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).
Analyse Legal and Ethical Issues Facing Paramedics In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients.
Paramedical ethics during acute emergency medical service referral At the same time, the task of the paramedics is to improve their patients health conditions and choose the best way of treatment in every particular case. Cuts in public health and community services funding have decimated programs, leaving unmet health needs. 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). Consequently, the crew began to assess for a psychological cause. 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. 2011). Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. 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).
Ethics and law in paramedic practice: Boundaries of capacity and Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. http://dx.doi.org/10.1136/pmj.79.929.151 Among the most significant and complicated ethical dilemmas in nursing, it is possible to distinguish the problem of euthanasia, abortion, truth-telling as opposed to deliberate deception, and freedom contrary to control. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. 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). 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).
Paramedic Practice Test | Answers & Explanations | Test-Guide For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. Notify the family that once CPR has been initiated, you are required to transport the patient. Abstract. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. 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). 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. Furthermore, capacity can fluctuate, so clinicians must favour capacity assessments made at each attendance over capacity assumptions because of vulnerability or previous dealings with the patient. You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice.
Maintaining a professional boundary between you and your patient (summary) Despite this, there remain multiple barriers to their fully effective provision of such care. 122: 10 Researching paramedic clinical practice a practical guide. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. Avulnerable adult is a person who is at increased risk of harm or exploitation because their ability to make decisions, express concerns or defend themselves is diminished (Oxford University Hospitals NHS Foundation Trust, 2016; Byju et al, 2019; de Chesnay, 2019; University Hospital Southampton NHS Foundation Trust, 2019). At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. The first concern for an EMT must be: A. patient safety. Mental illness can be a challenging vulnerability for clinicians to navigate. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. Law and Ethics for Paramedics: An Essential Guide Authors: Georgette Eaton University of Oxford Abstract Providing a clear and concise overview of applied law and ethics to UK paramedic.
Ethical Practice: NCLEX-RN - Registered nursing / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. Chat. 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. 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. 8 Quantitative research in paramedic practice an overview. 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). 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. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Many people with an intellectual disability or communication difficulties often have written information available, particularly in care facilities, that has been compiled with the assistance of family members, health professionals such as occupational therapists or speech pathologists, psychologists and (of course) the patient (e.g. Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence.
You will see the questions are broken down into the 5 different categories you will be tested on. 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. This research aims to highlight and explore underlying values present within practice-based decisions. 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. 1. be able to practise safely and effectively within their scope of practice 2. be able to practise within the legal and ethical boundaries of their profession 3. be able to maintain fitness to practise 4. be able to practise as an autonomous professional, exercising their own professional judgement All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice.
Ethics part 1: what do paramedics owe patients? Among the main legal principles to be fulfilled in paramedicine, protection of personal data, regulation of drugs consumption, suitability of the medical equipment, and protection and safety of the patients should be considered (AAOS, Elling, & Elling, 2009). Major incident clinical . are more commonly known symptoms of psychosis, the symptoms demonstrated by John fall within the six hallmark features of psychosis as described by Kleiger and Khadivi (2015). They may need to consider whether community rapid response services or home GP visits are appropriate, whether additional support services should be organised or if they may need to ensure family members or friends visit the patient in a timely manner. Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. Like the abuse of children, the abuse of older people is a significant community concern. D. Incomplete .
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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. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014).
Paramedics' perceptions of the care they provide to people who self Although, hallucinations, delusions etc. 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). Journal of Paramedic Practice is the leading monthly journal for paramedics.
Ethical challenges in Emergency Medical Services - PubMed 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). Summary. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. 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. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. Paramedicine occurs in the social fabric of society. Aircraft Accidents and Emergency Management, Live Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. This is a part of and more. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". Wednesday, December 2, 2020. Box 1.Autonomy in a childAs a local paramedic, you have come to know Terry quite well over the years. 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. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. 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. By continuing you agree to the use of cookies. Therefore, it is important to consider those principles more precisely. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. 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. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of ethical practice in order to: Recognize ethical dilemmas and take appropriate action. 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. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. Paramedics interact with these patients every day, often during times of such vulnerability. Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence.
