It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. Paramedics interact with these patients every day, often during times of such vulnerability. Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. Unfortunately, in this case, it was wrongly thought by the crew that the MCA could not be used to enforce treatment plans for mental health conditions. PDF Ethical Questions in Emergency Medical Services: Controversies and Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). Have your partner contact the communications center to send law enforcement to the scene, as this is now a legal issue and the officer will make the decision. Ethical issues in medical malpractice - PubMed These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. | This means that not only must they avoid doing harm - non-maleficence, they must also display active well-doing and an unselfish concern of the well being of others - beneficence. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: Select one: A. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. The crew's assessments and thought processes surrounding the management of John will be discussed. 136: 11 The future for paramedic research. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. Health care professionals may be more likely to use the MCA to enforce treatment should they consider the patient unlikely to meet the threshold for detention under the MHA. The paramedics should consider every individual case and act fairly and objectively in every situation (Beauchamp & Childress, 2008). Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. Gillick competence addresses children's understanding and provides paramedics and other health professionals with a means to determine the extent of involvement a child should have in decisions that affect their healthcare. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. The ethics in paramedicine has become a field of interest for many scientists and researchers. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). Paramedics are required to make these decisions within settings that are often disordered, uncontrolled and unpredictable, where all the relevant information and circumstances are not fully known. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. | Purpose of the fitness to practise process. This paper highlights some of the ethical dilemmas that face practising clinicians in their everyday life and restates how useful the General Medical Council guidance is to make appropriate decisions. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. practice with medical specialists. Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet This is a condition referred to as alogia or poverty of speech and is another sign of psychosis (Turner, 2009; Harris and Millman, 2011; Kleiger and Khadivi, 2015). Often, a person's capacity to consent to care is presumed intact until such a time that the patient refuses treatment, which appears to be in their best interest (Jones et al, 2014). In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. People with mental illness may also be vulnerable because their illness may sometimes render them unable to make some decisions or, like older patients, their decision-making ability fluctuates. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. Speaking about the legal principles of paramedical practices, it is important to mention that legislative acts and rules are common for all individuals and organizations despite the scopes and directions of their activities. Interestingly, in some Australian states, paramedics have been granted powers under their MHA to detain mentally ill patients who require involuntary treatment (Parsons and O'Brien, 2011). Ethics, bioethics and legal issues in paramedic practice. Sample Essay on Law and Ethics in Paramedical Science Continuing Professional Development: Ethical aspects of consent, duty From this standpoint, paramedics play a significant role in consideration of ethical issues and bear responsibility for the preservation of both legal and moral standards in every individual case of interaction with the patients. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). Paramedics are required to make these decisions within settings that are often disordered, uncontrolled and unpredictable, where all the relevant information and circumstances are not fully known. Paramedic: Legislation And And Guidance That Govern The - Edubirdie While the moral or ethical side of paramedicine depends on various religious, cultural, and personal beliefs and views, its legal aspect has a strict definition. As such, making John secure was a priority. Bachelor of Paramedic Practice (ADF Conversion) (53D) 4 Conducting ethical research in paramedic practice. ethics of paramedics - SlideShare However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? Legal & Ethical issues associated with paramedic practice during COVID19. After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. It is not clear though, how professionals (especially those who do not use the MHA) are likely to know in advance if a patient is likely to meet threshold for detention under this act, and so whether the MCA seems appropriate for use or not. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. You'll examine the relationship of law and medicine together with the interplay of medical ethics, analyse the development of medical negligence and consent to medical treatment as well as international medical ethics issues arising from birth to death. EMT Chapter 1 Flashcards | Quizlet The Australasian College of Paramedicine The term psychosis can be used as an umbrella term for a number of different psychotic disorders (NICE, 2014) and so will be utilised here due to the lack of specific diagnosis present for John. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. Ethical Issues in Paramedic Practice | Free Essay - Essayscreator.com Therefore, they should consider the needs and requirements of patients and act correspondingly. Ethics and law in paramedic practice: Boundaries of capacity and Together they form a unique fingerprint. Capacity is the legal principle, that a person is able to make decisions about their own healthcare where they can demonstrate an ability to understand relevant information given to them about their condition, retain that information and use or weigh that information to make an informed and considered choice (Mental Capacity Act 2005). Removed to place of safety for up to 72 hours for further assessment. Berry (2014) and Roberts and Henderson (2009) found that a large number of paramedics feel that they are undertrained and possibly underequipped to effectively assess and manage mental health conditions. B. EMTs are not liable for any actions that are accurately documented. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. care passports). author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". Download Free PDF View PDF AB - Decision-making is central to the everyday practice of paramedicine. 1 Demonstrate an adaptive, flexible and self-directed commitment to the promotion, maintenance and restoration of health and to the delivery of primary health care across the lifespan. Study with Quizlet and memorize flashcards containing terms like The judicial branch at the state level is responsible for, If a paramedic is attacked by a violent patient, When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. Consequently, the crew had to consider alternative management plans for John. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) Ethical Responsibilities of Paramedics | Work - Chron.com Paramedics may be the first health professionals to encounter these vulnerable adults and be the link to not only ensuring they receive the clinical care required at the time but also to breaking the cycle of abuse through notifications or referrals to agencies and support services. PARAMEDIC2 study: Ethical issues | Medicina Intensiva Therefore, it is important to consider those principles more precisely. The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. However, while parental responsibility involves exercising legal decision-making authority for children, children do have the ability to make some healthcare decisions for themselves in certain circumstances. A paramedic should always ensure the confidentiality of not only a patient's medical information but also his or her personal information (Pozgar & Pozgar, 2012). Decision-making is central to the everyday practice of paramedicine. It is diffcult tp prove actions were performed if they are not included on the report. Copyright 2023 An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests. Paramedics have professional duties toward vulnerable persons. Writing a prescription: the law and good practice Paramedic independent prescribing offers an opportunity to improve patient access to medications. Ethical problems in clinical practice | Postgraduate Medical Journal At the same time, the education should not be subjective, prejudiced, or convincing as the patients have to make their own decisions concerning their lives and health conditions. C. Patient care cannot be discredited based on poor documentation. If a person is then deemed to have capacity and continues to refuse care, paramedics are forced to balance their duty to protect life against the patient's right to make autonomous decisions (Hodgson, 2016). Pre Hospital Ethics and Legal Issues - LawTeacher.net Paramedicine presupposes direct interaction with individuals. Using a reflective format, the article explored some of the laws surrounding treatment without consent and how these may aid or hinder a paramedics' ability to provide good quality care to patients in complex situations. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. It seems that deciding which act is most appropriate must be managed on a case-by-case basis factoring in issues such as access to healthcare professionals available to utilise the MHA (as paramedics do not have it), the likely cause of the persons behaviour (physical/psychological), whether the patient seems likely to meet the threshold for detention under the MHA, and equally whether the patient is likely to be assessed as lacking capacity under the MCA. Children are considered vulnerable patients because until they reach the age of 16 (Mental Capacity Act 2005: section 2(5)), their parents have parental responsibility for decision-making. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . For others, their mental illness may impede them in such a way that clinicians will deem the person unable to make decisions about their own healthcare. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. People with a disability may have carers who assist with decision-making and/or to protect their wishes, or who are entirely responsible for decision-making. Undergraduate students who study ethics in nursing have an opportunity during their clinical practice, to discuss and reflect on a range of ethical and moral actions. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. A recent topic of concern has been the extent to which paramedics and other health and care professionals are required to report instances of known or suspected child abuse or neglect (Foster, 2020). With regard to the addition of powers under the MHA for paramedics, Berry (2014) argues that the MCA (2005) should be sufficient for paramedics to manage mental health patients and where needed deprive them of their liberties, however the act appears to be neither sufficiently understood nor utilised and requires the patient to lack capacity, which is complex to assess and often present in mental health cases. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. 