What is wrong? What wasn’t Ethical in the Bell J ar

1. What is wrong? What wasn’t Ethical in the Bell Jar

2. Ethical and Legal issues • Consent from patient wasn’t obtained • Procedures implemented in the Bell Jar weren’t implemented based on patient consent. • Health care providers didn’t inform patient about procedures, treatment side effects, and other treatment options weren’t discussed with the patient. • HIPPA was violated. Dr. Gordon didn’t ask Esther for her permission when disclosing her health status and health information to Esther’s mother. • Nurses at hospitals didn’t keep confidentiality of other patients; one of the nurse told Esther about other patient’s medical history. • Nurses weren’t patient advocate, no nurse advocated for Esther.

3. Patient had no right to refuse treatment, for example Esther didn’t want to take her treatment (ECT), but she was forced to take the treatment. • No one listen to what the patient has to say; especially mentally ill patients.

4. Esther wasn’t asked if she want visitors or not. • They brought a minister of the Unitarian church, and she didn't like it (Plath, 1967, p. 202). Before brining religion and spirituality to one's care clients must be asked if they are willing.  When visitors come they compared the past Esther and the present Esther, like comparing her weight change, hair, and in general her look, and they made her feel bad. Her mother kept on begging her to tell her what Esther had done wrong to be mentally ill. Which made Esther more stressed.

5. non-therapeutic communications used • Health care providers and family members didn’t use therapeutic communication when interacting with patients, or Esther. • Esther’s mother didn't use therapeutic communication. She was telling Esther that she has spent her whole money on her and she told Esther that Esther need to be thankful to mr. Guinea (Plath, 1967, p. 185).

6. The Nurse when she is trying to give Esther injection she said " Lie down " that was aggressive and wasn't polite. Esther being mentally ill should have been handled in more polite way. The nurse didn’t orient and inform clients about the events the client should be expecting during the day. When it comes to Esther’s case, the nurse was folding Esther's cloths without letting Esther know that she is moving to another facility, that increased suspicion in Esther and Esther ended up thinking they are going to take her to Wymark which is a place for those who are very ill (Plath, 1967, p. 193).

7. The Dr. Nolan was smoking cigarette infront of the patient (Plath, 1967, p. 201), that wasn’t appropriate.

8. In my opinion treatment used wasn’t appropriate. Esther’s treatments were electric shock and insulin injections. Electroconvulsive therapy wouldn't be a treatment of choice for patients like Esther, because Esther wasn't given other treatments before. ECT is initiated for major depressive disorder with psychotic of melancholic symptoms and bipolar disorder depression, only if other treatment of choices were considered and failed (Townsend, 2012, p. 346). 

9. References • Plath, S. (1967). The Bell Jar. England: Harper Collins. Retrieved March 05, 2013 • Townsend, M. C. (2012). Psychiatric mental health nursing. Philadelphia : F.A. Davis Company . doi:9780803627673