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NUR 620

Reply from Darya
Patient Care

Legal and ethical consequences caused by implementing the Baker Act in the specific case
of K.W.

The Baker Act, commonly referred to as the Florida Mental Health Act, establishes a legal
structure for the involuntary assessment and therapy of individuals considered to have a mental
disorder and who present a danger to themselves or others. The Baker Act may apply to K.W.,
who was discovered in a vulnerable condition, consuming food from a dumpster and rejecting
traditional housing. This legislation allows for the involuntary confinement of an individual
provided they satisfy certain conditions, which include:

• The individual must have clear signs of a psychiatric disorder.
• For an individual to be considered a threat to themselves or others or unable to care for

themselves, they must meet the criteria outlined in the Florida Statutes, Chapter 394,
2023.

K.W.’s conduct, which encompasses residing in unhygienic surroundings and declining
fundamental care, suggests a possible incapacity to attend to her own needs, fulfilling one of the
criteria outlined in the Baker Act.

Utilization of the Baker Act

According to the Baker Act, an involuntary examination can be initiated by a law enforcement
officer, mental health practitioner, or judge. Based on K.W.’s behavior, it is justified to intervene
under the statute.

• Involuntary Examination: This can be commenced if K.W. is deemed a threat to her well-
being due to her incapacity to meet her fundamental needs, perhaps resulting in
significant health risks.

• 72-Hour Hold: After being started, K.W. can be detained for a maximum of 72 hours to
observe and evaluate their condition to ascertain if more medical intervention is required.

Judicial precedents

The O’Connor v. Donaldson (1975) case determined that it is not permissible to involuntarily
detain an individual who is not dangerous and is capable of living safely in freedom. However,
K.W.’s circumstance is unique since she may not fulfil the requirement of being non-dangerous
due to her inability to take care of herself. This might theoretically justify her temporary
imprisonment under the Baker Act to ensure her safety and conduct an examination.

Newspaper Article in Support

An article published in the Miami Herald recently examined the situation of Jane Doe, a
homeless lady who was residing under challenging circumstances and displaying indications of
profound mental illness. The authorities utilized the Baker Act to administer her essential
medical and psychiatric assessment (Miami Herald, 2023). The legal procedure entailed a 72-
hour involuntary detainment, during which her mental well-being was evaluated, resulting in a
court ruling for ongoing therapy. This case highlights the use of the Baker Act to safeguard
individuals who are unable to make informed decisions about their healthcare because of mental
illness.

Ethical Considerations for Psychiatric Mental Health Nurse Practitioners (PMHNPs)

As a Psychiatric Mental Health Nurse Practitioner (PMHNP), it is essential to maintain a
harmonious equilibrium between legal obligations and ethical duties. The ideals of autonomy and
beneficence guide the acts done under the Baker Act.

• Autonomy: Upholding K.W.’s right to autonomous decision-making while considering
her safety and overall welfare is crucial.

• Beneficence: The main objective is to prioritize K.W.’s well-being by providing her with
the essential care and therapy required to address her mental health requirements.

In conclusion, applying the Baker Act in K.W.’s situation is consistent with legal statutes and
ethical values. Based on her behavior and living situations, it is evident that there is a substantial
threat to her health. Therefore, it is necessary to temporarily restrain her involuntarily to conduct
a thorough mental health assessment. This move guarantees her safety and enables the delivery
of suitable care while honoring her dignity and attending to her immediate needs.

References

American Psychiatric Nurses Association, & American Nurses Association. (2022). Psychiatric-
mental health nursing: Scope

and standards of practice (3rd ed.). Springer Publishing Company.

