C. Patient care cannot be discredited based on poor documentation. 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. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. 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. Paramedic practice must consider all of these factors to ensure ethically good care. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability.
Although provider judgment plays a large role in the . Legal and ethical practice in care. Fluctuation of capacity means that a person's ability to understand information, retain that information and make an informed decision can come and go. 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 MA Healthcare Ltd
Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. 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. 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.
The Paramedic'S Guide To Research: An Introduction - Google Books Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. 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). This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. What makes them vulnerable is their lack of defences or resources to deal with threats or risk (Schrder-Butterfill and Marianti, 2006). 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. Nevertheless, paramedicine policies should encourage patients to follow a healthy way of life and apply certain procedures, without intervening in their personal lives and decisions (Sharp, Palmore, & Grady, 2014). All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice. 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.
Paramedic ethics, capacity and the treatment of vulnerable patients 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). journal = "Journal of Paramedic Practice: the clinical monthly for emergency care professionals", Charles Sturt University Research Output Home, Ethics and law in paramedic practice: Boundaries of capacity and interests, Nursing, Paramedicine and Healthcare Sciences, Journal of Paramedic Practice: the clinical monthly for emergency care professionals, https://doi.org/10.12968/jpar.2020.12.10.CPD1. abstract = "Decision-making is central to the everyday practice of paramedicine. It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. 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. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). A sixth theme of ethical complexity was pervasive across these five themes. .
Ethics and law in paramedic practice: Boundaries of capacity and In such a way, they will not violate personal freedom and demonstrate respect for patients demands and plans (Blaber, 2012). Methods 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. On the one hand, the paramedics should not neglect the interests and intentions of the patients. 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. 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.
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. Paramedics' decisions on patients' treatment will often impact others. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. 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. 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.
Medical Ethics: Non-Maleficence - The Medic Portal Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Here we provide services and products that are for reference purpose only & are not intended to be put forward as finalised work & are to be used strictly for assistance in writing your own research material papers. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns.
Legal | Journal Of Paramedic Practice A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. 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. However, the Department of Health (2015) clearly state that it is, so long as the patient hasn't already had their liberties removed under the MHA (1983). Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. 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. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". Additionally, the measures taken by paramedics during the medical procedures should not contradict the existing laws and rules. 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. Police may remove a person from a public place where they are believed to be suffering from mental illness and at risk of harm to themselves or others. 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 is particularly important for clinicians to assess patient capacity every time they attend a person rather than relying on past experiences that because the person lacked capacity owing to their mental illness during a previous attendance, they will somehow lack capacity on all future presentations. Consumer rights in advocacy and health care. 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). 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. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 153: Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care.
Due to this misconception, the crew then considered the MHA (1983). To provide guidance for paramedics in how to meet their obligations in reporting children at risk, the London Ambulance Service NHS Trust (2020) has produced the Safeguarding Children and Young People Policy. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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.
PARAMEDIC2 study: Ethical issues | Medicina Intensiva Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Monday, January 2, 2017.
Paramedic Practice Test | Answers & Explanations | Test-Guide However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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. They must also deliver care that is consistent with ethical.
Ethical Responsibilities of Paramedics | Work - Chron.com Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care.
Paramedic Professional Practice | Curtin University Paramedicine occurs in the social fabric of society. As such, making John secure was a priority. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection.
Bachelor of Paramedic Practice (ADF Conversion) (53D) The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner.
Sample Essay on Law and Ethics in Paramedical Science In this case, both ethical and legal principles are important. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. 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. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". 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. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. 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). Therefore, consideration of these effects is part of how they treat patients and make decisions. 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.
(PDF) Reflective Practice for Paramedics - ResearchGate 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). The ethics in paramedicine has become a field of interest for many scientists and researchers. 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. Decision-making is central to the everyday practice of paramedicine.
An introduction to reflective practice for paramedics Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. 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). 2011).
Continuing Professional Development: Ethical issues in paramedic practice 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. 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. 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. Therefore, it is important to consider those principles more precisely. Mental illness can be a challenging vulnerability for clinicians to navigate. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. B.
In other words, paramedics need to adopt the principle of confidentiality and credence.
(PDF) Reflective Practice for Paramedics - Academia.edu Clinicians and families may become more involved in the decision-making process or take over that decision-making role in the vulnerable person's best interests. 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. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). care passports). However, again, in much the same way as with other vulnerable people, they may have a sliding scale of autonomy, and paramedics will need to determine each patient's ability to understand, retain and weigh the information being provided to them about their medical condition. The ambulance crew's concerns for John's welfare prompted them to assess his level of risk to self and others. This is not the case. 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. Terry's condition has been worsening in recent weeks and his parents and clinicians have arranged for Terry to be transported by ambulance to hospital.However, Terry does not want to go to hospital today. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Often, a person's capacity to consent to care is presumed intact until such a time that the patient refuses treatment, which appears to be in their best interest (Jones et al, 2014). On closer inspection of the literature, it seems that John could have been treated (or in this case transported for treatment) using the MCA, as he wasn't currently detained under the MHA, nor did it seem likely he was going to be at that time (due mainly to a lack of access to the relevant health care professionals required to perform a MHA assessment) in order to receive the treatment he appeared to require in his best interest. It seems that deciding which act is most appropriate must be managed on a case-by-case basis factoring in issues such as access to healthcare professionals available to utilise the MHA (as paramedics do not have it), the likely cause of the persons behaviour (physical/psychological), whether the patient seems likely to meet the threshold for detention under the MHA, and equally whether the patient is likely to be assessed as lacking capacity under the MCA.
Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. Inform client/staff members of ethical issues affecting client care. 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. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases.
Paramedics - Health and Care Professions Council 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. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. Gillick competence empowers children to exercise autonomy over their own medical decisions. Don't hesitate and rely on professionals! Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial.
Ethical Issues in Critical Care | Clinical Gate Continuing Professional Development: Ethical issues in paramedic practice Journal of Paramedic Practice is the leading monthly journal for paramedics. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. This research aims to highlight and explore underlying values present within practice-based decisions. 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). Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. Major incident clinical . The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. Specifically, the working lives of paramedics are unique and the distinguishing feature is not the medical scope of practice per se, but rather where it is practised (13,14). Practical decision-making strategies are provided and illustrated by brief examples. 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). 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. Older patients may have fluctuating capacity so may be able to make decisions for themselves in some circumstances and not others. The Department of Constitutional Affairs (2007) states that a person's ability to make decisions to protect themselves must always be in balance with their civil right to make such decisions. The Health and Care Professions Council (HCPC) (2016, section 7.3: 8) requires that paramedics must take appropriate action where they have concerns about the safety or well-being of children or vulnerable adults. 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.
PDF Ethical Questions in Emergency Medical Services: Controversies and It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions.
1 Ethics And Law For The Paramedic Copy - dev.endhomelessness They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). A significant ethical consideration for clinicians when treating older patients is their capacity. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. 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. While carers might have a duty to make decisions that benefit the patient and are least restrictive of the patient's rights, it can be difficult for clinicians to uphold and appropriately consider the patient's wishes when another person is responsible for their decision-making.
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