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. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. He was also unable to effectively communicate his decision making process. Notify the family that once CPR has been initiated, you are required to transport the patient. Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. . 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. 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). Paramedicine occurs in the social fabric of society. 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. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). 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. In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. 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. Once an allegation is made, the HPC will arrange for it to be reviewed by paramedics, other allied health professionals, and, most importantly, members of the public, to determine if 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. 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).
Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). 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). Legal & Ethical issues associated with paramedic practice during COVID19. 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). In conclusion, ethical and legal principles are of great importance in paramedical practices. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). Ethics, bioethics and legal issues in paramedic practice. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). A person may be deprived of their civil liberties in order to be provided with care or treatment that they are unable to consent to due to a lack of capacity, if is in their best interests (Ministry of Justice, 2008; Amblum, 2014). This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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. It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice.
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. Ethics part 1: what do paramedics owe patients? As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. Therefore, consideration of these effects is part of how they treat patients and make decisions. The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. Purpose and effectiveness - Decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines. Such a position will help improve the system and lead to effective and fruitful results. People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. 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. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. The COVID-19 pandemic and the paramedic response to it, has raised a raft of legal, ethical and professionalism questions for paramedic clinicians and managers. 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). @article{6040c026e1e34bd9b7239761b13480e7. D. personal safety. 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. Copyright 2023
The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. 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. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. By continuing you agree to the use of cookies. 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. If a registrant's fitness to practise is impaired (in other words, negatively affected) it means there are concerns about their ability to practise safely and effectively. The Health and Care Professions Council (HCPC) (2016, section 7.3: 8) requires that paramedics must take appropriate action where they have concerns about the safety or well-being of children or vulnerable adults. Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. 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 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. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". This third and final article in the series starts by describing the relationships between the legal principle of capacity and the ethical principles of autonomy and beneficence. Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. A major concern in healthcare ethics (including within paramedicine) is the protection of vulnerable persons within the realms of patient-practitioner interactions (Moritz, 2017; Townsend, 2017; Ebbs and Carver, 2019). Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. 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. However, paramedics must be aware that it is a medical event that is occurring and the person is generally not being held for criminal reasons. 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. 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. Nurses are expected to practise in an ethical manner, through the demonstration of a range of ethical competencies articulated by registering bodies and the relevant codes of ethics (see Boxes 5.1 and 5.2).It is important that nurses develop a 'moral competence' so that they are able to contribute to discussion and implementation of issues concerning ethics and human rights .