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Respond

to two Bianunka and Zenabou

· By sharing cultural considerations that may impact the legal or ethical issues present in their articles

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13 hours ago

· Respond to Biaunka By sharing cultural considerations that may impact the legal or ethical issues present in their articles. Remember 2 citations , two references for Biaunka.

week 2 discussion 

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Legal/ ethical considerations for adults

Respect for patients’ confidentiality and privacy are considered to be patients’ rights. Confidentiality is the primary virtue for building confidence in a psychiatrist relationship. Although the law considers confidentiality to be absolute except in legal cases, confidentiality violations are often inevitable despite attempts to protect the confidentiality, yet not generally unethical. Since 1996 the United States of America has adopted the Health Insurance Portability and Accountability Act (HIPAA); all healthcare providers should recognize HIPAA to protect patient information. The HIPAA also includes provisions for the preservation, review of records, and special techniques for preventing data abuse (Sidhu & Srinivasaraghavan, 2016).

HIPAA permit health care providers to communicate with family members of the patient, relatives, or those interested in the care of the patient; Listen to family members about their loved ones being treated for mental health; Communicate to the law enforcement authorities regarding the discharge of a patient brought to an emergency psychiatric hospital( Sidhu & Srinivasaraghavan, 2016). 

Legal/ethical Considerations for Children/Adolescents

Adolescents have the same right to confidentiality as adults. Privacy has an effect on adolescents-provider relationships, and lack of confidentiality may be a significant barrier to seeking health care. Children under the age of 18 will be challenging because we do not know their maturity to be compatible with their autonomy and decision-making abilities. Keeping their details confidential, making them accountable, and not telling their parents about their health-related concerns will be challenging (Noroozi et al., 2018).

 High-risk activity in adolescents is the primary cause of morbidity and mortality. Adolescents who seek health services and disclose their involvement in high-risk activities may have confidentiality issues. The fear of violation of confidentiality is the main reason why adolescents, particularly those at high risk, do not seek health care (Noroozi et al., 2018).

Considering the legal context, the implementation of well-established protocols and the required partnership with adolescents was important to respect confidentiality and reduce adolescents’ barriers to appeal to the health care system (Noroozi et al., 2018). 

Among patients seeking treatment, most (though not all) support the electronic exchange of medical information among providers. At the same time, these individuals wish to have power over who has access to what information. In particular, patients tend to keep control over which members of the health care team have access to their confidential medical details, including documents providing information on mental health and drug abuse.

  Clinical Practice

While HIPAA requires treatment providers to share specific types of mental health data without specific patient consent, it does not prevent providers from taking additional measures to protect the privacy and confidentiality of mental health information, such as seeking consent from patients prior to the disclosure of information to other providers or restricting mental health information (Raveesh  & Munoli, 2020). Providers should give high priority to informed consent—patients should have a clear understanding of what information in the medical records is accessible to other providers, including problem lists, medication lists, and schedules for visits to mental health providers (Raveesh  & Munoli, 2020).

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References

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018, June). Challenges of Confidentiality in Clinical Settings: Compilation of an Ethical Guideline. Iranian journal of public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077627/. Iranian Journal of Public Health, 47(6), 875-883. Retrieved from https://ezp.waldenulibrary.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fchallenges-confidentiality-clinical-settings%2Fdocview%2F2085863803%2Fse-2%3Faccountid%3D14872

Peregrin, T. (2021). Managing HIPAA Compliance Includes Legal and Ethical Considerations. Journal of the Academy of Nutrition and Dietetics, 121(2), 327–329. https://doi.org/10.1016/j.jand.2020.11.012 

Raveesh, B. N., & Munoli, R. N. (2020). Ethical and Legal Aspects of Telepsychiatry. Indian Journal of Psychological Medicine, 42(5 Suppl), 63S–69S. https://doi-org.ezp.waldenulibrary.org/10.1177/0253717620962033

Sidhu, N., & Srinivasraghavan, J. (2016). Ethics and Medical Practice: Why Psychiatry is Unique. INDIAN JOURNAL OF PSYCHIATRY, 58(6), 199–202. https://doi-org.ezp.waldenulibrary.org/10.4103/0019-5545.196838  

Challenges_of_Confidentiality_

Ethics and Medical Practice

Legal and Ethical Aspects of Mental Health Care

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2 days ago

· Respond to Zenabou By sharing cultural considerations that may impact the legal or ethical issues present in their articles. Remember 2 citations , two references for Zenabou too.

Main post – HIPAA 

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Many legal and ethical principles guide psychiatric-mental health (PMH) practice. According to Raths (2017), the Health Insurance Portability and Accountability Act (HIPAA) represents one salient ethical and the legal issue encountered by mental health professionals (MHPs). The HIPAA Rules intend to protect the privacy of individuals’ identifiable health information and to ensure that health information is available when needed for treatment and other appropriate purposes (Raths, 2017). Given the sensitive nature of information related to mental health and substance use disorders and treatment, Raths (2017) argued that HIPAA protections provide regulations regarding covered health care providers’ obligations and the circumstances in which covered providers can share information. The following discussion would relate to HIPAA regulations involving PMHNP practice for children/adolescents and adults.

HIPAA Ethical and Legal Issues in PMHNP Practice for Children/Adolescents

Legal Issues Summary

Health care confidentiality is the patient’s right. Concerning the minor clients, the international human rights community recognizes confidentiality as a component of a youth’s fundamental right to privacy (Strauss, 2016). According to Strauss (2016), HIPAA provides a minimum “floor” for confidentiality protection. As it applies to minors, Strauss (2016) argued that HIPAA would generally allow a parent to have access to medical records for children under the age of 18, with three exceptions:

1. When a minor obtains care at the direction of a court.

2. When a parent agrees that clinician and minor may have a confidential relationship.

3. And when a minor has consented to the care and the parent’s consent is not required by state or other applicable law.

Ethical Issues Summary

Confidentiality represents a concern in child and adolescent psychiatry. According to Navin and Wasserman (2017), parents/guardians commonly initiate care for their youth legitimately expect feedback from the mental health professional (MHP) to attempt improved care for their children. Ethical issues related to confidentiality in child and adolescent psychotherapy would focus on the minor patient’s and the patient’s guardian’s or parent’s right to have the client’s information kept private and confidential (Navin & Wasserman, 2017). Hence, PMHNPs should inform patients and their parents or guardians about confidentiality and any known limitations to confidentiality at each therapeutic relationship’s start to promote best practices related child or adolescent confidentiality.

Specific Implications for Practice Within Maryland

PMHNPs must be knowledgeable of their respective state laws of practice. Pathak and Chou (2019) indicated that States have variable confidentiality laws. Anyone younger than age 18 is legally a minor in Maryland (MD) (English, 2019).  Also, English (2019) identified that confidentiality in caring for the minor patient is not absolute in the state of MD. According to English (2019), mental health professionals (MHPs) must disclose confidential information for the child or adolescent health in the following situations: To comply with reporting mandates such as child abuse, infectious disease, assaults such as knife or gunshot wounds, domestic violence, and when a patient is dangerous to self or others. Additionally, Maryland (MD) laws allow married minors; pregnant minors; minor parents; and minors who live apart from their parents, with or without permission, and are self-supporting regardless of the source of their income to consent for their care; hence entitling them to confidentiality protections (English, 2019). Hence, maintaining confidentiality for minors receiving mental health services is an important aspect of legal and ethical PMHNP practice.

HIPAA Ethical and Legal Issues in PMHNP Practice for Adults

Legal Issues Summary

Health care confidentiality is every adult patient’s right. The HIPAA Privacy Rule provides federal protections for individually identifiable health information and gives patients an array of rights concerning their health information (Langjahr, 2018). Simultaneously, Langjahr (2018) indicated that the Privacy Rule permits the disclosure of health information needed for patient care and other essential purposes such as health insurance reimbursement and quality improvement activities. Finally, HIPPA protects the patients’ rights to the privacy and confidentiality of all medical information, including written, oral, electronic information, unless the client has expressly consented to it in writing (Langjahr, 2018). Hence, HIPAA legally limits access to medical records and information to only those with a need to know. Thus, PMHNPs must understand the implications of and the possible consequences for violations relating to HIPAA regulations and privacy rules for the competent adult.

