Ethics and Mental Health

    Ethics in mental health has been researched exponentially with the aspect of issues that have arised. Most often associated  with consent, confidentiality, conflicts of interest, vulnerability, and exploitation. Many don't realize how sever the ethical issues are that arise with mental health patients. Most think that care and treatment should be the same as those without mental health problems, but it is actually the opposite. 

Let's discuss the different issues we previously brought up. 

1. Consent or informed consent is permission that is granted in the knowledge of the possible consequences. Most often it is what a patient gives a doctor after explanation of a treatment plan, with the full and absolute knowledge of what the benefits and risk of that treatment may be. This can be an ethical issue because if a patient is suffering from a mental illness they may not fully and completely understand what it is they are consenting to. Most often than not, a POA or Power of Attorney, is allowed to consent in the well being of that patient. 

2. Confidentiality is the state of keeping or being kept secret or private. Most times this is a conflict when dealing with family. When I am typically at the desk on my unit at the hospital, I find that family is very intrusive and wants to know everything they can get from hospital staff. Luckily, we have establish Care Partners. It's one to two person max who we can give information to. With mental illness, it may be hard for the patient to amend someone as a care partner. Typically that POA would be the care partner if it was that type of situation. 

3. Conflicts of Interest usually arise if the patient knows or has a former relationship with the doctor or someone in higher power assigned to their treatment. Just like in the instance that my mom works for the same hospital but for a difference practice of Northside, if I wanted to obtain a job at her practice and leave the main hospital, I would have to apply for the practice that she was not a coordinator over. If I applied where she was the coordinator and got awarded the position, that could be seen as favoritism and be a conflict of interest when it comes to disciple and how to handle situations correctly. 

4. Vulnerability is the quality or state of being exposed to the possibility of being attacked or harmed, either physically or emotionally. Most patients with mental health are extremely vulnerable because they sometimes do not understand completely what is going on with respect to their treatment. 

5. Exploitation is the action or fact of treating someone unfairly in order to benefit from their work. Patients with mental illness and mental health issues can be exploited easily because again most times they do not understand fully what their treatment plans are and how to potentially advocate for themselves if needed. 

    Mental health is growing more and more each year. More people are finding that conflicts within mental health patients are rising and knowing what those potential conflicts are is important to spot and take control of. 

Professional Ethics in Healthcare

     Like the last blog post we talked about HIPAA and the harms caused when going into patients charts that you do not have permission to go through. Just like HIPAA there are plenty more ethical dilemmas that come up in the healthcare profession. 

    In the Society of Professional Journalists Code of Ethics they say to:

            1. Seek truth and report it

                In the hospital it is often hard to "seek truth", a lot of what happens in the healthcare industry is chart chart chart, to cover your butt. They tell you to chart what you see, hear, smell, any and everything that can be charted, do it. They say this because if the patient comes back with a claim against you or against the hospital, they will start checking everything that was charted. When I say it is hard to seek the truth, I say this because what we chart and what they say can be different things. Sometimes it may be that we need to seek truth with the doctor and take things with a grain of salt when it comes to what the patient actually says. 

            2. Minimize harm

                You can minimize harm by either:

                        A) Deciding whether or not it is truly appropriate to act on what you may be trying to act on. What is the harm you could be causing the patient by fighting whatever it is or bringing it up. 

                        B) Does it do you more harm to bring up something that could be settle easily at bedside and bringing in more drama than needed. 

                At what point does harm play a significant role in your ability to do your job and the ability to represent the truth. Hence why seeking the truth is always the best first step.

            3. Act Independently

                Acting on your own and independently really streamlines from saying if something comes up that you feel you have needed to do steps 1-2 so far, then don't go blabbing your mouth to everyone about what they situation may potentially be. It is unfair to yourself and others to start drama if there is no concrete evidence to back up what you are saying. In the case of having concrete evidence in healthcare situations it is still not advised to go running your mouth to whoever because that can cause you to destroy not only your own character but that of someone else as well. 

            4. Be Accountable and Transparent 

                Being accountable happens if you are asked to be there and do what needs to be done, then you need to show up and do what needs to be done. Being transparent means that if asked a question about something then you need to tell the truth as you know it and have the ability to back up your statements. 

Professional Ethics has a thin line in healthcare because little things that people don't think of can be completely unethical. Talking about a patient at the front nurses station (even without saying their name) can be completely unethical. That fine line is a like a seesaw everyone is trying to balance on.  

Ethical Dilemmas in Healthcare

      Ethics in healthcare... what a dozy that is. The biggest ethical violation in healthcare is HIPAA. Health Insurance Portability and Accountability Act, also known as HIPAA is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patients consent or knowledge. 

     I am going to tell everyone a story and basically tell on myself here. I have had a HIPAA violation... I entered my own chart. I know you are thinking what? How is this a HIPAA violation. Well at work a couple years back I went to the ER for irregular heart rhythmus. When I came back to the floor after being cleared, I decided I wanted to see what my labs were and what the doctors notes were. Unfortunately, going through a chart, even yours is an ethical violation. This is the reason when you go to a healthcare facility that usually they have you create a username and password for your MyChart that gets uploaded from medical records. I was impatient. It cost me in the end, I was suspended for a day without pay and after signed a release of information form saying that it was okay for myself to enter into my chart from our hospital computer system. In healthcare we talk all the time about ethics ad violations whether it be HIPAA or not but even after working at a hospital for many years I did not realize that my own chart could give me a strike on my record here at the hospital. 

     Ethics are a thin line in the healthcare world and it is hard to see the clear picture until you may be too far over the edge. In 2019 it was averaged that there were 418 HIPAA violations in that year. With willful neglect of HIPAA and an employee with no regards of fixing their actions the first violation is a penalty of $50,000 and up to a maximum of $1.5 million for repeated cases. 

     Moral of the story if you work in healthcare... absolutely under no circumstances should you look in yours or anyone else's chart in fear of potential HIPAA violations.