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Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
Legal & ethical issue in psychiatry by suresh aadi8888
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Legal & ethical issue in psychiatry by suresh aadi8888

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  • PSYCHIATRIC HOSPITALS AND PSYCHIATRIC NURSING HOMES   5. (1) The Central Government may, in any part of India, or the State Government may, within the limits of its jurisdiction, establish or maintain psychiatric hospitals or psychiatric nursing homes for the admission, treatment and care of mentally ill persons at such places as it things fit; and separate psychiatric hospitals and psychiatric nursing homes may be established or maintained for :- [Establishment or maintenance of psychiatric hospitals and psychiatric nursing homes]            (a) those who are under the age of sixteen years;            (b) those who are addicted to alcohol or other drugs which lead to behavioral changes in a person;            (c) those who have been convicted of any offence; and            (d) those belonging to such other class or category of persons as may be prescribed. (2) Where a psychiatric hospital or psychiatric nursing home is established or maintained by the Central Government, any reference in this Act to the State Government shall, in relation to such hospital or nursing home, be constructed as a reference to the Central Government.   6. (1) On and after the commencement of this Act, no person shall establish or maintain a psychiatric hospital or psychiatric nursing home unless he holds a valid license granted to him under this Act: [Establishment or maintenance of psychiatric hospitals or psychiatric nursing homes only with license.]   Provided that a psychiatric hospital or psychiatric nursing home (whether called asylum or by any other name) licensed by the Central Government or any State Government and maintained as such immediately before the commencement of this Act may continue to be maintained, and shall be deemed to be a licensed psychiatric hospital or licensed psychiatric nursing home, as the case may be, under this Act:- (a) for a period of three months from such commencement, or (b) if an application made in accordance with section 7 for a license is pending on the expiry of the period specified in clause (a), till the disposal of such application. (2) Nothing contained in sub-section (1) shall apply to a psychiatric hospital or psychiatric nursing home established or maintained by the Central Government or a State Government. 7. (1) Every person, who holds at the commencement of this Act, a valid license authorising that person to establish or maintain any psychiatric hospital or psychiatric nursing home, shall, if the said person intends to establish or continue the maintenance of such hospital or nursing home after the expiry of the period referred to in clause (a) of the proviso to sub-section (1) of section 6, make, at least one month before the expiry of such period, an application to the licensing authority for the grant of a fresh license for the establishment or maintenance of such hospital or nursing home, as the case may be[Application for license.]   (2) A person, who intends to establish or maintain, after the commencement of this Act, a psychiatric hospital or psychiatric nursing home shall, unless the said person already holds a valid license, make an application to the licensing authority for the grant of a license. (3)   Every application under sub-section (1) or sub-section (2) shall be in such form and be accompanied by such fee as may be prescribed.   8. On receipt of an application under section 7, the licensing authority shall make such inquiries as it may deem fit and where it is satisfied that – [Grant or refusal of license.]   (a) the establishment or maintenance of the psychiatric hospital or psychiatric nursing home or the continuance of the maintenance of any such hospital or nursing home established before the commencement of this Act is necessary; (b) the applicant is in a position to provide the minimum facilities prescribed for the admission, treatment and care of mentally ill persons; and (c) the psychiatric hospital or psychiatric nursing home, will be under the charge of a medical officer who is a psychiatrist, it shall grant a license to the applicant in the prescribed form, and where it is not so satisfied, the licensing authority shall, by order, refuse to grant the license applied for: Provided that, before making any order refusing to grant a license, the licensing authority shall give to the applicant a reasonable opportunity of being heard and every order of refusal to grant a license shall set out therein the reasons for such refusal and such reasons shall be communicated to the applicant in such manner as may be prescribed   9. (1) A license shall not be transferable or heritable [Duration and renewal of license] (2) Where a licensee is unable to function as such for any reason or where a licensee dies, the licensee or, as the case may be, the legal representative of such licensee shall forthwith report the matter in the prescribed manner to the licensing authority and notwithstanding anything contained in sub-section (1), the psychiatric hospital or psychiatric nursing home concerned may continue to be maintained and shall be deemed to be licensed psychiatric hospital or licensed nursing home, as the case may be:- (a) for a period of three months from the date of such report or in the case of the death of the licensee from the date of his death, or (b) if an application made in accordance with sub-section (3) for a license is pending on the expiry of the period specified in clause (a), till the disposal of such application. (3) The legal representative of the licensee referred to in sub-section (2), shall, if he intends to continue the maintenance of the psychiatric hospital or psychiatric nursing home after the expiry of the period referred to in sub-section (2), make, at least one month before the expiry of such Page 303period, an application to the licensing authority for the grant of a fresh license for the maintenance of such hospital or nursing home, as the case may be, and the provisions of section 8 shall apply in relation to such application as they apply in relation to an application made under section 7. (4) Every licence shall, unless revoked earlier under section 11, be valid for a period of five years from the date on which it is granted. (5) A licence may be renewed, from time to time, on an application made in that behalf to the licensing authority, in such form and accompanied by such fee, as may be prescribed, and every such application shall be made not less than one year before the date on which the period of validity of the license is due to expire: Provided that the renewal of a licensee shall not be refused unless the licensing authority is satisfied that – (i) the licensee is not in a position to provide in a psychiatric hospital or psychiatric nursing home, the minimum facilities prescribed for the admission, treatment and care therein of mentally ill persons; or (ii) the licensee is not in a position to provide a medical officer who is a psychiatrist to take charge of the psychiatric hospital or psychiatric nursing home; or (iii) the licensee has contravened any of the provisions of this Act or any rule made thereunder.   10. Every psychiatric hospital or psychiatric nursing home shall be maintained in such manner and subject to such condition as may be prescribed. [Psychiatric hospital and psychiatric nursing home to be maintained in accordance with prescribed conditions]   11. (1) The licensing authority may, without prejudice to any other penalty that may be imposed on the licence, by order in writing, revoke the license if it is satisfied that [Revocation of license] (a) the psychiatric hospital or psychiatric nursing home is not being maintained by the licensee in accordance with the provisions of this Act or the rules made there under; or (b) the maintenance of the psychiatric hospital or psychiatric nursing home is being carried on in a manner detrimental to the moral, mental or physical well-being of the inpatients thereof; Provided that no such order shall be made except after giving the licensee a reasonable opportunity of being heard, and every such order shall be set out therein the grounds for the revocation of the license and such grounds shall be communicated to the licensee in such manner as may be prescribed. (2) Every order made under sub-section(1) shall contain a direction that the inpatients of the psychiatric hospital or psychiatric nursing home shall be transferred to such other psychiatric hospital or psychiatric nursing home as may be specified in that order and it shall also contain such provisions (including provisions by way of directions) as to the care and custody of such inpatients pending such transfer. (3) Every order made under sub-section (1) shall take effect:- Page 304(a) where no appeal has been preferred against such order under section 12, immediately on the expiry of the period prescribed for such appeal; and (b) where such appeal has been preferred and the same has been dismissed, from the date of the order of such dismissal.
