Continuing Professional Development: Ethical issues in paramedic practice Continuing Professional Development: Ethical issues in paramedic practice Friday, August 5, 2011 OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. 1 Demonstrate an adaptive, flexible and self-directed commitment to the promotion, maintenance and restoration of health and to the delivery of primary health care across the lifespan. However, it is also essential to explain their view on the problem and prove the beneficence of their choice to reach an agreement with the patients (Aehlert, 2012). T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Such a position will help improve the system and lead to effective and fruitful results. 2011). Capacity can fluctuate over time or as a health condition changes. 4 Conducting ethical research in paramedic practice. For paramedics, this requires careful thought on how transport and referral dispositions may affect the care and wellbeing of the other vulnerable person. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. 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). 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. 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. There are particular ethical challenges when multiple vulnerable groups are involved, such as when a mental health patient is also a parent or is caring for an older person. The ethical principle of respect for the patients autonomy presupposes the non-interference in the freedom of their decisions and choices (Steer, 2007). Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. It affirms the supremacy of law and appreciation of human rights and freedom. 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). Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. 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. They must also deliver care that is consistent with ethical. 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 . 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. 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. Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. Many people with an intellectual disability or communication difficulties often have written information available, particularly in care facilities, that has been compiled with the assistance of family members, health professionals such as occupational therapists or speech pathologists, psychologists and (of course) the patient (e.g. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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). Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. Summary of the key detaining sections relevant to paramedic practice (Hawley et al, 2013b). 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. A progression of learning in terms of acting morally and ethically is necessary when nurses undergo training on both an undergraduate and a specialist level. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. This research aims to highlight and explore underlying values present within practice-based decisions. All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. One of the most important legal principles in paramedicine is the preservation of patients personal information and data. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. Paramedics play an integral part in community end-of-life care (EoLC) in the UK, especially given the lack of out-of-hours cover by palliative care specialists. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. Paramedics' decisions on patients' treatment will often impact others. N2 - Decision-making is central to the everyday practice of paramedicine. 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. This was because of current UK law and a lack of access to a GP respectively. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. 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. It is not clear though, how professionals (especially those who do not use the MHA) are likely to know in advance if a patient is likely to meet threshold for detention under this act, and so whether the MCA seems appropriate for use or not. Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. 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. For example, if a patient is transported and this leaves an older person or older child at home, will they be sufficiently able to manage activities of daily living including food preparation, medication management and personal care? B. EMTs are not liable for any actions that are accurately documented. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. In the first article of this series on applied ethics in paramedicine, the authors examined the ethical principles of autonomy and beneficence in the context of principlism (Ebbs et al, 2020). Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. 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). Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. A. This highlights the importance of having a good understanding of the MCA, as this is not limited by the persons whereabouts. 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. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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 provider must be always stalwart in the face of challenges to. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. 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. 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). On the one hand, the paramedics should not neglect the interests and intentions of the patients. The police, however, do have the power to utilise section 135 and 136 of the MHA (1983). NHS Research and Development Permissions were sought and granted. 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. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . Least restrictive option and maximising independence - Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. 153: 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. This exploratory case study utilized semi-structured interviews of thirteen North. A paramedic should always ensure the confidentiality of not only a patient's medical information but also his or her personal information (Pozgar & Pozgar, 2012). It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. Legal and ethical practice in care. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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? Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. 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 . 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. 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Despite this, there remain multiple barriers to their fully effective provision of such care. AB - Decision-making is central to the everyday practice of paramedicine. 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. Alternatively, when a patient is deemed to lack capacity, paramedics can then act in a patient's best interests without their consent under the MCA; this can create an equally complex situation where paramedics attempt to ensure the patient receives the right care in the least restrictive manner possible (Townsend and Luck, 2009). It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. Therefore, consideration of these effects is part of how they treat patients and make decisions. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). In these complex cases with so many variables, it can sometimes be difficult to fit patients in-between the lines of any law, often meaning that when decisions are unclear, paramedics are forced to engage in a risk management strategy without the power or provision of involuntary sectioning (Palmer, 2011). As such, making John secure was a priority. Legal & Ethical issues associated with paramedic practice during COVID19. Some patients with a disability are considered vulnerable in a similar way to older patients: they sometimes lack the defences or resources to deal with threats to them. Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). A mother (Victoria Gillick) sought to have medical practitioners refuse to provide medical advice to her daughters, aged under 16, in relation to contraception. 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. Writing a prescription: the law and good practice Paramedic independent prescribing offers an opportunity to improve patient access to medications. Among the most significant and complicated ethical dilemmas in nursing, it is possible to distinguish the problem of euthanasia, abortion, truth-telling as opposed to deliberate deception, and freedom contrary to control. 122: 10 Researching paramedic clinical practice a practical guide. There are many ethical issues that are encountered during the prehospital care of children and adults. You'll examine the relationship of law and medicine together with the interplay of medical ethics, analyse the development of medical negligence and consent to medical treatment as well as international medical ethics issues arising from birth to death.