PHEthicoLegal 1
EthicoLegal LAWS RA 11036 Philippine Mental Health Law the right to mental health to every Filipino The RA 11036, also known as the Philippine Mental Health Law, is a legislation that seeks to provide affordable and accessible mental health services to all Filipinos, promote mental health education and awareness, and protect the rights of people with mental health needs.
4 Objectives of RA 11036
1) Effective leadership and governance for mental health
2) Comprehensive, integrated, effective, efficient national mental health care system
3) Protect rights and freedom of persons with psychiatric, neurologic, and psychosocial health needs 4) Information system, evidence, and research for mental health
RA 9710 Magna Carte for Women eliminate discrimination against women
The RA 9710 Magna Carta for Women is a law in the Philippines that aims to eliminate discrimination against women by recognizing, protecting, fulfilling, and promoting their EthicoLegal 2 rights.
RA 11313 Safe Spaces Act of 2019
Bawal Bastos Law Penalizes wolf whistling, catcalling, misogynistic and homophobic slurs,unwanted sexual advances, and other forms of sexual harassment in public places, workplaces, schools, and onlinespaces.
Unlike RA 7877 (Anti-Sexual Harassment Act of 1995), under this law anyone can be offenders.
1st degree: wolf-whistling, catcalling, slurs, intrusive gazing, unwanted comments or requests for personal details, invasion of personal space or safety – P1,000 fine to 11-30 days in prison + P10,000 fine 2nd degree: offensive gestures, public ********tion, flashing of body parts, groping – P10,000 + 12 hr community service + GendSev seminar to 1 month, 1 day to 6 months in prison + P20,000 fine
3rd degree: stalking, sexual advances, touching any part of the victim’s body – P30,000 + 11-30 days in prison + GendSev seminar to 4 months, 1 day to 6 months in prison + P100,000 fine Online harassment – prisioncorreccional + P100,000 to P500,000 + revocation of license or franchise
RA 7277 Magna Carta for Disabled Persons
Replaced the term “disabled persons” since 2009 due to RA 10070 (amended Magna Carta for Disabled Persons) Disability- Physical or mental impairment that substantially limits one or more psychological, physiological or anatomical function of an individual or activities of such individual.
Persons with Disabilities (PWD)- Those who suffer from restriction or different abilities, as a result of a mental, physical or sensory impairment, to perform an activity in the manner or within the range considered normal for a human being.
EthicoLegal 3 Individual Rights
▪ Good quality health care and humane treatment
▪ Dignity
▪ Be informed of rights and obligations of a px
▪ Choose his physician/health institution
▪ Informed consent
▪ Refuse diagnostic and medical treatment
▪ Refuse participation in medical research
▪ Religious belief and assistance Privacy and confidentiality
▪ Disclosure of, and access to, information
▪ Correspondence and to receive visitors
▪ Medical records ▪ Health education
▪ Leave against medical advise
▪ E×ρréšš grievances Societal Rights Health
▪ Access to quality public health care
▪ Healthy and safe workplace
▪ Medical information and education programs
▪ Participate in policy decisions
▪ Access to health facilities
▪ Equitable and economical use of resources
▪ Continuing health care
▪ Provided health care in times of insolvency
Obligations Know rights ▪ Provide adequate, accurate, complete information ▪ Report unexpected health changes ▪ Understand the purpose and cost of treatment ▪ Accept consequences of own informed consent ▪ Settle financial obligations ▪ Respect rights of health care providers, health care institutions, and other patients ▪ Obligation to self ▪ Provide adequate health information and actively participate in his/her treatment ▪ Respect right to privacy of health care providers and institutions ▪ Exercise fidelity on privileged communication ▪ Respect a physician’s refusal to treat him ▪ Respect the physician’s decision on medical reasons based on his/her religious beliefs ▪ Ensure integrity and authenticity of medical records ▪ Participate in training of competent future physicians ▪ Report infractions and exhaust grievance mechanism
EthicoLegal Considerations Involuntary Hospitalization A person can be detained in a psychiatric facility for 48 to 72 hours on an emergency basis until a hearing can be conducted to determine the necessity of such admission.