  • A mentally ill may be admitted as inpatienton a request by friends or relatives. Such requestshould be supported by medical certificates to theeffect. In such cases medical officer in-charge mayadmit the patient if he thinks necessary. Requestfor admission may also be made by a police officerif such mentally ill person is dangerous to himselfor others. Such persons will be discharged bymagistrate on request by friends/relatives or afterthey are certified to be sane by the board of experts.“Reception order” from magistrate
  • INSPECTION   37. (1) The State Government or the Central Government, as the case may be, shall appoint for every psychiatric hospital and every psychiatric nursing home, not less than five Visitors, of whom at least one shall be a medical officer, preferably a psychiatric and two social works. (2)   The head of the Medical Services of the State or his nominee preferably a psychiatrist shall be an ex officio Visitor of all the psychiatric hospitals and psychiatric nursing homes in the State. (3)   The qualifications of persons to be appointed as Visitors under sub-section (1) and the terms and conditions of their appointment shall be such as may be prescribed. [Appointment of Visitors]   38. Not less than three Visitors shall, at least once in every month, make a joint inspection of every part of the psychiatric hospital or psychiatric nursing home in respect of which they have been appointed and examine every minor admitted as a voluntary patient under section 17 and, as far as circumstances will permit, every other mentally ill person admitted therein and the order for the admission of, and the medical certificates relating to, every mentally ill person admitted subsequent to the joint inspection immediately preceding, and shall enter in a book kept for that purpose such remarks as they deem appropriate in regard to the management and condition of such hospital or nursing home and of the inpatients thereof : [Monthly inspection by Visitors] Provided that the Visitors shall not be entitled to inspect any personal records of an inpatient which in the opinion of the medical officer-in-charge are confidential in nature:   Provided further that if any of the Visitors does not participate in the joint inspection of the psychiatric hospital or psychiatric nursing home in respect of which he was appointed a Visitor for three consecutive months, he shall cease to hold office as such Visitor.  
  • 50. (1) Where an alleged mentally ill person is possessed of property, an application for holding an inquisition into the mental condition of such person may be made either – [Application for judicial inquisition] (a)  By any of his relatives, or (b)  By a public curator appointed under the Indian succession Act, 1925 or [39 of 1925] (c) By the advocate – general of the state in which the alleged mentally ill person resides, or (d)  Where the property of the alleged mentally ill person comprises land or interest in land, or where the property or part thereof is of such a nature as can lawfully be entrusted for management to a court of wards established under any law for the time being in force in this state, by the Collector of the District in which such land is situate,   to the District Court within the local limits of whose jurisdiction the alleged mentally ill person resides. (2) on receipt of an application under sub-section (1), the District Court shall, by personal service or by such other mode of service as it may deem fit, serve a notice on the alleged mentally ill person to attend at such place and such time as may be specified in the notice or shall, in like manner, serve a notice on the person having the custody of the alleged mentally ill person to produce such person at the said place and at the said time, for being examined by the District Court or by any other person whom the District Court may call for a report concerning the mentally ill person:
  • The cost of maintenance of a mentally ill person detained as an inpatient in any psychiatric hospital or psychiatric nursing home shall, unless otherwise provided for by any law for the time being in force, be borne by the Government of the State wherein the authority which passed the order in relation to the mentally ill person is subordinate, if - [Cost of maintenance to be borne by Government in certain cases]   (a)   that authority which made the order has not taken an undertaking from any person to hear the cost of maintenance of such mentally ill person, and (a) (b) (b)   no provision for bearing the cost of maintenance of such a District Court under this Chapter
  • 82. (1) Any person who establishes or maintains a psychiatric hospital or psychiatric nursing home in contravention of the provisions of Chapter III shall, on conviction, be punishable with imprisonment for a term which may extend to three months, or with fine which may extend to two hundred rupees, or with both, and in case of a second or subsequent offence, with imprisonment for a term which may extend to six months, or with fine which may extend to one thousand rupees, or with both. [Penalty for establishment or maintenance of psychiatric hospital or psychaitric nursing home in contravention of Chapter III]   (2)   Whoever, after conviction under sub-section (1), continues to maintain a psychiatric hospital or psychiatric nursing home in contravention of the provisions of Chapter III Shall, on conviction, be punishable with fine which may extend to one hundred rupees, for every day after the first day during which the contravention is continued.   83.        Any person who receives or detains or keeps a mentally ill person in a psychiatric hospital or psychiatric nursing home otherwise than in accordance with the provisions of this Act, shall, on conviction, be punishable with imprisonment for a term which may extend to two years or with fine which may extend to one thousand rupees, or with both. [Penalty for improper reception of mentally ill person] 84.              Any manager appointed under this Act to manage the property of a mentally ill person, who contravenes the provisions of section 60 or sub-section (2) of section 69, shall, on conviction, be punishable with fine which may extend to two thousand rupees and may be detained in a civil prison till he complies with the said provisions. [Penalty for contravention of sections 60 and 69]   85.              