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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. keywords = "Ethics, Decision making, paramedic, complexity". Overview This CPD module aims to outline, describe and explain some of the key ethical-legal issues in paramedic practice, and their relation to the concept of consent, a duty of care and negligence. Paramedics' decisions on patients' treatment will often impact others. Continuing Professional Development: Ethical issues in paramedic practice It affirms the supremacy of law and appreciation of human rights and freedom. 2 The HCPC standards of conduct, performance and ethics. 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. 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. 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. 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). 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). At the same time, the task of the paramedics is to improve their patients health conditions and choose the best way of treatment in every particular case. Ethics and law in paramedic practice: Boundaries of capacity and 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). 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. While invasive options may be necessary for the safety of the patient, the clinician and the broader community in some circumstances, they should be used only as a last resort and less invasive treatment options should be preferred where possible, such as voluntary transport to hospital or a community referral. 1 Ethics And Law For The Paramedic Copy - dev.endhomelessness 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. Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. Another ethical principle in paramedicine is beneficence. With regard to the addition of powers under the MHA for paramedics, Berry (2014) argues that the MCA (2005) should be sufficient for paramedics to manage mental health patients and where needed deprive them of their liberties, however the act appears to be neither sufficiently understood nor utilised and requires the patient to lack capacity, which is complex to assess and often present in mental health cases. Our fitness to practise process is designed to protect the public from those who are not fit to practise. Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. Ethical challenges in Emergency Medical Services - PubMed (PDF) Reflective Practice for Paramedics - Academia.edu 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. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. 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. 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. Our paramedic test questions are listed below. They identify and direct the work of the paramedical practices as well as determine all possible ways of interacting and communicating with patients (Bledsoe et al., 2006). A person may be deprived of their civil liberties in order to be provided with care or treatment that they are unable to consent to due to a lack of capacity, if is in their best interests (Ministry of Justice, 2008; Amblum, 2014). There are many ethical issues that are encountered during the prehospital care of children and adults. Ethics in EMS: 10 things you need to know to save lives This expanded role builds on the skills and preparation of the Emergency Medical Technician (EMT) and Paramedic, with the intention of fulfilling the health care needs of those populations with limited access to primary care services. Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. In the case of paramedicine, both ethics and law should remain unprejudiced and objective. Copyright 2023 The paramedics should consider every individual case and act fairly and objectively in every situation (Beauchamp & Childress, 2008). To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. 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). The ethical and legal dilemmas paramedics face when managing a mental 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. Medical Ethics: Non-Maleficence - The Medic Portal Once an allegation is made, the HPC will arrange for it to be reviewed by paramedics, other allied health professionals, and, most importantly, members of the public, to determine if In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). Exploring New Zealand Paramedic Attitudes Towards Advance Directives Continuing Professional Development: Ethical issues in paramedic practice However, paramedics must be aware that it is a medical event that is occurring and the person is generally not being held for criminal reasons. Should paramedics ever accept patients' refusal - BMC Medical Ethics MA Healthcare Ltd It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. 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 . This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. For example, a person presenting with suicidal thoughts may score higher on the JRCALC tool, and thus be at high risk of self injury, but at a lower risk of being involved in an accident, a risk which may be higher in a person suffering from psychosis. Paramedics have professional duties toward vulnerable persons. 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). 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. Therefore, consideration of these effects is part of how they treat patients and make decisions. From this standpoint, paramedics play a significant role in consideration of ethical issues and bear responsibility for the preservation of both legal and moral standards in every individual case of interaction with the patients. 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. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. EBOOK: Blaber's Foundations for Paramedic Practice: A Theoretical Perspective Amanda Blaber 2018-11-19 This bestselling undergraduate level book is an ideal resource for student paramedics looking for an excellent introduction to the main theoretical subjects studied in paramedic courses, and links practice issues to the all-important theory . 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 For example, a patient might have capacity to refuse their temperature being taken or other observations but not to refuse transport to hospital. After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. The paramedics should take into account the health conditions of patients, the seriousness of their problem, their relations with relatives, and probable reactions to different types of treatment before making the final decision. Copyright 2023 It can be used by . It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. 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). Bachelor of Paramedic Practice (Conversion Pathway) (53C) A mother (Victoria Gillick) sought to have medical practitioners refuse to provide medical advice to her daughters, aged under 16, in relation to contraception. 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). Therefore, they should consider the needs and requirements of patients and act correspondingly. Consequently, the crew had to consider alternative management plans for John. . 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. 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. 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). Although, hallucinations, delusions etc. 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. Mental illness can be a challenging vulnerability for clinicians to navigate. Paramedics - Health and Care Professions Council The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). All relevant services should work together to facilitate timely, safe and supportive discharge from detention. This course is made up of a number of paramedic specific units and additional health care units. 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]). Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. ethics of paramedics - SlideShare 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. Paramedic Professional Practice | Curtin University 105: 9 Using quantitative research methods in paramedic practice. 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. Non-maleficence states that a medical practitioner has a duty to do no harm or allow harm to be caused to a patient through neglect. Together they form a unique fingerprint. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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. 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). abstract = "Decision-making is central to the everyday practice of paramedicine. AB - Decision-making is central to the everyday practice of paramedicine. 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. | The ethics in paramedicine has become a field of interest for many scientists and researchers. Law and Ethics for Paramedics: An Essential Guide Authors: Georgette Eaton University of Oxford Abstract Providing a clear and concise overview of applied law and ethics to UK paramedic. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. prevent the safe and effective practice.5 Ideally, the paramedic concerned should report any of the above issues themselves, as this reflects professional behaviour. Professional practice framework, professional rights and responsibilities, record keeping, governance. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice. The police, however, do have the power to utilise section 135 and 136 of the MHA (1983). Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention . 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). Integrated health care including mental health. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. 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. 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. You will see the questions are broken down into the 5 different categories you will be tested on. 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). Wednesday, December 2, 2020. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. 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. 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. Pre Hospital Ethics and Legal Issues - LawTeacher.net 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. In the forthcoming sections, these standards, guidelines and ethical principles are used to explore key issues relating to patients who are commonly considered to be vulnerable: children, older people and those with mental illness or disability.