PROFESSIONALISM Professionalism in UK paramedic practice Prof Malcolm 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. This article explores 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. The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. Psychiatric admission for assessment and subsequent treatment if required. Together they form a unique fingerprint. B. EMTs are not liable for any actions that are accurately documented. 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).
Paramedic ethics, capacity and the treatment of vulnerable patients A legal concept important in understanding the extent to which children have autonomy in making their own healthcare decisions is Gillick competence, named after a landmark UK case (Gillick v West Norfolk and Wisbech Area Health Authority [1985]). Copyright 2023
They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. There were no obvious physical causes for John's behaviour at this stage. All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient.
The Paramedic'S Guide To Research: An Introduction - Google Books More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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. Monday, January 2, 2017. 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. 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. In other words, the paramedicine practitioners should inform the patients about all the probable effects of treatment as well as explain its moral and ethical issues. 136: 11 The future for paramedic research. Consumer rights in advocacy and health care. For many, staying at home is an important consideration in their decisions; older people may only wish to receive care that can be delivered in their home. Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. Paramedic ethics, capacity and the treatment of vulnerable patients Paramedic ethics, capacity and the treatment of vulnerable patients Dominique Moritz, Phillip Ebbs, Hamish Carver Wednesday, December 2, 2020 Vulnerable patients are at an increased risk of harm or exploitation in healthcare. 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. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008).
Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. 2 The HCPC standards of conduct, performance and ethics. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. There is currently some debate as to whether the police are the most suitable personnel to be detaining patients under the MHA for a variety of reasons, and paramedics are mentioned as a potential alternative group to utilise this law in the future (Department of Health, 2014). 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). It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. 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). This principle refers to both physical and mental damage, which can be done to the clients. 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. 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. MA Healthcare Ltd
Vulnerable patients are at an increased risk of harm or exploitation in healthcare.
Bachelor of Paramedic Practice (ADF Conversion) (53D) According to Jones et al (2014), the third principle of the MCA (see Table 1) allows patients with capacity to make their own decisions even if they appear unwise or irrational. 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. These factors contribute to an ethically complex decision-making environment. Paramedic practice must consider all of these factors to ensure ethically good care. 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.
Continuing Professional Development: Ethical issues in paramedic practice In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. For paramedics, this requires careful thought on how transport and referral dispositions may affect the care and wellbeing of the other vulnerable person. In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. 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. 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. Professional practice framework, professional rights and responsibilities, record keeping, governance. 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.
When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns.
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. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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. Paramedic Practice Test. 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. 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).
Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. Continuing Professional Development: Ethical issues in paramedic practice Continuing Professional Development: Ethical issues in paramedic practice Friday, August 5, 2011 OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. The crew's assessments and thought processes surrounding the management of John will be discussed. NHS Research and Development Permissions were sought and granted. 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. Other sections of the MHA can be utilised to remove a person from their property but require further input from other professionals ranging from magistrates to psychiatric doctors and approved mental health professionals (see appendix 2). Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). Decision making in this environment is intended to provide care and treatment in the best interests of the patient. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them.
This will also help you learn important concepts for the exam.
Paramedic ethics, capacity and the treatment of vulnerable patients Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet Confusions surrounding said laws have been extracted from the case report and discussed in more generic terms in order to be more readily applicable to other similar cases. 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. Paramedics have professional duties toward vulnerable persons. 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? As such, John was assessed using the MCA (Department of Health, 2005) to ensure that he had the capability and right to make his own decisions. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . Should the MCA have been used, John would have been transported to an accident and emergency department, which may not be the most suited to deal with his condition (Morrisson-Rees et al, 2015; O'Hara et al, 2015), whereas the use of the MHA allowed him to be transported directly to a mental health unit. C. vehicle safety. 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. In addition, due to John's virtually complete lack of speech, it was excessively difficult to ascertain if he was suffering any hallucinations/delusions at that time.