Ethical Issues In Patient Care

Researchers and activists alike are concerned about the rate at which individuals with mental illness are incarcerated in the United States. Many consider that the increase in incarceration is a direct result of deinstitutionalization. In this essay, I will discuss how the solutions to the prevention of the incarceration of the mentally ill but ultimately lead to the common goal of improving the care of the mentally ill. This will be done by comparing and contrasting the key points of Knoll, Etter et al and Kincaid. The points discussed will be their views on the cause of mass incarceration, the way in which they approach solutions to the problem and the suggested role of law enforcement officers in this solution.

In a study conducted in Berkeley, “In a study of more than 600 young men and women conducted at Berkeley, researchers concluded that one’s perceived social status — or lack thereof — is at the heart of a wide range of mental illnesses,” (Anwar). The head nurse, Miss Ratched, used her words and knowledge of the mental patients to weaken their confidence and force them into submission. She made them feel small in society, resulting in the men believing that they don’t belong. Harding had even compared Miss Ratched to Adolf Hitler. Regardless of the evilness associated with these two people, there is the fact that they both accomplished gaining power, which is something a majority of people want. Another form of sadism shown in the novel was the electric shock therapy (EST) and lobotomy, both of which were used to “cure” mental patients. McMurphy and Bromden were subjected to a series of electric shock therapies and later on, McMurphy undergone lobotomy. “The procedure was not reserved for the most hopeless cases but instead applied to ‘difficult’ patients, becoming a way to control behavior rather than to relieve symptoms of mental disorder,” (Haycock and Cataldo). Although the morality of these treatments are questionable, these helped establish power in the asylum by using fear. A person would need to have no regret to force a person to have psychosurgery and with the actions of the hospital workers, this borders on sadistic and psychotic behavior. However, this raises the question of whether people labeled as psychopaths are the only ones who accomplish their

The Beat Generation of the 1950’s and early 1960’s encouraged a new lifestyle for young Americans striving for individualism and freedom, which included rock and roll music, long hair, relaxed style attire, vegetarianism, and experimenting with drugs (“Beat Movement”). Many young Americans of this era wanted to experiment with new social and cultural concepts, rebelling against “normal” American life. One Flew Over the Cuckoo’s Nest, written by Ken Kesey, portrays the gruesomeness of conformity through the lives of patients in one of the asylum’s wards. The novel shows how the patients are confined to strict rules and limited freedom because of Nurse Ratched’s power. The Beat Generation wanted change because of this conformity, by rebelling against the rules and structure of society. In the text, Kesey implies that conformity is damaging because he believed that conformity and mental institutions negatively impact the patients by destroying their self-esteem, while many in the ‘50s and early ‘60s believed mental institutions helped someone become a normal member of society.

As a result of the Act, there was a shift of mentally ill persons in custodial care in state institutions to an increase of the mentally ill receiving prosecutions in criminal courts. The shift is attributed to the unexpected clinical needs of this new outpatient population, the inability of community mental health centers to meet these needs, and the changes in mental health laws (Pollack & Feldman, 2003).

In our textbook we learned that around the 1960’s many intuitions were being broken up and a more community approach was being adopted. This was signed by President John F. Kennedy in 1963. This approach was implemented because of the predicted success of new anti-psychotic medications. This coupled with the often mistreatment of clients made for the push away from large intuitions (Trattner 1999). While this did benefit some individuals it did not for a majority of people. Many mentally ill individuals were left homeless after hospitals deinstitutionalized, making up one-third of the homeless population (D.E. Torrey). According to one study many people who are severely mentally ill are now treated during their incarceration in a correctional facility (D.E. Torrey). This is one trend

A lecture i attended started off with uneasy jokes about how the mentally ill behave. Dr.Goldberg went on to explain his daily duties of working at a mental hospital and the things he experiences while working there. When an audience member asked how the workers deal with situations where the patients don't take their medicine, Dr.Goldberg laughed and stated something along the lines of “well we just hope and pray they don't kill us.” This specific statement along some other questionable jokes, helped me understand how he viewed his patients in the hospital-stereotypical. However, Dr.Goldberg was able to provide some real life examples of how the mentally ill are dehumanized where he works. He went on to explain that the people in those institutions are very limited to the things they are able to do and the choices that they can make. Simple choices such as what to eat, what to wear, and what to do in your freetime are made for the mentally ill by the workers. The patients are forced to take medication against their will and are also limited to everyday things such as being outside. There is so much dehumanization that occurs that the mental hospital doesn't feel like a place where the patients are receiving help. Instead, the patients themselves refer to being at the mental hospital as “doing time” as they would in

