Current through Register Vol. 30, No. 38, September 20, 2024
A. Except in an
emergency according to A.R.S. §§ 36-512 or 36-513 or
R9-21-204,
or a court order according to A.R.S. Title 36, Chapter 5, Articles 4 and 5, a
mental health agency shall obtain written informed consent in at least the
following circumstances:
1. Before providing
a client a treatment with known risks or side effects, including:
a. Psychotropic medication,
b. Electro-convulsive therapy, or
c. Telemedicine;
2. Before a client participates in research
activities; and
3. Before admitting
a client to any medical detoxification, inpatient facility, or residential
program operated by a mental health agency.
B. The informed consent in subsection (A)
shall be voluntary and shall be obtained from:
1. The client, if the client is determined to
be competent according to
R9-21-206,;
or
2. The client's guardian, if a
court of competent jurisdiction has adjudicated the client
incompetent.
C. If
informed consent is required according to subsection (A), a medical
practitioner or a registered nurse with at least one year of behavioral health
experience shall, before obtaining the informed consent, provide a client or,
if applicable, the client's guardian with the following information:
1. The client's diagnosis;
2. The nature of and procedures involved with
the proposed treatment, the client's participation in a research activity, or
the client's admission to a program operated by a mental health
agency;
3. The intended outcome of
the proposed treatment, the client's participation in a research activity, or
the client's admission to a program operated by a mental health
agency;
4. The risks, including any
side effects, of the proposed treatment, the client's participation in a
research activity, or the client's admission to a program operated by a mental
health agency;
5. The risks of not
proceeding with the proposed treatment, the client's participation in a
research activity, or the client's admission to a program operated by a mental
health agency;
6. The alternatives
to the proposed treatment, the client's participation in a research activity,
or the client's admission to a program operated by a mental health agency,
particularly alternatives offering less risk or other adverse
effects;
7. That any informed
consent given may be withheld or revoked orally or in writing at any time, with
no punitive action taken against the client;
8. The potential consequences of revoking the
informed consent; and
9. A
description of any clinical indications that might require suspension or
termination of the proposed treatment, research activity, or program operated
by a mental health agency.
D. A client or, if applicable, the client's
guardian who gives informed consent for a treatment, participation in a
research activity, or admission in a program operated by a mental health
agency, shall give the informed consent by:
1.
Signing and dating an acknowledgment that the client or, if applicable, the
client's guardian has received the information in subsection (C) and gives
informed consent to the proposed treatment, participation in a research
activity, or admission of the client to the program operated by a mental health
agency; or
2. If the informed
consent is for use of psychotropic medication or telemedicine and the client
or, if applicable the client's guardian, refuses to sign an acknowledgement
according to subsection (D)(1), giving verbal informed consent.
E. If a client or, if applicable,
a client's guardian gives verbal informed consent according to subsection
(D)(2), a medical practitioner shall document in the client's record that:
1. The information in subsection (C) was
given to the client or, if applicable, the client's guardian;
2. The client or, if applicable, the client's
guardian refused to sign an acknowledgement according to subsection (D)(1);
and
3. The client or, if
applicable, the client's guardian gives informed consent to the use of the
psychotropic medication or telemedicine.
F. A client or, if applicable, the client's
guardian may revoke informed consent at any time orally or by submitting a
written statement revoking the informed consent.
G. If informed consent is revoked according
to subsection (F):
1. The treatment, the
client's participation in a research activity, or the applicant's or client's
admission to a program operated by a mental health agency shall be immediately
discontinued, or
2. If abrupt
discontinuation of a treatment poses an imminent risk to a client, the
treatment shall be phased out to avoid any harmful effects.
H. If a client or, if applicable,
the client's guardian needs assistance with revoking informed consent according
to subsection (F), the client or, if applicable, the client's guardian shall
receive the assistance.
