ethical issues in paramedic practice

MA Healthcare Ltd 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. A policy set by an EMS Medical Director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a (n): A. direct order. D. personal safety. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: Select one: A. In some cases, it may be a confusing task to react properly to the emerged contradictory issues, preserving the legal implications and moral duties at the same time. This course is made up of a number of paramedic specific units and additional health care units. 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). If a person is then deemed to have capacity and continues to refuse care, paramedics are forced to balance their duty to protect life against the patient's right to make autonomous decisions (Hodgson, 2016). Legal & Ethical issues associated with paramedic practice during COVID19. 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. Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. 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. Our researchers and research supervisors undertake their studies within a wide range of theoretical frameworks and models relating to the development of policy and practice that takes account of: lived experiences of health and social issues, health and social care use, and, service delivery by the nursing, midwifery and paramedic professions . 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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). What makes them vulnerable is their lack of defences or resources to deal with threats or risk (Schrder-Butterfill and Marianti, 2006). Principlism in paramedicine: An examination of applied healthcare ethics Ethical dilemmas in prehospital emergency care - SpringerLink Practical decision-making strategies are provided and illustrated by brief examples. Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. Sample Essay on Law and Ethics in Paramedical Science Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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). Maintaining a professional boundary between you and your patient (summary) Ethics part 1: what do paramedics owe patients? They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. AB - Decision-making is central to the everyday practice of paramedicine. The ethical and legal dilemmas paramedics face when managing a mental At this point, healthcare professionals (for example paramedics) are likely to question and subsequently assess the person's ability to make this decision. 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. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. 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. Notify the family that once CPR has been initiated, you are required to transport the patient. T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. B. Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. The tenet of justice presupposes that paramedicine practitioners should treat all patients equally, without showing personal evaluations and attitudes. This is not the case. 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. 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. Some patients with a disability are considered vulnerable in a similar way to older patients: they sometimes lack the defences or resources to deal with threats to them. While clinical information should always be held in confidence, the stigma associated with mental illness means that most patients value their privacy more so in this regard, and paramedics have a duty to ensure they do not share this information, even inadvertently. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 153: Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). 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. It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. . At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. Mental illness can be a challenging vulnerability for clinicians to navigate. Fitness to practise - Health and Care Professions Council 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? This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Their vulnerability may impede their autonomy, which can then affect . This research aims to highlight and explore underlying values present within practice-based decisions. 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). While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. U2 - https://doi.org/10.12968/jpar.2020.12.10.CPD1, DO - https://doi.org/10.12968/jpar.2020.12.10.CPD1, JO - Journal of Paramedic Practice: the clinical monthly for emergency care professionals, JF - Journal of Paramedic Practice: the clinical monthly for emergency care professionals. 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. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). This situation will hopefully alter over time, so this module attempts to present the four ethical contexts common in other health disciplines and discuss them in relation to paramedic practice.Learning OutcomesAfter completing this module you will be able: To provide an overview of the four key ethical principles that underpin current clinical practice in the UK To explore these four ethical principles in relation to specific prehospital and clinical issues To encourage the practitioner to reflect on their own ethical practice To begin to develop the ability to share, discuss and debate the four ethical principles with colleagues and friends, in relation to your own clinical practice. 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). 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. 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. Gillick competence empowers children to exercise autonomy over their own medical decisions. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet Community Paramedics | American Nurses Association (PDF) Ethics In Paramedic Practice: A Qualitative Case Study of 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. 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. 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. This principle refers to both physical and mental damage, which can be done to the clients. 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. Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) 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. 4 Conducting ethical research in paramedic practice. A consensus among paramedic supervisors B. The question of justice is another part of the paramedical performance. Paramedics delivering palliative and end-of-life care in community 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. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. 