In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. While carers might have a duty to make decisions that benefit the patient and are least restrictive of the patient's rights, it can be difficult for clinicians to uphold and appropriately consider the patient's wishes when another person is responsible for their decision-making. 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. Legal & Ethical issues associated with paramedic practice during COVID19. Integrated health care including mental health. Despite this, there remain multiple barriers to their fully effective provision of such care. Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. However, the crew were able to identify some typical symptoms of psychosis in Johns' behaviour. Using a reflective format, the article explored some of the laws surrounding treatment without consent and how these may aid or hinder a paramedics' ability to provide good quality care to patients in complex situations. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. Therefore, the personal attitudes and opinions of paramedicine practitioners should not be valued higher than the intentions and desires of patients. author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). 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? You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. It is important to remember that capacity is not a binary state; it exists on a continuum and depends upon the patient's circumstances and the potential consequences of the decision being made. This can make the balance of patient care and patient autonomy exceedingly difficult to strike, and lead to a number of ethical and legal dilemmas for paramedics (Townsend and Luck, 2009). Utilizing a priority dispatch system allows dispatchers to send response . John spent most of his time standing, staring into space during the crew's presence, a further sign associated with psychosis, where patients spend extended periods of time seemingly doing nothing (Turner, 2009). Don't hesitate and rely on professionals! 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. Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. 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. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). 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. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. That said, we must not forget the potential for the additional confusion seen overseas once given access to further legislative powers (Townsend and Luck, 2009). B. EMTs are not liable for any actions that are accurately documented. A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. This is a condition referred to as alogia or poverty of speech and is another sign of psychosis (Turner, 2009; Harris and Millman, 2011; Kleiger and Khadivi, 2015). 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. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. 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. 2011b) and it didn't seem that John could have kept himself safe until such a time he could have been detained in this way. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Speaking about the legal principles of paramedical practices, it is important to mention that legislative acts and rules are common for all individuals and organizations despite the scopes and directions of their activities. Like the abuse of children, the abuse of older people is a significant community concern. It can be used by . The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). There are many ethical issues that are encountered during the prehospital care of children and adults. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. And even though the legal issues may have been covered, the ethical implications of the lack of healthcare provided are undoubtedly contrary to good clinical practice given it represents the deliberate concealment of a therapy (or lack of it) used in a given person. Reflective practice is undertaken for a variety of reasons. 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. Purpose of the fitness to practise process. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. 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. Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. Dominique Moritz, Phillip Ebbs, Hamish Carver All relevant services should work together to facilitate timely, safe and supportive discharge from detention. This course is made up of a number of paramedic specific units and additional health care units. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. 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. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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. Samantha May EBOOK: Blaber's Foundations for Paramedic Practice: A Theoretical Perspective Amanda Blaber 2018-11-19 This bestselling undergraduate level book is an ideal resource for student paramedics looking for an excellent introduction to the main theoretical subjects studied in paramedic courses, and links practice issues to the all-important theory . Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. 4 Conducting ethical research in paramedic practice. The paramedics should take into account the health conditions of patients, the seriousness of their problem, their relations with relatives, and probable reactions to different types of treatment before making the final decision. Chat. NHS Research and Development Permissions were sought and granted. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. 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. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. Nurses are expected to practise in an ethical manner, through the demonstration of a range of ethical competencies articulated by registering bodies and the relevant codes of ethics (see Boxes 5.1 and 5.2).It is important that nurses develop a 'moral competence' so that they are able to contribute to discussion and implementation of issues concerning ethics and human rights .
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