Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
COURSE : NCM 108 HEALTHCARE ETHICS
MODULE 5 : ETHICS IN GERIATRIC, PSYCHIATRIC AND MENTAL HEALTH NURSING
By: Mae Geraldine E. Dacer, DM
I. Introduction
Ageism, psychiatric and mental health nursing underlies many ethical issues. Society often
neglects to notice determinations of decisional capacity based on prejudiced assumptions rather
than facts. They may perceive the quality of their lives to be higher than health care professionals
perceive it based on observational judgments. Focusing on an ethic of dignity rather than a strict
ethic of autonomy may be more realistic in caring for them, especially in long-term care situations
when elderly persons are not completely able to exercise their autonomy.
II. Time Allotment: 9 hours
III. Requirements
A. Pre-Entry:
Mastery of the following concepts:
- Logic
- Philosophy Man
- Introductory Concept on Nursing Ethics
- The Ethics of Respect for Person
- Reproductive Issues and Nursing Ethics
- Nursing Ethics in the Care of Infant, Children and Adolescent
B. Entry:
Mastery - 70% passing percentage in Pre-Test and Post-Test
- 70% passing percentage in Modular Exam
Completed notes related to the concept (based on objectives)
Punctuality and attendance
Accomplished given worksheets and case analysis
Reaction paper for journal review
IV. Objectives
After 9 hours of varied teaching-learning activities, the Level 2 Students will be able to:
1. review the following related concepts on:
1.1 psychosocial development
1.2 characteristics of psychiatric nursing
1.2 mental health
1.3 Aging process
2. explain and discuss nursing ethics in the care of:
2.1 geriatric
2.1.1 moral agency
2.1.1.1 decisional capacity
2.1.1.2 autonomy and paternalism
2.1.1.3 vulnerability and dependence
2.1.1.4 dementia
2.1.2 virtues needed by elders
2.1.3 elderly care
2.1.4 elder abuse
2.2 psychiatric and mental health
2.2.1 stigma
2.2.1 privacy, confidentiality and privileged communication
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Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
2.2.2 decisional capacity
2.2.3 ethical dilemma
3. integrate knowledge when making moral judgment to achieve ethical relativism in the
management and care geriatric, psychiatric and mental health nursing in:
3.1 humanistic nursing
3.2 reducing stigma
3.3 advocacy
.
V. Enrichment activities
1. Worksheets.
2. Case analysis (with given hypothetical situation) on related concept on ethics in geriatric,
psychiatric and health nursing.
3. Journal reading on issues and trends on related concept on introductory concept on ethics in
geriatric, psychiatric and health nursing.
VI. References
Robert M. Veatch , “ Basics of Bioethics”. 2nd edition. Pearson Education South Asia PTE. LTD.
Philippines, 2007.
Janie B. Butts, et. Al., “Nursing Ethics: Across the Curriculum and into Practice”. Malloy Inc.
Philippines, 2006.
Atty. Rustico T. De Belen, et. Al., . “Nursing Law, Jurisprudence and Professional Ethics ” 1st
edition. C&E Publishing, Inc. Quezon City, 2007.
Kozier, Barbara; Erb, Glenora, et.al “Fundamentals of Nursing: Concepts, Process and
Practice” 7th edition
Beauchamp, Tom L. “Philosophical Ethics: An Introduction to Moral Philosophy”. 3rdedition.
New York: McGraw-Hill, 2000.
Venzon, Lydia M., et. al., Professional Nursing in the Philippines. 10th edition, C&E Publishing,
Inc. Quezon City, 2005.
Prepared by:
MAE GERALDINE E. DACER, DM
Clinical Instructor
2
Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
COURSE : NCM 108 HEALTHCARE ETHICS
MODULE 5 : ETHICS IN GERIATRIC, PSYCHIATRIC AND MENTAL HEALTH NURSING
By: Mae Geraldine E. Dacer, DM
CASE ANALYSIS NO. 5
Name: ______________________________________ Date: ___________ Grade: _________
INSTRUCTION: Answer the questions briefly on the space provided.
