ethical issues in paramedic practice
This may entail organising supervision or support, transporting both the patient and their dependants in more than one ambulance if need be or arranging neighbour, support services or family visits. Consumer rights in advocacy and health care. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). 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. Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet Consequently, the crew began to assess for a psychological cause. In doing so, the article attempts to provide a clearer format of understanding of the laws and management of these situations, both for the benefit of future patients and the emergency services alike. keywords = "Ethics, Decision making, paramedic, complexity". Challenges UK paramedics currently face in providing fully effective 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. 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. This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. Journal of Paramedic Practice is the leading monthly journal for paramedics. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. These factors contribute to an ethically complex decision-making environment. 40: . Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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. Another ethical principle in paramedicine is beneficence. 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. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . 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). In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. 22,26,29,31,37,39-42 More than half the participants in one study raised concerns over handling conflict between patients and family members, especially when there were inconsistent expectations of . Ethical Issues in Paramedic Practice | Free Essay - Essayscreator.com Adult patients are presumed to have capacity to make medical decisions so treating them against their will violates their autonomy. 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. EMS Chapter 3 Medical, Legal, and Ethical Issues Quiz Ethics and law in paramedic practice : Boundaries of capacity and interests. The Bachelor of Paramedic Practice (Conversion) is a fully online program, designed to help currently practicing paramedics and advanced medics in the Australian Defence Force upgrade their existing qualifications. Paramedic: Legislation And And Guidance That Govern The - Edubirdie How does a paramedic use chemistry? [FAQ!] Ethical problems in clinical practice | Postgraduate Medical Journal @article{6040c026e1e34bd9b7239761b13480e7. 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. Therefore, it is important to consider those principles more precisely. 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.. 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. 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. Ethical Challenges in Emergency Medical Services: Controversies and | While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. 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. 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. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. Alternatively, when a patient is deemed to lack capacity, paramedics can then act in a patient's best interests without their consent under the MCA; this can create an equally complex situation where paramedics attempt to ensure the patient receives the right care in the least restrictive manner possible (Townsend and Luck, 2009). Consequently, the crew had to consider alternative management plans for John. Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. 136: 11 The future for paramedic research. 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. Legal and Ethical Aspects of Paramedic Practice Article - Studentshare Paramedic practice must consider all of these factors to ensure ethically good care. Purpose of the fitness to practise process. 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. 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. Dominique Moritz, Phillip Ebbs, Hamish Carver In this case, both ethical and legal principles are important. This raises the prospect that a patient with legal capacity may still be a vulnerable person, and also that a vulnerable person may be harmed or exploited unintentionally within healthcare settings (Oxford University Hospitals NHS Foundation Trust, 2016; Ebbs and Carver, 2019: 27). This research aims to highlight and explore underlying values present within practice-based decisions. The ethical and legal dilemmas paramedics face when managing a mental For example, a patient might have capacity to refuse their temperature being taken or other observations but not to refuse transport to hospital. School of Nursing, Midwifery & Paramedic Practice C. Patient care cannot be discredited based on poor documentation. 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). In other words, paramedics need to adopt the principle of confidentiality and credence. A person must be presumed to have capacity unless it is established that he lacks capacity. MA Healthcare Ltd After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. 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). 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. 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. 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). 2011). Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. Legal | Journal Of Paramedic Practice 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. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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). Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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. The ethical principle of respect for the patients autonomy presupposes the non-interference in the freedom of their decisions and choices (Steer, 2007). More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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. Ethical Practice: NCLEX-RN - Registered nursing There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Ethical dilemmas in prehospital emergency care - SpringerLink 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 sixth theme of ethical complexity was pervasive across these five themes. B. crew control. As with any patient, capacity can fluctuate, although this is more likely with older patients. 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. Community Paramedics | American Nurses Association EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz Paramedicine occurs in the social fabric of society. Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their 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 Another important aspect when treating patients with mental illness is the stigma associated with mental ill health (Fink and Tasman, 1992). 8 Quantitative research in paramedic practice an overview. This is a part of and more. Such a position will help improve the system and lead to effective and fruitful results. PDF Ethical Questions in Emergency Medical Services: Controversies and The paramedics and patients views on treatments may vary as well as moral and legal explanations of different procedures are different according to the cultural, religious, and social backgrounds. A person's decision-making capacity is subject to change depending on circumstances such as the illness or injury being experienced at the time, the seriousness of the decision and various other factors. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity to consent until proved otherwise. From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. 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. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). While not criminally liable, registered health professionals (including paramedics) do have a clear professional and ethical duty to act upon instances of known or suspected child abuse or neglect. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. The design of the PARAMEDIC-2 trial required paramedics to independently determine eligibility and randomise patients into the trial by administering the blinded drugs (either adrenaline or a saline placebo) from a trial-specific drug pack. There were no obvious physical causes for John's behaviour at this stage. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life 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. 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. There are many ethical issues that are encountered during the prehospital care of children and adults. 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. Bachelor of Paramedic Practice (Conversion Pathway) (53C) 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. Separate to the MCA (2005), the Mental Health Act (1983) (MHA) may also be used to provide treatment without consent in case of a mental health disorder (Department of Constitutional Affairs, 2007). A person is not to be treated as unable to make a decision merely because he makes an unwise decision. It is clear from these assessments that there are consequent physical risks to the patient's wellbeing depending on the mental health condition(s) present. It then explores practical issues of capacity, autonomy and beneficence as these apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, persons with a mental illness and those with a disability. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. http://dx.doi.org/10.1136/pmj.79.929.151 For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Professional practice framework, professional rights and responsibilities, record keeping, governance. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. 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. Methods 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. Confidentiality, capacity and consent. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Ethical considerations in prehospital ambulance based research Principlism in paramedicine: an examination of applied healthcare ethics
ethical issues in paramedic practice