Therefore, consideration of these effects is part of how they treat patients and make decisions. Capacity is the legal principle, that a person is able to make decisions about their own healthcare where they can demonstrate an ability to understand relevant information given to them about their condition, retain that information and use or weigh that information to make an informed and considered choice (Mental Capacity Act 2005). Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . This exploratory case study utilized semi-structured interviews of thirteen North. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. 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). This principle refers to both physical and mental damage, which can be done to the clients. A recent topic of concern has been the extent to which paramedics and other health and care professionals are required to report instances of known or suspected child abuse or neglect (Foster, 2020). Ethical problems in clinical practice | Postgraduate Medical Journal 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. Monday, January 2, 2017. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. In any case, the role of paramedics consists in the elimination of harmful aspects of patients ethical decisions as well as protection of their legal freedom and choice. Due to this misconception, the crew then considered the MHA (1983). Such an approach preserves all ethical aspects of the paramedical profession since it shows respect to patients and reveals professional competence and help at once (Blaber, 2012). In conclusion, ethical and legal principles are of great importance in paramedical practices. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. Up to 28 days, can be extended by subsequent assessments if required, Person must be at significant risk of: harm to self, harm to others, self-neglect, Requires an approved mental health professional (AMHP) and 2 doctors, Up to 6 months then re-assessed (if not already re-assessed), Critical and urgent admission for up to 72 hours, Used in emergencies as only requires one medical opinion so quicker than section 2 or 3, Police may enter a person's property (with a warrant obtained from a magistrate's court) to remove them to a place of safety if they are believed to be suffering from a mental illness and at risk of harm to self or others, Removal to place of safety (can be police station) for further assessment. The ambulance crew's concerns for John's welfare prompted them to assess his level of risk to self and others. 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 primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. Nevertheless, it is important to understand that many ethical issues presented in health care have little to do with paramedicine as the latter focuses mainly on emergencies. 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. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. Introduction. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. Paramedic Practice Test. 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. 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. Together they form a unique fingerprint. Ethical considerations in prehospital ambulance based research The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. Some people with a disability may have mobility issues that do not affect their capacity to consent to treatment and decision-making, while others with a disability may not have decision-making capacity for numerous reasons, including communication difficulties or intellectual disability. However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? In particular, privacy and confidentiality considerations must be foremost when others are present such as work colleagues or neighbours. It shall conclude with this student's position on the issue based on the discussions. Legal, ethical and social aspects of child abuse - NursingAnswers.net Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. The crew's assessments and thought processes surrounding the management of John will be discussed. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. 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). 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. 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). EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz 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. Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. AB - Decision-making is central to the everyday practice of paramedicine. Thompson et al (2011) highlight that frequent callers (also known as frequent users) are known to clinicians because they regularly require paramedic support, usually as a result of a mental illness. Consumer rights in advocacy and health care. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Despite this, there remain multiple barriers to their fully effective provision of such care. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. 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 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. Practical decision-making strategies are provided and illustrated by brief examples. 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). Vulnerable patients are no exception. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. Ethical Practice: NCLEX-RN - Registered nursing 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. 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. 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). However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). 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). 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. MA Healthcare Ltd
This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. Medical Ethics: Beneficence - The Medic Portal 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. Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . Additionally, the measures taken by paramedics during the medical procedures should not contradict the existing laws and rules. Within this, confusion and limitations surrounding both the MCA and the MHA will be explored, as well as how these may affect patient care and any key areas that could be developed in the future. C. Patient care cannot be discredited based on poor documentation. In the first article of this series on applied ethics in paramedicine, the authors examined the ethical principles of autonomy and beneficence in the context of principlism (Ebbs et al, 2020). Ethical deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. 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. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). In this case, John refused to engage with the ambulance crew leading the crew to consider both the MCA and the MHA to protect the patient's wellbeing without his consent. Indeed, there is an argument that if we are to expect an improvement in the way emergency services manage mental health presentations and safeguard a vulnerable patient group, emergency services must be provided with the relevant tools and training to do so (Brown, 2014). However, children's life experiences, maturity and understanding differ from one individual to the nextdepending on factors such as their age, culture, health, upbringing, background and environmentsand their ability to process healthcare-related information also varies. By continuing you agree to the use of cookies. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. 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). Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet Examples of harmful actions include the lack of hospital care, utilization of unsuitable medicines, implementation of some procedures and interventions without the agreement of patients as well as the disclosure of confidential information (Aehlert, 2012). N2 - Decision-making is central to the everyday practice of paramedicine. (PDF) Reflective Practice for Paramedics - Academia.edu Removed to place of safety for up to 72 hours for further assessment. 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).
Legal and Ethical Aspects of Paramedic Practice Article - Studentshare 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. Consequently, the crew had to consider alternative management plans for John. 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. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. There were no obvious physical causes for John's behaviour at this stage. Pre Hospital Ethics and Legal Issues - LawTeacher.net 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. Paramedics delivering palliative and end-of-life care in community This principle refers to both physical and mental damage, which can be done to the clients. MA Healthcare Ltd
Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. 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. 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. Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. 03 What factors affect paramedics' involvement of people with dementia 4 Conducting ethical research in paramedic practice. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. A policy set by an EMS Medical Director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a (n): A. direct order.