Florida Statutes, Chapter 394 (2023). Mental Health. Retrieved from Florida Legislature Website

Miami Herald. (2023). Authorities invoke Baker Act for homeless woman’s safety. Retrieved
from Miami Herald

Tusaie-BC, K., & Fitzpatrick, J. J. (2022). Advanced practice psychiatric nursing: Integrating
psychotherapy, psychopharmacology,
and complementary and alternative approaches across the life span (3rd ed.). Springer
Publishing Company

Reply from Daniela
Patient Care

Baker Act Law and Application

The Baker Act is also referred to as Florida Mental Health Act (Florida Statute (F.S.)
394.463). According to this act, an individual is involuntarily examined in case of a presumed
mental illness and an anticipated threat to him- or herself and others. To justify this kind of
examination, then the person should look mentally ill, they need to have either refused a
voluntary examination or lack the ability to give consent, and the behaviors of this person in the
recent past should justify the idea of real and imminent danger of substantial harm (Florida
Legislature, 2023). The law also demands that there is consideration of less restrictive
alternatives that are found to be inadequate before the less restrictive are adopted. Provided that
such requirements are not documented clearly, incarceration of a person under the Baker Act
may be deemed as unlawful restraint. Consequently, the legislation provides a basis to counter
the deprivation of liberty without justification and a protector of patients.
In the case of K.W., her inability to inhabit an apartment and tendency to search in the
garbage cans to find water and food might indicate that she has impaired judgment and is
mentally ill. Such behavior as eating food out of a dumpster and drinking out of a dirty hose are
also quite-unhealthy choices with the addition of her long-term lack of hygiene. In case such
actions are directly related to a mental illness that implies imminent peril of self-harm due to
neglect, one may call the Baker Act (Florida Legislature, 2023). A PMHNP will have a reason to
claim that his or her inaction will cause severe health damage to K.W. Therefore, the Act offers a
procedural way to initiate involuntary examination and at the same time, making sure that this
decision is driven by documented and observable facts.

It should be borne in mind that the Baker Act also suggests the least restrictive
alternative. Before engaging in the use of involuntary examination, the PMHNP should make
reasonable efforts to provide voluntary services or outreach and state why such would not stop
harm. To illustrate, K.W. refuses to take food assistance, housing or even simple hygiene care,
then the justification on involuntary action becomes viable. But assuming that she can agree to
receive some type of voluntary assistance, then the legal criteria of detention would not be
fulfilled (Florida Legislature, 2023). With minimal caution in mind, the PMHNP may justify
their actions and not be accused of a criminal offense of unlawful restraint.

Newspaper Article Example

There was a recent incidence in Florida that shows the danger of overlying the Baker
Act. In 2022, a Miami-Dade jury awarded the wrongfully institutionalized under the Act Susan
Khoury 520,000. The case alleged that the police had Baker Acted her without legitimate cause
and thus violated her civil liberties and acted against the specific provisions of the law. The jury
concurred that her arrest was unreasonable since she was not facing an imminent threat to herself
or anybody at the time (Local 10 News, 2024). This case demonstrates how simple an abduction

of the Act may be and what a devastating legal results and damage to rights of an individual may
follow.

The Khoury case reveals the manner in which courts regard the standards used by the
Baker Act. In order to be valid, a Baker Act must show behavior in the recent past that indicates
an imminent danger of harm (Local 10 News, 2024). In the case of Khoury, the officers lacked
the ability to prove the existence of such imminent dangers. The verdict made by the jury implies
that indicators under the law should be evident and objective rather than any casual suspicion.
This case is a lesson to healthcare practitioners to always adhere to the statute in order not to
incur liability by detaining someone.

Besides the Khoury case, the case incidences a lesson to the PMHNPs to always ensure
that the individual steps that they are about to take have been well documented and justified
before moving forward. The provider should make sure that he or she has denied the voluntary
care, less strenuous options are not applicable, and that the probability of harm can be proved by
the recent observable behavior. When these conditions are not met it not only violates patient
rights but also subjects the provider to the claims of false imprisonment or unlawful restraint.
The PMHNP can thus operate the best interest of the patient and be legally shielded, recognizing
the limitations of the statute and still within the scope of the statute, then care can be
administered (Local 10 News, 2024). The Khoury judgment explains that adherence to the
principle of law is important to the ethical and legal treatment of patients.

References

Florida Legislature. (2023). The Florida Mental Health Act (Baker Act), Fla. Stat. § 394.463.
Online Sunshine.
Links to an external site.
Local 10 News. (2022, May 14). Jury sides with woman’s claim of Baker Act misuse, awards
$520,000 in damages. Local 10 News.
agrees-with-miami-dade-womans-claim-of-baker-act-misuse-awards-500k-in-damages/?
utm_source=chatgpt.com

Links to an external site.

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