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Jane,

I posted 2 different posts. Just reply to each “sharing cultural considerations that may impact the legal or ethical issues present in their articles”. 2 paragraphs with 2-3 sources each should be fine. THANKS!

1) Cas

Elder abuse is a violation on older adults’ fundamental rights to be safe and free from violence and contradicts efforts toward quality of life in healthy aging. According to Taylor (2014), 1 in 10 older adults in the United States experience physical, psychological, or sexual abuse, neglect, or financial exploitation. Child abuse is now recognized as a medical problem. Children under the age of 18 may be exposed to abuse and neglect by a parent, caregiver, or another person in custodial role. There are four common types of child abuse---physical, sexual, emotional and neglect (AAP, 2019).

Legal Consideration of Elder Abuse and Child Abuse

I live in the state of Virginia. There exist a mandated reporting laws regarding child and elder abuse for mental health professionals including PMHNP. The Child Abuse and Neglect Reporting Act (CANRA) that was passed in 1980 states that mental health professionals need to report any form of child abuse known or suspected. The various forms of child abuse mentioned in the Act include physical abuse, child sexual abuse, neglect, unlawful corporal punishment or injury, general neglect, and willful cruelty or unjustified punishment. The mandatory reporting requirement for the elders is also available in Virginia and mental health professionals are mandated to report any form of abuse of the elders. The abuse includes physical abuse, abduction, abandonment, financial abuse, isolation, and neglect. These laws align with the APA codes. Therefore, it is the duty of PMHNP to report any abuse to CPS or APS and document findings in detail as they may be used in the court of law. PMHNP should be educated on identifying elder and child abuse to improve detection and ultimately patient outcomes (Concialdi & Read, 2016).

Ethical Consideration of Elder Abuse

When looking at ethical issues that surround elder abuse, it is very much evident that lot needs to be done to ensure that elders live in an environment that favors their situation and age. One of the ethical considerations that need to be put in place is the issue of autonomy. Autonomy is the ability of an individual to make free as well as informed decisions. Scheiderer’s article “Elder Abuse: Ethical and Related Considerations for Professionals in Psychology” describes that it is necessary for an individual to make his or he own decisions independently. This capability also includes understanding what should be put into consideration as well as having an appreciation of the consequences of a decision. The individual needs to be able to communicate a decision in the most efficient way. The decision-making capacity of an older person that also needs to place into considerations is the issue of consistency, rationality, influencing factors as well as other cultural issues (Scheiderer, 2012). In connection with the issue of ethical considerations, it is important to note that physical frailty does not imply mental weakness and this, therefore, suggests that the decision-making capacity of elderly people should not be compromised.

Ethical Consideration of Child Abuse

I feel like it is a good thing that we are mandated to report any form of abuse to a child because they are vulnerable individuals in the society, and they can have no voice especially after being abused. Children are dependents and they can be taken advantage of. The pros of being a mandated reporter is that one gets to help a child who is being abused. It also helps to arrest the person subjecting the child to any form of abuse. The cons of being a mandated reporter is that the child might refuse any form of abuse subjected to them because they fear of being abused more by the abuser. In addition, the child being abused might be left without any guardian since they might be the only people caring for them (AAP, 2019).

References

American Academy of Pediatrics. (2019). Child abuse: overview and evaluation.

Concialdi, M., & Read, S. (2016). Child abuse and neglect: Mandatory reporting for EMS providers. EMS World, 45(5), 52–55.

Scheiderer, E. (2012). Elder abuse: Ethical and related considerations for professionals in psychology. Ethics & Behavior, 22(1), 75–87.

Taylor, R. M. (2014). Elder abuse and its prevention: workshop summary. National Academies Press.

2) POT

HIPAA

            The Health Insurance Portability and Accountability Act (HIPAA) is a rule that limits the use and disclosure of patient information by any medical practitioner. In the regulation, the sharing of patient information is ethical and legally bound whether it is within the state of Minnesota or nationally. Burnett (2019) conducted a legal-based study on HIPAA laws in mental health and explained that within the law, there are national standards that secure individual health information from any disclosure. The article goes into detail about how adult patient information should not be disclosed even based on psychotherapy notes. As for Ford et al. (2004), the journal article provides a detailed argument on the legal rights that adolescents possess when it comes to seeking healthcare services. This includes the concept of confidentiality and what are the limits. The article further elaborates on the fundamental rights that adolescents have based on the view of the professional boundaries. For ethical regulations, Allen Langjahr (2018) lists the ethical problems that may exist if a professional break the ethical rules of engagement in any mental healthcare perspective. The focus of the article is about the communication of patient information of an adult based on the patient’s non-adherence to medication, thus, the need to explain to the family members of any impending danger. Golberstein et al. (2020) discusses about the ethical guidelines that affect children when it concerns mental healthcare. The article focuses on the social and economic problems that the children are experiencing with the current COVID-19 pandemic.

            The information provided by the articles provide a detailed overview of the specific rules and ethical regulations, limitations in privacy rules, and how professionals are limited within the given boundaries on when and how to reveal patient information both in children/adolescents and adults. The impact that this information has on my clinical practice is that HIPAA laws play a central role in how patients are handled in any care setting. For instance, if family members of any adult patient continue pursuing information about the particular patient, then ethically, one is required to ensure that such information is not leaked unless there is a court injunction stating otherwise. In Maryland, the implication of the legal and ethical regulations is that even when the patient information is held under any public office, information is still considered private under HIPAA Laws.

References

Allen Langjahr, E. (2018). HIPAA and Sharing Information Related to Mental Health. US Pharm, 43(11), 33–35.

Burnett, E. (2019). Solving the Uncertainty: Why the HIPAA Privacy Rule Fails to Appropriately Address Disclosures of Psychotherapy Notes of Deceased Patients. Health Matrix, 29, 401.

Ford, C., English, A., & Sigman, G. (2004). Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 35(2), 160–167.

Golberstein, E., Wen, H., & Miller, B. F. (2020). Coronavirus disease 2019 (COVID-19) and mental health for children and adolescents. JAMA Pediatrics, 174(9), 819–820.