2 The HCPC standards of conduct, performance and ethics. You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. For example, in England and Wales under section 74 of the Serious Crimes Act 2015, health professionals have a legal duty to notify the police if they discover female genital mutilation. The police, however, do have the power to utilise section 135 and 136 of the MHA (1983). In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. For example, older patients may experience an acute delirium from an infection that temporarily renders their capacity limited, or may lose capacity permanently because of progressive illnesses such as dementia. Nevertheless, paramedicine policies should encourage patients to follow a healthy way of life and apply certain procedures, without intervening in their personal lives and decisions (Sharp, Palmore, & Grady, 2014). John's risk to the public must also be considered, which, in spite of public opinion, is not usually any higher in psychotic patients (Davies, 2009). Vulnerable patients are no exception. And even though the legal issues may have been covered, the ethical implications of the lack of healthcare provided are undoubtedly contrary to good clinical practice given it represents the deliberate concealment of a therapy (or lack of it) used in a given person. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Foundations for paramedic practice: a theoretical perspective - Amazon After that, we provide a few recommendations that can assist healthcare professionals in improving their capacity for making ethical decisions. In the first article of this series on applied ethics in paramedicine, the authors examined the ethical principles of autonomy and beneficence in the context of principlism (Ebbs et al, 2020). Efficiency and equity - Providers commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. Ethics National Health Service (NHS) ethical approval was deemed unnecessary during proportionate review, as interviews were with existing staff and no changes to their practice were planned, nor was any contact made with patients. Purpose and effectiveness - Decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines. Ethical considerations in prehospital ambulance based research They must also deliver care that is consistent with ethical. Sign up to Journal of Paramedic Practices regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. Chat. They help organize the work activities and solve various contradictions between the legal and moral aspects, professional and personal judgments, and cultural and social norms. However, it is also essential to explain their view on the problem and prove the beneficence of their choice to reach an agreement with the patients (Aehlert, 2012). Ethics and law for the paramedic Reflective practice and communication Professional issues, including clinical audit and governance and anti-discriminatory practice Psychological perspectives on health and ill health Safeguarding children Sociological perspective on health and ill health and social policy Principlism in paramedicine: an examination of applied healthcare ethics Integrated health care including mental health. It means that all actions and decisions implemented by the paramedicine practitioners should not only comply with the moral aspect but also with the legislative laws and rules (Aehlert, 2012). BSc (Hons) Paramedic Science | Buckinghamshire New University Within this, confusion and limitations surrounding both the MCA and the MHA will be explored, as well as how these may affect patient care and any key areas that could be developed in the future. The MHA already provides the provision for the appropriate clinicians to provide medical treatment for mental health disorders without consent, whether the patient has capacity or not. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. Such an approach preserves all ethical aspects of the paramedical profession since it shows respect to patients and reveals professional competence and help at once (Blaber, 2012). This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Disclosure of errors; quality improvement activities; the practice of defensive medicine; dealing with patients who wish to leave against medical advice; provision of . Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. This can make the balance of patient care and patient autonomy exceedingly difficult to strike, and lead to a number of ethical and legal dilemmas for paramedics (Townsend and Luck, 2009). Ethical Issues in Sports Medicine - In the United States - studocu.com Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Paramedical practice should not neglect the intentions of patients to undergo certain types of treatment but fulfill the required tasks responsibly and credibly (Sharp, Palmore, & Grady, 2014). All relevant services should work together to facilitate timely, safe and supportive discharge from detention. Although John appeared calm, and wasn't behaving at all aggressively at that time, the acute state of psychosis can be unpredictable, and pose serious risks (Hawley et al, 2011). Confidentiality, capacity and consent. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity to consent until proved otherwise. The authors have faced all eight of the clinical scenarios in this paper in their routine clinical practice. Copyright 2023 This expanded role builds on the skills and preparation of the Emergency Medical Technician (EMT) and Paramedic, with the intention of fulfilling the health care needs of those populations with limited access to primary care services. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? By utilising a reflective format, the article explores some of the laws surrounding treatment without consent and how these may aid or hinder a paramedics' ability to provide good quality care to patients in these situations. To assist paramedics in navigating these complex issues, the London Ambulance Service NHS Trust (2019) provides guidance on how to refer vulnerable people to services which may investigate the circumstances and ensure the safety and welfare of the patient). Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention . Ethical deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. Paramedic ethics, capacity and the treatment of vulnerable patients He wants to stay at home with his dog, who he feels safe with.Even though Terry legally lacks the capacity to make a decision against being transported to hospital, he is still a human being with agency and a level of intelligence. A person's capacity depends upon the nature of their disability. OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care.
ethical issues in paramedic practice
