacity (Bipeta, 2019). Therefore, psychiatric patients' consents need to be considered and evaluated against the existing ethical standards of beneficence and autonomy.
Ethical Decision-Making Process
The first decision-making step that PMHP needs to follow to address the ethical concerns of autonomy, patient privacy, and consent would be to listen to the patients' concerns and gather enough information to define the ethical issues involved (“Ethics & Compliance Initiative,” 2021). Secondly, it would be essential to identify those affected by the information collected, such as family members, experts, and institutional stakeholders, and identify the consequences for each of them. Most importantly, identifying and evaluating alternative solutions and implementing the decision marks the beginning of changing the underlying psychiatric ethical concerns.
Conclusion
Mental health practitioners face ethical dilemmas in their workplaces every day. These challenges, including patient autonomy and beneficence, patient privacy concerns, and taking action without patients' consent, pose significant challenges to the practitioners and institutions. By utilizing the ethical-decision making process in the formulation of institutional policies and legislations, mental health practitioners’ training provides the cognitive abilities required to deal with the problems.
References
Aydin Er, R., & Ersoy, N. (2017). Ethical Problems Experienced By Nurses Who Work in Psychiatry Clinics in Turkey. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 8(2).
Bipeta, R. (2019). Legal and Ethical Aspects of Mental Health Care. Indian Journal Of Psychological Medicine, 41(2), 108-112. doi: 10.4103/ijpsym.ijpsym_59_19
Bruun, H., Lystbaek, S. G., Stenager, E., Huniche, L., & Pedersen, R. (2018). Ethical challenges assessed in the clinical ethics Committee of Psychiatry in the region of Southern Denmark in 2010–2015: a qualitative content analyses. BMC medical ethics, 19(1), 1-13.
Ethics & Compliance Initiative, (2021). The PLUS Ethical Decision Making Model - Ethics & Compliance Toolkit. (2021). Retrieved 27 March 2021, from https://www.ethics.org/resources/free-toolkit/decision-making-model/
Finley, B. A. (2020). Psychiatric mental health nurse practitioners meeting rural mental health challenges. Journal of the American Psychiatric Nurses Association, 26(1), 97-101.
