Ethical Issues in Emergency Psychiatry

Allen, Nathan G.; Khan, Jeffrey Steven; Alzahri, Mohammad S; Stolar, Andrea

doi:10.1016/j.emc.2015.07.012

Cited by 13 publications

(8 citation statements)

References 39 publications

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“…The ethical dilemma in emergency psychiatry continues to remain debatable [8][9][10][11][12][13][14][15][16][17]. The general principle of autonomy, which permits patients to refuse or accept treatment, is frequently called into question when patients present with presentations that are clouded by impaired decision-making capacity and presenting with common symptoms like acute psychomotor agitation, suicidal ideations, homicidal ideations, threats of self-harm or violence to caretakers, and self-neglect [17][18]. These potentially fatal clinical symptoms can be seen in various common psychiatric illnesses, needing rapid treatment following a risk assessment [3,5,7,[9][10][12][13][14].…”

Section: Emergency Approaches To Medication Administration In Patient...mentioning

confidence: 99%

“…Other times, medications are administered involuntarily, involving parenteral injections to restore physiologic function substantially. In the principle of medical ethics, a psychiatrist may only authorize the use of their certification for the involuntary treatment of any person after having personally examined that person [8,10,16,[17][18][19]. To do so, the physician must determine that the person's mental condition prevents them from deciding what is in their best interests and that there is a significant risk to them or others in the absence of treatment.…”

Section: Non-acute and Maintenance Approachesmentioning

confidence: 99%

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Approaches to Medication Administration in Patients With Lack of Insight

Okobi¹,

Agazie²,

Ayisire³

et al. 2022

Cureus

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Lack of insight typically complicates psychiatric presentations, necessitating careful thought and planning to choose the best course of treatment. Exploring methods of medication administration techniques in the context of a lack of insight is crucial to achieving the ultimate goal of overcoming the insight barrier as rapidly as possible, which will result in therapeutic benefit. This study's objective was to systematically review the evidence on medication administration techniques in a backdrop of lack of insight and how that evidence was curated in the scientific literature. This study used the literature search strategy, which entails retrieving and analyzing the existing scientific literature pertinent to medication administration techniques for individuals with no insight between 2010 and 2022. Accessing online databases, such as PubMed, Google Scholar, and Medline was utilized in this study's literature search strategy. In our findings, in the primary evidence search, no randomized control trial (RCT) comparing the various models of medication administration with a lack of insight was found. No study provided data on the superiority of utility, quality of life, or efficacy outcome. Some 17 scientific papers were identified that cited various trials about lack of insight and medication use and met the inclusion criteria. We concluded that it could be challenging to administer medication to patients who lack insight.Nonetheless, progress has been made to mitigate this obstacle. Common moral values, common sense, medicolegal support, person-centered integrated care, and cutting-edge medication techniques may play a role. However, these models of medication administration are still evolving, along with the ethical concerns accompanying them. Hopefully, the available models discussed in this analysis will serve as a foundation for future developments. Nonetheless, much remains to be done. We encourage contemporary research to investigate safer and more dynamic methods that can alleviate this condition.

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Section: Emergency Approaches To Medication Administration In Patient...mentioning

confidence: 99%

Section: Non-acute and Maintenance Approachesmentioning

confidence: 99%

Approaches to Medication Administration in Patients With Lack of Insight

Okobi¹,

Agazie²,

Ayisire³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…Is it ethical to ask the patient to tell over and over the painful story? Ethical issues in emergency psychiatry have been enumerated 66,67 . Nevertheless, emergencies may be different when mental health services are provided through internet-based systems.…”

Section: Responses To Emergenciesmentioning

confidence: 99%

Ethical controversies in mental health services delivered through videoconference platforms

Maldonado-Castellanos¹

2021

BUP

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Mental health disorders represent a burden to people including poorer well-being. Telehealth is one among various potential options to handle mental health needs when barriers to care are present. Scholars constantly reflect upon the appropriateness or the unsuitableness of modern technology in telehealth. The aim of this work is to identify and describe some ethical controversies in telehealth for mental health services in five specific areas. The main discussed questions were grouped in the following categories: confidentiality and privacy, informed consent, identity verification, data protection and responses to emergencies. Different questions were identified to stimulate ethical debates among mental health professionals and patients regarding the impact of the use of videoconferencing technologies when providing psychotherapy. This discussion may yield insights to solve these ethical quandaries.

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“…Several ethical considerations have been raised to promote forced medication of the agitated psychiatric patient in an emergency situation, including "goal of restoration of autonomy, reduced risk of harm, and treatment of the underlying condition" (12). Furthermore, the protection of staff in an ever-increasingly dangerous workplace (27) to ensure the continued staffing of emergency rooms for all patients is a legitimate public interest.…”

Section: Emergent Treatment Outside Of the Psychiatric Inpatient Unitmentioning

confidence: 99%

“…(11), when the eminent Justice Cordoza wrote: "Every human being of adult years and sound mind has a right to determine what shall be done with his own body." The process by which we honor this patient autonomy is known as informed consent, wherein the physician explains the procedure, risks and benefits of either accepting or refusing, and then allows the patient to choose whether to proceed (12). The key part of the Schoendorff ruling is that the patient must be of a sound mind, for which the legal term is competence.…”

Section: Introductionmentioning

confidence: 99%

Implied Consent in Treating Psychiatric Emergencies

Becker¹,

Forman²

2020

Front. Psychiatry

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Keywords: involuntary treatment, involuntary commitment, psychiatry and the law, patient autonomy, psychiatric policy A significant percentage of psychiatric emergencies occur outside the psychiatric inpatient unit (1), such as in emergency rooms, outpatient clinics, and on medical floors. The existing literature on the legal, ethical, and practical considerations of compulsory treatment in psychiatric emergency is limited. The purpose of this article is to review the relevant legal and ethical background of treatment over objection in the United States of America, define the term "psychiatric emergency, " examine the legal and ethical bases for physicians to act in these situations, and suggest further areas for thought and research. It is our hope that the legal underpinnings of involuntary treatment in the United States, as well as consideration of the relevant ethical issues, will allow lawmakers and providers to create the ideal framework for involuntary treatment outside of inpatient units, wherever they live.

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Ethical Issues in Emergency Psychiatry

Cited by 13 publications

References 39 publications

Approaches to Medication Administration in Patients With Lack of Insight

Approaches to Medication Administration in Patients With Lack of Insight

Ethical controversies in mental health services delivered through videoconference platforms

Implied Consent in Treating Psychiatric Emergencies

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