"Ethical Issues in Mental Health" is a delightful example of a paper on medical ethics. The article discusses the increase in psychotropic medications on elderly patients who move to care homes. Majority of the people moving to care homes have dementia or other mental illnesses but it is not on a severe level that they require mental health attention just incapacitates them and hence the need to be offered special care. These patients have their normal dosage of the psychotropic drugs but research has unveiled that once they move into the care homes, these dosages have increased dramatically by almost over 20% compared to those at the community level. Even if these elderly people have dementia, they do not present threats to themselves or others and an increase in drugs in their bodies act as a chemical restrainer for them and hence providing the nurses with even less work as the patients are restrained by drugs and further incapacitated.
Critiques have argued that this is wrong because the person needs care, not restraint and hence the move to care home where they can receive that care.
Chemically restraining them through over drugging them is not only morally but ethically wrong as well (Maguire, et al. 2013). Others put up an argument that these patients are elderly and the chemical restraint is actually helping them relax and enjoy their final years without worries and other negative symptoms that come with having dementia. With these arguments, an ethical dilemma builds of whether it is ethically correct to increase the dosage of mentally ill elderly patients in care homes simply to chemically restrain them. The dilemma in the research was approached from different angles ranging from the medical aspect to moral and ethical aspect with these experts presenting the arguments for and against the chemical restraint of mentally ill elderly patients in care homes where they are already secluded from the community and hence pose no danger to others.
They are also old and hence physically unfit to even have enough strength to fight the nurses or present them with any threats, unlike the younger generation. The dilemma was not resolved and even the issue went public in the media creating other ethical dilemma debates for the public to argue.
The dilemma is hard to resolve because, on the medical front, the nurses and doctors in the care homes in Northern Ireland have to care for their patients and ensure they are safe. The only way they know how is to chemically restrain them as opposed to physically restraining them like is the case in most mental health institutions but this does not sit well with the ethical and moral critiques. The nurses violate the principle of beneficence where they are supposed to cause no harm to the patients but in this case, they actually cause more harm medically and ethically by increasing their drug dosage to chemically restrain them instead of providing them with the care they have come to seek in those care homes (Benjamin and Curtis, 2010). The nurses should just provide the regular drug dosage for the harmless elderly population in the care homes and any patient presenting with violent tendencies to be recommended to psychiatric institutions.
With such different handling, the dilemma would have been avoided.
Benjamin, M. and Curtis, J. (2010). Ethics in Nursing: Cases, Principles, and Reasoning. Oxford: Oxford University Press.
Maguire, A. et al. (February, 2013). “Psychotropic Medications and the Transition into Care: A National Data Linkage Study.” Journal of the American Geriatrics Society, vol. 61(2), pp. 215-221.