Situation: Whose Wishes Should be Honored?
Mrs. Ryan, a frail 85-year-old woman who lived alone, was admitted to a geriatric psychiatric
unit because of irritability, confusion and increasing incontinence. Mrs. Ryan’s family stated that
she continually refused assistance from her home health aides and became angry when her family
and home care nurses tried to reason with her about these refusals. The patient’s family had
installed child gates in her home to block her entry into her bathroom, trying to force Mrs. Ryan to
use bedside commode. Mrs. Ryan began having frequent accidents of incontinence on the floor
near the bathroom door while trying to get through the gates. During her hospital admission, a
couple of her medications were adjusted and she subsequently became calm and cooperative with
the care she received while in the hospital. When the nurse and social worker talked with Mrs.
Ryan about the safety risks of her living in her home alone, the patient stated, “I am 85 years old
and think that I should be able to decide how I want to live the remainder of my life. I’m willing to
take my chances.” She was often unsure about the correct day of the week when questioned, yet
she knew the name of the hospital and the reason she was admitted for treatment. She was also
often confused about the name of the hospital staff but was able to state her own name, her family
continued to insist that Mrs. Ryan be admitted to a long-term care facility and requested that the
psychiatrist shall complete all the paperwork so that the judge could have the patient declared
incompetent. The psychiatrist did not usually seem sincerely interested in his patients and he had
spent little time with Mrs. Ryan. The psychiatrist was usually willing to comply with families’ wishes.
The nurse and social worker disagreed with the decision to decision to declare Mrs. Ryan’s
incompetent and were in favor of allowing her to return to home as she wished.
Based on the presented data, the following salient points are addressed:
1. Does it seem that Mrs. Ryan has decisional-making capacity? What criteria can be used as a
basis for your decision? And what needs to be included in a complete assessment of Mrs.
Ryan’s decisional-making capacity?
2. Does safety at home for Mrs. Ryan seem feasible? If so, how might this be accomplished?
3. What could the nurse and social worker do to try to resolve the disagreement among the patient,
her family, the psychiatrist and themselves?
4. What type of quality-of-life evaluation is most appropriate in this situation? What is your rationale
for this choice?
Signature of Student: ___________________ Signature of Faculty: ___________________
3
Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
COURSE : NCM 108 HEALTHCARE ETHICS
MODULE 5 : ETHICS IN GERIATRIC, PSYCHIATRIC AND MENTAL HEALTH NURSING
By: Mae Geraldine E. Dacer, DM
WORKSHEET NO. 5
Name: ______________________________________ Date: ___________ Grade: _________
INSTRUCTION: Answer the questions briefly. Below are ethical issues related to ethics in
geriatric, psychiatric and mental health nursing. Fill-in its brief description and corresponding ethical
dilemma on the space provided.
Brief Description Ethical Dilemma
Stigma
Privacy
Confidentiality
Incompetent
Decisional
Capacity
Elder Abuse
Signature of Student: ___________________ Signature of Faculty: ___________________
4
Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
COURSE : NCM 108 HEALTHCARE ETHICS
MODULE 5 : ETHICS IN GERIATRIC, PSYCHIATRIC AND MENTAL HEALTH NURSING
By: Mae Geraldine E. Dacer, DM
JOURNAL REVIEW NO. 5
Name: ____________________________________________ Date: _________________ Grade: _________
I. Title of the Journal : ____________________________________________________________________
II. Name of the Author : ____________________________________________________________________
III. Date Issued /Published : ____________________________________________________________________
IV. Title of the Article : ____________________________________________________________________
5
Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
V. Reaction:
6
Republic of the Philippines
Biliran Province State University
(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
Remarks:
Student’s Signature : _________________________________ Date Submitted: ______________
Instructor’s Name and Signature : _________________________________ Date Submitted: ______________
