human rights of mentally ill
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“All human beings are born free and equal in dignity and rights”.
UDHR (1948)
HUMAN RIGHTS OF THE MENTALLY ILL
Ramachandra Associate Professor Dept of Nursing
What are Human rights?
Human rights are "basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language, or other status."These rights are all interrelated, interdependent and indivisible.
What is mental illness?
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture.
The International Bill of Human Rights
The Universal Declaration of Human Rights
The International Covenant on Economic, Social and Cultural Rights
The International Covenant on Civil and Political Rights.
Since the dawn of human civilization, mentally ill
patients have received the scant care and concern
of the community because of their unproductive
value in the socio-economic value system.
They have not only been neglected but received
step motherly treatment from the health planners
especially in the developing countries.
The mentally ill person deserves the same
privileges as enjoyed by any other human being.
They include a right to better and more accessible
care, to good recovery and increased hopes of
reintegration into society.
However, the Stigma, residual disability and
its intolerance, and more importantly the
inability of the mentally ill to protest against
exploitation, have all made basic human
rights of the mentally ill a major cause of
growing concern.
HUMAN RIGHTS OF MENTALLY ILL
1. Right to communicate with people outside the
hospital through correspondence, telephone, and
personal visits
2. Right to wear clothing and personal effects with
them in the hospital
3. Right to religious freedom
4. Right to be employed if possible
5. Right to manage and dispose of property
6.Right to execute bills
7.Right to enter into contractual relationships
8.Right to make purchases
9.Right to education
10.Right to habeas corpus
11.Right to independent psychiatric examination
12.Right to civil service status
13.Right to retain licences, privileges, or permits
established by law, such as a driver’s or
professional licence
14.Right to sue or be sued
15.Right to marry and divorce
16.Right not to be subject to unnecessary
mechanical restraints
17.Right to periodic review of status
17.Right to legal representation
18.Right to privacy
19.Right to informed consent
20.Right to treatment
21.Right to refuse treatment
22.Right to treatment in the least restrictive setting
Right to Communicate With People outside the Hospital
This right allows patient to visit and hold telephone
conversations in privacy and send unopened letters
to anyone of their choice, including judges, lawyers,
families, and staff. The hospital also can limit the
times when telephone calls are made and received
and when visitors can enter the facility.
Right to Keep Personal Effects
The patient may bring clothing and personal items to
the hospital, taking into consideration the amount of
storage space available. The hospital is not responsible
for their safety, and valuable items should be left at
home.
Right to Enter Into Contractual Relationships
The court considers contracts valid if the person understands the circumstances of the contract and its consequences.
To prove incompetence in court, all of the following must be shown:1.The person has a mental disorder.2.This disorder causes a defect in judgment.3.This defect makes the person incapable of handling personal affairs.
Right to Education
Many patient exercises the right to education on
behalf of their emotionally ill or mentally
retarded children.
Right to Habeas Corpus
Habeas corpus is an important constitutional right
patients retain in all states even if they have been
involuntarily hospitalized. It provides for the speedy
release of any person who claims to be detained
illegally.
Right to Privacy
The right to privacy implies the person’s right to
keep some personal information completely secret
or confidential.
Confidentiality involves the nondisclosure of
specific information about a person to someone else
unless authorized by that person
The Health Insurance Portability and Accountability Act (HIPAA,2003)
1.To be educated about HIPAA privacy protection
2.To have access to their own medical records
3.To request correction or amendment of their health
information to which they object
4.To require their permission for disclosure of their
own personal information.
Right to Informed Consent
The goal of informed consent is to help patients
make better decisions.
Informed consent means that a clinician must give
the patient a certain amount of information about the
proposed treatment and must attain the patient’s
consent, which must be informed, competent, and
voluntary.
Information to be disclosed in Obtaining Informed Consent
Diagnosis
Description of the patient’s problem
Treatment
Nature and purpose of the proposed
treatment
Consequences
•Risks and benefits of the proposed treatment including physical and psychological effects, costs, and potential resulting problems•Alternatives•Viable alternatives to the proposed treatment and their risks and benefits•Prognosis•Expected outcomes with treatment, with alternative treatments, and without treatment.
Information to be disclosed in Obtaining Informed Consent
Diagnosis
Description of the patient’s problem
Treatment
Nature and purpose of the proposed
treatment
Consequences
Risks and benefits of the proposed treatment
Alternatives
Viable alternatives to the proposed treatment and
their risks and benefits
Prognosis
Expected outcomes with treatment, with alternative
treatments, and without treatment.
Right to Treatment
The courts defined three criteria for adequate
treatment:
1.A humane psychological and the physical
environment
2.A qualified staff with a sufficient number of
members to administer adequate treatment
3.Individualized treatment plans
Right to Refuse Treatment
The relationship between right to treatment
and right to refuse treatment is complex.
The right to refuse treatment includes the
right to refuse involuntary hospitalization. It has
been called the right to left alone.
The involuntary therapy conflicts with two
basic legal rights: freedom of thought and
the right to control one’s life and actions as
long as they do not interfere with the rights
of others.
Right to Treatment in the Least Restrictive Setting
Its goal is evaluating the needs of each patient
and maintaining the greatest amount of personal
freedom, autonomy, dignity, and integrity in
determining treatment.
This right applies to both hospital-based and
community programs.
Role of Nursing
The National League for Nursing (1977) issued a statement on the nurse’s role in patient’s rights.
Right to health care that is accessible and meets professional standards, regardless of the setting
Right to courteous and individualized health care
that is equitable, humane, and given without
discrimination based on race, color, creed, sex,
national origin, source of payment, or ethical or
political beliefs
Right to information about their diagnosis,
prognosis, and treatment, including alternatives
to care and risks involved
Right to information about the qualifications,
names, and titles of health care personnel
Right to refuse observation by those not directly
involved in their care
Right to coordination and continuity of health care
Right to information on the charges for services,
including the rights to challenge these charges
Above all, the right to be fully informed about all
their rights in all health care settings.
Perhaps the most important factors in
ensuring patient’s rights are the attitude,
knowledge, and commitment of the mental
health professional
Ramachandra Associate Professor
Dept of Nursing
“All human beings are born free and equal in dignity and rights”.
UDHR (1948)
What are Human rights?
• Human rights are "basic rights and freedoms that all people are
entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language, or other status.“
• These rights are all interrelated, interdependent and indivisible.
What is mental illness?
• A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture.
The International Bill of Human Rights
• The Universal Declaration of Human Rights,• The International Covenant on Economic,
Social and Cultural Rights,• The International Covenant on Civil and
Political Rights .
• Since the dawn of human civilization, mentally ill patients have received the scant care and concern of the community because of their unproductive value in the socio-economic value system.
• They have not only been neglected but received step motherly treatment from the health planners especially in the developing countries.
• The mentally ill person deserves the same privileges as enjoyed by any other human being.
• They include a right to better and more accessible care, to good recovery and increased hopes of reintegration into society.
• However, the Stigma, residual disability and its intolerance, and more importantly the inability of the mentally ill to protest against exploitation, have all made basic human rights of the mentally ill a major cause of growing concern
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