Any person who contravenes any of the provisions of this Act or of any rule of regulation made thereunder, for the contravention of which no penalty is expressly provided, in this Act, shall, on conviction, be punishable with imprisonment for a term which may extend to six months, or with fine which may extend to five hundred rupees, or with both. [General provision for punishment of other offence]   86. (1) Where an offence under this Act has been committed by a company, every person who, at the time the offence was committed, was in charge of, and was responsible to, the company for the conduct of the business of the company, as well as the company, shall be deemed to be guilty of the offence and shall be liable to be proceeded against and punished accordingly: [Offences by companies]Page 332  Provided that nothing contained in this sub-section shall render any such person liable to any punishments, if he proves that the offence was committed without his knowledge or that he had exercised all due diligence to prevent the commission of such offence. (2) Notwithstanding anything contained in sub-section (1), where an offence under this Act has been committed by a company and it is proved that the offence has been committed with the consent or connivance of, or is attributable to any neglect on the part of, any director, manager, secretary or other officer of the company, such director, manager, secretary or other officer shall also be deemed to be guilty of that offence and shall be liable to be proceeded against and punished accordingly.   Explanation – For the purposes of this section, - (a)  “company” means a body corporate and includes a firm or other association of individuals; and b)    “director”, in relation to a firm, means a partner in the firm.
  • 88. The provisions of Chapter XXXIII of the Code of Criminal Procedure, 1973, as far as may be, apply to bonds taken under this Act. [Provision as to bonds] 2 of 1974   89. The medical officer in charge of a psychiatric hospital or psychiatric nursing home shall, as soon as may be, after any mentally ill person detained therein has been discharged make a report in respect of his mental and physical condition to the authority under whose orders such person had been so detained. [Report by medical officer]   90. (1) Where any sum is payable in respect of pay, pension, gratuity or any allowance to any person by any Government and the person to whom the sum is payable is certified by a Magistrate under this Act to be a mentally ill person, the officer under whose authority such sum would be payable, may pay to the person having charge of the mentally ill person to much of the said sum, as he thinks fit, having regard to the cost of maintenance of such person and may pay to such members of the family of the mentally ill person as are dependent on him for maintenance, the surplus, if any, or such part thereof, as he thinks fit, having regard to the cost of maintenance of such members. (2) Where there is any further surplus amount available out of the funds specified in sub-section (1) after making payments as provided in that sub-section, the Government shall hold the same to be dealt with as follows, namely:- (a)       where the mentally ill person is certified to have ceased to be mentally ill by the District Court within the local limits of whose jurisdiction such person resides or is kept or detained, the whole of the surplus amount shall be paid to that person; (b)         where the mentally ill person dies before payment, the whole of the surplus amount shall be paid over to those of his heirs who are legally entitled to receive the same; (c)       Where the mentally ill person comes during his mental illness without leaving nay person legally entitled to succeed to his estate. The whole of the surplus amount shall, with the prior permission of the District Court, be utilized for such charitable purpose as may be approved by the District Court. (3) The Central Government or the State Government, as the case may be, shall be discharged of all liability in respect of any amounts paid in accordance with this section. 91. (1) Where a mentally ill person is not represented by a legal practitioner in any proceeding under this Act before a District Court or a Magistrate and it appears to the District Court or Magistrate Page 334that such person has not sufficient means to engage a legal practitioner, the District Court or Magistrate shall assign a legal practitioner to represent him at the expense of the State. [Legal aid to mentally ill person at State expense in certain cases]   (2)       Where a mentally ill person having sufficient means to engage a legal practitioner is not represented by a legal practitioner in any proceeding under this Act before a District Court or a Magistrate and it appears to the District Court or Magistrate, having regard to all the circumstances of the case, that such person ought to be represented by a legal practitioner, the District Court or Magistrate may assign a legal practitioner to represent him and direct the State to bear the expenses with respect thereto and recover the same from out of the property of such person. (3)       The High Curt may, with the previous approval of the State Government, make rules providing for – (a)    the mode of selecting legal practitioners for the purpose of subsections (1) and (2) (b)   the facilities to be allowed to such legal practitioners, (c)    the fees payable to such legal practitioners by the Government and generally for carrying out the purpose of sub-sections (1) and (2) Explanation - In this section “legal practitioner” shall have the meaning assigned to it in clause (i) of section 2 of the Advocates Act, 1961. [25 of 1961]   92. (1) No suit, prosecution or other legal proceeding shall lie against any person for anything which is in good faith done or intended to be done in pursuance of this act or any rules, regulations or orders made thereunder. [Protection of action taken in good faith]   (2)   No suit or other legal proceeding shall lie against the Government for any damage caused or likely to be caused for anything which is in good faith done or intended to be done in pursuance of this Act or any rules, regulations or orders made thereunder.   93. (1) Any references in this Act to a law which is not in force in any area shall, in relation to that area, be construed as a reference to the corresponding law, if any, in force in that area. [Construction of refrence to certain laws, etc]   (2) Any reference in this Act to any officer or authority shall, in relation to any area in which there is no officer or authority with the same designation, be constructed as a reference to such officer or authority as may be specified by the General Government by notification.   