ethical issues in paramedic practice

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). This was because of current UK law and a lack of access to a GP respectively. The crew's assessments and thought processes surrounding the management of John will be discussed. 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. Although John appeared calm, and wasn't behaving at all aggressively at that time, the acute state of psychosis can be unpredictable, and pose serious risks (Hawley et al, 2011). 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 article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. 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. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? With regard to the addition of powers under the MHA for paramedics, Berry (2014) argues that the MCA (2005) should be sufficient for paramedics to manage mental health patients and where needed deprive them of their liberties, however the act appears to be neither sufficiently understood nor utilised and requires the patient to lack capacity, which is complex to assess and often present in mental health cases. 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. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. 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 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. Overview Fingerprint Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. | However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? Ethical issues are closely intertwined with legal aspects of care and this module will therefore consider the four ethical principles, focusing on the two key principles of autonomy and . C. vehicle safety. 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. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. 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. 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 . This principle refers to both physical and mental damage, which can be done to the clients. 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. Although provider judgment plays a large role in the . These factors contribute to an ethically complex decision-making environment. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. Journal of Paramedic Practice is the leading monthly journal for paramedics. 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). Confidentiality, capacity and consent. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. For many, staying at home is an important consideration in their decisions; older people may only wish to receive care that can be delivered in their home. In addition, due to John's virtually complete lack of speech, it was excessively difficult to ascertain if he was suffering any hallucinations/delusions at that time. 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). Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. 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. Our fitness to practise process is designed to protect the public from those who are not fit to practise. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. Undergraduate students who study ethics in nursing have an opportunity during their clinical practice, to discuss and reflect on a range of ethical and moral actions. It is diffcult tp prove actions were performed if they are not included on the report. It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. 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. 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. 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. The term psychosis can be used as an umbrella term for a number of different psychotic disorders (NICE, 2014) and so will be utilised here due to the lack of specific diagnosis present for John. At this point, healthcare professionals (for example paramedics) are likely to question and subsequently assess the person's ability to make this decision. C. Patient care cannot be discredited based on poor documentation. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. 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. 40: . A person's decision-making capacity is subject to change depending on circumstances such as the illness or injury being experienced at the time, the seriousness of the decision and various other factors. 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. 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. 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. The complexity of mental illness means a person's capacity can fluctuate so they may lose or regain capacity at different stages of their illness. 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 Notify the family that once CPR has been initiated, you are required to transport the patient. This can be a common complication in psychosis and is frequently exacerbated by the effects psychosis has on a person's levels of trust, insight and the ability to rationalise, making them reluctant to share information (Kleiger and Khadivi, 2015). They help organize the work activities and solve various contradictions between the legal and moral aspects, professional and personal judgments, and cultural and social norms. As with any patient, capacity can fluctuate, although this is more likely with older 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. Consumer rights in advocacy and health care. Paramedics have professional duties toward vulnerable persons. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . B. Major incident clinical . A policy set by an EMS Medical Director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a (n): A. direct order. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. Summary. NHS Research and Development Permissions were sought and granted. 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. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. 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 . 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. There were no obvious physical causes for John's behaviour at this stage.

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