Continuing Professional Development: Ethical issues in paramedic practice OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. The Paramedic'S Guide To Research: An Introduction - Google Books . Like the abuse of children, the abuse of older people is a significant community concern. 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . PDF Ethical Questions in Emergency Medical Services: Controversies and 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 . Paramedicine occurs in the social fabric of society. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. 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. 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. 8 Quantitative research in paramedic practice an overview. 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. 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. Consumer rights in advocacy and health care. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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). You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. Journal of Paramedic Practice: Vol 3, No 8 It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? It affirms the supremacy of law and appreciation of human rights and freedom. Paramedics - Health and Care Professions Council 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. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. You'll examine the relationship of law and medicine together with the interplay of medical ethics, analyse the development of medical negligence and consent to medical treatment as well as international medical ethics issues arising from birth to death. Cuts in public health and community services funding have decimated programs, leaving unmet health needs. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. 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). Download Free PDF View PDF This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. 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. C. Patient care cannot be discredited based on poor documentation. (PDF) Reflective Practice for Paramedics - ResearchGate Ethical Issues in Critical Care | Clinical Gate This will also help you learn important concepts for the exam. 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). Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. EMT Chapter 1 Flashcards | Quizlet As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. 136: 11 The future for paramedic research. 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. Practitioners must be mindful that, despite the frequent interactions with these patients, their behaviour is often perpetuated by mental illness, and the patient needs care for their chronic illness just the same as they would for any other illness. AB - Decision-making is central to the everyday practice of paramedicine. Ethics and law in paramedic practice: boundaries of capacity and They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Ethical issues in medical malpractice - PubMed This third and final article in the series starts by describing the relationships between the legal principle of capacity and the ethical principles of autonomy and beneficence. This is a part of and more. John had arrived at a friend's house during the night, behaving in a strange, confused manner. 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. | 03 What factors affect paramedics' involvement of people with dementia However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? 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). 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. With this considered, it appears that in John's case, the MCA would have been an appropriate means with which to act in John's best interests and convey him to a place of safety for further treatment, which would most likely have been the nearest emergency department. EMS Chapter 3 Medical, Legal, and Ethical Issues Quiz 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. He was also unable to effectively communicate his decision making process. 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. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. Bachelor of Paramedic Practice (ADF Conversion) (53D) Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. Methods The principles of the Mental Capacity Act 2005 and the Mental Health Act 1983. This is not the case. The crew's assessments and thought processes surrounding the management of John will be discussed. 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). Copyright 2023 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. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. Decision-making is central to the everyday practice of paramedicine. Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. http://dx.doi.org/10.1136/pmj.79.929.151 This article looks into the current difficulties many UK paramedics face when trying to manage patients presenting with a mental health condition in a safe and respectful manner; particularly when the patient requires some form of treatment but refuses this against medical advice. Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. states registered nurses are legally required to report cases of child abuse if there is a "belief on reasonable grounds that a child is in need of protection on a ground referred to in Section 162 (c) or 162 (d), or formed in the course of practicing in . 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. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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. 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. Due to this misconception, the crew then considered the MHA (1983). While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. Confidentiality, capacity and consent. Practice in a manner consistent with a code of ethics for registered nurses. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Integrated health care including mental health. 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. Exploring New Zealand Paramedic Attitudes Towards Advance Directives 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). 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). Although provider judgment plays a large role in the . Legal, ethical and social aspects of child abuse - NursingAnswers.net 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. 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. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. A sixth theme of ethical complexity was pervasive across these five themes. Utilizing a priority dispatch system allows dispatchers to send response . In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. 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 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. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. Capacity can fluctuate over time or as a health condition changes. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. 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. The researchers have outlined four main ethical principles, which are important for consideration in paramedicine.