94. (1) The Central Government may, by notification, make rules providing for the qualifications of Page 335persons who may be appointed as Mental Health Authority under section 3 and the terms and conditions subject to which they may be appointed under that section and all other matters relating to such authority. [Power of Central Government and State Government to make rules] (2)  Subject to the provisions of sub-section (1), the State Government, with the previous approval of the Central Government may, by notification, make rules for carrying out the provisions of this Act: Provided that the first rules shall be made by the Central Government by notification. (3)        In particular, and without prejudice to the generality of the foregoing power, rules made under sub-section (2) may provide for all or any of the following maters, namely:- (a)    the qualifications of persons who may be appointed as Mental Health Authority and the terms and conditions subject to which they may be appointed under section 4 and all other maters relating to such authority. (b)   The class or category of persons for whom separate psychiatric hospitals and psychiatric nursing homes may be established and maintained under clause (d) of subsection (1) of section 5; (c)    The form in which – (i)      an application may be made for grant or, renewal of a license and the fee payable in respect thereof under section 7 or, as the case may be, section 9; (ii) a license may be granted for the establishment or maintenance of a psychiatric hospital or a psychiatric nursing home under section 8; (iii)               an application may be made for a reception order under section 20;   (d) the manner in which an order refusing in grant, or revoking a license shall be communicated under section 8 or, as the case may be section 11; (e) the manner in which a report may be made to the licensing authority under sub-section (2) of section 9; (f) the minimum facilities referred to in the provisio to sub-section (5) of section 9 including – (i)    psychiatrist – patient ratio; (ii)  other medical or para-medical staff (i) (iii)    space requirement; (iv)  treatment facilities; and (v)    equipment; Page 336(g) the manner in which and the conditions subject to which a psychiatric hospital or psychiatric nursing home shall be maintained under section 10; (h) the form and manner in which and the period within which an appeal against any order refusing to grant or renew a license of revoking a license shall be preferred the fee payable in respect thereof under section 12; (i) the manner in which records shall be maintained under sub-section (1) o section 13. (j) The facilities to be provided under section 14 for the treatment of a mentally ill person as an outpatient. (k) the manner in which application for a reception order shall be signed and verified under sub-section (5) of section 20; (l)   the qualifications of persons who may be appointed as Visitors and the terms and conditions on which they may be appointed under section 37 and their functions; (m)   prevention of vexatious or defamatory communications and other matters referred to in sub-section (3) of section 81; (n)     any other matter which is required to be, or may be, prescribed.   95. (1) Every rule made by the Central Government under this Act shall be laid, as soon as may be after it is made, before each House of Parliament, while it is in session, for a total period of thirty days which may be comprised in one session or in two or more successive sessions, and if, before the expiry of the session immediately following the session or the successive sessions aforesaid, both Houses agree in making any modification in the rule or both Houses agree that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be; so however, that any such modification or annulment shall be without prejudice to the validity of anything previously done under that rule. [Rules made by Central Government or the State Government to be laid before the Legislatures] (2) Every rule made by the State Government under this Act shall be laid, as soon as may be after it is made, before the State Legislature.   96. The provisions of this Act shall have effect notwithstanding anything inconsistent therewith contained in any other law for the time being in force and to the extent of such inconsistency that other law shall be deemed to have no effect. [Effect of Action other law]   97. If any difficulty arises in giving effect to the provisions of this Act in any State, the State Government may by order, do anything not inconsistent with such provisions which appears to be necessary or Page 337expedient for the purpose of removing the difficulty. [Power in remove difficulty]     Provided that no other shall be made under this section in relation to any State after the expiry of two years from the date on which this Act comes into force in that State.
  • Transcript

    1. Presented by:Mr. Suresh Kumar Sharma RN, ACCN, MSN PSYCHIATRY Legal issues in Psychiatric Nursing.
    2. Psychiatry and the law Relationship between Psychiatry and the Law reflects a tension between individual rights and social needs.
    3. Ethical considerations for Psychiatric Nurses Ethical dilemmas “What is the right thing to do?” When is it appropriate for society to regulate personal behavior?
    4. Ethical Considerations Sensitivity to patient’s rights and needs. The element of power Skilled clinician versus”keeper of the keys” Paternalistic attitude: deciding what is best for another person, without considering the person’s thoughts, feelings, or preferences.
    5. Mental Health and the Legal System: An Overview  Mental Health and the Legal System   Guided by ethical principles and state and federal laws Shifting Perspectives on Mental Health Law    Liberal era (1960 to 1980) – Rights of persons with mental illness dominated Neoconservative era (1980 to present) – Emphasized limiting rights of mentally ill The Issues  The nature of civil vs. criminal commitment  Balancing ethical considerations vs. legal considerations  The role of psychiatrist in legal matters  Rights of patients and research subjects
    6. Sources of Laws
    7. Constitutional Law Statutory law or Legislative Law Sources of Law Administrative Agencies Court Decisions
    8. HISTORY Indian Lunacy asylum Act, Act 36 of1858 Indian Lunacy Act, Act 4 of 1912 1946- Bhore Commitee 1947- Indian Psychiatry Society 1949- adhoc Committee 1978- MHA Introduced in Loksabha 1981- MHA Re-introduced in Loksabha MHA Passed rajyasabha (1986), Loksabha (1987) 1993- MHA Act came into effect NATIONAL MENTAL HEALTH CARE ACT, 2010 (DRAFT)
    9. Definition of the act "An act to consolidate and amend the law relating to the treatment and care of mentally ill persons, to make better provision with respect to their property and affairs and for matters connected there with or incidental thereto."
