However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests. It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. Ethical Challenges in Emergency Medical Services: Controversies and This research aims to highlight and explore underlying values present within practice-based decisions. 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. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. This will also help you learn important concepts for the exam. The ability to do the above forms key elements of an MCA assessment and suggests that John lacked capacity at that time (Department of Constitutional Affairs, 2007). Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. In this case, the MCA can be applied in the normal way, to provide treatment, even if for mental health disorders, should the person lack capacity (Department of Constituational Affairs, 2007). EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz 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). There are many ethical issues that are encountered during the prehospital care of children and adults. Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. Utilizing a priority dispatch system allows dispatchers to send response . This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. 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. Don't hesitate and rely on professionals! C. Patient care cannot be discredited based on poor documentation. Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet This course is made up of a number of paramedic specific units and additional health care units. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". Although, hallucinations, delusions etc. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. MA Healthcare Ltd The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. Ethics, bioethics and legal issues in paramedic practice. abstract = "Decision-making is central to the everyday practice of paramedicine. (PDF) Law and Ethics for Paramedics: An Essential Guide 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. 2011b) and it didn't seem that John could have kept himself safe until such a time he could have been detained in this way. By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. Older patients may have fluctuating capacity so may be able to make decisions for themselves in some circumstances and not others. prevent the safe and effective practice.5 Ideally, the paramedic concerned should report any of the above issues themselves, as this reflects professional behaviour. Therefore, they should consider the needs and requirements of patients and act correspondingly. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Ethical considerations in prehospital ambulance based research 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. Our paramedic test questions are listed below. In other words, paramedics need to adopt the principle of confidentiality and credence. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. 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. As with any patient, capacity can fluctuate, although this is more likely with older patients. Elder abuse can encompass neglect, financial duress, psychological threats and violence. 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 . T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. The priorities of the medical director C. The wishes of the general public D. Locally accepted protocols, During your monthly internal quality improvement (QI) meeting, you review several patient care reports . Notify the family that once CPR has been initiated, you are required to transport the patient. Many with intellectual or communication disabilities are able to live independently in the community and make autonomous choices about their healthcare. Inform client/staff members of ethical issues affecting client care. It affirms the supremacy of law and appreciation of human rights and freedom. Like the abuse of children, the abuse of older people is a significant community concern. 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. Paramedic: Legislation And And Guidance That Govern The - Edubirdie Practical decision-making strategies are provided and illustrated by brief examples. The paramedics should consider every individual case and act fairly and objectively in every situation (Beauchamp & Childress, 2008). Legal, ethical and social aspects of child abuse - NursingAnswers.net Legal & Ethical issues associated with paramedic practice during COVID19. Samantha May Journal of Paramedic Practice: Vol 3, No 8 Purpose of the fitness to practise process. 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). 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. It seems important to note that had John been in a private place, this option would have been void, which may have presented an even more complex situation to manage safely and legally. 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. Background This case report discusses an ethical communication dilemma in prehospital patient interaction, involving a patient who was about to board a plane at a busy airport. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. All rights reserved, Paramedic ethics, capacity and the treatment of vulnerable patients, Dominique Moritz, Phillip Ebbs, Hamish Carver, Explain why some people are considered vulnerable, Identify vulnerable patient groups that may be treated by paramedics, Discuss the relationship between autonomy and capacity in vulnerable patients, Reflect on their own practice to implement strategies that ensure vulnerable patients are protected. Wednesday, December 2, 2020. Paramedic attitudes and experiences of enrolling patients into the At these times, police are frequently involved in the prehospital management of patients where there is a potential risk of physical harm to either the patient or paramedics. 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. Major incident clinical . On assessment, John didn't appear to understand the information given to him, the decision he needed to make, and he was unable to retain or comprehend treatment plans or the risks of noncompliance. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. School of Nursing, Midwifery & Paramedic Practice They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. 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. Medical Ethics: Non-Maleficence - The Medic Portal 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. 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. 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. Practice in a manner consistent with a code of ethics for registered nurses. This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. 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. Paramedic practice must consider all of these factors to ensure ethically good care. 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). 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. PARAMEDIC2 study: Ethical issues | Medicina Intensiva 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. While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. Mental illness can be a challenging vulnerability for clinicians to navigate. Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. A sixth theme of ethical complexity was pervasive across these five themes. 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. 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. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. 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 are explored. Ethics and law in paramedic practice : Boundaries of capacity and interests. 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. 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. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. 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).