Therefore, consideration of these effects is part of how they treat patients and make decisions. Continuing Professional Development: Ethical aspects of consent, duty Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. People with a disability may have carers who assist with decision-making and/or to protect their wishes, or who are entirely responsible for decision-making. 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). It can be used by . Medical Ethics: Beneficence - The Medic Portal John's risk to the public must also be considered, which, in spite of public opinion, is not usually any higher in psychotic patients (Davies, 2009). It seems that deciding which act is most appropriate must be managed on a case-by-case basis factoring in issues such as access to healthcare professionals available to utilise the MHA (as paramedics do not have it), the likely cause of the persons behaviour (physical/psychological), whether the patient seems likely to meet the threshold for detention under the MHA, and equally whether the patient is likely to be assessed as lacking capacity under the MCA. Maintaining a professional boundary between you and your patient (summary) People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. Nurses are expected to practise in an ethical manner, through the demonstration of a range of ethical competencies articulated by registering bodies and the relevant codes of ethics (see Boxes 5.1 and 5.2).It is important that nurses develop a 'moral competence' so that they are able to contribute to discussion and implementation of issues concerning ethics and human rights . However, paramedics have no powers under the MHA (1983), and can have difficulties accessing further support from mental health services (Hawley et al, 2011). Study with Quizlet and memorize flashcards containing terms like The judicial branch at the state level is responsible for, If a paramedic is attacked by a violent patient, When an administrative agency proposes a licensing action in a state that licenses paramedics, the agency must notify the paramedic of the actions that allegedly constituted the infraction. 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. For example, older patients may experience an acute delirium from an infection that temporarily renders their capacity limited, or may lose capacity permanently because of progressive illnesses such as dementia. Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. AB - Decision-making is central to the everyday practice of paramedicine. By continuing you agree to the use of cookies. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 105: 9 Using quantitative research methods in paramedic practice. Older patients may have fluctuating capacity so may be able to make decisions for themselves in some circumstances and not others. Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. There are particular ethical challenges when multiple vulnerable groups are involved, such as when a mental health patient is also a parent or is caring for an older person. Ethics and law in paramedic practice: Boundaries of capacity and Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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. Paramedic Practice Test. 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. Samantha May After that, we provide a few recommendations that can assist healthcare professionals in improving their capacity for making ethical decisions. Consequently, the crew began to assess for a psychological cause. 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. Specifically, the working lives of paramedics are unique and the distinguishing feature is not the medical scope of practice per se, but rather where it is practised (13,14). 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). C. Patient care cannot be discredited based on poor documentation. The use of the other sections of the MHA can require much more time (Hawley et al. It also calls for the appropriate estimation of patients rights and a tolerant attitude to them. 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. In particular, privacy and confidentiality considerations must be foremost when others are present such as work colleagues or neighbours. (PDF) Ethics In Paramedic Practice: A Qualitative Case Study of As with any patient, capacity can fluctuate, although this is more likely with older patients. Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on patients. Journal of Paramedic Practice: Vol 3, No 8 However, again, in much the same way as with other vulnerable people, they may have a sliding scale of autonomy, and paramedics will need to determine each patient's ability to understand, retain and weigh the information being provided to them about their medical condition. 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). This can make the balance of patient care and patient autonomy exceedingly difficult to strike, and lead to a number of ethical and legal dilemmas for paramedics (Townsend and Luck, 2009). Health care professionals may be more likely to use the MCA to enforce treatment should they consider the patient unlikely to meet the threshold for detention under the MHA. Gillick competence empowers children to exercise autonomy over their own medical decisions. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? keywords = "Ethics, Decision making, paramedic, complexity". Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. PDF Ethical Questions in Emergency Medical Services: Controversies and Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. Copyright 2023 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. Chapter 4: Medical/Legal and Ethical Issues (Post Test) - Quizlet 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. B. crew control. Healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of ethical practice in order to: Recognize ethical dilemmas and take appropriate action. 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. 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. 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 . The tenet of justice presupposes that paramedicine practitioners should treat all patients equally, without showing personal evaluations and attitudes. 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). As such, making John secure was a priority. The Paramedic'S Guide To Research: An Introduction - Google Books From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Respect and dignity - Patients, their families and carers should be treated with respect and dignity and listened to by professionals. Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) 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.