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. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. 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? The question of justice is another part of the paramedical performance. Box 1.Autonomy in a childAs a local paramedic, you have come to know Terry quite well over the years. 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. Ethics and law in paramedic practice: Boundaries of capacity and The Bachelor of Paramedic Practice (Conversion) is a fully online program, designed to help currently practicing paramedics and advanced medics in the Australian Defence Force upgrade their existing qualifications. 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. Paramedics have professional duties toward vulnerable persons. With regard to the addition of powers under the MHA for paramedics, Berry (2014) argues that the MCA (2005) should be sufficient for paramedics to manage mental health patients and where needed deprive them of their liberties, however the act appears to be neither sufficiently understood nor utilised and requires the patient to lack capacity, which is complex to assess and often present in mental health cases. The crew's assessments and thought processes surrounding the management of John will be discussed. Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. This research aims to highlight and explore underlying values present within practice-based decisions. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". 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). Utilizing a priority dispatch system allows dispatchers to send response . 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. 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. 2011). In the forthcoming sections, these standards, guidelines and ethical principles are used to explore key issues relating to patients who are commonly considered to be vulnerable: children, older people and those with mental illness or disability. 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. There are many ethical issues that are encountered during the prehospital care of children and adults. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. (PDF) Reflective Practice for Paramedics - Academia.edu 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. 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. 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). Nevertheless, it is important to understand that many ethical issues presented in health care have little to do with paramedicine as the latter focuses mainly on emergencies. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. In some cases, it may be a confusing task to react properly to the emerged contradictory issues, preserving the legal implications and moral duties at the same time. Continuing Professional Development: Ethical aspects of consent, duty Introduction. They may need to consider whether community rapid response services or home GP visits are appropriate, whether additional support services should be organised or if they may need to ensure family members or friends visit the patient in a timely manner. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. MA Healthcare Ltd As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. Overview Fingerprint Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. 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). EMS Chapter 3 Medical, Legal, and Ethical Issues Quiz Perceptions and concerns about receiving treatment at hospital may arise for a number of reasons, such as fear of not returning home, an experience of relatives dying in hospital, worry about pets, stoicism and beliefs about not wanting to bother others. 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. 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. Monday, January 2, 2017. In the second article, potential conflicts between autonomy and beneficence in relation to end-of-life care were explored (Carver et al, 2020). It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). Ethical issues are closely intertwined with legal aspects of care and this module will therefore consider the four ethical principles, focusing on the two key principles of autonomy and . All relevant services should work together to facilitate timely, safe and supportive discharge from detention. However, in the emergency setting, where a patient is only temporarily detained (either under section 4, 5 or 136 of the MHA) and awaiting further assessment, the patient cannot yet be treated without consent under the MHA. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". practice with medical specialists. It is diffcult tp prove actions were performed if they are not included on the report. Maintaining a professional boundary between you and your patient (summary) By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. EMT Chapter 1 Flashcards | Quizlet In the UK, paramedics are currently not able to utilise any part of the MHA, though it is debated whether this would be beneficial (Berry, 2014; DOH, 2014). 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. 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. Paramedic practice must consider all of these factors to ensure ethically good care. Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet 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. Nevertheless, paramedicine policies should encourage patients to follow a healthy way of life and apply certain procedures, without intervening in their personal lives and decisions (Sharp, Palmore, & Grady, 2014). 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. Exploring New Zealand Paramedic Attitudes Towards Advance Directives After completing this module, the paramedic will be able to: If you would like to send feedback, please email jpp@markallengroup.com. Challenges UK paramedics currently face in providing fully effective 40: . Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. D. Incomplete . (PDF) Ethics In Paramedic Practice: A Qualitative Case Study of 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 Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians.