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. Legal, ethical and social aspects of child abuse - NursingAnswers.net 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. C. Patient care cannot be discredited based on poor documentation. Have your partner contact the communications center to send law enforcement to the scene, as this is now a legal issue and the officer will make the decision. Foundations for paramedic practice: a theoretical perspective - Amazon 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 Bachelor of Paramedic Practice (Conversion) is a fully online program, designed to help currently practicing paramedics and advanced medics in the Australian Defence Force upgrade their existing qualifications. 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. 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. Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Purpose of the fitness to practise process. | 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. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. This article looks into the current difficulties many UK paramedics face when trying to manage patients presenting with a mental health condition in a safe and respectful manner; particularly when the patient requires some form of treatment but refuses this against medical advice. 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). 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. Paramedic ethics, capacity and the treatment of vulnerable patients 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. 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. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. A significant ethical consideration for clinicians when treating older patients is their capacity. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. 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. 2011). What makes them vulnerable is their lack of defences or resources to deal with threats or risk (Schrder-Butterfill and Marianti, 2006). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. Separate to the MCA (2005), the Mental Health Act (1983) (MHA) may also be used to provide treatment without consent in case of a mental health disorder (Department of Constitutional Affairs, 2007). According to Jones et al (2014), the third principle of the MCA (see Table 1) allows patients with capacity to make their own decisions even if they appear unwise or irrational. 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. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. Another important aspect when treating patients with mental illness is the stigma associated with mental ill health (Fink and Tasman, 1992). Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. 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. However, ethical issues relating to vulnerability and the treatment of children extend well beyond Gillick competence. 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. Copyright 2023 Vulnerable patients are no exception. MA Healthcare Ltd Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. Moreover, the principle of beneficence involves the necessity to provide sufficient and professional communication and interaction with such patients, without demonstrating their subjective judgments and assessments of the situation. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. On the one hand, the paramedics should not neglect the interests and intentions of the patients. How does a paramedic use chemistry? [FAQ!] Legal & Ethical issues associated with paramedic practice during COVID19. 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. Paramedicine presupposes direct interaction with individuals. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Health care professionals may be more likely to use the MCA to enforce treatment should they consider the patient unlikely to meet the threshold for detention under the MHA. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. Nevertheless, paramedicine policies should encourage patients to follow a healthy way of life and apply certain procedures, without intervening in their personal lives and decisions (Sharp, Palmore, & Grady, 2014). 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. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. @article{6040c026e1e34bd9b7239761b13480e7. Due to this misconception, the crew then considered the MHA (1983). The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. For example, in England and Wales under section 74 of the Serious Crimes Act 2015, health professionals have a legal duty to notify the police if they discover female genital mutilation. Confidentiality, capacity and consent. At the same time, the task of the paramedics is to improve their patients health conditions and choose the best way of treatment in every particular case. 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). Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. 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). EMT Chapter 1 Flashcards | Quizlet 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, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). Their vulnerability may impede their autonomy, which can then affect . Paramedicine occurs in the social fabric of society. Although provider judgment plays a large role in the . 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. For paramedics, this requires careful thought on how transport and referral dispositions may affect the care and wellbeing of the other vulnerable person. Gillick competence empowers children to exercise autonomy over their own medical decisions. 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. B. crew control. This exploratory case study utilized semi-structured interviews of thirteen North. NHS Research and Development Permissions were sought and granted. Inform client/staff members of ethical issues affecting client care. Continuing Professional Development: Ethical issues in paramedic practice Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. 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. He was also unable to effectively communicate his decision making process. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. The police, however, do have the power to utilise section 135 and 136 of the MHA (1983). This highlights the importance of having a good understanding of the MCA, as this is not limited by the persons whereabouts. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. Therefore, it is important to consider those principles more precisely. In the forthcoming sections, these standards, guidelines and ethical principles are used to explore key issues relating to patients who are commonly considered to be vulnerable: children, older people and those with mental illness or disability. 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). Challenges UK paramedics currently face in providing fully effective He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. MA Healthcare Ltd 40: . In order to begin to discuss some of these complexities, a case report will be presented to allow exploration of the challenges paramedics may face when trying to manage patients presenting with mental health conditions that require treatment but are refusing aid against advice. 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. There are many ethical issues that are encountered during the prehospital care of children and adults. T1 - Ethics and law in paramedic practice, T2 - Boundaries of capacity and interests. 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. Ethical challenges in Emergency Medical Services - PubMed As such, John was assessed using the MCA (Department of Health, 2005) to ensure that he had the capability and right to make his own decisions. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). Decision-making is central to the everyday practice of paramedicine. Efficiency and equity - Providers commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. Reflective practice is undertaken for a variety of reasons. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. Reflective practice is the link between theory and practice and a powerful means of using theory to inform practice thus promoting evidence based practice (Tsingos et al., 2014). Legal and Ethical Aspects of Paramedic Practice Article - Studentshare 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. 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.