Ethical Issues Summary

            Many ethical issues surround adult care in PMHNP practice. According to Kloss (2019), so long as the patient does not object, HIPAA allows the provider to share or discuss a patient’s mental health information with the patient’s family, friends, or other persons involved in their care. If the provider believes, based on professional judgment, that the patient does not have the capacity to agree or object to sharing the information at that time, and that sharing the information would be in the patient’s best interests, the provider may tell the patient’s family member (Kloss, 2019). In either case, the health care provider may share or discuss only the information that the family member involved needs to know about the patient’s care or payment for care. Finally, Kloss (2019) argued that in determining the patient’s best interests, the provider should consider the patient’s prior expressed preferences regarding disclosures of their information, if any, as well as the circumstances of the current situation.

Specific Implications for Practice Within Maryland

PMHNPs must know the adult patient’s rights to confidentiality in their respective state laws of practice to ensure safe and competent care. In Maryland, HIPAA grants an individual a qualified right of access to one’s health information, a right to seek amendment of the health information, the right to seek a modification of the health information and to receive a copy of the record (Reynolds et al., 2017). Also, Reynolds et al. (2017) indicated that HIPAA includes additional patient rights, including the right to receive an accounting of disclosures and a notice of privacy protections. Hence, PMHNPs must keep patient privacy as one of their top priorities and use best clinical judgment to share or disclose patient information appropriately.

HIPAA laws protect healthcare consumers from having their personal health information shared inappropriately. Depending on the incident, breaches in mental health practices could have significant ramifications for the child, adolescent, and adult clients. Hence, PMHNPs must know how to ensure that ethical violations to confidentiality don’t occur in the first place and what to do in case it happens. Be familiar with HIPAA regulations and their state laws could help PMHNPs prevent privacy violations and ensure safe and optimal care to their patients.

References

English, A. (2019). Adolescent & young adult health care in Maryland: A guide to understanding consent & confidentiality laws. Retrieved March 7, 2020, from https://nahic.ucsf.edu/wp-content/uploads/2019/01/Maryland-AYAH-Confidentiality-Guide_Final

Kloss, L. L. (2019). Exercising personal health information access rights: A proactive primer on enforcing health information rights and accessing personal medical data. Generations, 43(4), 38–45. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=141872998&site=eds-live&scope=site

Langjahr, A. (2018). HIPAA and sharing information related to mental health. U.S. Pharmacist, 43(11), 33–35. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edb&AN=133174803&site=eds-live&scope=site

Navin, M. C., & Wasserman, J. A. (2017). Reasons to amplify the role of parental permission in pediatric treatment. The American Journal of Bioethics : AJOB, 17(11), 6–14. https://doi-org.ezp.waldenulibrary.org/10.1080/15265161.2017.1378752

Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the U.S. health care system. Journal of patient-centered research and reviews, 6(1), 46–50. https://doi.org/10.17294/2330-0698.1656

Raths, D. (2017). Comply with patient medical record requests: Providers must confer with federal HIPAA guidance as well as state laws. Behavioral Healthcare Executive, 37(1), 48–52. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edsgea&AN=edsgcl.503295371&site=eds-live&scope=site

Reynolds, V., Metro, L., Howe, J. (2017). New Maryland law: Disclosure of directory information and medical records. Retrieved from https://www.mdhima.org/new-maryland-law-effective-october-1-2017/

Strauss, L. J. (2016). HIPAA privacy rule highlights related to minor children. Journal of Health Care Compliance, 18(2), 49–54. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=bth&AN=113733993&site=eds-live&scope=site

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