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. 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. The approach to both participation and trial protocol training varied between ambulance services. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). 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. Therefore, they should consider the needs and requirements of patients and act correspondingly. Ethical Practice: NCLEX-RN - Registered nursing 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. Bachelor of Paramedic Practice (ADF Conversion) (53D) A progression of learning in terms of acting morally and ethically is necessary when nurses undergo training on both an undergraduate and a specialist level. Have your partner contact the communications center to send law enforcement to the scene, as this is now a legal issue and the officer will make the decision. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Legal and ethical practice in care. Ethics and law in paramedic practice: Boundaries of capacity and 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. 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. (PDF) Applied paramedic law and ethics . Townsend and Luck (eds)(2013 More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). He was also unable to effectively communicate his decision making process. The provider must be always stalwart in the face of challenges to. 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. 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). 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 . 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. 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. Chat. 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). The first concern for an EMT must be: A. patient safety. In conclusion, ethical and legal principles are of great importance in paramedical practices. 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. 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). 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). At the same time, the education should not be subjective, prejudiced, or convincing as the patients have to make their own decisions concerning their lives and health conditions. Methods 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. 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. Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. 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. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Continuing Professional Development: Ethical issues in paramedic practice 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 . Consequently, the crew began to assess for a psychological cause. 105: 9 Using quantitative research methods in paramedic practice. Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. Practice in a manner consistent with a code of ethics for registered nurses. 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). Together they form a unique fingerprint. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. After that, we provide a few recommendations that can assist healthcare professionals in improving their capacity for making ethical decisions. Continuing Professional Development: Ethical issues in paramedic practice It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). By continuing you agree to the use of cookies. The ethical and legal dilemmas paramedics face when managing a mental health patient | Journal Of Paramedic Practice Features The ethical and legal dilemmas paramedics face when managing a mental health patient The ethical and legal dilemmas paramedics face when managing a mental health patient Samantha May Monday, January 2, 2017 Decision making in this environment is intended to provide care and treatment in the best interests of the patient. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Older patients may have fluctuating capacity so may be able to make decisions for themselves in some circumstances and not others. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. The authors have faced all eight of the clinical scenarios in this paper in their routine clinical practice. (PDF) Reflective Practice for Paramedics - Academia.edu The principles of the Mental Capacity Act 2005 and the Mental Health Act 1983. Elder abuse can encompass neglect, financial duress, psychological threats and violence. Paramedics - Health and Care Professions Council 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. John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. Ethics, bioethics and legal issues in paramedic practice. Legal, ethical and social aspects of child abuse - NursingAnswers.net 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? Professional practice framework, professional rights and responsibilities, record keeping, governance. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). 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). Monday, January 2, 2017. Despite this, there remain multiple barriers to their fully effective provision of such care. Our fitness to practise process is designed to protect the public from those who are not fit to practise. 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. Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. In the case of paramedicine, both ethics and law should remain unprejudiced and objective. In such a way, they will not violate personal freedom and demonstrate respect for patients demands and plans (Blaber, 2012). While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. Having considered the probability of causes for John's symptoms, the crew suspected John may have been suffering from psychosis. Ethics in EMS: 10 things you need to know to save lives 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. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. 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). 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. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . A significant ethical consideration for clinicians when treating older patients is their capacity. 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. Such a position will help improve the system and lead to effective and fruitful results. Nurses are expected to practise in an ethical manner, through the demonstration of a range of ethical competencies articulated by registering bodies and the relevant codes of ethics (see Boxes 5.1 and 5.2).It is important that nurses develop a 'moral competence' so that they are able to contribute to discussion and implementation of issues concerning ethics and human rights . Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. It is important to remember that capacity is not a binary state; it exists on a continuum and depends upon the patient's circumstances and the potential consequences of the decision being made. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. 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. 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. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. Samantha May @article{6040c026e1e34bd9b7239761b13480e7. 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. The Paramedic'S Guide To Research: An Introduction - Google Books It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. It affirms the supremacy of law and appreciation of human rights and freedom. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. Paramedic Professional Practice | Curtin University Confidentiality, capacity and consent. 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. Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. However, it is also essential to explain their view on the problem and prove the beneficence of their choice to reach an agreement with the patients (Aehlert, 2012). Vulnerable patients are no exception. 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. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? 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). 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. 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 was because of current UK law and a lack of access to a GP respectively. This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. Ethical Responsibilities of Paramedics | Work - Chron.com EMT Chapter 1 Flashcards | Quizlet Ethical Issues in Sports Medicine - In the United States - studocu.com 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). This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. School of Nursing, Midwifery & Paramedic Practice And even though the legal issues may have been covered, the ethical implications of the lack of healthcare provided are undoubtedly contrary to good clinical practice given it represents the deliberate concealment of a therapy (or lack of it) used in a given person. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. http://dx.doi.org/10.1136/pmj.79.929.151 Mental illness can be a challenging vulnerability for clinicians to navigate. Another ethical principle in paramedicine is beneficence. Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. (PDF) Ethics In Paramedic Practice: A Qualitative Case Study of Gillick competence addresses children's understanding and provides paramedics and other health professionals with a means to determine the extent of involvement a child should have in decisions that affect their healthcare. . D. Incomplete . The crew's assessments and thought processes surrounding the management of John will be discussed. Inform client/staff members of ethical issues affecting client care. This means that not only must they avoid doing harm - non-maleficence, they must also display active well-doing and an unselfish concern of the well being of others - beneficence. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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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