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). 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). Dominique Moritz, Phillip Ebbs, Hamish Carver As with any patient, capacity can fluctuate, although this is more likely with older patients. The provider must be always stalwart in the face of challenges to. 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). Besides, their classification sets the right vision for the development of paramedicine and provides it with the required tools and methods of acting and solving various dilemmas. 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). The paramedics and patients views on treatments may vary as well as moral and legal explanations of different procedures are different according to the cultural, religious, and social backgrounds. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). 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. Sample Essay on Law and Ethics in Paramedical Science 03 What factors affect paramedics' involvement of people with dementia They may need to consider whether community rapid response services or home GP visits are appropriate, whether additional support services should be organised or if they may need to ensure family members or friends visit the patient in a timely manner. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). Maintaining a professional boundary between you and your patient (summary) Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. Furthermore, those with mental illness may at times experience treatment and management that limits their autonomy, such as during times of severe psychosis where a patient's autonomy is lawfully overridden in their best interests through the use of chemical or even physical restraint. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. 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. C. vehicle safety. 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. Ethics and law in paramedic practice : Boundaries of capacity and interests. However, if a person seems likely to be detained under the MHA, decision-makers cannot normally (p.234) rely on the MCA to give treatment for, or make decisions about, a mental health condition. Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. Avulnerable adult is a person who is at increased risk of harm or exploitation because their ability to make decisions, express concerns or defend themselves is diminished (Oxford University Hospitals NHS Foundation Trust, 2016; Byju et al, 2019; de Chesnay, 2019; University Hospital Southampton NHS Foundation Trust, 2019). A patient who is treated by paramedics may be vulnerable because they lack the capacity to consent to treatment or, if they do have the capacity to consent to treatment, they lack the ability (or avenues) to express their worries about that treatment, or to defend themselves in circumstances where their consent has been misinterpreted. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. You will see the questions are broken down into the 5 different categories you will be tested on. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). With the exception of life-threatening situations (where a paramedic will often act in the patient's best interests to protect the patient's wellbeing), the preference is for clinicians to restore capacity or to wait for capacity to resume before intervening in the care of the patient. 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. While not criminally liable, registered health professionals (including paramedics) do have a clear professional and ethical duty to act upon instances of known or suspected child abuse or neglect. Jobs that involve the application of the MCA, either to protect the patient or deprive them of their civil liberties, can present a number of challenges to paramedics. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of ethical practice in order to: Recognize ethical dilemmas and take appropriate action. 105: 9 Using quantitative research methods in paramedic practice. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? 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. 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. 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). 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Children are considered vulnerable patients because until they reach the age of 16 (Mental Capacity Act 2005: section 2(5)), their parents have parental responsibility for decision-making. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. (PDF) Applied paramedic law and ethics . Townsend and Luck (eds)(2013 In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. Paramedic attitudes and experiences of enrolling patients into the Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Such a position will help improve the system and lead to effective and fruitful results. 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. 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). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Paramedic ethics, capacity and the treatment of vulnerable patients For example, older patients may experience an acute delirium from an infection that temporarily renders their capacity limited, or may lose capacity permanently because of progressive illnesses such as dementia. Utilizing a priority dispatch system allows dispatchers to send response . There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. 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. | Vulnerable patients are no exception. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet People with a disability may have carers who assist with decision-making and/or to protect their wishes, or who are entirely responsible for decision-making. This was because of current UK law and a lack of access to a GP respectively. 1 Ethics And Law For The Paramedic Copy - dev.endhomelessness The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Wednesday, December 2, 2020. That said, we must not forget the potential for the additional confusion seen overseas once given access to further legislative powers (Townsend and Luck, 2009). Removed to place of safety for up to 72 hours for further assessment. It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. Therefore, they should consider the needs and requirements of patients and act correspondingly. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Perceptions and concerns about receiving treatment at hospital may arise for a number of reasons, such as fear of not returning home, an experience of relatives dying in hospital, worry about pets, stoicism and beliefs about not wanting to bother others. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. keywords = "Ethics, Decision making, paramedic, complexity". Therefore, it is important to consider those principles more precisely. