Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay

Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay

Practicum Journal Entry: Analyzing an Ethical Decision
In your role as a PMHNP, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear-cut answer of how to address the issue, but your ethical decision making must be based on evidenced-based practice and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their socio-demographic and ethnic/racial background. You must be prepared to critically analyze ethical situations and develop an appropriate plan of action. For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.
Learning Objectives

Students will:
• Analyze salient ethical issues in psychiatric mental health practice
• Compare ethical dilemmas with state health laws and regulations
• Analyze ethical decision-making processes
To prepare:
• Review literature for moral/ethical issues encountered by a PMHNP.
• Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.
Write a 2-page paper in which you do the following:
• Summarize the moral/ethical issue in the article (no more than 1 paragraph).
• Describe the moral and ethical dilemmas surrounding the issue Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay.
• Analyze the ethical issue and compare them to the state health laws and regulations in your state.
• Outline the process of ethical decision making you would use to address this ethical dilemma.
Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.


Summary of the Moral/Ethical Issue

Confidentiality is key to maintaining the therapeutic relationship that exists between patients and mental health practitioners. It is for this reason that as healthcare providers, they are required to value privacy and confidentiality as a patient’s basic right by not sharing a patient’s medical data to unauthorized persons or without a client’s consent. Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay Except for legal situations, while the law considers confidentiality to be absolute, there are unavoidable yet ethical clinical scenarios where confidentiality may be breached. In mental health practice, confidentiality as an ethical principle is defined as only availing patient information to authorized persons with a patient’s informed consent.

The Ethical/Moral Dilemma Surrounding The Issue

The case scenario as presented by Jie (2015) involved a 57-year-old male patient who was diagnosed with aggressive end-stage prostate cancer. The shared with a nursing staff his attempt to commit suicide and requested the nursing staff not to share with other healthcare providers. This positioned the nursing staff in a difficult scenario where she had to decide between mutually exclusive options. The nursing staff had two morally upright choices to make: to remain silent as requested by the patient or to share the information with staff and prevent a suicide attempt. If she decides to remain silent as requested by the client, the patient’s decision will be respected. However, this decision may result to harm as the patient may commit suicide without any interventions. On the other hand, should the nursing staff share this information with other healthcare providers, through teamwork, the patient would be closely monitored to prevent suicide? However, his confidentiality and autonomy would be violated. The major ethical dilemma is if or not the nurse should share with colleague staff members on the client’s suicide attempt without his consent.

Ethical Issue In Comparison to State Health Laws And Regulations

The state health laws and regulations require all healthcare providers to focus on decisions and actions which benefit patients. This implies that healthcare professionals are only obligated to take positive actions which promote the wellbeing and health of patients. Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay Despite being required to maintain confidentiality, there are specific exceptions which are considered ethical and acceptable to breach patient confidentiality by the law (Barnhorst, Wintemute & Betz, 2018). Most of these exceptions involve circumstances which can easily result in personal harm, harm to society or another person. The HIPAA law allows healthcare providers to disclose protected health information (PHI) when it can help to either reduce or prevent an immediate threat to themselves, a family member or anyone in the public. Similarly, the state law requires that confidentiality can be broken and mandatory reporting done in cases that involve self-harm or harm to the public to safeguard individuals (Barnhorst, Wintemute & Betz, 2018).  Therefore, based on state laws, the nursing staff had to do take steps that would promote and maintain the patient’s health. Mandatory reporting to the relevant authority or sharing with staff would be the best choice Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay.

Process of Ethical Decision Making To Address This Ethical Dilemma

Mental health practitioners have an ethical, legal and professional role of safeguarding patient privacy and confidentiality except for specific legal situations or when found incompetent by a judge. When comparing the two choices that the nurse staff had to make based on a nurse’s ethical-legal roles and the state laws, the choice to maintain confidentiality would be of no essence and the patient could have probably committed suicide (Hiriscau et al., 2014). This decision only benefits the patient and satisfies his desire to die. On the other hand, it could negatively impact healthcare staff and family members. However, the decision to share with third parties such as staff as required by law could promote avoidance and prevention. This could be of significance to the patient, his family and healthcare providers. Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay.


Barnhorst, A., Wintemute, G., & Betz, M. E. (2018). How should physicians make decisions about mandatory reporting when a patient might become violent?. AMA journal of ethics20(1), 29-35.

Elger, B. S., Handtke, V., & Wangmo, T. (2015). Informing patients about limits to confidentiality: a qualitative study in prisons. International journal of law and psychiatry41, 50-57 Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay.

Hiriscau, I. E., Stingelin-Giles, N., Stadler, C., Schmeck, K., & Reiter-Theil, S. (2014). A right to confidentiality or a duty to disclose? Ethical guidance for conducting prevention research with children and adolescents. European child & adolescent psychiatry23(6), 409-416.

Jie, L. (2015). The patient suicide attempt–An ethical dilemma case study. International Journal of Nursing Sciences2(4), 408-413. Practicum Journal Entry: Analyzing an Ethical Decision Case study Essay.

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