Paramedical ethics during acute emergency medical service referral In this case, both ethical and legal principles are important. This exploratory case study utilized semi-structured interviews of thirteen North. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? The design of the PARAMEDIC-2 trial required paramedics to independently determine eligibility and randomise patients into the trial by administering the blinded drugs (either adrenaline or a saline placebo) from a trial-specific drug pack. They must also deliver care that is consistent with ethical. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. As such, John was assessed using the MCA (Department of Health, 2005) to ensure that he had the capability and right to make his own decisions. Abstract. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. On the one hand, the paramedics should not neglect the interests and intentions of the patients. Unlike in countries such as Australia, Canada and the Republic of Ireland where there are mandatory reporting laws, individual health professionals in England are not criminally liable if they fail to report other instances of known or suspected child abuse or neglect (Forster, 2020). Paramedics may be the first health professionals to encounter these vulnerable adults and be the link to not only ensuring they receive the clinical care required at the time but also to breaking the cycle of abuse through notifications or referrals to agencies and support services. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. From this standpoint, the paramedics have to follow the same regulations and standards that are mandatory for the whole country. A consensus among paramedic supervisors B. To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. These factors contribute to an ethically complex decision-making environment. 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 . By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. Paramedics delivering palliative and end-of-life care in community Police may remove a person from a public place where they are believed to be suffering from mental illness and at risk of harm to themselves or others. To provide guidance for paramedics in how to meet their obligations in reporting children at risk, the London Ambulance Service NHS Trust (2020) has produced the Safeguarding Children and Young People Policy. Journal of Paramedic Practice: Vol 3, No 8 Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. 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. Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. Download Free PDF View PDF Paramedic Practice Test | Answers & Explanations | Test-Guide Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. Paramedic attitudes and experiences of enrolling patients into the The complexity of mental illness means a person's capacity can fluctuate so they may lose or regain capacity at different stages of their 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. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Due to this misconception, the crew then considered the MHA (1983). 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. Legal, ethical and social aspects of child abuse - NursingAnswers.net A sixth theme of ethical complexity was pervasive across these five themes. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. The ethical and legal principles of autonomy and capacity help to protect patients and clinicians from abuses of power and exploitation in the healthcare relationship because they establish safeguards for patients. 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. 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). Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. 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. 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). 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. Principlism in paramedicine: an examination of applied healthcare ethics Legal and ethical practice in care. Paramedics - Health and Care Professions Council In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. In particular, privacy and confidentiality considerations must be foremost when others are present such as work colleagues or neighbours. Paramedics interact with these patients every day, often during times of such vulnerability. Professional practice framework, professional rights and responsibilities, record keeping, governance. 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. 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. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. It seems paramount that whichever decision is made and Act is used, should the patient receive any form of involuntary treatment, the principles of the MCA and the MHA are upheld, and any decision made is in the patients best interest (Department of Health, 2005). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. The term psychosis can be used as an umbrella term for a number of different psychotic disorders (NICE, 2014) and so will be utilised here due to the lack of specific diagnosis present for John. 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. 40: . doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". This paper highlights some of the ethical dilemmas that face practising clinicians in their everyday life and restates how useful the General Medical Council guidance is to make appropriate decisions. Summary. 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. Inform client/staff members of ethical issues affecting client care. 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. 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). The crew's assessments and thought processes surrounding the management of John will be discussed. There were no obvious physical causes for John's behaviour at this stage. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Purpose of the fitness to practise process. 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. From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. 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). In the UK, paramedics are currently not able to utilise any part of the MHA, though it is debated whether this would be beneficial (Berry, 2014; DOH, 2014). John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. 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. 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. Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. Removed to place of safety for up to 72 hours for further assessment. The Bachelor of Paramedic Practice (Conversion) is a fully online program, designed to help currently practicing paramedics and advanced medics in the Australian Defence Force upgrade their existing qualifications. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). abstract = "Decision-making is central to the everyday practice of paramedicine. 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. 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. 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). Older people are largely understood as vulnerable when they fall within the high-risk groups of frail, isolated or poor (Schrder-Butterfill and Marianti, 2006). Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. 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. 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). D. Incomplete . Medical Ethics: Non-Maleficence - The Medic Portal AB - Decision-making is central to the everyday practice of paramedicine. PARAMEDIC2 study: Ethical issues | Medicina Intensiva Although provider judgment plays a large role in the . 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.