Published in 1962, Ken Kesey’s One Flew Over the Cuckoo’s Nest tells the story of Patrick McMurphy, a newly-admitted patient at a psychiatric hospital where individuals with various mental conditions are treated. Run primarily by Nurse Ratched, a demeaning autocrat who exhibits complete control over others, the patients are subjected to various forms of treatments and therapy with the intent of rehabilitation (Kesey 5). Most forms of treatment depicted in Kesey’s novel, such as group therapy, are an accurate representation of what typical psychiatric patients may encounter while under care at a mental facility. Yet others, particularly electroshock therapy and lobotomies, were quite controversial at the time of the novel’s publication. Such treatments were questioned for their effectiveness at improving patients’ condition – and while these procedures were still occasionally performed at the time, they often did not benefit the treated individual. Often painful and traumatic, these treatments physically degraded the patient’s mental status; and in extreme

In today’s society, when someone mentions a mental institution most people picture a dark, dirty, and horrendous hospital like structure. While this image may at times be accurate, this was not always the case. Mental institutions, otherwise known as asylums, have a past full of ups and downs. During different time periods standards for care in these facilities fluctuated from proper care to improper care. With more of an understanding of these mental abnormalities we have a better chance of finding solutions and resolving them.

I have neither given nor received nor have I tolerated others’ use of unauthorized aid.

Nellie Bly states Margaret’s story, “Her name was Margaret. She told me she had been a cook, and was extremely neat. One day, after she had scrubbed the kitchen floor, the chambermaids came down and deliberately soiled it. Her temper was aroused and she began to quarrel with them, an officer was called and she was taken to an asylum.” Margaret was sent to an institution because some maids tipped her over the edge and she freaked out, not because she was insane. One last story was Josephine Despereaux who was locked up for becoming sick. Her story was, “One morning as I was trying to get breakfast I grew deathly sick, and two officers were called in by the woman of the house, and I was taken to the station-house. I was unable to understand their proceedings, and they paid little attention to my story. Doings in this country were new to me, and before I realized it I was lodged as an insane woman in this asylum.” Josephine was just another example of a false imprisonment because of what other people said. Because the woman of her house wanted her to go to an institution she was sent there. No one listened to what Josephine had to say and it was because of this reason that many people including Josephine were falsely imprisoned. The institution was a place where real mentally ill patients could get treatment, but people were taking advantage of it and getting rid of their wifes and people

Long-term care facilities have become home to some individuals due to loss of capacity for independent living which normally caused by some illness that result in them not being able to care for themselves or to perform any daily living activities, such as cooking, eating, bathing, and toileting. Now as an administrator of a long-term care facility, I am responsible to make sure that everything runs smooth; in another word I play most important role in the facility. I am in charge of everything that goes on including patient admissions, facility policies, laws, finances, facility maintenance, residential care and staffing. A number of ethical issues can and will arise in a long-term care facility, such as providing patient care, dealing with

This book opened my eyes to many new things. Before reading this book all I knew about mental institutions was that that’s where the crazy people are sent. After reading this book I have concluded that there is so much more to it. This book showed me that a mental institution hospital is not a joke, but a place where people can go to get serious help. This was my first real exposure to mental institutions and mental illnesses. Both are way more complex than I could have ever imagined.

The movie “One flew over the cuckoo’s nest” gives an inside look into the life of a patient living in a mental institution; helping to give a new definition of mental illnesses. From a medical standpoint, determinants of mental illness are considered to be internal; physically and in the mind, while they are seen as external; in the environment or the person’s social situation, from a sociological perspective (Stockton, 2014). Additionally, the movie also explores the idea of power relations that exist between an authorized person (Nurse Ratched) and a patient and further looks into the punishment a deviant actor receives (ie. McMurphy contesting Nurse Ratched).

In the 1961 article titled “Psychiatry in American Life” published in The Atlantic magazine, American psychiatrist and author Geer William wrote that “The typical state hospital does a good job keeping patients physically alive and mentally sick." (qtd. in Ford). Although many advances have been made in the field of mental health, one core issue remains the same. Which is the mentally ill being pushed into facilities that are seldom concerned with the patient’s well-being. -------------

Deinstitutionalization fundamentally consists of three different components: “the release of persons residing in psychiatric hospitals to alternative facilities in the community, the diversion of potential new admissions to alternative facilities, and the development of special services for the care of a noninstitutionalized mentally ill population.” Here, we expand that definition with the inclusion of intellectually and developmentally disabled persons. As we know, this group was similarly situated as ‘patients’ of institutions, and similarly inherited both the benefits and the problems of