| Description | A legal situation can concern a legal status and/or representation.
The legal status indicates the basis on which the patient is staying in a healthcare organization. This can be either voluntary or involuntary, however the legal status is always determined by a judge.
Representation is important in situations where a person is legally not competent to give permission and/or factually (partly) incapable of doing so. A representative supports and takes decisions in the interest of the representee when they cannot do so themselves (temporarily or permanently).
#### Purpose
Health professionals must be aware of the existence of a legal status or representation because this in part determines what type of care can be provided to the patient. For example, a supporting legal status can be required for using freedom restricting interventions. For a mentally incompetent patient, it must be clear that there is a representative for further decision-making: in this case, the health professional should follow the decision of the representative of the mentally incompetent patient, unless this is incompatible with the care of a good health professional.
#### Evidence Base
In version 2.0, the new legal statuses resulting from the new legislation on involuntary / compulsory care have been added to the LegalStatus value list. In version 1.0 this list was based on the Vektis value list LegalStatus. However, this list is no longer maintained. That is why the value lists in the new version are based on an internal Nictiz codesystem.
#### Instructions
In case of an intervention, a distinction is made between seclusion and separation. For the purpose of unambiguous recording, the following definitions are used:
Seclusion:
Seclusion is the confinement of a patient for care, nursing and treatment in a specially designated seclusion room. A seclusion room is generally a bare single room with only a bed, sometimes with a table, a chair, a wardrobe and occasionally washing facilities. Seclusion may not take place in the "own" bedroom.
Separation:
Separation is the confinement of a patient in a specially designated enclosed space that has been approved as a separation residence; for several years now the term Extra Secure Room (EBK) has been used for this. The separation space is a specially equipped room, with a mattress or riveted bed and mostly without furniture. Separation should be applied with great caution. The risks of harmful side effects of separation, such as anxiety and stress, are significant. Also in the context of safety, separation should be avoided as much as possible and alternatives should be sought to avert the danger. |
FHIR