    10. THE INDIAN LUNACY ACT 1912
    11. introduction Derived from English lunacy act, 1890 it replaced act 36 of the indian lunatic asylum act, 1858 OBJECTIVES:Govern reception Detention lunatics Care of lunatics & their property Consolidate & Amend the law relating to lunacy Opening of many new asylums Improving the general condition of asylums awareness regarding the prevailing of lunatics in such asylums
    12. . 4 parts 8chapters 100 sections CHAPTER 1:preliminary information and definitions CHAPTER 2:Admission in mental hospital
    13. ILA,1912 CONTD… CHAPTER 3:Administering care, treatment & discharge. TERM:Parole:permission given to patients to perform certain rituals or attend certain family function Acc.. Can leave any time from hospital Can be brought back forcefully within a max period of 90 days.
    14. CHAPTER 4:Proceedings of lunacy in presidency town . CHAPTER 5:Proceedings of lunacy outside presidency town CHAPTER 6:Establishment of asylums. CHAPTER 7:Expenses of lunatics CHAPTER 8:Rules to be imposed by the state govt regarding care of lunatics
    15. Mental health Act 1987 .
    16. INTRODUCTION Protecting the rights Accessible and effective mental health services Legal framework To overcome stigma Standards for high quality medical care Protect civil, political, social and economic rights Right of access to education, employment and social security
    17. HISTORY 1978- Introduced in Loksabha 1981- Re-introduced in Loksabha Passed rajyasabha (1986), Loksabha (1987) 1993-Act came into effect
    18. Objectives of the act 1. To establish central and state authorities for licensing and supervising the psychiatric hospitals. 2. To establish such psychiatric hospitals and nursing homes. 3. To provide a check on working of these hospitals. 4. To provide for the custody of mentally ill persons who are unable to look after themselves and are dangerous for themselves and or, others.
    19. 5. To protect the society from dangerous manifestations of mentally ill. 6. To regulate procedure of admission and discharge of mentally ill persons to the psychiatric hospitals or nursing homes either on voluntary basis or on request. 7. To safeguard the rights of these detained individuals.
    20. 8. To protect citizens from being detained unnecessarily. 9. To provide for the maintenance charges of mentally ill persons undergoing treatment in such hospitals. 10. To provide legal aid to poor mentally ill criminals at state expenses 11. To change offensive terminologies of Indian Lunacy act to new soother ones.
    21. Facts: At the time of conception of law, 1.private psychiatry was still in infancy 2.growth and development of private psychiatry was not foreseen The field of psychiatry itself has grown
    22. Terminologies used in the act New term Psychiatric hospital / Nursing home Mentally ill person Mentally ill prisoner Outdated terms Asylum Lunatic Criminal lunatic
    23. Salient features of the act Mental health act is divided into 10 chapters consisting of 98 sections.
    24. CHAPTER I “Medical Officer” a gazetted medical officer in the service of Government and includes a medical practitioner declared, by a general or special order of the State Government, to be a medical officer for the purpose of this Act. “mentally ill person” a person who is in need of treatment by reason of any mental disorder other than mental retardation “psychiatrist” a medical practitioner possessing a post-graduate degree or diploma in psychiatry, recognized by the Medical Council of India, constituted under the Indian Medical Council Act, 1956,
    25. “Psychiatric hospital" or “Psychiatric nursing home" for the treatment and care of mentally ill persons and which provides also for psychiatric services; “ Reception order" an order made under the provision of this Act for the admission and detention of a mentally ill person in a psychiatric Hospital or psychiatric nursing home
    26. Chapter I: (criticism ):) 1.Medical officer: “ A registered medical practitioner.” - Ayurvedic or homeopathic medical officer ? 2. Mentally ill person: “person who is in need of treatment by reason of any mental disorder other than mental retardation” -not specify the types of mental illness to be included -Mentally retarded subjects have been excluded.
    27. Chapter I: 3. Licensed psychiatric hospital or licensed psychiatric nursing home: “ means a psychiatric hospital or psychiatric nursing home as the case may be licensed, or deemed to be licensed, under the Act” -discriminatory, uniform policy should be adopted.
    28. CHAPTER II Central Authority For Mental Health Services The Central Government shall establish an authority for mental health It shall be in charge of regulation, development, direction and co-ordination with respect to Mental Health Services under the Central Government. Supervise the psychiatric hospitals and psychiatric nursing homes and other Mental Health Service Agencies (including places in which mentally ill persons may be kept or detained) under the control of the Central Government. Advise the Central Government on all matters relating to mental health State Authority for Mental Health Services in States/UTs
    29. CHAPTER III It lays down the guidelines for establishment and maintenance of psychiatric hospitals and nursing homes. There is a provision for licensing authorities to process applications for license and their renewal. Criticism: 1. No mention is made of incorporating General hospitals 2. Licensing process should be made simpler. 3. No Provision for checking & working of licensing authorities
    30. CHAPTER IV It deals with the procedures of admission and detention of mentally ill in psychiatric hospitals 1.Reception order with petition 2.Reception order without petition 3.Voluntary admission criticism:Temporary treatment order Emergency addmission set criteria and procedure for involuntary admission
    31. CHAPTER V It deals with the inspection, discharge, leaves of absence and Removal of mentally ill persons. Criticism: 1.No provisions are made for after discharge care and rehabilitation, of patients. 2.Much stress is laid on hospital admission and treatment 3.No provisions are made for home treatment.
    32. CHAPTER VI It deals with the judicial inquisition regarding alleged mentally ill persons possessing property and its management. Criticism: control one's inherited assets requires the opinion of a medical professional
    33. CHAPTER VII It deals with the maintenance of mentally ill persons in a psychiatric hospital or psychiatric nursing homes Criticism: No provision for patients with no estate and no relative, the state should be made responsible for such patients.
