Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. 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. Copyright 2023 Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. 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. The crew's assessments and thought processes surrounding the management of John will be discussed. 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. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). This is not the case. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. Paramedics interact with these patients every day, often during times of such vulnerability. A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. B. crew control. 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 . Vulnerable patients are at an increased risk of harm or exploitation in healthcare. However, if a person seems likely to be detained under the MHA, decision-makers cannot normally (p.234) rely on the MCA to give treatment for, or make decisions about, a mental health condition. Another ethical principle in paramedicine is beneficence. This research aims to highlight and explore underlying values present within practice-based decisions. Copyright 2023 Together they form a unique fingerprint. 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 . All relevant services should work together to facilitate timely, safe and supportive discharge from detention. 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. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. Integrated health care including mental health. Professional practice framework, professional rights and responsibilities, record keeping, governance. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. 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. In the theory of principle based ethics a paramedic must practise non-maleficence and beneficence. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. It shall conclude with this student's position on the issue based on the discussions. 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 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. Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. Writing a prescription: the law and good practice Paramedic independent prescribing offers an opportunity to improve patient access to medications. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. 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. 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. In conclusion, ethical and legal principles are of great importance in paramedical practices. 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. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. 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. 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. Interestingly, in some Australian states, paramedics have been granted powers under their MHA to detain mentally ill patients who require involuntary treatment (Parsons and O'Brien, 2011). A Department of Health and Social Security memorandum at the time instructed medical practitioners to provide confidential medical advice to children under the age of 16 without a parent present. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. 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. 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. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. Paramedics' decisions on patients' treatment will often impact others. 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). On closer inspection of the literature, it seems that John could have been treated (or in this case transported for treatment) using the MCA, as he wasn't currently detained under the MHA, nor did it seem likely he was going to be at that time (due mainly to a lack of access to the relevant health care professionals required to perform a MHA assessment) in order to receive the treatment he appeared to require in his best interest. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. The disawdvantage to the use of the MHA in this case though, is that it required police involvement as opposed to health care professionals (Parsons et al, 2011), which the Department of Health (2014) appear to be attempting to move away from in their review of section 136 of the MHA. A legal concept important in understanding the extent to which children have autonomy in making their own healthcare decisions is Gillick competence, named after a landmark UK case (Gillick v West Norfolk and Wisbech Area Health Authority [1985]). 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. 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). 105: 9 Using quantitative research methods in paramedic practice. There were no obvious physical causes for John's behaviour at this stage. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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). Reflective practice is undertaken for a variety of reasons. Download Free PDF View PDF 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. Ethics part 1: what do paramedics owe patients?
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