On assessment, John didn't appear to understand the information given to him, the decision he needed to make, and he was unable to retain or comprehend treatment plans or the risks of noncompliance. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. 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. The ethical principle of non-maleficence means that paramedicine practitioners should discuss the probable negative consequences of their decisions and prevent them in order not to harm the patients. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. author = "Hamish Carver and Dominique Moritz and Phillip Ebbs". You note that at 10 years old, he has already had life experiences that many adults would dread.Is it reasonable for a paramedic to be concerned about infringing Terry's autonomy and, if so, how might a paramedic address this problem? A. Practice in a manner consistent with a code of ethics for registered nurses. prevent the safe and effective practice.5 Ideally, the paramedic concerned should report any of the above issues themselves, as this reflects professional behaviour. 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. Samantha May Medical Technician-Basic (EMT-B)/ Emergency Medical Technician-Paramedic (EMT-P) team) arrive and assume care. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. A person is not to be treated as unable to make a decision merely because he makes an unwise decision. Paramedicine occurs in the social fabric of society. Gillick competence empowers children to exercise autonomy over their own medical decisions. From this standpoint, paramedics play a significant role in consideration of ethical issues and bear responsibility for the preservation of both legal and moral standards in every individual case of interaction with the patients. Paramedicine presupposes direct interaction with individuals. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. Integrated health care including mental health. Any consideration of beneficence is likely, therefore, to involve an examination of non-maleficence. Aircraft Accidents and Emergency Management, Live John scored low risk on the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) self-harm and suicide assessment tool (JRCALC, 2006), but could still be vulnerable to other dangers such as neglect or accidental involvement in incidents such as walking out in front of cars when in a confused state (Azakan and Taylor, 2009). Ethics part 1: what do paramedics owe patients? Monday, January 2, 2017. 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. After that, we provide a few recommendations that can assist healthcare professionals in improving their capacity for making ethical decisions. Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. 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. These preferences can then be communicated to paramedics during attendances and care should be consistent with these preferences whenever practicable. These factors contribute to an ethically complex decision-making environment. 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. John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. 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. Their vulnerability may impede their autonomy, which can then affect . The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. Consequently, the crew began to assess for a psychological cause. Psychiatric admission for assessment and subsequent treatment if required. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. However, paramedics must be aware that it is a medical event that is occurring and the person is generally not being held for criminal reasons. However, it's unclear whether the MCA would have been the best act to utilise to provide treatment without consent in this case. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. In the theory of principle based ethics a paramedic must practise non-maleficence and beneficence. 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. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: A. 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. Although, hallucinations, delusions etc. This may entail organising supervision or support, transporting both the patient and their dependants in more than one ambulance if need be or arranging neighbour, support services or family visits. 4 Conducting ethical research in paramedic practice. 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. Due to this misconception, the crew then considered the MHA (1983). While carers might have a duty to make decisions that benefit the patient and are least restrictive of the patient's rights, it can be difficult for clinicians to uphold and appropriately consider the patient's wishes when another person is responsible for their decision-making. This principle refers to both physical and mental damage, which can be done to the clients. Another important aspect when treating patients with mental illness is the stigma associated with mental ill health (Fink and Tasman, 1992). However, the House of Lords found there were circumstances when a child could consent to their own medical treatment without the clinician seeking or obtaining parental consent. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. 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. Here we provide services and products that are for reference purpose only & are not intended to be put forward as finalised work & are to be used strictly for assistance in writing your own research material papers. It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. Consequently, the crew had to consider alternative management plans for John. All rights reserved, Paramedic ethics, capacity and the treatment of vulnerable patients, Dominique Moritz, Phillip Ebbs, Hamish Carver, Explain why some people are considered vulnerable, Identify vulnerable patient groups that may be treated by paramedics, Discuss the relationship between autonomy and capacity in vulnerable patients, Reflect on their own practice to implement strategies that ensure vulnerable patients are protected. 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. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. Despite this, there remain multiple barriers to their fully effective provision of such care. 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. Very often, the patients points of view on the most suitable treatment do not correlate with the opinions of professionals. 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 term psychosis can be used as an umbrella term for a number of different psychotic disorders (NICE, 2014) and so will be utilised here due to the lack of specific diagnosis present for John. 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. 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). abstract = "Decision-making is central to the everyday practice of paramedicine. Having considered the probability of causes for John's symptoms, the crew suspected John may have been suffering from psychosis. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. Principlism in paramedicine: an examination of applied healthcare ethics Phillip Ebbs, Hamish Carver, Dominique Moritz Sunday, August 2, 2020 Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). All rights reserved, Continuing Professional Development: Ethical issues in paramedic practice. Ethics and law for the paramedic Reflective practice and communication Professional issues, including clinical audit and governance and anti-discriminatory practice Psychological perspectives on health and ill health Safeguarding children Sociological perspective on health and ill health and social policy 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. Legal & Ethical issues associated with paramedic practice during COVID19. Major incident clinical . It shall conclude with this student's position on the issue based on the discussions. This can explain why paramedics also report feelings of confusion surrounding the MCA and a lack of confidence in utilising it (Amblum 2014). The ethical principle of respect for the patients autonomy presupposes the non-interference in the freedom of their decisions and choices (Steer, 2007). Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. 2 The HCPC standards of conduct, performance and ethics. While parents should be making decisions for infants and very young children, children develop in their maturity as they age and experience life. Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. 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). It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. 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). To get things started, we give a rundown of the most recent research on ethical issues in sports medicine. Such a position will help improve the system and lead to effective and fruitful results. The article argues that the situation raised dilemmas about communication, patient autonomy and paternalism. This paper highlights some of the ethical dilemmas that face practising clinicians in their everyday life and restates how useful the General Medical Council guidance is to make appropriate decisions. While the moral or ethical side of paramedicine depends on various religious, cultural, and personal beliefs and views, its legal aspect has a strict definition. Therefore, it is important to consider those principles more precisely. 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). Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. | This essay identifies two legal and two ethical principles in paramedical science discussing how these aspects of law and ethical issues influence paramedic practice. However, what should paramedics do when their intended, evidence based course of treatment is different from the patient{\textquoteright}s own wishes? At this point, healthcare professionals (for example paramedics) are likely to question and subsequently assess the person's ability to make this decision. Some people with a disability may only be capable of autonomy in choices about low acuity or minor treatment, but not about more serious conditions. 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.