Cuts in public health and community services funding have decimated programs, leaving unmet health needs. He wasn't known to have sustained a head injury, nor taken any alcohol or drugs. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). 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). 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 patients with a disability are considered vulnerable in a similar way to older patients: they sometimes lack the defences or resources to deal with threats to them. 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). Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. B. EMTs are not liable for any actions that are accurately documented. Notify the family that once CPR has been initiated, you are required to transport the patient. In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). 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. | Paramedicine occurs in the social fabric of society. The principles of non-maleficence and beneficence form an area of special interest for the paramedics since these ethical issues are of paramount importance to them. At this point, healthcare professionals (for example paramedics) are likely to question and subsequently assess the person's ability to make this decision. Capacity is the legal principle, that a person is able to make decisions about their own healthcare where they can demonstrate an ability to understand relevant information given to them about their condition, retain that information and use or weigh that information to make an informed and considered choice (Mental Capacity Act 2005). 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. 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. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. Ethical issues in medical malpractice - PubMed Continuing Professional Development: Ethical aspects of consent, duty Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). Major incident clinical . Practice in a manner consistent with a code of ethics for registered nurses. 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. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. 153: Wednesday, December 2, 2020. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. 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. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). It seems that deciding which act is most appropriate must be managed on a case-by-case basis factoring in issues such as access to healthcare professionals available to utilise the MHA (as paramedics do not have it), the likely cause of the persons behaviour (physical/psychological), whether the patient seems likely to meet the threshold for detention under the MHA, and equally whether the patient is likely to be assessed as lacking capacity under the MCA. Paramedic Practice Test | Answers & Explanations | Test-Guide 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. Continuing Professional Development: Ethical issues in paramedic practice Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. That said, given the earlier acknowledgment of paramedics feeling undertrained to assess mental health patients (Roberts and Henderson, 2009; Berry, 2014) it could be questioned how equipped paramedics would be to utilise this act. B. crew control. 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. Despite this, there remain multiple barriers to their fully effective provision of such care. It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. Principlism in paramedicine: An examination of applied healthcare ethics Paramedic: Legislation And And Guidance That Govern The - Edubirdie An introduction to reflective practice for paramedics More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Some people with a disability may only be capable of autonomy in choices about low acuity or minor treatment, but not about more serious conditions. Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. Monday, January 2, 2017. Chat. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. (PDF) Reflective Practice for Paramedics - ResearchGate Fitness to practise - Health and Care Professions Council Paramedics - Health and Care Professions Council It is particularly important for clinicians to assess patient capacity every time they attend a person rather than relying on past experiences that because the person lacked capacity owing to their mental illness during a previous attendance, they will somehow lack capacity on all future presentations. In other words, paramedics need to adopt the principle of confidentiality and credence. 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 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. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. 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. In such a way, they will not violate personal freedom and demonstrate respect for patients demands and plans (Blaber, 2012). Samantha May Many with intellectual or communication disabilities are able to live independently in the community and make autonomous choices about their healthcare. People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. 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). A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. Vulnerable patients are no exception. Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. However, in this case the crew on scene were unable to utilise any sections of MHA, nor could they arrange for an MHA assessment by other professionals. EMT Chapter 3 -- Medical, Legal, and Ethical Issues Quiz 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). 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. Ethics part 1: what do paramedics owe patients? 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. Paramedics should be able to find good solutions to these dilemmas, but they have not received much attention . After that, we provide a few recommendations that can assist healthcare professionals in improving their capacity for making ethical decisions. Consequently, the crew began to assess for a psychological cause. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. Preventing children from exercising their autonomy may cause ethical challenges (Box 1). This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. This case report highlights the potential difficulties and complications associated with the management of mental health incidents for ambulance crews (Parsons and O'Brien, 2011) as well as how potentially confusing the ethical and legal aspects are when managing mental health conditions that require some involuntary form of treatment (Townsend and Luck, 2009). 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. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Our paramedic test questions are listed below. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.

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