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Right To Autonomy

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by whitelady888 whitelady888 (New Member) New Member

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Is it all right if, for example, Ana, a 25 years old anorexic was forced by her parents to be confined at the hospital for weight management? Aren't they stepping on the woman's right to autonomy? and besides, she is not a minor anymore. What's the nursing ethic/law to be followed here? And if the nurse is aware that she was forced and she doesn't want to be treated anyway,what's the best thing to do?

My prof answered me already but I just want to solicit more opinions. thank you.

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piper_for_hire specializes in SRNA.

494 Posts; 3,757 Profile Views

The two areas to look into are paternalism and competency. The latter is where the law really comes into play. If you can be deemed incompetent to make your own medical decisions, then you lose that right. It seems far too easy to be considered legally incompetent.

-S

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9 Posts; 785 Profile Views

The two areas to look into are paternalism and competency. The latter is where the law really comes into play. If you can be deemed incompetent to make your own medical decisions, then you lose that right. It seems far too easy to be considered legally incompetent.---OK,so she lost her right to autonomy because she's incompetent to care for herself...right? Thanks!

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534 Posts; 5,542 Profile Views

you have to be declared incompetent legally. but in the interim I imagine she could be put on a 5150 and then converted to a 5250 for being a harm to self or gravely disabled.

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piper_for_hire specializes in SRNA.

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5150? I think that's only in California - but every state has it's own lock-em-up-for-24-hours-for-their-own-good kind of law.

-S

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534 Posts; 5,542 Profile Views

5150? I think that's only in California - but every state has it's own lock-em-up-for-24-hours-for-their-own-good kind of law.

-S

oh maybe it is just california.

for clarification:

5150 - 72 hour involuntary hold

5250 - 2 week involuntary hold

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

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Yeah, that 5150 Hold, or as piper_for_hire so colorfully put it "lock-em-up-for-their-own-good kind of law" :lol2: is a California law. And, my notebook with information on it is buried at the moment so I can't get to it, but there are specific conditions that have to be present in order to evoke it's use on someone.

The OP stated the patient "was forced by her parents to be confined at the hospital for weight management". Now, the OP is living in the Philippines so the law there may be quite different than it is here in the U.S. or another country. However, from the wording of the post it sounds to me as if the patient did agree to admission voluntarily but it was probably done more in the way of being coerced by her parents. That's more of an ethical issue, I think, rather than a legal one. Sounds more along the lines of what I would call psychological blackmail on the part of the parents. The question was "if the nurse is aware that she [the patient] was forced and she doesn't want to be treated anyway, what's the best thing to do?" I'm trying to reason this scenario out because I have to tell you guys I had similar situations come up in actual practice during my years as a working RN. So, the deed is done. The patient has been admitted and you are confronted with doctor's orders to treat her and you begin to realize she's not exactly happy about being there and you realize something might be wrong. I would talk with the patient, hear her side of the story, and verify that she really feels this way. If it is true then I would notify the patient's physician immediately. To perform any treatment or attempt to force any treatment upon a patient without their consent would be a crime (assault and battery). Now, that would be the here in the U.S. Don't know what the answer would be in the Philippines. I'm sure in some countries on this planet a person can be hauled into a hospital against their will and forced to submit to whatever treatment has been mandated for them. But, it ain't gonna happen here in the U.S.

We know that anorexics are self-destructive. However, knowing that doesn't permit us to step all over their rights for what we "think" to be their own good. As long as the patient is alert, oriented, and competent to make their own decisions, they have the right to withdraw their consent to be treated at any time. Period. End of story.

This might end up being a case of the patient going home AMA (against medical advice) or just being discharged by the doctor because of refusing medical treatment. Another possibility is that the doctor could urge the parents or the hospital, based upon his assessment of the patient's physical and mental status, to file a request with the local court for legal guardianship of the patient due to mental incompetence and then whoever has legal guardianship can give the consent for treatment even if the patient refuses. However, the patient's right to due process under the law must be followed first.

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9 Posts; 785 Profile Views

Wow...you are so good, ma'am! Thank you so much! your post definitely answered all of my questions! Now it's all clear to me. Thank you, thank you so much! Hope you won't get tired helping out nursing students/nurses all over the world! God bless!

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