OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. 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). 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. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. 153: Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. C. Patient care cannot be discredited based on poor documentation. practice with medical specialists. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. 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). Inform client/staff members of ethical issues affecting client care.
Analyse Legal and Ethical Issues Facing Paramedics 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. A sixth theme of ethical complexity was pervasive across these five themes. C. Follow to your local protocols and contact medical direction if unsure how to proceed. 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. 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? 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). In particular, privacy and confidentiality considerations must be foremost when others are present such as work colleagues or neighbours. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. 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. Although John appeared calm, and wasn't behaving at all aggressively at that time, the acute state of psychosis can be unpredictable, and pose serious risks (Hawley et al, 2011). This seems like a confusing area and it is unsurprising that paramedics report feeling unsure of exactly how to assess and utilise the capacity act (Amblum, 2014). Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. Some of these are easier to address in the pre-hospital environment than others, for example, a simple blood glucose and temperature check excluded hypoglycaemia and lowered the index of suspicion for infection, as John had a normal temperature and blood sugar level. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. 122: 10 Researching paramedic clinical practice a practical guide. 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). Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . It affirms the supremacy of law and appreciation of human rights and freedom. Gillick competence empowers children to exercise autonomy over their own medical decisions. Vulnerable patients are no exception. 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. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. 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. author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". Summary of the key detaining sections relevant to paramedic practice (Hawley et al, 2013b). Samantha May
Our fitness to practise process is designed to protect the public from those who are not fit to practise. 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. It shall conclude with this student's position on the issue based on the discussions. 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. The use of the other sections of the MHA can require much more time (Hawley et al. Continuing Professional Development: Ethical aspects of consent, duty Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. This exploratory case study utilized semi-structured interviews of thirteen North. 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. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". Paramedics interact with these patients every day, often during times of such vulnerability. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. This course is made up of a number of paramedic specific units and additional health care units. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. Together they form a unique fingerprint. 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. 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? Section 136 allows a police officer to remove a person from a public place to a place of safety if they believe them to be suffering from a mental health condition and at risk of harm to themselves or others (Hawley et al. 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). 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). This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. Such a position will help improve the system and lead to effective and fruitful results. Paramedics - Health and Care Professions Council Ethical Issues in Critical Care | Clinical Gate Clinicians must, therefore, consider the least restrictive means of achieving patient care (Department of Health and Social Care, 2015). This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. He wants to stay at home with his dog, who he feels safe with.Even though Terry legally lacks the capacity to make a decision against being transported to hospital, he is still a human being with agency and a level of intelligence. Mental illness can be a challenging vulnerability for clinicians to navigate. Continuing Professional Development: Ethical issues in paramedic practice As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. 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. They help organize the work activities and solve various contradictions between the legal and moral aspects, professional and personal judgments, and cultural and social norms. Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. 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 . More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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. Legal, ethical and social aspects of child abuse - NursingAnswers.net 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 considerations in prehospital ambulance based research Exploring New Zealand Paramedic Attitudes Towards Advance Directives Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. 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. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. 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). 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). 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). Fluctuation of capacity means that a person's ability to understand information, retain that information and make an informed decision can come and go. 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. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. 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. Maintaining a professional boundary between you and your patient (summary) 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. Reflective practice is undertaken for a variety of reasons. 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). 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 A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. In conclusion, ethical and legal principles are of great importance in paramedical practices. Least restrictive option and maximising independence - Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. B. crew control. 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. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. The tenet of justice presupposes that paramedicine practitioners should treat all patients equally, without showing personal evaluations and attitudes. 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). 136: 11 The future for paramedic research. 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. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. Wednesday, December 2, 2020. Additionally, the measures taken by paramedics during the medical procedures should not contradict the existing laws and rules. 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. 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. 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). |
The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). 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]). 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. Some people with a disability may only be capable of autonomy in choices about low acuity or minor treatment, but not about more serious conditions. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. 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. Ethical Issues in Sports Medicine - In the United States - studocu.com 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.