A nurse is explaining medication benefits and adverse effects to a client with a history of psychosis. The client's sibling states that explaining things to the client is a waste of the nurse's time. What information about informed consent should the nurse use to respond to the sibling's negative statement?

The nurse should inform the sibling that it is both a legal and ethical obligation to ensure that patients are given comprehensive explanations about their treatments, including the benefits and potential side effects of any medications prescribed. A patient with a history of psychosis still has the right to informed consent unless they have been legally declared incompetent to make such decisions.

Informed consent means that a patient must be in possession of all facts necessary to make a decision about their healthcare. This includes understanding what the medication is for, how to take it, the benefits it offers, as well the potential negative effects it may have. Even if a patient has a mental health condition like psychosis, they can often still understand explanations and participate in decisions about their care.

To respect the autonomy of the patient, the nurse should always attempt to communicate healthcare information in a way the patient can understand. If the client is not in a state to give true informed consent, the appropriate steps should be taken, which might involve working with a legally-assigned guardian or healthcare proxy, but this does not negate the responsibility to inform.

Extra: Informed consent is based on the principle that every patient has the right to autonomy – the right to choose or refuse treatment. This concept is grounded in basic human rights and is a fundamental part of healthcare. For informed consent to be valid, the information must be given in simple, clear language that the patient can understand, and the patient must be competent to make the decision.

For people with a history of mental illness such as psychosis, assessing competence can be more nuanced. Competency is not a fixed state and can change. A person may be competent at one time and not at another, depending on their mental state. If a person is in the midst of a psychotic episode, they might not be able to understand information or make decisions. However, outside of these episodes, they may be fully capable.

If a patient is deemed incompetent temporarily or permanently, alternatives to informed consent include obtaining consent from a legal guardian or healthcare proxy who is charged with making decisions in the best interest of the patient.

The conversation around medication in particular is vital because psychiatric medications often come with a significant risk of side effects, some of which can be severe. People taking these medications need to be aware of these risks to make an informed decision about their treatment and to recognize adverse effects if they occur. It is also a part of building trust between the patient and healthcare providers and ensuring adherence to the treatment plan.