ethical issues in paramedic practice

As with any patient, capacity can fluctuate, although this is more likely with older patients. Inform client/staff members of ethical issues affecting client care. A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. Some people with a disability may have mobility issues that do not affect their capacity to consent to treatment and decision-making, while others with a disability may not have decision-making capacity for numerous reasons, including communication difficulties or intellectual disability. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. MA Healthcare Ltd Negligence relates to all areas of legal and ethical issues for a paramedic, if a paramedic breaches their duty of care, treats without consent, or doesn't treat patient information with the confidentiality that they deserve then they may be deemed negligent, and therefore face legal action. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. 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). Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. There are many ethical issues that are encountered during the prehospital care of children and adults. John spent most of his time standing, staring into space during the crew's presence, a further sign associated with psychosis, where patients spend extended periods of time seemingly doing nothing (Turner, 2009). However, in this case the crew on scene were unable to utilise any sections of MHA, nor could they arrange for an MHA assessment by other professionals. 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. Removed to place of safety for up to 72 hours for further assessment. Disclosure of errors; quality improvement activities; the practice of defensive medicine; dealing with patients who wish to leave against medical advice; provision of . 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, given the earlier acknowledgment of paramedics feeling undertrained to assess mental health patients (Roberts and Henderson, 2009; Berry, 2014) it could be questioned how equipped paramedics would be to utilise this act. This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. Ethical Responsibilities of Paramedics | Work - Chron.com It seems important to note that had John been in a private place, this option would have been void, which may have presented an even more complex situation to manage safely and legally. (PDF) Law and Ethics for Paramedics: An Essential Guide Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action. A. Although, hallucinations, delusions etc. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. Moreover, the principle of beneficence involves the necessity to provide sufficient and professional communication and interaction with such patients, without demonstrating their subjective judgments and assessments of the situation. 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. Allowing a 16-year-old person to make healthcare decisions yet restricting a person one month before their 16th birthday from doing the same seems arbitrary and illogical. Practical issues of capacity, autonomy and beneficence as they apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, those with a mental illness and persons with a disability are explored. | From this standpoint, the paramedics have to follow the same regulations and standards that are mandatory for the whole country. This study explores the nature of paramedical ethics during the high-stakes referral of emergency ambulance patients, and relates findings to accepted concepts of professionalism. Older people are largely understood as vulnerable when they fall within the high-risk groups of frail, isolated or poor (Schrder-Butterfill and Marianti, 2006). Paramedics interact with these patients every day, often during times of such vulnerability. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. For example, a patient might have capacity to refuse their temperature being taken or other observations but not to refuse transport to hospital. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. . Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. 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. Copyright 2023 However, it's unclear whether the MCA would have been the best act to utilise to provide treatment without consent in this case. Paramedicine presupposes direct interaction with individuals. 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. ethics of paramedics - SlideShare Ethics and law in paramedic practice : Boundaries of capacity and interests. Bachelor of Paramedic Practice (Conversion Pathway) (53C) 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. The use of the other sections of the MHA can require much more time (Hawley et al. An introduction to reflective practice for paramedics The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. It is important to remember that capacity is not a binary state; it exists on a continuum and depends upon the patient's circumstances and the potential consequences of the decision being made. EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz 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 deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. In this case, the MCA can be applied in the normal way, to provide treatment, even if for mental health disorders, should the person lack capacity (Department of Constituational Affairs, 2007). 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. A person may be deprived of their civil liberties in order to be provided with care or treatment that they are unable to consent to due to a lack of capacity, if is in their best interests (Ministry of Justice, 2008; Amblum, 2014). Besides, their classification sets the right vision for the development of paramedicine and provides it with the required tools and methods of acting and solving various dilemmas. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. This seems like a confusing area and it is unsurprising that paramedics report feeling unsure of exactly how to assess and utilise the capacity act (Amblum, 2014). T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. 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. 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. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". 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). It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. 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). However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. Challenges UK paramedics currently face in providing fully effective AB - Decision-making is central to the everyday practice of paramedicine. Thompson et al (2011) highlight that frequent callers (also known as frequent users) are known to clinicians because they regularly require paramedic support, usually as a result of a mental illness. A clinician's role in supporting vulnerable people and reporting abuse and neglect is crucial to protecting patients and allowing them to continue exercising the greatest possible level autonomy over their own healthcare. 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). practice with medical specialists. http://dx.doi.org/10.1136/pmj.79.929.151 Due to this misconception, the crew then considered the MHA (1983). Medical Ethics: Non-Maleficence - The Medic Portal Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. By continuing you agree to the use of cookies. The ethical principle of non-maleficence means that paramedicine practitioners should discuss the probable negative consequences of their decisions and prevent them in order not to harm the patients. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. Principlism in paramedicine: an examination of applied healthcare ethics Nevertheless, it is important to understand that many ethical issues presented in health care have little to do with paramedicine as the latter focuses mainly on emergencies. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? A mother (Victoria Gillick) sought to have medical practitioners refuse to provide medical advice to her daughters, aged under 16, in relation to contraception. Principlism in paramedicine: an examination of applied healthcare ethics Phillip Ebbs, Hamish Carver, Dominique Moritz Sunday, August 2, 2020 Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. A patient who is treated by paramedics may be vulnerable because they lack the capacity to consent to treatment or, if they do have the capacity to consent to treatment, they lack the ability (or avenues) to express their worries about that treatment, or to defend themselves in circumstances where their consent has been misinterpreted. The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. The legal principle of capacity is closely aligned with the ethical principle of autonomy as both relate to the independence and freedom that a person can exercise over their own actions and decisions. This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. Practice in a manner consistent with a code of ethics for registered nurses. A sixth theme of ethical complexity was pervasive across these five themes. John scored low risk on the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) self-harm and suicide assessment tool (JRCALC, 2006), but could still be vulnerable to other dangers such as neglect or accidental involvement in incidents such as walking out in front of cars when in a confused state (Azakan and Taylor, 2009). 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). If a registrant's fitness to practise is impaired (in other words, negatively affected) it means there are concerns about their ability to practise safely and effectively. The approach to both participation and trial protocol training varied between ambulance services. Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. Introduction. This principle refers to both physical and mental damage, which can be done to the clients. 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. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. These factors contribute to an ethically complex decision-making environment. Paramedic practice must consider all of these factors to ensure ethically good care. Paramedic Practice Test. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. Consequently, the crew had to consider alternative management plans for John. Ethical deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. Background This case report discusses an ethical communication dilemma in prehospital patient interaction, involving a patient who was about to board a plane at a busy airport. The paramedics should take into account the health conditions of patients, the seriousness of their problem, their relations with relatives, and probable reactions to different types of treatment before making the final decision. D. Incomplete . OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. Ethical challenges in Emergency Medical Services - PubMed When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. (PDF) Reflective Practice for Paramedics - ResearchGate Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. 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. 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. Therefore, they should consider the needs and requirements of patients and act correspondingly. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). Such a position will help improve the system and lead to effective and fruitful results. Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict. 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. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. A major concern in healthcare ethics (including within paramedicine) is the protection of vulnerable persons within the realms of patient-practitioner interactions (Moritz, 2017; Townsend, 2017; Ebbs and Carver, 2019). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". At these times, police are frequently involved in the prehospital management of patients where there is a potential risk of physical harm to either the patient or paramedics. B. EMTs are not liable for any actions that are accurately documented.

Dupage County Arrests This Week, Peacock In Japanese Culture, Lax To Santa Monica Taxi Fare, Articles E