Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. This principle refers to both physical and mental damage, which can be done to the clients. Overview Fingerprint Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession.
Paramedical ethics during acute emergency medical service referral EMT Chapter 1 Flashcards | Quizlet The priorities of the medical director C. The wishes of the general public D. Locally accepted protocols, During your monthly internal quality improvement (QI) meeting, you review several patient care reports . In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. Ethics part 1: what do paramedics owe patients? On the one hand, the paramedics should not neglect the interests and intentions of the patients. Together they form a unique fingerprint. The matter is that some spontaneous solutions or actions can negatively influence the patients and fail in the achievement of the desirable results (Beauchamp & Childress, 2008).
Paramedic attitudes and experiences of enrolling patients into the In other words, paramedics need to adopt the principle of confidentiality and credence. These risks seemed higher in John's case as he appeared somewhat detached from reality, as is true in psychosis (Kleiger and Khadivi, 2015), and so oblivious to the risks around him. Once an allegation is made, the HPC will arrange for it to be reviewed by paramedics, other allied health professionals, and, most importantly, members of the public, to determine if Mental illness can be a challenging vulnerability for clinicians to navigate.
There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. Consequently, the crew had to consider alternative management plans for John. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). There are particular ethical challenges when multiple vulnerable groups are involved, such as when a mental health patient is also a parent or is caring for an older person. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. Capacity can fluctuate over time or as a health condition changes. Overview This CPD module aims to outline, describe and explain some of the key ethical-legal issues in paramedic practice, and their relation to the concept of consent, a duty of care and negligence. All of these ethical issues represent significant dilemmas to consider for the sake of patients health as well as moral and legal justification (Bledsoe, Porter, Cherry, & Armacost, 2006). A progression of learning in terms of acting morally and ethically is necessary when nurses undergo training on both an undergraduate and a specialist level.
Our fitness to practise process is designed to protect the public from those who are not fit to practise. However, if a person seems likely to be detained under the MHA, decision-makers cannot normally (p.234) rely on the MCA to give treatment for, or make decisions about, a mental health condition.
Community Paramedics | American Nurses Association Legal | Journal Of Paramedic Practice With this considered, it appears that in John's case, the MCA would have been an appropriate means with which to act in John's best interests and convey him to a place of safety for further treatment, which would most likely have been the nearest emergency department.
Continuing Professional Development: Ethical issues in paramedic practice Practitioners must be mindful that, despite the frequent interactions with these patients, their behaviour is often perpetuated by mental illness, and the patient needs care for their chronic illness just the same as they would for any other illness. However, the House of Lords found there were circumstances when a child could consent to their own medical treatment without the clinician seeking or obtaining parental consent. Notify the family that once CPR has been initiated, you are required to transport the patient. These factors contribute to an ethically complex decision-making environment. They identify and direct the work of the paramedical practices as well as determine all possible ways of interacting and communicating with patients (Bledsoe et al., 2006). Paramedic practice must consider all of these factors to ensure ethically good care. 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. 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 is not the case. 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).
Fitness to practise - Health and Care Professions Council A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. This course is made up of a number of paramedic specific units and additional health care units. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. 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. MA Healthcare Ltd
2011). After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. There were no obvious physical causes for John's behaviour at this stage. While the second article in this series (Carver et al, 2020) discussed mental illness where it related to end-of-life care and self-harm, it should be remembered that patient vulnerability can exist in those with chronic mental illness over their lifetime. Specifically, if a child has sufficient intelligence and maturity to understand the nature and consequences of particular treatment, they are able to consent to that treatment independently and without parental input according to the UK's Gillick competence doctrine. Having considered the probability of causes for John's symptoms, the crew suspected John may have been suffering from psychosis.
(PDF) Applied paramedic law and ethics . Townsend and Luck (eds)(2013 This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). That said, we must not forget the potential for the additional confusion seen overseas once given access to further legislative powers (Townsend and Luck, 2009). 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.
Paramedic: Legislation And And Guidance That Govern The - Edubirdie Inform client/staff members of ethical issues affecting client care. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities.
Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. Chat. 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. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. A Department of Health and Social Security memorandum at the time instructed medical practitioners to provide confidential medical advice to children under the age of 16 without a parent present. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". Although provider judgment plays a large role in the . Consumer rights in advocacy and health care. 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.
Challenges UK paramedics currently face in providing fully effective 2 Function, build and sustain collaborative, professional relationships as a member of a team within multidisciplinary teams and agencies doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". 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. author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". Paramedics play an integral part in community end-of-life care (EoLC) in the UK, especially given the lack of out-of-hours cover by palliative care specialists. In order to begin to discuss some of these complexities, a case report will be presented to allow exploration of the challenges paramedics may face when trying to manage patients presenting with mental health conditions that require treatment but are refusing aid against advice. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. As with any patient, capacity can fluctuate, although this is more likely with older patients. This article looks into the current difficulties many UK paramedics face when trying to manage patients presenting with a mental health condition in a safe and respectful manner; particularly when the patient requires some form of treatment but refuses this against medical advice. 2011b) and it didn't seem that John could have kept himself safe until such a time he could have been detained in this way.
Exploring New Zealand Paramedic Attitudes Towards Advance Directives Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. 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 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. Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. The ability to do the above forms key elements of an MCA assessment and suggests that John lacked capacity at that time (Department of Constitutional Affairs, 2007). NHS Research and Development Permissions were sought and granted. Examples of harmful actions include the lack of hospital care, utilization of unsuitable medicines, implementation of some procedures and interventions without the agreement of patients as well as the disclosure of confidential information (Aehlert, 2012). Unlike in countries such as Australia, Canada and the Republic of Ireland where there are mandatory reporting laws, individual health professionals in England are not criminally liable if they fail to report other instances of known or suspected child abuse or neglect (Forster, 2020).
In these complex cases with so many variables, it can sometimes be difficult to fit patients in-between the lines of any law, often meaning that when decisions are unclear, paramedics are forced to engage in a risk management strategy without the power or provision of involuntary sectioning (Palmer, 2011). Methods Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment.
(PDF) Reflective Practice for Paramedics - ResearchGate Copyright 2023
Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. Furthermore, those with mental illness may at times experience treatment and management that limits their autonomy, such as during times of severe psychosis where a patient's autonomy is lawfully overridden in their best interests through the use of chemical or even physical restraint. . Wherever possible a patient's independence should be encouraged and supported with a focus on promoting recovery wherever possible. The first concern for an EMT must be: A. patient safety. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. The ethical and legal principles of autonomy and capacity help to protect patients and clinicians from abuses of power and exploitation in the healthcare relationship because they establish safeguards for patients. It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. With the exception of life-threatening situations (where a paramedic will often act in the patient's best interests to protect the patient's wellbeing), the preference is for clinicians to restore capacity or to wait for capacity to resume before intervening in the care of the patient. It is diffcult tp prove actions were performed if they are not included on the report. The crew's assessments and thought processes surrounding the management of John will be discussed. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. Townsend and Luck (2009) state that these additional legislative powers have actually led to more confusion for paramedics attempting to manage mental health patients, advocating the need for further training in order to grasp a better understanding of the ethics and law involved. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes?
Ethical problems in clinical practice | Postgraduate Medical Journal Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. Understanding capacity to consent to research (capacity) The first theme addresses physical and mental capacity and the ability of patients in the ambulance setting to make informed choices. It can be used by . According to Harris and Millman (2011), in the earlier stages of schizophrenia, a chronic form of psychosis, the patient is likely to behave in a bizarre manner that is out of character to them, as was true of John. Legal & Ethical issues associated with paramedic practice during COVID19. Clinicians and families may become more involved in the decision-making process or take over that decision-making role in the vulnerable person's best interests. Indeed, there is an argument that if we are to expect an improvement in the way emergency services manage mental health presentations and safeguard a vulnerable patient group, emergency services must be provided with the relevant tools and training to do so (Brown, 2014). It affirms the supremacy of law and appreciation of human rights and freedom. prevent the safe and effective practice.5 Ideally, the paramedic concerned should report any of the above issues themselves, as this reflects professional behaviour. However, the Department of Health (2015) clearly state that it is, so long as the patient hasn't already had their liberties removed under the MHA (1983). All of these actions may devaluate the positive results of treatment and harm patients health and well-being. Removed to place of safety for up to 72 hours for further assessment.
