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Zorluk: OrtaEthical Practice

A client admitted with severe depression and suicidal ideation has been receiving treatment for several days. The client's involuntary legal hold is set to expire in two hours. The client suddenly appears remarkably calm, smiles, hands their favorite watch to the nurse, and states, "Everything is finally clear. I am leaving as soon as my hold is up." Which ethical action must the nurse prioritize?

  1. Uphold the principle of nonmaleficence by advocating for a continued legal hold and implementing one-to-one observation.Cevap
  2. B
    Respect the client's autonomy by beginning the discharge paperwork since the legal hold is expiring.
  3. C
    Ask the client, "Why are you giving me your watch if you are feeling better?"
  4. D
    Ensure the client's safety by immediately applying physical restraints until the healthcare provider arrives.

Cevap

The nurse must prioritize nonmaleficence by implementing one-to-one observation and advocating for the extension of the involuntary hold, as the client is exhibiting signs of imminent suicide risk.
The correct action prioritizes the ethical principle of nonmaleficence (the duty to do no harm). The client's sudden shift to a calm demeanor and the act of giving away a prized possession are classic, high-risk indicators that they have formulated a concrete suicide plan. Because the client presents an immediate danger to themselves, the nurse must intervene to prevent harm by implementing continuous one-to-one observation and advocating for the provider to extend the involuntary legal hold. In situations of imminent self-harm, the duty to protect life temporarily supersedes the client's right to autonomy.

Adım Adım Çözüm

1
Analyze the client's clinical presentation and statements.
The sudden calmness and the act of giving away a prized possession (the watch) are critical warning signs of a concrete, imminent suicide plan.
Recognizing high-risk psychiatric behaviors is essential before determining the appropriate ethical and clinical response.
2
Identify the ethical conflict between autonomy and nonmaleficence.
The client wishes to exercise autonomy by leaving when the legal hold expires, but doing so presents a severe, immediate threat to their life.
Ethical principles often conflict in practice, and the nurse must weigh the risk of harm against the client's right to self-determination.
3
Prioritize the appropriate ethical principle based on the imminent risk.
The principle of nonmaleficence (the duty to do no harm) temporarily overrides the client's autonomy in this scenario.
When a client poses a direct and immediate threat to themselves, safety protocols and legal holds must be utilized to protect their life.

Anahtar Kavram

Balancing Autonomy and Nonmaleficence in Psychiatric Emergencies
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Konular

Ethical Practice

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