ethical issues in paramedic practice

When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. Section 136 allows a police officer to remove a person from a public place to a place of safety if they believe them to be suffering from a mental health condition and at risk of harm to themselves or others (Hawley et al. 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. 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). 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. 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. The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. 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. Practice in a manner consistent with a code of ethics for registered nurses. 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). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. Download Free PDF View PDF 40: . http://dx.doi.org/10.1136/pmj.79.929.151 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. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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. 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. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. (PDF) Reflective Practice for Paramedics - ResearchGate 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. Inform client/staff members of ethical issues affecting client care. Paramedic attitudes and experiences of enrolling patients into the Mental illness can be a challenging vulnerability for clinicians to navigate. Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. In some cases, it may be a confusing task to react properly to the emerged contradictory issues, preserving the legal implications and moral duties at the same time. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Monday, January 2, 2017. Copyright 2023 This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). 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. Despite this, there remain multiple barriers to their fully effective provision of such care. 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. 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 beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. To assist paramedics in navigating these complex issues, the London Ambulance Service NHS Trust (2019) provides guidance on how to refer vulnerable people to services which may investigate the circumstances and ensure the safety and welfare of the patient). It then explores practical issues of capacity, autonomy and beneficence as these apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, persons with a mental illness and those with a disability. Paramedic ethics, capacity and the treatment of vulnerable patients The ethics in paramedicine has become a field of interest for many scientists and researchers. Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? Non-maleficence states that a medical practitioner has a duty to do no harm or allow harm to be caused to a patient through neglect. 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). Paramedics' perceptions of the care they provide to people who self Professional practice framework, professional rights and responsibilities, record keeping, governance. How does a paramedic use chemistry? [FAQ!] 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. Ethical problems in clinical practice | Postgraduate Medical Journal Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) Ethical Issues in Sports Medicine - In the United States - studocu.com Community Paramedics | American Nurses Association Efficiency and equity - Providers commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Legal, ethical and social aspects of child abuse - NursingAnswers.net C. Patient care cannot be discredited based on poor documentation. Unfortunately, in this case, it was wrongly thought by the crew that the MCA could not be used to enforce treatment plans for mental health conditions. 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. Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). B. crew control. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Together they form a unique fingerprint. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. A consensus among paramedic supervisors B. For example, a patient might have capacity to refuse their temperature being taken or other observations but not to refuse transport to hospital. Ethics, bioethics and legal issues in paramedic practice. Analyse Legal and Ethical Issues Facing Paramedics Major incident clinical . Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. 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. . In doing so, the article attempts to provide a clearer format of understanding of the laws and management of these situations, both for the benefit of future patients and the emergency services alike. While invasive options may be necessary for the safety of the patient, the clinician and the broader community in some circumstances, they should be used only as a last resort and less invasive treatment options should be preferred where possible, such as voluntary transport to hospital or a community referral. Older people, persons with disabilities or mental illness, or even those who have poorer social and economic standing (such as people who are homeless) may experience periods of substantial vulnerability. You note that at 10 years old, he has already had life experiences that many adults would dread.Is it reasonable for a paramedic to be concerned about infringing Terry's autonomy and, if so, how might a paramedic address this problem? 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). The ethical principle of non-maleficence means that paramedicine practitioners should discuss the probable negative consequences of their decisions and prevent them in order not to harm the patients. Ethical issues in medical malpractice - PubMed The crew's assessments and thought processes surrounding the management of John will be discussed. Journal of Paramedic Practice: Vol 3, No 8 The authors have faced all eight of the clinical scenarios in this paper in their routine clinical practice. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. care passports). Ethics and law in paramedic practice: Boundaries of capacity and Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. As such, making John secure was a priority. Having considered the probability of causes for John's symptoms, the crew suspected John may have been suffering from psychosis. Sample Essay on Law and Ethics in Paramedical Science More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? As with any patient, capacity can fluctuate, although this is more likely with older patients. 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. 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. This principle refers to both physical and mental damage, which can be done to the clients. 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. 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. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. 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. This will also help you learn important concepts for the exam. 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.

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