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The MHA already provides the provision for the appropriate clinicians to provide medical treatment for mental health disorders without consent, whether the patient has capacity or not. Summary of the key detaining sections relevant to paramedic practice (Hawley et al, 2013b). This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. In conclusion, ethical and legal principles are of great importance in paramedical practices. Alternatively, when a patient is deemed to lack capacity, paramedics can then act in a patient's best interests without their consent under the MCA; this can create an equally complex situation where paramedics attempt to ensure the patient receives the right care in the least restrictive manner possible (Townsend and Luck, 2009). Such a position will help improve the system and lead to effective and fruitful results. Ethics National Health Service (NHS) ethical approval was deemed unnecessary during proportionate review, as interviews were with existing staff and no changes to their practice were planned, nor was any contact made with patients. For example, if a patient is transported and this leaves an older person or older child at home, will they be sufficiently able to manage activities of daily living including food preparation, medication management and personal care? 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. Their vulnerability may impede their autonomy, which can then affect . In other words, paramedics need to adopt the principle of confidentiality and credence. He was also unable to effectively communicate his decision making process. http://dx.doi.org/10.1136/pmj.79.929.151 D. Incomplete . Specifically, if a child has sufficient intelligence and maturity to understand the nature and consequences of particular treatment, they are able to consent to that treatment independently and without parental input according to the UK's Gillick competence doctrine. Fluctuation of capacity means that a person's ability to understand information, retain that information and make an informed decision can come and go. Berry (2014) and Roberts and Henderson (2009) found that a large number of paramedics feel that they are undertrained and possibly underequipped to effectively assess and manage mental health conditions. 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). 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. 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). 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). Decision making in this environment is intended to provide care and treatment in the best interests of the patient. This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). | 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. This study explores the nature of paramedical ethics during the high-stakes referral of emergency ambulance patients, and relates findings to accepted concepts of professionalism. During the shared decision-making process between clinician and patient, paramedics must respect these preferences but also be sure that the material risks associated with alternative options for treatment (including non-transport) are clearly explained to the patient (Chan et al, 2017). 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. 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. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. Sample Essay on Law and Ethics in Paramedical Science Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. Up to 28 days, can be extended by subsequent assessments if required, Person must be at significant risk of: harm to self, harm to others, self-neglect, Requires an approved mental health professional (AMHP) and 2 doctors, Up to 6 months then re-assessed (if not already re-assessed), Critical and urgent admission for up to 72 hours, Used in emergencies as only requires one medical opinion so quicker than section 2 or 3, Police may enter a person's property (with a warrant obtained from a magistrate's court) to remove them to a place of safety if they are believed to be suffering from a mental illness and at risk of harm to self or others, Removal to place of safety (can be police station) for further assessment. Professional practice framework, professional rights and responsibilities, record keeping, governance. Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. In other words, the paramedicine practitioners should inform the patients about all the probable effects of treatment as well as explain its moral and ethical issues. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet Understanding capacity to consent to research (capacity) The first theme addresses physical and mental capacity and the ability of patients in the ambulance setting to make informed choices. Indeed, there is an argument that if we are to expect an improvement in the way emergency services manage mental health presentations and safeguard a vulnerable patient group, emergency services must be provided with the relevant tools and training to do so (Brown, 2014). Challenges UK paramedics currently face in providing fully effective 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). The priorities of the medical director C. The wishes of the general public D. Locally accepted protocols, During your monthly internal quality improvement (QI) meeting, you review several patient care reports . Introduction. While not criminally liable, registered health professionals (including paramedics) do have a clear professional and ethical duty to act upon instances of known or suspected child abuse or neglect. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Writing a prescription: the law and good practice Paramedic independent prescribing offers an opportunity to improve patient access to medications. 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. Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). Allowing a 16-year-old person to make healthcare decisions yet restricting a person one month before their 16th birthday from doing the same seems arbitrary and illogical. Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. The tenet of justice presupposes that paramedicine practitioners should treat all patients equally, without showing personal evaluations and attitudes. Study with Quizlet and memorize flashcards containing terms like The judicial branch at the state level is responsible for, If a paramedic is attacked by a violent patient, When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. The Paramedic'S Guide To Research: An Introduction - Google Books Pre Hospital Ethics and Legal Issues - LawTeacher.net 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). Major incident clinical . John's risk to the public must also be considered, which, in spite of public opinion, is not usually any higher in psychotic patients (Davies, 2009). keywords = "Ethics, Decision making, paramedic, complexity". Ethical issues in medical malpractice - PubMed 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. 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. 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. 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). Copyright 2023 Within this, confusion and limitations surrounding both the MCA and the MHA will be explored, as well as how these may affect patient care and any key areas that could be developed in the future. Although provider judgment plays a large role in the . Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet It shall discuss the legal and ethical aspects of the issue and how these aspects can be resolved. The ethics in paramedicine has become a field of interest for many scientists and researchers. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. Although John appeared calm, and wasn't behaving at all aggressively at that time, the acute state of psychosis can be unpredictable, and pose serious risks (Hawley et al, 2011). Our researchers and research supervisors undertake their studies within a wide range of theoretical frameworks and models relating to the development of policy and practice that takes account of: lived experiences of health and social issues, health and social care use, and, service delivery by the nursing, midwifery and paramedic professions . 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. 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. 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.