Ethics and law in paramedic practice: Boundaries of capacity and Ethics and law in paramedic practice : Boundaries of capacity and interests. This third and final article in the series starts by describing the relationships between the legal principle of capacity and the ethical principles of autonomy and beneficence.
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The COVID-19 pandemic and the paramedic response to it, has raised a raft of legal, ethical and professionalism questions for paramedic clinicians and managers. Cuts in public health and community services funding have decimated programs, leaving unmet health needs.
Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet 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.
Ethical challenges in Emergency Medical Services - PubMed Fluctuation of capacity means that a person's ability to understand information, retain that information and make an informed decision can come and go.
Paramedic Professional Practice | Curtin University 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. Therefore, consideration of these effects is part of how they treat patients and make decisions. abstract = "Decision-making is central to the everyday practice of paramedicine. The disawdvantage to the use of the MHA in this case though, is that it required police involvement as opposed to health care professionals (Parsons et al, 2011), which the Department of Health (2014) appear to be attempting to move away from in their review of section 136 of the MHA. 4 Conducting ethical research in paramedic practice. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. 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). 2 The HCPC standards of conduct, performance and ethics. In the theory of principle based ethics a paramedic must practise non-maleficence and beneficence. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. However, children's life experiences, maturity and understanding differ from one individual to the nextdepending on factors such as their age, culture, health, upbringing, background and environmentsand their ability to process healthcare-related information also varies. B. EMTs are not liable for any actions that are accurately documented. 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. Samantha May
Introduction. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. You note that at 10 years old, he has already had life experiences that many adults would dread.Is it reasonable for a paramedic to be concerned about infringing Terry's autonomy and, if so, how might a paramedic address this problem? This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. This case report highlights the potential difficulties and complications associated with the management of mental health incidents for ambulance crews (Parsons and O'Brien, 2011) as well as how potentially confusing the ethical and legal aspects are when managing mental health conditions that require some involuntary form of treatment (Townsend and Luck, 2009). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient.
Ethical Issues in Sports Medicine - In the United States - studocu.com Jobs that involve the application of the MCA, either to protect the patient or deprive them of their civil liberties, can present a number of challenges to paramedics. This will also help you learn important concepts for the exam.
(PDF) Ethics In Paramedic Practice: A Qualitative Case Study of There are many ethical issues that are encountered during the prehospital care of children and adults. Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). This principle refers to both physical and mental damage, which can be done to the clients. The ethical responsibilities of a paramedic also include acting fairly and helping any patient who needs it, regardless of their race, age, gender, religion or another personal characteristic.. Reflective practice is undertaken for a variety of reasons. Abstract. Download Free PDF View PDF Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. All rights reserved, Paramedic ethics, capacity and the treatment of vulnerable patients, Dominique Moritz, Phillip Ebbs, Hamish Carver, Explain why some people are considered vulnerable, Identify vulnerable patient groups that may be treated by paramedics, Discuss the relationship between autonomy and capacity in vulnerable patients, Reflect on their own practice to implement strategies that ensure vulnerable patients are protected. 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. Another important aspect when treating patients with mental illness is the stigma associated with mental ill health (Fink and Tasman, 1992). After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. However, in the emergency setting, where a patient is only temporarily detained (either under section 4, 5 or 136 of the MHA) and awaiting further assessment, the patient cannot yet be treated without consent under the MHA. 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. Nurses are expected to practise in an ethical manner, through the demonstration of a range of ethical competencies articulated by registering bodies and the relevant codes of ethics (see Boxes 5.1 and 5.2).It is important that nurses develop a 'moral competence' so that they are able to contribute to discussion and implementation of issues concerning ethics and human rights .