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). It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). They must also deliver care that is consistent with ethical. If a registrant's fitness to practise is impaired (in other words, negatively affected) it means there are concerns about their ability to practise safely and effectively. 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). After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com.
title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". Gillick competence allows clinicians to assess a child's capacity to determine their decision-making ability. This is not the case. 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. NHS Research and Development Permissions were sought and granted. Paramedic ethics, capacity and the treatment of vulnerable patients Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. Sample Essay on Law and Ethics in Paramedical Science Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. While invasive options may be necessary for the safety of the patient, the clinician and the broader community in some circumstances, they should be used only as a last resort and less invasive treatment options should be preferred where possible, such as voluntary transport to hospital or a community referral. From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. B. crew control. Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. On the one hand, the paramedics should not neglect the interests and intentions of the patients. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. The Paramedic'S Guide To Research: An Introduction - Google Books 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. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Principlism in paramedicine: An examination of applied healthcare ethics Neglect or ill treatment of a person who lacks capacity (including older people) is a criminal offence in the UK (Mental Capacity Act 2005, section 44).
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Due to this misconception, the crew then considered the MHA (1983). All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. In this case, both ethical and legal principles are important. 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). 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. 03 What factors affect paramedics' involvement of people with dementia 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Purpose of the fitness to practise process. An introduction to reflective practice for paramedics Practical issues of capacity, autonomy and beneficence as they apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, those with a mental illness and persons with a disability are explored. Psychiatric admission for assessment and subsequent treatment if required. Ethics in EMS: 10 things you need to know to save lives Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). 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). However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Ethical Practice: NCLEX-RN - Registered nursing Current Issues in Paramedic Practice Also, the ambulance crew is often vulnerable to physical and verbal abuse in the course of discharging their duty. Paramedic ethics, capacity and the treatment of vulnerable patients http://dx.doi.org/10.1136/pmj.79.929.151 The frequent exposure to physical and verbal abuse is directly associated with the increasing rate of alcohol-related call-outs. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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. N2 - Decision-making is central to the everyday practice of paramedicine. 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. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: Select one: A. In this case, the MCA can be applied in the normal way, to provide treatment, even if for mental health disorders, should the person lack capacity (Department of Constituational Affairs, 2007). Samantha May
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. Non-maleficence states that a medical practitioner has a duty to do no harm or allow harm to be caused to a patient through neglect. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. In these complex cases with so many variables, it can sometimes be difficult to fit patients in-between the lines of any law, often meaning that when decisions are unclear, paramedics are forced to engage in a risk management strategy without the power or provision of involuntary sectioning (Palmer, 2011). This principle refers to both physical and mental damage, which can be done to the clients. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. (PDF) Reflective Practice for Paramedics - Academia.edu This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). 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. Ethical Issues in Sports Medicine - In the United States - studocu.com Ethical Responsibilities of Paramedics | Work - Chron.com The Health and Care Professions Council (HCPC) (2016, section 7.3: 8) requires that paramedics must take appropriate action where they have concerns about the safety or well-being of children or vulnerable adults. Thompson et al (2011) highlight that frequent callers (also known as frequent users) are known to clinicians because they regularly require paramedic support, usually as a result of a mental illness. Exploring New Zealand Paramedic Attitudes Towards Advance Directives 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). Examples of harmful actions include the lack of hospital care, utilization of unsuitable medicines, implementation of some procedures and interventions without the agreement of patients as well as the disclosure of confidential information (Aehlert, 2012). 2011). However, the Department of Health (2015) clearly state that it is, so long as the patient hasn't already had their liberties removed under the MHA (1983). EMT Chapter 1 Flashcards | Quizlet Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. Paramedics' perceptions of the care they provide to people who self Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. A major concern in healthcare ethics (including within paramedicine) is the protection of vulnerable persons within the realms of patient-practitioner interactions (Moritz, 2017; Townsend, 2017; Ebbs and Carver, 2019). Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. Their vulnerability may impede their autonomy, which can then affect . 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). In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. Principlism in paramedicine: an examination of applied healthcare ethics 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. 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. 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. 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 . The question of justice is another part of the paramedical performance. Paramedicine presupposes direct interaction with individuals. Elder abuse can encompass neglect, financial duress, psychological threats and violence. All of these ethical issues represent significant dilemmas to consider for the sake of patients health as well as moral and legal justification (Bledsoe, Porter, Cherry, & Armacost, 2006). Jobs that involve the application of the MCA, either to protect the patient or deprive them of their civil liberties, can present a number of challenges to paramedics. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). Removed to place of safety for up to 72 hours for further assessment.
In the case of paramedicine, both ethics and law should remain unprejudiced and objective. 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. 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". Integrated health care including mental health. Furthermore, capacity can fluctuate, so clinicians must favour capacity assessments made at each attendance over capacity assumptions because of vulnerability or previous dealings with the patient. By utilising a reflective format, the article explores 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 these situations. Chat. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. 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). It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. This third and final article in the series starts by describing the relationships between the legal principle of capacity and the ethical principles of autonomy and beneficence. However, it is also essential to explain their view on the problem and prove the beneficence of their choice to reach an agreement with the patients (Aehlert, 2012). Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. Ethical challenges in Emergency Medical Services - PubMed To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. This highlights the importance of having a good understanding of the MCA, as this is not limited by the persons whereabouts. 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. Gillick competence addresses children's understanding and provides paramedics and other health professionals with a means to determine the extent of involvement a child should have in decisions that affect their healthcare. Vulnerable patients are no exception. Journal of Paramedic Practice is the leading monthly journal for paramedics. Paramedics - Health and Care Professions Council To assist paramedics in navigating these complex issues, the London Ambulance Service NHS Trust (2019) provides guidance on how to refer vulnerable people to services which may investigate the circumstances and ensure the safety and welfare of the patient). (PDF) Law and Ethics for Paramedics: An Essential Guide 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. The principles of the Mental Capacity Act 2005 and the Mental Health Act 1983. There are many ethical issues that are encountered during the prehospital care of children and adults. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. 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. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. Many with intellectual or communication disabilities are able to live independently in the community and make autonomous choices about their healthcare. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. 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. In the theory of principle based ethics a paramedic must practise non-maleficence and beneficence. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. Practitioners must be mindful that, despite the frequent interactions with these patients, their behaviour is often perpetuated by mental illness, and the patient needs care for their chronic illness just the same as they would for any other illness. Ethics part 1: what do paramedics owe patients? A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes?