N 520 Legal and Ethical Issues in Health Care Module 1 Assignment  Legal and Ethical Issues Related to Psychiatric Emergencies

 

The United States contains several states with their own set of laws that guide the hospitalization of all mental health patients with a capacity to harm those in their surroundings in both temporal and involuntary manners (Canady, 2018)The legitimacy and value of the choice of treatment intervention however relyon several factors like statutory criteria, and how they are applied; accessibility to care concerning the selected intervention; and accuracy to the emergency hold procedure. The purpose of this paper is to conduct a comprehensive assessment of the psychiatric emergency laws of the state of Maryland for both children and adults.

State Laws for Involuntary Psychiatric Holds

The Maryland state, the laws allow healthcare workers such as physician, a psychologist, a county health officer among others to “file an emergency evaluation petition for involuntary hospitalization even without getting the approval of the judge (Durns et al., 2021, p. 4). The petitioner must have substantial reason to believe that the person is mentally ill and display potential danger to themselves or others. Morris (2018) posits that amongst the provision of this law is the clause that permits authorities to issues involuntary commitment order within 72 hours whilst hearing should occur within 20 days after the former as regards adults. For children below the age of 18 years, the civil commitment hearing must be scheduled within 14 days, from the date of admission of the individual. The patient will be held for this period, however, when the psychiatrist fails to meet the hold criteria, the judge immediately releases the patient. A family member or emergency contact can come and pick the patient once the release order has been approved.

Evaluation/Psychiatric Hold, Inpatient Commitment, and Outpatient Commitment

The state of Maryland also allows civil holds as regards involuntary hospitlaizations to occur distinctively between both inpatient and outpatient commitments (Becker & Forman, 2020). According to the inpatient commitment laws in this state, the judge has the prerogative to make an order for a forceful patient hospitalization even when a patient has not contravened any of the civil commitment criteria and the elapsing of the emergency evaluation period. On the contrary, the outpatient civil commitment permits the same judge to order for the forceful hospitalization of mentally ill patients whose symptomatology is in tandem with the civil criteria whilst they are within the bounds of the community setup. Commonalities exist in the detainment time, the hearing and release orders in the two instances.

Difference Between Capacity and Competency

In mental health sphere, capacity is associated with the ability of a patient to undertake decisions that are regarded as sound as well as offer informed consent upon request. Therefore, the patient has the correct information such as the mental status, treatment interventions as well as their relevance and precise diagnosis of their condition (Perlin et al., 2018). On the other hand, competency is associated with the ability that a person has with regards to independent acting and participation in decision-making on matters associated with their health.

Legal and Ethical Issues

The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed into law in the year 1986 by the United States Congress (Terp et al., 2019). It was considered part of the Consolidated Omnibus Reconciliation Act (COBRA) mainly handling Medicare issues. The main legal and ethical issue associated with EMTALA is the inability to uphold and respect the patients’ autonomy and confidentiality, especially when it comes to payment issues.

Evidence-Based Suicide Risk Assessment and Violence Risk Assessment

Psychiatric emergencies see the adoption of various diagnostic tools for purposes of determining the levels of severity of the mental health illness in a patient. Tools such as Evidence-based Screening tools like Patient Health Questionnaire 2 (PHQ2) play important roles in the diagnosis of the severity of suicidal ideation. On the other hand, the risk for violence can be diagnosed using Brøset Violence Checklist and Violence Risk Screening-10 can be used to assess for risks of violence among others (Chunduri et al., 2019).

Conclusion

Psychiatric emergencies call for involuntary hospitalization of mentally ill individuals for evaluation and treatment. The laws governing psychiatric emergencies however vary from state to state. However, the entire process is mainly aimed at protecting community members from harm that can be caused by the mentally ill individual.

Order this paper