Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. The principles of the Mental Capacity Act 2005 and the Mental Health Act 1983. (PDF) Applied paramedic law and ethics . Townsend and Luck (eds)(2013 http://dx.doi.org/10.1136/pmj.79.929.151 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. This principle refers to both physical and mental damage, which can be done to the clients. 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. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. During the shared decision-making process between clinician and patient, paramedics must respect these preferences but also be sure that the material risks associated with alternative options for treatment (including non-transport) are clearly explained to the patient (Chan et al, 2017). 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). The principles of non-maleficence and beneficence form an area of special interest for the paramedics since these ethical issues are of paramount importance to them. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity to consent until proved otherwise. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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). D. Incomplete . Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. An introduction to reflective practice for paramedics For example, if a patient is transported and this leaves an older person or older child at home, will they be sufficiently able to manage activities of daily living including food preparation, medication management and personal care? Sample Essay on Law and Ethics in Paramedical Science 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). In the UK, paramedics are currently not able to utilise any part of the MHA, though it is debated whether this would be beneficial (Berry, 2014; DOH, 2014). 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. Introduction. Community Paramedics | American Nurses Association 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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. In other words, paramedics need to adopt the principle of confidentiality and credence. Like the abuse of children, the abuse of older people is a significant community concern. 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). Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. This course is made up of a number of paramedic specific units and additional health care units. 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 preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Reflective practice is the link between theory and practice and a powerful means of using theory to inform practice thus promoting evidence based practice (Tsingos et al., 2014). The first concern for an EMT must be: A. patient safety. care passports). 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. From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Copyright 2023 Integrated health care including mental health. The ethics in paramedicine has become a field of interest for many scientists and researchers. MA Healthcare Ltd Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. 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. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. (PDF) Reflective Practice for Paramedics - Academia.edu Harris and Millman (2011) highlight the importance of ruling out a physical cause for the patient presenting with altered mental status such as hypoglycaemia, head injuries, infection and alcohol or drug use. 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. 4 Conducting ethical research in paramedic practice. 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 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. Neglect or ill treatment of a person who lacks capacity (including older people) is a criminal offence in the UK (Mental Capacity Act 2005, section 44). Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). Perceptions and concerns about receiving treatment at hospital may arise for a number of reasons, such as fear of not returning home, an experience of relatives dying in hospital, worry about pets, stoicism and beliefs about not wanting to bother others. Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. 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). Paramedics' decisions on patients' treatment will often impact others. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. AB - Decision-making is central to the everyday practice of paramedicine. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Writing a prescription: the law and good practice Paramedic independent prescribing offers an opportunity to improve patient access to medications. BSc (Hons) Paramedic Science | Buckinghamshire New University The paramedics should consider every individual case and act fairly and objectively in every situation (Beauchamp & Childress, 2008). 03 What factors affect paramedics' involvement of people with dementia For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. MA Healthcare Ltd In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. ethics of paramedics - SlideShare Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. 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. Reflective practice is undertaken for a variety of reasons. PROFESSIONALISM Professionalism in UK paramedic practice Prof Malcolm 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. 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. For example, some people with conditions such as cerebral palsy may appear to have an intellectual disability that precludes decision-making capacity, where in fact they have no cognitive disability, only communication difficulties. 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). Ethical challenges in Emergency Medical Services - PubMed Paramedical ethics during acute emergency medical service referral It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. In any case, the role of paramedics consists in the elimination of harmful aspects of patients ethical decisions as well as protection of their legal freedom and choice. 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). Preventing children from exercising their autonomy may cause ethical challenges (Box 1). A person's capacity depends upon the nature of their disability. 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. Bachelor of Paramedic Practice (ADF Conversion) (53D) / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Paramedic: Legislation And And Guidance That Govern The - Edubirdie Paramedic Professional Practice | Curtin University The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. 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). Journal of Paramedic Practice: Vol 3, No 8 John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. Practice in a manner consistent with a code of ethics for registered nurses. Utilizing a priority dispatch system allows dispatchers to send response . They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Older people, persons with disabilities or mental illness, or even those who have poorer social and economic standing (such as people who are homeless) may experience periods of substantial vulnerability. 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. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. 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). The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. 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. EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. 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. However, the crew were able to identify some typical symptoms of psychosis in Johns' behaviour. 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. Copyright 2023 Clinicians must, therefore, consider the least restrictive means of achieving patient care (Department of Health and Social Care, 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.
Lewis And Clark Middle School Yearbook, Pazuzu House Documentary, When Does Brooke Tell Haley She Stole The Test, Articles E