Question

Mr. D is scheduled for discharge from the unit. He has a history of schizophrenia and depression. He is homeless. He is morbidly obese and is in an electric wheelchair because of paraplegia. The Case Manager is attempting to find him housing but he says he does not want to spend his money on anything but prostitutes.

Ethical Discussion

What should the Case Worker do in this situation? What is the ethical dilemma of this situation? How can you intervene as the RN?

Answer 1

Ans) Psychiatric research has several important ethical issues which are different from other medical disciplines. These issues are related to informed consent, confidentiality, conflict of interest, therapeutic misconception, placebo related, vulnerability, exploitation, operational challenges, among others.

- The conflict between autonomy and beneficence/nonmaleficence often leads to distress among health care professionals, as well as patients and their families, and frequently manifests in psychiatric consultations for evaluation of the patient's capacity to make medical decisions or to refuse recommended treatment.

RN Intervention:

- Assess a patient's mental state.
- Establish good communication with the patient.
- Build a relationship with the patient.
- Use language that shows consideration.
- Provide sensitive patient-centered care.
- Consult with knowledgeable mental health professionals.