Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. On closer inspection of the literature, it seems that John could have been treated (or in this case transported for treatment) using the MCA, as he wasn't currently detained under the MHA, nor did it seem likely he was going to be at that time (due mainly to a lack of access to the relevant health care professionals required to perform a MHA assessment) in order to receive the treatment he appeared to require in his best interest. 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 . C. vehicle safety. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . This course is made up of a number of paramedic specific units and additional health care units. 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). Therefore, it is important to consider those principles more precisely. 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. With this considered, it appears that in John's case, the MCA would have been an appropriate means with which to act in John's best interests and convey him to a place of safety for further treatment, which would most likely have been the nearest emergency department. 153: Paramedics have professional duties toward vulnerable persons. 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. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. This raises the prospect that a patient with legal capacity may still be a vulnerable person, and also that a vulnerable person may be harmed or exploited unintentionally within healthcare settings (Oxford University Hospitals NHS Foundation Trust, 2016; Ebbs and Carver, 2019: 27). The ethical responsibilities of a paramedic also include acting fairly and helping any patient who needs it, regardless of their race, age, gender, religion or another personal characteristic.. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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). It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. 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. After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. There were no obvious physical causes for John's behaviour at this stage. 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. Gillick competence empowers children to exercise autonomy over their own medical decisions. The paramedics and patients views on treatments may vary as well as moral and legal explanations of different procedures are different according to the cultural, religious, and social backgrounds. Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. 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. Therefore, consideration of these effects is part of how they treat patients and make decisions. The design of the PARAMEDIC-2 trial required paramedics to independently determine eligibility and randomise patients into the trial by administering the blinded drugs (either adrenaline or a saline placebo) from a trial-specific drug pack. Practice in a manner consistent with a code of ethics for registered nurses. 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. Background This case report discusses an ethical communication dilemma in prehospital patient interaction, involving a patient who was about to board a plane at a busy airport. 1. be able to practise safely and effectively within their scope of practice 2. be able to practise within the legal and ethical boundaries of their profession 3. be able to maintain fitness to practise 4. be able to practise as an autonomous professional, exercising their own professional judgement By continuing you agree to the use of cookies. You'll develop your knowledge of the legal, ethical & professional issues in paramedic practice. 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 deliberation contributes to practitioners' critical thinking skills and helps prepare them for decision-making under uncertainty. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. The first concern for an EMT must be: A. patient safety. U2 - https://doi.org/10.12968/jpar.2020.12.10.CPD1, DO - https://doi.org/10.12968/jpar.2020.12.10.CPD1, JO - Journal of Paramedic Practice: the clinical monthly for emergency care professionals, JF - Journal of Paramedic Practice: the clinical monthly for emergency care professionals. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). 22,26,29,31,37,39-42 More than half the participants in one study raised concerns over handling conflict between patients and family members, especially when there were inconsistent expectations of . Dive into the research topics of 'Ethics and law in paramedic practice: Boundaries of capacity and interests'. 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. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Paramedic Practice Test. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. A policy set by an EMS Medical Director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a (n): A. direct order. are more commonly known symptoms of psychosis, the symptoms demonstrated by John fall within the six hallmark features of psychosis as described by Kleiger and Khadivi (2015). Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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). While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. 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. The legal principle of capacity is closely aligned with the ethical principle of autonomy as both relate to the independence and freedom that a person can exercise over their own actions and decisions. NHS Research and Development Permissions were sought and granted. 136: 11 The future for paramedic research. Psychiatric admission for assessment and subsequent treatment if required. At the same time, the task of the paramedics is to improve their patients health conditions and choose the best way of treatment in every particular case. The question of justice is another part of the paramedical performance. The ethical and legal dilemmas paramedics face when managing a mental health patient | Journal Of Paramedic Practice Features The ethical and legal dilemmas paramedics face when managing a mental health patient The ethical and legal dilemmas paramedics face when managing a mental health patient Samantha May Monday, January 2, 2017 They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action. 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). To provide guidance for paramedics in how to meet their obligations in reporting children at risk, the London Ambulance Service NHS Trust (2020) has produced the Safeguarding Children and Young People Policy. Due to this misconception, the crew then considered the MHA (1983). @article{6040c026e1e34bd9b7239761b13480e7. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care.