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. Ethical Practice: NCLEX-RN - Registered nursing 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. How does a paramedic use chemistry? [FAQ!] As such, making John secure was a priority. 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. 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). The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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. NHS Research and Development Permissions were sought and granted. The code of practice for the MCA (Department of Constitutional Affairs, 2007) doesn't clearly set out which specific treatments may or not be provided under the MCA; however, it does seek to explain the relationship between the MHA and MCA. Consequently, the crew began to assess for a psychological cause. 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. From this standpoint, the paramedics have to follow the same regulations and standards that are mandatory for the whole country. Elder abuse can encompass neglect, financial duress, psychological threats and violence. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. Paramedics' perceptions of the care they provide to people who self The disawdvantage to the use of the MHA in this case though, is that it required police involvement as opposed to health care professionals (Parsons et al, 2011), which the Department of Health (2014) appear to be attempting to move away from in their review of section 136 of the MHA. (PDF) Ethics In Paramedic Practice: A Qualitative Case Study of . Ethical Challenges in Emergency Medical Services: Controversies and Paramedics interact with these patients every day, often during times of such vulnerability. 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 . However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). Overview This CPD module aims to outline, describe and explain some of the key ethical-legal issues in paramedic practice, and their relation to the concept of consent, a duty of care and negligence. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. Major incident clinical . Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. N2 - Decision-making is central to the everyday practice of paramedicine. Foundations for paramedic practice: a theoretical perspective - Amazon Analyse Legal and Ethical Issues Facing Paramedics 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. Our fitness to practise process is designed to protect the public from those who are not fit to practise. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. 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. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. 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). 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). From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Should the MCA have been used, John would have been transported to an accident and emergency department, which may not be the most suited to deal with his condition (Morrisson-Rees et al, 2015; O'Hara et al, 2015), whereas the use of the MHA allowed him to be transported directly to a mental health unit. 1. be able to practise safely and effectively within their scope of practice 2. be able to practise within the legal and ethical boundaries of their profession 3. be able to maintain fitness to practise 4. be able to practise as an autonomous professional, exercising their own professional judgement A consensus among paramedic supervisors B. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. This research aims to highlight and explore underlying values present within practice-based decisions. Legal, ethical and social aspects of child abuse - NursingAnswers.net A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. In the theory of principle based ethics a paramedic must practise non-maleficence and beneficence. The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. Study with Quizlet and memorize flashcards containing terms like The judicial branch at the state level is responsible for, If a paramedic is attacked by a violent patient, When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). Speaking about the legal principles of paramedical practices, it is important to mention that legislative acts and rules are common for all individuals and organizations despite the scopes and directions of their activities. 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). Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). Although ethical and legal conduct and practices are often in harmony, in many areas ethical principles and the issues surrounding medical liability appear to come into conflict. Terry's condition has been worsening in recent weeks and his parents and clinicians have arranged for Terry to be transported by ambulance to hospital.However, Terry does not want to go to hospital today. Here we provide services and products that are for reference purpose only & are not intended to be put forward as finalised work & are to be used strictly for assistance in writing your own research material papers. However, the House of Lords found there were circumstances when a child could consent to their own medical treatment without the clinician seeking or obtaining parental consent. Chat. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. 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. Ethical dilemmas in prehospital emergency care - SpringerLink http://dx.doi.org/10.1136/pmj.79.929.151 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. Cuts in public health and community services funding have decimated programs, leaving unmet health needs. After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. However, while parental responsibility involves exercising legal decision-making authority for children, children do have the ability to make some healthcare decisions for themselves in certain circumstances. 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. Ethical issues in medical malpractice - PubMed 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? T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. Ethical considerations in prehospital ambulance based research 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. Townsend and Luck (2009) state that these additional legislative powers have actually led to more confusion for paramedics attempting to manage mental health patients, advocating the need for further training in order to grasp a better understanding of the ethics and law involved. 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). Clinicians and families may become more involved in the decision-making process or take over that decision-making role in the vulnerable person's best interests. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. Minecraft Aquaculture 2 Neptunium Ingot, Alex Lifeson Les Paul Axcess For Sale, Wilmington, Nc Obituaries, Articles E
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