Release from Hospital EthicoLegal 5 Voluntarily-admitted clients can leave as long as they no longer pose danger to themselves or others and they sign a written request for discharge against medical advice (DAMA). Psychiatrist may file for a civil commitment to detain the client against his/her will until a hearing takes place to decide on the matter. Discharged clients are still required to participate in treatment on an involuntary basis after their release from the hospital into the community. Conservator or Legal Guardian Assigned by a court for people who are gravely disabled, or are found to be incompetent; cannot provide food, clothing, and shelter for themselves even when resources exist. Conservator - Manages all of client’s financial affairs Legal Guardian - Assumes many responsibilities: giving informed consent, writing checks, and entering contracts The client with a legal guardian loses the right to enter into legal contracts or agreements that require a signature Least Restrictive Environment Restraint - Restraint is the direct application of physical force to a person without his/her permission to restrict his/her freedom of movement. Human Restraint Human restraint is when staff members physically control the client and move him/her to a seclusion room. Mechanical Restraint Mechanical restraint is a device, usually ankle and wrist, fastened to the bed frame to curtail the client’s physical aggression such as hitting, kicking, and hair pulling. Seclusion EthicoLegal 6 Seclusion is the involuntary confinement of a person in a specially constructed, locked room equipped with a security window or camera for direct visual monitoring. The goal of seclusion is to give the client an opportunity to regain physical and emotional self-control. Seclusion decreases stimulation, protects others from the client, prevents property destruction, provides privacy for the client. During seclusion, the bed is bolted to the floor and mattress. Pens, glasses, belts, and matches are removed from the client. Nursing Interventions Nurses caring for clients on restraint or seclusion must perform assessment and documentation. Assess the client within 1 hour and every 8 hours thereafter. Children should be assessed every 4 hours. Monitor and document client’s skincondition, blood circulation in hands and feet, emotional well-being, readiness to discontinue seclusion or restraint. Physicians should renew orders for restraint or seclusion every 4 hours for ãdül† clients or every 2 hours for children. Debriefing must be performed within 24 hours following release from restraint or seclusion. Debriefing is a set of proceduresincluding counseling and the giving of information aimed at preventing psychological morbidity and aiding recovery after a traumatic event. Confidentiality Health Insurance Portability and Accountability Act (HIPAA) in the US Data Privacy Act of 2012 (RA 10173) in the Philippines Duty to Warn Third Parties Identifiable third parties of threats made by clients must be informed even if these threats were discussed during therapy sessions for their safety. The decision to warn is made if: EthicoLegal 7 Is the client dangerous to others? Is the danger the result of serious mental illness? Is the danger serious? Are the means to carry out the threat available? Is the danger targeted at identifiable victims? Is the victim accessible? Insanity Defense M’Naghten Rule A person accused of a crime is NOT guilty if he/she meets these two (2) criteria for insanity defense: 1. They cannot control their actions. 2. They cannot understand the wrongfulness of the act. Ideally, the person will still be held responsible for the crime but can receive treatment for mental illness. However, as long as the 2 criteria are met, the person will not be held responsible. The defendant must prove that he/she is indeed insane immediately before or at the moment of committing the crime (Revised Penal Code of the Philippines). When the crime is committed during a lucid interval (i.e., not insane), the person will be held criminally liable. Once proven insane, the person will be ordered confinement in a mental institute and will not be permitted to leave without obtaining permission from the court . Tort Wrongful act that results in injury, loss, or damage. Unintentional: Negligence, Malpractice Intentional: Assault, Battery, False Imprisonment EthicoLegal 8 Unintentional Negligence Causing harm by failing to do what a reasonable and prudent person would do in similar circumstances Malpractice Any act or omission by a health care provider that leads to substandard treatment, resulting in injury to a patient. 4 Elements of Malpractice 1. Duty – a legally recognized relationship existed 2. Breach of Duty – nurse (or physician) failed to conform to standards of care thereby failing the existing duty 3. Injury or Damage– client suffered some type of loss, damage, or injury 4. Causation– breach of duty directly caused the loss, damage, or injury Intentional Assault Any action that causes a person to fear being touched in a way that is offensive, insulting, or physically injurious without consent or authority Battery Harmful or unwarranted contact with a client with or without actual harm or injury False Imprisonment Unjustifiable detention of a client such as inappropriate use of restraint or seclusion
Thus, nurses should provide safe, competent nursing care, and descriptive, accurate documentation. EthicoLegal 9 Ethics Branch of philosophy that deals with values of human conduct related to the rightness or wrongness of action and to the goodness and badness of the motives and ends of such action Sets of principles used to decide what is morally right or wrong Utilitarianism, Deontology Utilitarianism Bases decisions on “greatest good for the greatest number”; considers which action would produce the greatest benefit for most people Deontology Bases decisions on whether an action is morally right regardless of the result or consequences Deontology Includes principles such as autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity Autonomy right to self-determination and independence Beneficence duty to benefit or to promote thegood of others Nonmaleficence To do no harm to others either intentionally or unintentionally Justice Fairness, treating all people fairly, and equally without regard for social or economic status, race, ***, marital status, religion, ethnicity, or cultural beliefs Veracity Duty to be honest or truthful EthicoLegal 10 Fidelity Obligation to honor commitments and contracts Ethical Dilemma Situation in which ethical principles conflict or when there is no one clear course of action in a given situation influenced by emotions, values,opinions, and beliefs