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Operationalizing autonomy: solutions for mental health nursing practice
Author(s) -
HARNETT P. J.,
GREANEY A.M.
Publication year - 2008
Publication title -
journal of psychiatric and mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 63
eISSN - 1365-2850
pISSN - 1351-0126
DOI - 10.1111/j.1365-2850.2007.01183.x
Subject(s) - operationalization , autonomy , mental health , normative , health care , bioethics , legislature , nursing , narrative , sociology , psychology , engineering ethics , medicine , political science , psychotherapist , law , epistemology , philosophy , linguistics , engineering
The new Mental Health Act (2001) became a law on 1 November 2006. The new Act, reflective of international legislative norms, outlines an agenda for the mental health services in Ireland which, in part, aims to maximize patient autonomy. This paper seeks to contextualize autonomy within nurse–patient interactions in the mental health care setting. The acceptance of autonomy as an unconditional principle, as outlined within traditional bioethics, is challenged. The paper draws on the social critique of normative ethics and suggests an alternative framework within which to operationalize patient autonomy. The authors conclude that a broader, more contextualized perspective on autonomy would more suitably inform mental health nursing. Narrative ethics and a framework of ‘protective responsibility’ are offered as an alternative to more traditional approaches. Practice‐based initiatives to maximize patient autonomy and facilitate‐reasoned ethical decision making are outlined.