Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). Some of these are easier to address in the pre-hospital environment than others, for example, a simple blood glucose and temperature check excluded hypoglycaemia and lowered the index of suspicion for infection, as John had a normal temperature and blood sugar level. 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. 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. 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). 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. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Therefore, the personal attitudes and opinions of paramedicine practitioners should not be valued higher than the intentions and desires of patients. 122: 10 Researching paramedic clinical practice a practical guide. 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. A person must be presumed to have capacity unless it is established that he lacks capacity. Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. 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. 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). 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. The ethical and legal dilemmas paramedics face when managing a mental 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. Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). On the one hand, the paramedics should not neglect the interests and intentions of the patients. 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. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . In any case, the role of paramedics consists in the elimination of harmful aspects of patients ethical decisions as well as protection of their legal freedom and choice. Adult patients are presumed to have capacity to make medical decisions so treating them against their will violates their autonomy. abstract = "Decision-making is central to the everyday practice of paramedicine. 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. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. Such a position will help improve the system and lead to effective and fruitful results. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. 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). Medical Ethics: Non-Maleficence - The Medic Portal With this considered, it appears that in John's case, the MCA would have been an appropriate means with which to act in John's best interests and convey him to a place of safety for further treatment, which would most likely have been the nearest emergency department. However, in the emergency setting, where a patient is only temporarily detained (either under section 4, 5 or 136 of the MHA) and awaiting further assessment, the patient cannot yet be treated without consent under the MHA. Major incident clinical . It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. Consequently, the crew began to assess for a psychological cause. Introduction. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. While the moral or ethical side of paramedicine depends on various religious, cultural, and personal beliefs and views, its legal aspect has a strict definition. Despite this, there remain multiple barriers to their fully effective provision of such 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. The use of the other sections of the MHA can require much more time (Hawley et al. Although, hallucinations, delusions etc. While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. 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. journal = "Journal of Paramedic Practice: the clinical monthly for emergency care professionals", Charles Sturt University Research Output Home, Ethics and law in paramedic practice: Boundaries of capacity and interests, Nursing, Paramedicine and Healthcare Sciences, Journal of Paramedic Practice: the clinical monthly for emergency care professionals, https://doi.org/10.12968/jpar.2020.12.10.CPD1. 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). How does a paramedic use chemistry? [FAQ!] EMT Chapter 1 Flashcards | Quizlet Vulnerable patients are no exception. 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). 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Specifically, if a child has sufficient intelligence and maturity to understand the nature and consequences of particular treatment, they are able to consent to that treatment independently and without parental input according to the UK's Gillick competence doctrine. 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. All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. Other sections of the MHA can be utilised to remove a person from their property but require further input from other professionals ranging from magistrates to psychiatric doctors and approved mental health professionals (see appendix 2). For example, children (according to the law) have not reached the required age to make their own healthcare decisions, although some have the maturity to do so and will be able to make some autonomous decisions. Continuing Professional Development: Ethical aspects of consent, duty states registered nurses are legally required to report cases of child abuse if there is a "belief on reasonable grounds that a child is in need of protection on a ground referred to in Section 162 (c) or 162 (d), or formed in the course of practicing in . (PDF) Reflective Practice for Paramedics - Academia.edu Bachelor of Paramedic Practice (Conversion Pathway) (53C) Paramedic Practice Test. 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. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. 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. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. This is not the case. Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Paramedic attitudes and experiences of enrolling patients into the It is diffcult tp prove actions were performed if they are not included on the report. Ethical challenges in Emergency Medical Services - PubMed Ethics and law for the paramedic Reflective practice and communication Professional issues, including clinical audit and governance and anti-discriminatory practice Psychological perspectives on health and ill health Safeguarding children Sociological perspective on health and ill health and social policy Cuts in public health and community services funding have decimated programs, leaving unmet health needs. Older patients may have fluctuating capacity so may be able to make decisions for themselves in some circumstances and not others. This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. In other words, the paramedicine practitioners should inform the patients about all the probable effects of treatment as well as explain its moral and ethical issues. care passports). 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. 40: . 153: More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. The Department of Constitutional Affairs (2007) states that a person's ability to make decisions to protect themselves must always be in balance with their civil right to make such decisions. In the case of paramedicine, both ethics and law should remain unprejudiced and objective. The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. Continuing Professional Development: Ethical issues in paramedic practice Elder abuse can encompass neglect, financial duress, psychological threats and violence. Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. For paramedics, this requires careful thought on how transport and referral dispositions may affect the care and wellbeing of the other vulnerable person. 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. Like the abuse of children, the abuse of older people is a significant community concern. 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). 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. Ethical Issues in Sports Medicine - In the United States - studocu.com Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. They must also deliver care that is consistent with ethical. 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. To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. By continuing you agree to the use of cookies. Therefore, it is important to consider those principles more precisely. B. The ethics in paramedicine has become a field of interest for many scientists and researchers. 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. Removed to place of safety for up to 72 hours for further assessment. Journal of Paramedic Practice: Vol 3, No 8 In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. A recent topic of concern has been the extent to which paramedics and other health and care professionals are required to report instances of known or suspected child abuse or neglect (Foster, 2020). D. personal safety. Additionally, the measures taken by paramedics during the medical procedures should not contradict the existing laws and rules. 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 the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). 136: 11 The future for paramedic research. 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. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. Challenges UK paramedics currently face in providing fully effective This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". Legal and Ethical Aspects of Paramedic Practice Article - Studentshare 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. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action. Reflective practice is undertaken for a variety of reasons. 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. 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. 2 Function, build and sustain collaborative, professional relationships as a member of a team within multidisciplinary teams and agencies Methods There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. C. Patient care cannot be discredited based on poor documentation. Confusions surrounding said laws have been extracted from the case report and discussed in more generic terms in order to be more readily applicable to other similar cases. A consensus among paramedic supervisors B. The matter is that some spontaneous solutions or actions can negatively influence the patients and fail in the achievement of the desirable results (Beauchamp & Childress, 2008). Paramedics have professional duties toward vulnerable persons. 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
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