Paramedics' perceptions of the care they provide to people who self This situation will hopefully alter over time, so this module attempts to present the four ethical contexts common in other health disciplines and discuss them in relation to paramedic practice.Learning OutcomesAfter completing this module you will be able: To provide an overview of the four key ethical principles that underpin current clinical practice in the UK To explore these four ethical principles in relation to specific prehospital and clinical issues To encourage the practitioner to reflect on their own ethical practice To begin to develop the ability to share, discuss and debate the four ethical principles with colleagues and friends, in relation to your own clinical practice. Ethical dilemmas in prehospital emergency care - SpringerLink This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). This course is made up of a number of paramedic specific units and additional health care units. It is clear from these assessments that there are consequent physical risks to the patient's wellbeing depending on the mental health condition(s) present. Many people with an intellectual disability or communication difficulties often have written information available, particularly in care facilities, that has been compiled with the assistance of family members, health professionals such as occupational therapists or speech pathologists, psychologists and (of course) the patient (e.g. Consumer rights in advocacy and health care. Such an approach preserves all ethical aspects of the paramedical profession since it shows respect to patients and reveals professional competence and help at once (Blaber, 2012). More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. 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). Ethical practice forms a fundamental aspect of paramedic care, and not only is the of model 2 paramedic expected to meet standards of ethics as laid down by the HPC, but more importantly paramedics Following attendance to a call, a reflective account was completed using model 2. are required to treat patients in a way that is humane The Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. 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. B. Summary of the key detaining sections relevant to paramedic practice (Hawley et al, 2013b). Chapter 4 Medical, Legal and Ethical Issues Flashcards | Quizlet The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. A person's capacity depends upon the nature of their disability. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. They identify and direct the work of the paramedical practices as well as determine all possible ways of interacting and communicating with patients (Bledsoe et al., 2006). 2011). (PDF) Reflective Practice for Paramedics - Academia.edu Ethical deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. 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). All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. It shall conclude with this student's position on the issue based on the discussions. Our paramedic test questions are listed below. 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 At these times, police are frequently involved in the prehospital management of patients where there is a potential risk of physical harm to either the patient or paramedics. 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). To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. This principle refers to both physical and mental damage, which can be done to the clients. N2 - Decision-making is central to the everyday practice of paramedicine. 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. Paramedic ethics, capacity and the treatment of vulnerable patients Paramedic ethics, capacity and the treatment of vulnerable patients Dominique Moritz, Phillip Ebbs, Hamish Carver Wednesday, December 2, 2020 Vulnerable patients are at an increased risk of harm or exploitation in healthcare. 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. B. crew control. 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. 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. There is currently some debate as to whether the police are the most suitable personnel to be detaining patients under the MHA for a variety of reasons, and paramedics are mentioned as a potential alternative group to utilise this law in the future (Department of Health, 2014). D. personal safety. Continuing Professional Development: Ethical issues in paramedic practice Reflective practice is undertaken for a variety of reasons. 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. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity to consent until proved otherwise. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Major incident clinical . 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Therefore, the personal attitudes and opinions of paramedicine practitioners should not be valued higher than the intentions and desires of patients. In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. practice with medical specialists. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. It then explores practical issues of capacity, autonomy and beneficence as these apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, persons with a mental illness and those with a disability. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Capacity can fluctuate over time or as a health condition changes. Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. What makes them vulnerable is their lack of defences or resources to deal with threats or risk (Schrder-Butterfill and Marianti, 2006). In particular, privacy and confidentiality considerations must be foremost when others are present such as work colleagues or neighbours. Continuing Professional Development: Ethical issues in paramedic practice Continuing Professional Development: Ethical issues in paramedic practice Friday, August 5, 2011 OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. People with mental illness may also be vulnerable because their illness may sometimes render them unable to make some decisions or, like older patients, their decision-making ability fluctuates. For paramedics, this requires careful thought on how transport and referral dispositions may affect the care and wellbeing of the other vulnerable person. Undergraduate students who study ethics in nursing have an opportunity during their clinical practice, to discuss and reflect on a range of ethical and moral actions. 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). Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. 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. 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. (PDF) Law and Ethics for Paramedics: An Essential Guide Some people with a disability may have mobility issues that do not affect their capacity to consent to treatment and decision-making, while others with a disability may not have decision-making capacity for numerous reasons, including communication difficulties or intellectual disability. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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. Older people, persons with disabilities or mental illness, or even those who have poorer social and economic standing (such as people who are homeless) may experience periods of substantial vulnerability. As with any patient, capacity can fluctuate, although this is more likely with older patients. Many with intellectual or communication disabilities are able to live independently in the community and make autonomous choices about their healthcare. Children are considered vulnerable patients because until they reach the age of 16 (Mental Capacity Act 2005: section 2(5)), their parents have parental responsibility for decision-making. Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Ethical Issues in Critical Care | Clinical Gate Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. Aircraft Accidents and Emergency Management, Live 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). It means that all actions and decisions implemented by the paramedicine practitioners should not only comply with the moral aspect but also with the legislative laws and rules (Aehlert, 2012). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. This article explores 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. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. 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. Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. Mental illness can be a challenging vulnerability for clinicians to navigate. 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. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). It affirms the supremacy of law and appreciation of human rights and freedom. A consensus among paramedic supervisors B. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. This can be a common complication in psychosis and is frequently exacerbated by the effects psychosis has on a person's levels of trust, insight and the ability to rationalise, making them reluctant to share information (Kleiger and Khadivi, 2015). abstract = "Decision-making is central to the everyday practice of paramedicine. It is not clear though, how professionals (especially those who do not use the MHA) are likely to know in advance if a patient is likely to meet threshold for detention under this act, and so whether the MCA seems appropriate for use or not. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? Confidentiality, capacity and consent. For example, some people with conditions such as cerebral palsy may appear to have an intellectual disability that precludes decision-making capacity, where in fact they have no cognitive disability, only communication difficulties. Paramedicine occurs in the social fabric of society. From this standpoint, the paramedics have to follow the same regulations and standards that are mandatory for the whole country. For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests. 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. Ethical Issues in Paramedic Practice | Free Essay - Essayscreator.com Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. The data for the case report is gathered from personal experience and presented as a piece of academic, reflective practice from which to learn. 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. 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. (PDF) Reflective Practice for Paramedics - ResearchGate 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).

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