3. Legal and civil rights of hospitalized patients - the right to:
   1. Wear own clothes, keep and use personal possessions and reasonable sum of money for small purchases.
   2. Have individual storage space for private use.
   3. See visitors daily.
   4. Have reasonable access to confidential phone conversations.
   5. Receive unopened correspondence and have access to stationery, stamps, and a mailbox.
   6. Refuse: shock treatments, lobotomy.


4. Concepts central to community mental health (Community Mental Health Act, 1980)
   1. Systems perspective: scope of care moves beyond the individual to the community, with influences from biological, psychological, and sociocultural forces.
   2. Emphasis on prevention: primary (reduce incidents by preventing harmful social conditions); secondary (early identification and treatment of disorders to reduce duration); tertiary (early rehabilitation to reduce impairment from disorders).
   3. Interdisciplinary collaboration: flexible roles based on unique areas of expertise.
   4. Consumer participation and control.
   5. Comprehensive services: outpatient care, partial hospitalization, 24-hour hospitalization and emergency care; consultation and education; screening services.
   6. Continuity of care.

Legal Aspects of Preparing a Patient for Surgery

1. No surgical procedure, however minor, can proceed without the voluntary, informed, and written consent of the patient.
   1. Surgical permits are witnessed by the physician, nurse, or other authorized person.
   2. Surgical permits protect the patient against unsanctioned surgery and also protect the surgeon and hospital staff against claims of unauthorized operations.
   3. Informed consent means that the operation has been fully explained to the patient, including possible complications and disfigurements, as well as whether any organ or parts of the body are to be removed.
   4. Adults and emancipated minors may sign their own operative permits if they are mentally competent; permission for surgery of minor children and incompetent or unconscious adults must be obtained from a responsible family member or guardian.
   5. The signed operative permit is placed in a prominent place on the patient’s chart and accompanies the patient to the operating room.
   6. Legal issues in the emergency room: record keeping plays an essential role in both the prevention and defense of malpractice suits. Detailed documentation not only provides for continuity of care but also perpetuates evidence that care was appropriately given. Records should:
      1. Be written legibly.
      2. Clearly note events and time of occurrence.
      3. Contain all lab slips and results of other tests.
      4. Describe events and patients objectively.
      5. Clearly note physician’s parting instructions to the patient.
      6. Be signed where appropriate, such as with doctor’s orders.
      7. Contain descriptions of every event that might lead to a lawsuit, such as fights, injuries, equipment failures.
   Consent - although there is no law requiring written consent before performing medical treatment, all elective procedures can only be performed if the patient has been fully informed and voluntarily consents to the procedure.
   1. If informed consent cannot be obtained because of the patient’s condition and immediate treatment is necessary to save life or safeguard health, the emergency rule can be applied. This rule implies consent. However, if time allows, it is advisable to obtain either oral or written informed consent from someone who has authority to act for the patient.
   2. Verbal consents should be recorded in detail, witnessed and signed by two individuals.
   3. Written or verbal consent can be given by alert, coherent, or otherwise competent adults, by parents, legal guardian, or person in loco parentis (one standing in for the parent with the parent’s rights, duties, and responsibilities) of minors or incompetent adults.
   4. If the minor is 14 yr old or older, consent must be acquired from the minor as well as from the parent or legal guardian. Emancipated minors can consent for themselves.