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). This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Undergraduate students who study ethics in nursing have an opportunity during their clinical practice, to discuss and reflect on a range of ethical and moral actions. Paramedic Professional Practice | Curtin University To assist paramedics in navigating these complex issues, the London Ambulance Service NHS Trust (2019) provides guidance on how to refer vulnerable people to services which may investigate the circumstances and ensure the safety and welfare of the patient). 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Download Free PDF View PDF The code of practice for the MCA (Department of Constitutional Affairs, 2007) doesn't clearly set out which specific treatments may or not be provided under the MCA; however, it does seek to explain the relationship between the MHA and MCA. Paramedic: Legislation And And Guidance That Govern The - Edubirdie Paramedic Practice Test. Ethical issues are closely intertwined with legal aspects of care and this module will therefore consider the four ethical principles, focusing on the two key principles of autonomy and . The complexity of mental illness means a person's capacity can fluctuate so they may lose or regain capacity at different stages of their illness. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? On assessment, John didn't appear to understand the information given to him, the decision he needed to make, and he was unable to retain or comprehend treatment plans or the risks of noncompliance. 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). As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . 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. Copyright 2023 In conclusion, ethical and legal principles are of great importance in paramedical practices. C. Patient care cannot be discredited based on poor documentation. 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). 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. 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. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). Copyright 2023 Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. Bachelor of Paramedic Practice (Conversion Pathway) (53C) Ethics and law in paramedic practice: Boundaries of capacity and Therefore, it is important to consider those principles more precisely. The first concern for an EMT must be: A. patient safety. 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). Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention . Decision making in this environment is intended to provide care and treatment in the best interests of the patient. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? C. vehicle safety. 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). The ambulance crew's concerns for John's welfare prompted them to assess his level of risk to self and others. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Ethical Issues in Paramedic Practice | Free Essay - Essayscreator.com It can be used by . prevent the safe and effective practice.5 Ideally, the paramedic concerned should report any of the above issues themselves, as this reflects professional behaviour. 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. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. This highlights the importance of having a good understanding of the MCA, as this is not limited by the persons whereabouts. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. 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). Beneficence asks us to promote a course of action, but in practice, we also need to de-promote certain courses of action if there are better options available. 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. Psychiatric admission for assessment and subsequent treatment if required. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? 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. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. Chat. 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. Ethical practice forms a fundamental aspect of paramedic care, and not only is the of model 2 paramedic expected to meet standards of ethics as laid down by the HPC, but more importantly paramedics Following attendance to a call, a reflective account was completed using model 2. are required to treat patients in a way that is humane The Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. This principle refers to both physical and mental damage, which can be done to the clients. John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. 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). Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Foundations for paramedic practice: a theoretical perspective - Amazon Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". (PDF) Law and Ethics for Paramedics: An Essential Guide Fluctuation of capacity means that a person's ability to understand information, retain that information and make an informed decision can come and go. However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). 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. In this case, both ethical and legal principles are important. Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. BSc (Hons) Paramedic Science | Buckinghamshire New University 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. 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). 2011). Such a position will help improve the system and lead to effective and fruitful results. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. This can be a common complication in psychosis and is frequently exacerbated by the effects psychosis has on a person's levels of trust, insight and the ability to rationalise, making them reluctant to share information (Kleiger and Khadivi, 2015). After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. 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. It seems paramount that whichever decision is made and Act is used, should the patient receive any form of involuntary treatment, the principles of the MCA and the MHA are upheld, and any decision made is in the patients best interest (Department of Health, 2005). http://dx.doi.org/10.1136/pmj.79.929.151 For example, paramedics have a statutory requirement to safeguard and promote the welfare of children in their care under section 11(2) of the Children Act 2004. 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. 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. Ethical deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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. 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. Although provider judgment plays a large role in the . 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. Utilizing a priority dispatch system allows dispatchers to send response . Practice in a manner consistent with a code of ethics for registered nurses.

Random Soccer Team Wheel, Physical Features Of Jamaica, Harold Balin Shoe Magnate, Anderson County Accident Reports, Articles E