ethical issues in paramedic practice ethical issues in paramedic practice

According to Harris and Millman (2011), in the earlier stages of schizophrenia, a chronic form of psychosis, the patient is likely to behave in a bizarre manner that is out of character to them, as was true of John. The code of practice for the MCA (Department of Constitutional Affairs, 2007) doesn't clearly set out which specific treatments may or not be provided under the MCA; however, it does seek to explain the relationship between the MHA and MCA. Consequently, the crew began to assess for a psychological cause. Removed to place of safety for up to 72 hours for further assessment. 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. 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. 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 . This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. Besides, their classification sets the right vision for the development of paramedicine and provides it with the required tools and methods of acting and solving various dilemmas. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. D. personal safety. MA Healthcare Ltd This case report highlights the potential difficulties and complications associated with the management of mental health incidents for ambulance crews (Parsons and O'Brien, 2011) as well as how potentially confusing the ethical and legal aspects are when managing mental health conditions that require some involuntary form of treatment (Townsend and Luck, 2009). People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). For many, staying at home is an important consideration in their decisions; older people may only wish to receive care that can be delivered in their home. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). Furthermore, those with mental illness may at times experience treatment and management that limits their autonomy, such as during times of severe psychosis where a patient's autonomy is lawfully overridden in their best interests through the use of chemical or even physical restraint. While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. Paramedical practice should not neglect the intentions of patients to undergo certain types of treatment but fulfill the required tasks responsibly and credibly (Sharp, Palmore, & Grady, 2014). It seems important to note that had John been in a private place, this option would have been void, which may have presented an even more complex situation to manage safely and legally. 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. Professional practice framework, professional rights and responsibilities, record keeping, governance. There are many ethical issues that are encountered during the prehospital care of children and adults. 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. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. You will see the questions are broken down into the 5 different categories you will be tested on. The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Using a reflective format, the article explored 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 complex situations. The ambulance crew's concerns for John's welfare prompted them to assess his level of risk to self and others. 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. Integrated health care including mental health. Introduction. Practical decision-making strategies are provided and illustrated by brief examples. EBOOK: Blaber's Foundations for Paramedic Practice: A Theoretical Perspective Amanda Blaber 2018-11-19 This bestselling undergraduate level book is an ideal resource for student paramedics looking for an excellent introduction to the main theoretical subjects studied in paramedic courses, and links practice issues to the all-important theory . This principle refers to both physical and mental damage, which can be done to the clients. One of the most important legal principles in paramedicine is the preservation of patients personal information and data. An EMT or paramedic with integrity adheres to ethical principles despite any pressures or temptations to do otherwise [4]. A mother (Victoria Gillick) sought to have medical practitioners refuse to provide medical advice to her daughters, aged under 16, in relation to contraception. 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). Legal and ethical practice in care. Monday, January 2, 2017. Police may remove a person from a public place where they are believed to be suffering from mental illness and at risk of harm to themselves or others. Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. All relevant services should work together to facilitate timely, safe and supportive discharge from detention. 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 . Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. 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. 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). More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? C. Follow to your local protocols and contact medical direction if unsure how to proceed. 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). This principle refers to both physical and mental damage, which can be done to the clients. 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? All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Major incident clinical . Inform client/staff members of ethical issues affecting client care. In this case, John refused to engage with the ambulance crew leading the crew to consider both the MCA and the MHA to protect the patient's wellbeing without his consent. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. 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. 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). Should the MCA have been used, John would have been transported to an accident and emergency department, which may not be the most suited to deal with his condition (Morrisson-Rees et al, 2015; O'Hara et al, 2015), whereas the use of the MHA allowed him to be transported directly to a mental health unit. 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. Harris and Millman (2011) highlight the importance of ruling out a physical cause for the patient presenting with altered mental status such as hypoglycaemia, head injuries, infection and alcohol or drug use. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008). Overview This CPD module aims to outline, describe and explain some of the key ethical-legal issues in paramedic practice, and their relation to the concept of consent, a duty of care and negligence. 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). Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. 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).