    34. CHAPTER VIII PROTECTION OF HUMAN RIGHTS OF MENTALLY ILL PERSONS 1) No mentally ill person shall be subjected during treatment to any indignity (whether physical or mental) or cruelty. (2) No mentally ill person under treatment shall be used for purposes of research, unless(i) such research is of direct benefit to him for purposes of diagnosis or treatment; or (ii) such person, being a voluntary patient, has given his consent in writing or where such person (whether or not a voluntary patient) is incompetent by reason of minority or otherwise, to give valid consent, the guardian or other person competent to give consent on his behalf, has given his consent in writing for such research.
    35. Criticism: - Once a person is admitted to mental hospital he is termed insane or mad informed consent for experimental treatment
    36. CHAPTER IX It deals with the penalties and procedures for infringement of guidelines of the act.
    37. CHAPTER X It deals with miscellaneous matters not covered in other chapters of the act.
    38. MHA-87;Focus on treatment and care of Patients Establishment or maintenance of psychiatric hospitals or psychiatric nursing homes only with license Psychiatric hospital and psychiatric nursing home to be maintained in accordance with prescribed conditions Inspection of psychiatric hospitals and psychiatric nursing homes and visiting of patients Admission And Detention In Psychiatric Hospital Or Psychiatric Nursing Home
    39. Summary-MHA 87 An Act to regulate and set standard for restrictive psychiatric treatment facilities To establish procedure for Guardianship for mentally ill who need it To protect Human Rights of mentally ill To set up authorities for development , regulation and coordination of mental health services
    40. Suggestions for improvement of the act 1. Provisions for educating society about mental illness and treating it at par with physical illness should be incorporated. 2. Licensing process should be made simpler. 3. Provision should be there for checking the working of licensing authorities and powers vested in them to be limited. 4. Licensing authorities should appoint a doctor preferably a psychiatrist as inspecting officer.
    41. 5. Private Doctors and general nursing homes should be allowed to treat such patients at par with recognized centres. This will help in reducing the workload on the system and will provide much better health care to the patients. This provision can be withdrawn later, once there are adequate recognized hospitals with adequate staff. 6. To regulate procedure of admission and discharge of mentally ill persons to the psychiatric hospitals or nursing homes either on voluntary basis or on request
    42. 7. Adequate provisions to be provided for long term treatment and expenses on treatment. If this is not possible, then community mental health centres should be opened to provide such care. 8. Provisions for rehabilitation centres are to be incorporated. Efforts should be there for post discharge care and rehabilitation. 9. Strict provisions should be there for punishing the individuals requesting unnecessary detention and exploitation of mentally ill.
    43. 10. Stress should be on treatment of illness rather than the ill 11. Treatment should be based on concept of socialization and not on hospitalization.
    44. NATIONAL MENTAL HEALTH CARE ACT, 2010 (DRAFT) Chapter I: Preliminary (sec 1-6) Chapter II : Rights of Persons with Mental Illness (sec 7-16) Chapter III Duties of Government (sec 17-20) Chapter IV Mental Health Review Commission (sec 21-31) Chapter V State Mental Health Authority (sec 32-38)
    45. Chapter VI Mental Health Facilities (sec 39-41) Chapter VII : Admission, Treatment and Discharge (sec42-55) Chapter VIII : Responsibilities of Other Agencies(sec 56-60) Chapter IX : Penalties and Miscellaneous provisions (sec 61-67)
    46. Basic Rights of Psychiatric Patients and Nurse's Responsibilities
    47. . . Patients’ Rights (AHA) Patient’s Bill of Rights
    48. As a person receiving mental health services, you have the right to: Be treated with dignity and respect. Choose the services or programs in which you participate based upon information about rules, treatment procedures, costs, risks, rights and responsibilities. Ask questions and get answers about services. Participate fully in all decisions about treatment or services.
    49. Request changes in treatment or services. Receive treatment in the least restrictive setting - one that provides the most freedom appropriate to your treatment needs. Refuse treatment or service unless ordered by the Court to participate. Be informed about the rules that will result in discharge from a program if violated.
    50. Participate fully in decisions regarding your discharge from a program and receive advance notice, unless your behavior threatens the well being of another person. Be given help in obtaining another place to live prior to discharge from a residential program. Know the name of the medication you are taking, why you are taking it, and what its possible side effects might be.
    51. Refuse to take medication, if you choose. (Note: You should not discontinue taking medication suddenly without first discussing the possible dangers with a psychiatrist.) Have your family involved in your treatment. Refuse family participation in your treatment, if you choose. Not be subjected to verbal, physical, sexual, emotional or financial abuse; harsh or unfair
    52. Make complaints, have them heard, get a prompt response, and not receive any threats or mistreatments as a result. File a grievance if you are not satisfied with the response to a complaint. Be assisted by an advocate of your choice; for example, family, friend, case manager, member of a consumer advocacy committee or organization, etc. Review your record, with two exceptions. Limited portions of your records can be withheld from you if your treatment team leader has written that seeing specific information would,
    53. Visit and communicate privately with family and others, at home or in the community (unless restricted by service plan); send and receive personal mail unopened; have access to a telephone. Meet and participate with social, religious and community groups of your choice. Keep and use personal clothing and possessions as space permits, unless it infringes upon others. Exercise all civil and legal rights afforded to citizens of the United States; for
    54. Right to consent • Psychosis does not necessarily mean that a person is unable to consent to treatment and many psychotic patients are capable of giving informed consent.For patients not able to consent and for all minors, informed consent should be obtained from a substitute decision maker.
    55. Right to refuse medication • Symptoms such as delusions and denial may cause the refusal. • Nurses should judge each situation on a case-by-case basis.
    56. Right to treatment in the least restrictive setting • Maintain the greatest amount of personal freedom, autonomy, dignity, and integrity in determining treatment • Restriction includes the nature of the choices being restricted and the method by which choices are restricted.
    57. Forensic Psychiatry
    58. What is forensic psychiatry? Forensic psychiatry is a branch of medicine which focuses on the interface of law and mental health. it may include psychiatric consultation in a wide variety of legal matters :1. Crime & psychiatric disorders 2. Criminal responsibility 3. Civil responsibility 4. Law relating to psychiatric disorder 5. Admission procedures in psychiatric hospital 6. Civil rights of mentally ill 
    59. 1.Crime & psychiatric disorders Mentally ill people may commit offence because : They don’t understand the implication of their behaviour  Due to delusions & hallucinations  Abnormal mental states like confusion, excitement etc  Drug related violence
    60. 2. Criminal responsibility  Acco. Indian penal code(1860) Sec 84:-  “Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is ‘incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law’
    61. Contd… Criteria used to determine Criminal responsibility: 1. 2. 3. 4. M’NAGHTEN’S RULE THE IRRESISTIBLE IMPULSE TEST THE DURHAM TEST/PRODUCT RULE AMERICAN LAW INSTITUTE
    62. 1. M’NAGHTEN’S RULE   Individual at the time of the crime didn’t know the nature & quality of the act & if he did know what he was doing, he did not comprehend it to be wrong. These rules are referred to as the nature & quality rule & right from wrong test
    63. 2. THE IRRESISTIBLE IMPULSE TEST a person may have known an act was illegal but as a result of mental impairment lost control of their actions.
    64. 3. THE DURHAM TEST /PRODUCT RULE  an accused is not criminally responsible if his unlawful act was the product of mental disease/defect.  In this the causal connection b/w the mental abnormality and the alleged crime should be established
    65. 4. AMERICAN LAW INSTITUTE (ALI) TEST   A person is not responsible for criminal conduct if at the time of such conduct, as a result of mental disease or defects he lacks adequate capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirement of the law. Similar to M’NAGHTEN’S RULE & THE IRRESISTIBLE IMPULSE TEST.
    66. 1.Crime & psychiatric disorders 2. Criminal responsibility 3. civil responsibility of a mentally ill person.
    67. 3. civil responsibility of a mentally ill person. 1. Management of property: Application from any relative court may direct an inquiry whether a person is of unsound mind and incapable of managing his property.  Manager appointed by the court of law who may include sale or disposal of the property to settle his debts/expenses.
    68. Contd…2. MARRIAGE:    HINDU MARRIAGE ACT(1955) If one is unsound of mind at the marriage time that marriage is consider null & void in the eyes of the law. One is unsound of mind for long time(>2yrs) with RX can file for obtaining divorce. However if divorced is filed after a 3yrs period then other party has to pay maintance charges for mentally ill person
    69. Contd..3. TESTAMENTARY CAPACITY    AS per indian succession act, TESTAMENTARY CAPACITY of a mental ability of a person is precondition for making a valid will. Test for orientation, concentration & memory Delusional person can also make a valid will if those delusion are not related to the disposal of property
    70. Contd..4. RIGHT TO VOTE  Cannot contest for elections or exercise the privilege of voting.
    71. 1.Crime & psychiatric disorders 2. Criminal responsibility 3. civil responsibility of a mentally ill person. 4. law relating to psychiatric disorders
    72. 4. law relating to psychiatric disorders I. II. III. IV. V. VI. Law relating to psychiatry in India Mental health related legislations Civil laws relating to mental ill persons Civil laws relating to psychiatry Suicide and Indian law The narcotic drug & psychotropic substances act
    73. 1.Crime & psychiatric disorders 2. Criminal responsibility 3. civil responsibility of a mentally ill person. 4. law relating to psychiatric disorders 5.psychiatrists ant the court
    74. 5.psychiatrists ant the court  Can give convincing a judge that crimes were committed as a result of his mental illness.
    75. Role of the Nurse in Admission Procedure
    76. 1. Settling the patient in the ward. 2. Before assigning him a bed consider his biological and emotional needs. 3. Shown various facilities like eating, recreation, bathroom facilities. 4. Acquaint him with some of the ward rules. 5. Nurse needs to be sensitive to feelings, and give enough time and attention and allow them to express their feelings about the patient's condition, treatment and outcome.
    77. • Types of Hospital Admission
    78. Types of Hospital Admission •Voluntary •Involuntary
    79. Characteristics of Voluntary Admission • Written application by the patient • Civil rights are fully retained by the patient (right to vote, hold a driver’s license, buy and sell property, hold office, practice a profession, engage in a business. • Discharge is initiated by the patient • Justification: patient voluntarily seeks help
    80. Involuntary Admissions To retain without the right is false imprisonment Magistrate’s order – check chart to understand what’s going on for the admission 1) Evaluation/emergency care (ED) –form filled out by police/others; usually for 48 to 72 hours- gives time to assess & find illness (UTI)/mental 2) Order of protective custody (OPC)- legal papers filed in court; vary from days to weeks – 2 different drs have assessed & court decides to lock up – 7d to 14d pt must be released after the time/OPC is up.
    81. 1)Extended/indeterminate care- legal system involved; long term; may be 30-90 days 2)Magistrates warrant – legal sworn statement issued about a patient through judge, by a family member, signs document that pt is incompetent.
    82. Involuntary Hospitalization • Laws are determined by each state; • • know the laws of the state where you practice Persons detained in this way lose only the right to freedom; all other rights are intact Persons held without their consent must present an imminent danger to themselves or others
    83. Characteristics of Involuntary Admission (Commitment) • Admission did not originate with patient • Discharge is initiated by the hospital or • • • • • court Patient may retain some, none or all civil rights depending on state law. Justification: mentally ill and one or more of the following: Dangerous to self or others Need for treatment Unable to meet own basic needs
    84. The Commitment Process • Process begins with a sworn petition by a • • relative, friend, physician stating that the person is mentally ill and needs treatment. Examination of the patient’s mental status. (Some states require at least one of the physicians be a psychiatrist. Determination as to whether to hospitalize the patient or release them is made next by the physician or courts (judge or formal jury)
    85. Three Lengths of Hospital Stay • Emergency- to control an immediate threat to self or others • Short-term or Observational- to diagnose and for short-term therapy • Long-Term is for an indefinite time or until the patient is ready for discharge. Periodic reviews may be made every 3, 6, or 12 months.
    86. Role of the Nurse in Leave of absence.
    87. Relatives are clearly instructed about the purpose for which the patient is being sent home and when he should be brought back. Instruct the relatives as to how they should converse or behave with the mentally ill person according to the instructions given by the doctor. If the patient is receiving any medications, insist on regularity and give necessary instructions to the family members about dosage, side-effects, etc.
    88. Role of the Nurse in Discharge Procedure
    89. Nurse must ensure that the patient leaves the unit with all belongings and personal effects. All necessary instructions especially regarding his medication regimen, side-effects etc. must be given clearly to patient and family members. Any paper work, signing of documents should be completed. The hospital file along with all charts and notes should be sent to the medical records section. The nurse should ascertain his travel plan and offer assistance if necessary. The nurse must bear in mind that the patient may have mixed feelings about leaving the hospital and going back to his home environment.
    90. Conservatorship • Legal guardianship is separate from civil • commitment for hospitalization A hearing can be held to determine whether the person is competent. An incompetent patient cannot provide his or her own shelter, food, and clothing; cannot act in his or her own best interests; and cannot run his or her own business and financial affairs. If a patient is found incompetent, a guardian is appointed to speak for the patient.
    91. Legal responsibilitie s of Psychiatric Nurse
    92. Report pertinent information to co- workers. Accurate records. Confidentiality. Current knowledge of law. Respect rights of individual. Inform consent. Vigilant and watchful.
    93. Nurse's implications for protecting Patient's Rights. • To protect patient's rights, the nurse should be aware of these rights in the first place. • She should ensure that ward procedures and policies should not violate patient's rights. • Discussing these rights with the mental health team and including these rights in the nursing care plan is all part of her responsibility in protecting the patient's rights.
    94. Do’s • Do document all unusual incidences. • Do report all unusual incidents. • Do follow policies and procedures as established by your employing agency. • Do keep current year license to practice. • Do perform procedure that you have been taught and that are within the standard scope of your practice. • Do protect patients from injuring themselves.
    95. Don'ts • Do not remove side rails on patients bed, unless there is an order or hospital policy to do so. • Do not allow patients to leave the hospital or nursing home unless there is an order to signed release. • Do not accept money or gifts from patients. • Do not give advice that is contrary to doctors orders or nursing care plan. • Do not witness a patient’s will. • Do not take medications that belong to patients. • Do not work as a nurse, in a state in which you are not licensed.
    96. Legal Role of the Nurse • Nurse as Provider: • . • To avoid litigation, the psychiatric nurse can follow the following preventive measures:
    97. Legal Role of the Nurse • Know one’s state laws • Keep accurate and concise records • Maintain patient confidentiality • Consult a lawyer if any questions arise.
    98. Nurse as Employee • Nurses are responsible to supervise and evaluate those under their authority for the quality of care given. • They must observe their employer’s rights and responsibilities to clients and other employees, fulfill the obligations of the contracted service.
    99. Nurse As Citizen • This role forms the foundation for the nurse’s other legal relationships. • These are inherent rights that include civil rights, property rights, right to protection from harm, and right to due process.
    100. Common areas of liability in psychiatric services • • • • • • • • Sexual contact with a patient Preventing patient suicide Med errors Problems related to ECT Breach of confidentiality Failure to refer a patient Failure to obtain informed consent failure to report abuse
    101. Malpractice in Nursing • A failure in the professional duty, practice or skill that leads to the injury or harm to the client or patient.
    102. Tort Law    Torts are civil wrongs for which money damages are collected by the injured party (plaintiff) from the wrongdoer (defendant) Civil liability for nsg practice falls in the area of tort law 3 types of torts:    Intentional Quasi-intentional Unintentional
    103. Tort: A wrongful Act That Results in Injury, Loss, or Damage Have to watch what say & do – assault & battery Unintentional Torts  Negligence: harm caused by failure to do what is reasonable and prudent  Malpractice: breach of duty directly causes injury or loss to the client Intentional Torts  Assault: causes person to fear being touched in an offensive manner)  Battery: harmful or unwanted actual contact)  False imprisonment: unjustifiable detention
    104. Intentional  Assault   Battery   An act resulting in a person’s apprehension of an immediate harmful or offensive touching (battery) Harmful or offensive touching False imprisonment   An act with intent to confine a person to a specific area The use of seclusion or restraint that is not defensible as being necessary or in the pt’s best interest
    105. Quasi-Intentional  Defamation is made up of 2 torts: Slander or oral communication  Libel or written communication   Breach of confidentiality
    106. Unintentional  Professional negligence   Involves harm resulting from the failure of a person to conduct himself or herself in a reasonable and prudent manner 4 items needed to prove negligence are:     Duty—measured by standard of care Breach of duty—conduct that exposes the client to an unreasonable risk of harm Proximate cause—Intervening actions or persons that were, in fact, the causes of harm to the client Damages—pain and suffering
    107. Duty to Warn Third Parties Do have the right to warn the person that is being threatened – error on the side of safety   Duty to warn a third party is an exception to client confidentiality Clinicians must warn identifiable third parties of threats made by a client • 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?
    108. . 111
    109. •ASSIGNMENT law relating to psychiatric disorders??????????? ???????????????????? ?????????

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