Responsibility and Autonomy

There are many ethical concerns involved in understanding an individual with schizophrenia and if they have the mental capability to make an increase in decision making about treatment.

  1. If the individual is going through acute psychosis, they may have delusions or hallucinations that can cause severe impairment in their understanding concerning the risks and benefits that may be associated with the treatment.
  2. Autonomy will be vulnerable at the same time addressing the psychosocial responsibility.
  3. In the law, the responsibility for the legal and ethical framework will rest on capacity assessments in decision making and contribution concerning potential treatment involuntary.

Confidentiality and Duty to Protect

Confidentiality is of great importance when dealing with schizophrenia as a mental illness, all symptoms of schizophrenia must be eliminated.

  1. If a mental health patient poses a credible threat to others, the clinician is within their legal right to warn the potential victims or inform the police on grounds of (Tarasoff v. Regents of the University of California, 1976).
  2. In ethics, the professional is required to make a choice between privacy and peace.

Involuntary Treatment and Hospitalization

Involuntary hospitalization is one of the most common synonyms to schizophrenia. Schizophrenia is one of the most common diagnoses that are associated with involuntary commitment.

There are instances where people must be admitted even if they don’t want to be. This is the case when a person:

• Is a potential threat to themselves or to people around them

• Cannot fulfill their basic daily requirements

• Has severe impairments in their ability to make rational decisions due to symptoms such as hallucinatory episodes

There are ethical issues such as:

• Upholding people’s rights

• Not using force

• Trying to be as unrestrictive as possible when people are being admitted.

       3. Social Justice, Stigma, and Discrimination

      People who have schizophrenia are heavily stigmatized when it comes to getting jobs, housing, and even healthcare.

      • Ethically, It is our responsibility to fight against the untrue beliefs of people. For example, it is a stereotype to say all people with schizophrenia are violent.

      • In a legal sense, these people are covered by disability laws such as the ADA, which protects disabled people from unfair treatment, as well as unreasonable lack of accommodations for their disabilities.

           4. Equity and Access to Care

          One of the most basic tenets of ethics in medicine is that all people must be guaranteed equitable access to all forms of healthcare, including effective treatment.

          There are multiple barriers that come into play such as:

          • Social Isolation

          • Poverty

          • Inadequate health insurance

          • Insufficient numbers of available psychiatrists

            All of these missing components lead to inequity and raise ethical issues of justice and fairness in the delivery of mental health care.

            Antipsychotic medication can be ethical base on which of the following:

            • Side effects (e.g. metabolic syndrome, tardive dyskinesia)

            • Long-term medication management

            • Patient choice vs. provider choice

            These traits must be considered while providing treatment.

            LEGAL COMPETENCY AND CRIMINAL JUSTICE INVOLVEMENT

            Schizophrenia has a disproportionate representation of this symptom within the criminal justice system.

            Ignoring treatment symptoms.

            Some key legal points include,

            • Competency to stand trial

            • Insanity defenses

            • Corrrectional facilities must provide adequate humane treatment

            • There must be a bypass from incarceration to treatment

            Vulnerable people must be protected. The system must be in place to ensure there is no system violation.

            CULTURAL CONSIDERATIONS

            Cultural beliefs influence the approach to understanding and treating schizophrenia.

            • In some cultures, symptoms are attributed to the spiritual or the supernatural.

            • Others see mental illness as highly stigmatizing.

            Cultural Competence is the ethical norm which requires clinicians to provide accurate care while respecting the culturally the care is to be equal and accurate.