Ethical and Legal Foundations of PMHNP Care

Respond to two of your colleagues by sharing cultural considerations that may impact the legal or ethical issues present in their articles.

1. respond


Ethical and Legal Foundations of PMHNP Care




Mental health providers are required to consider the legal and ethical implications to ensure patient satisfaction and improve health outcomes. The code of ethics provides healthcare professionals with rules and guidelines for treating patients. The discussion will focus on the issue of informed consent.

Informed consent is one of the essential issues in mental health settings and focuses on emphasizing respect for persons (Lamont et al., 2019). The issue relates to autonomy because the patient must accept or refuse treatment. Additionally, informed consent involves the permission of care between the healthcare professional and the patient. However, there are differences involved in the case of informed consent when treating children or adolescents and adults.

The other article by Lamont et al. (2019) focuses on ethical considerations linked to informed consent when dealing with children and adolescents. According to the article’s most salient ethical issue, though parents are allowed to undertake informed consent and engage in decision-making when treating adolescents, in case the adolescent refuses a certain treatment, it is unethical for the healthcare professional to continue with the treatment. The article by Mathai et al. (2022), it is ethical for the adult patient to be offered the legal right to consent. However, the healthcare provider may not offer this right if the mental capacity and understanding of the patient are overwhelmed.

The salient legal issue that emerges from the article by Carnevale et al. (2021) is that adolescents and children are incompetent when making psychotherapy decisions. According to O’Shea et a. (2022), healthcare professionals have a legal mandate to uphold their patient’s autonomy and offer informed consent unless the patient shows cases of limitation of their cognitive capacity.

This information will apply to treating adults with mental capabilities limitations in my clinical practice. Also, it will be used to treat children and adolescents who do not require the clinicians to continue with certain treatments contrary to their parent’s or guardians’ views. In Ohio, psychiatric nurse practitioners should not make decisions for their patients and should offer full consent to adult patients. However, parents and guardians make decisions for children and adolescents.


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Carnevale, F. A., Collin‐Vézina, D., Macdonald, M. E., Ménard, J. F., Talwar, V., & Van Praagh, S. (2021). Childhood ethics: An ontological advancement for childhood studies.   Children & Society,  35(1), 110-124.

Lamont, S., Stewart, C., & Chiarella, M. (2019). Capacity and consent: knowledge and practice of legal and healthcare standards.   Nursing Ethics,  26(1), 71-83.

Mathai, D. S., Lee, S. M., Mora, V., O’Donnell, K. C., Garcia-Romeu, A., & Storch, E. A. (2022). Mapping consent practices for outpatient psychiatric use of ketamine.   Journal of Affective Disorders,  312, 113-121.

O’Shea, D. U., Gabel, N., Aghjayan, S., Shmidheiser, M., & Divers, R. (2022). Guiding Principles and Common Pitfalls of Capacity Assessment.   A Casebook of Mental Capacity in US Legislation, 24-37.






Ethical and Legal Foundations of PMHNP Care



As it pertains to a patient’s health, each individual has the right to make their own decisions of medical treatment. This relates to the patient choosing doctors, treatment, and etc. in which they choose to receive care. This is what one can call patient “autonomy”. Patient “autonomy” is an essential word in healthcare that everyone in each state in American is required to have; it’s the medical law. It’s important because it empowers patients to feel in control and self-assured in the ability to make educated health decisions and choices of the right doctors that they believe that is best for themselves. Having patient autonomy leads to positive health outcomes, however, it is different for children and adults from legal and ethical views which also may vary from state to state.

Autonomy in Adults

Ethical Considerations

Autonomy means an adult has the right to make informed decisions about their medical care and what is best suited for them. However, the individual must be a competent adult (Georgia State University, 2021). The article highlights that autonomy must be honored by every healthcare providers/practitioner. Providers must provide transparency, options, openness, and educate patients. Providers must not use pressure or force patients in making decisions. But providers must consider age groups, beliefs/religions, view, and most importantly decision-making abilities on if the individual competent to make their own healthcare decisions.

Legal Consideraations

In healthcare, it is essential to adhere to the laws in order to prevent any actions that may be considered illegal regarding medical treatment. In the state of Georgia regarding autonomy, one must be the age of 18 or older to be able to make their own choices regarding healthcare treatment. The adult must be believed to be able to make their own sensible decisions unless the individual is not alert and oriented or suffering from a cognitive issue such as dementia and etc. In the event an individual is suffering from such, then medical authority will appoint a chosen person such as closest of kin in order to be in compliance with the state of Georgia standards (Secretary of State, 2022).



Autonomy in Children and Adolescents

Ethical Considerations

In comparisons to adults, children and adolescents concept regarding autonomy is not the same; in fact, its limited. For children and adolescents, parents/guardians are an essential tool in making decisions regarding treatment or care pertaining to their health. If the child is able to talk and is competent, then the child can be involved in the decisions making. The parent, child, and doctor can discuss choices; triangle sides. The concept of autonomy controls influenced activities in the process of getting informed permission from children and adolescents (Thompson, 2020). This is for the state of Georgia and many other states. Parents and healthcare providers must consider the age and competency level of the child when regarding the decision making. Parents and guardians of the child have a responsibility to reassure the independence and the child’s ability to make decisions regarding their health and that their opinion matters.

Legal Considerations

Anyone under the age of 18 in the state of Georgia, parents/guardians are involved in making decisions regarding the child or adolescent autonomy. However, as children get older, their brains develop which inhabits them to develop better judgement and insight. Therefore, children with substantial brain growth, increases their potential to make choices that are in their best interests (Parsapoor et al., 2017). But in the state of Georgia and many other states, parents and guardians by law, have authority in making major decisions regarding their child’s medical treatment. It is automatically granted for parents and guardians being the power of attorney and having the ability to make decisions regarding their child or teenagers health. As stated previously, there are limitations, and teenagers can make some choices on their own without parents. In the state of Georgia, teenagers have the right in making decisions as it pertains to certain healthcare services regarding to sexual transmitted illnesses and contraceptives.




Georgia State University. (2021).  Nurse Practitioner Autonomy in Georgia: Exploring Barriers to Full Practice Authority . Retrieved from

Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2017). Autonomy of children and adolescents in consent to treatment: ethical, jurisprudential and legal considerations. Retrieved from

Secretary of State. (2022). Rules and Regulations of the State of Georgia. Retrieved from

Thompson, Haley. (2020). Children’s Autonomy and Medical Decision Making. Retrieved from

Attachment:  File  Week 2 Article 1.pdf  (152.45 KB)

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Attachment:  File Week 2 Article 2.pdf  (334.327 KB)


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