ethical issues in paramedic practice

Apart from being a paramedic, entails checking for dangers as part of your primary survey, to protect yourself, bystanders and the patient. 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. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. Consumer rights in advocacy and health care. For example, paramedics have a statutory requirement to safeguard and promote the welfare of children in their care under section 11(2) of the Children Act 2004. For example, a patient might have capacity to refuse their temperature being taken or other observations but not to refuse transport to hospital. John spent most of his time standing, staring into space during the crew's presence, a further sign associated with psychosis, where patients spend extended periods of time seemingly doing nothing (Turner, 2009). More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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). Therefore, it is important to consider those principles more precisely. 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. 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. abstract = "Decision-making is central to the everyday practice of paramedicine. Therefore, a set of laws regulates the requirements of paramedics competence and professional skills that are essential for successful and effective performance (Woollard, 2009). During the shared decision-making process between clinician and patient, paramedics must respect these preferences but also be sure that the material risks associated with alternative options for treatment (including non-transport) are clearly explained to the patient (Chan et al, 2017). Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. 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. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? John had arrived at a friend's house during the night, behaving in a strange, confused manner. 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. Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality. 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). Purpose of the fitness to practise process. 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. This third and final article in the series starts by describing the relationships between the legal principle of capacity and the ethical principles of autonomy and beneficence. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. 122: 10 Researching paramedic clinical practice a practical guide. You will see the questions are broken down into the 5 different categories you will be tested on. The patient, who will be called John for confidentiality purposes, presented to the ambulance service with an altered mental state. For others, their mental illness may impede them in such a way that clinicians will deem the person unable to make decisions about their own healthcare. Currently, few published research or evidence-based texts exist, specifically in relation to prehospital care. 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). N2 - Decision-making is central to the everyday practice of paramedicine. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. These risks seemed higher in John's case as he appeared somewhat detached from reality, as is true in psychosis (Kleiger and Khadivi, 2015), and so oblivious to the risks around him. 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. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. 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. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine.". In such circumstances, clinicians should include the patient in the decision-making where possible, and be mindful of the impact of decisions on 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. 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. 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). 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. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. 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. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. Practitioners must be mindful that, despite the frequent interactions with these patients, their behaviour is often perpetuated by mental illness, and the patient needs care for their chronic illness just the same as they would for any other illness. All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. Paramedicine presupposes direct interaction with individuals. Ethics and law 1 The ethical, legal and professional issues that inform and shape paramedic practice. A Department of Health and Social Security memorandum at the time instructed medical practitioners to provide confidential medical advice to children under the age of 16 without a parent present. In the first article of this series on applied ethics in paramedicine, the authors examined the ethical principles of autonomy and beneficence in the context of principlism (Ebbs et al, 2020). | 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. Some people's mental illness will not prevent them from exercising their autonomy and their mental illness will not affect their decision-making capacity. 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. The use of the other sections of the MHA can require much more time (Hawley et al. At the same time, the education should not be subjective, prejudiced, or convincing as the patients have to make their own decisions concerning their lives and health conditions. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. Aircraft Accidents and Emergency Management, Live After answering the questions, use the detailed answer explanations to learn why an answer was correct or incorrect. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. 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. 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. A mother (Victoria Gillick) sought to have medical practitioners refuse to provide medical advice to her daughters, aged under 16, in relation to contraception. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. 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. For example, children (according to the law) have not reached the required age to make their own healthcare decisions, although some have the maturity to do so and will be able to make some autonomous decisions. A patient who is treated by paramedics may be vulnerable because they lack the capacity to consent to treatment or, if they do have the capacity to consent to treatment, they lack the ability (or avenues) to express their worries about that treatment, or to defend themselves in circumstances where their consent has been misinterpreted. Other sections of the MHA can be utilised to remove a person from their property but require further input from other professionals ranging from magistrates to psychiatric doctors and approved mental health professionals (see appendix 2). They must also deliver care that is consistent with ethical. Our paramedic test questions are listed below. Terry's condition has been worsening in recent weeks and his parents and clinicians have arranged for Terry to be transported by ambulance to hospital.However, Terry does not want to go to hospital today. 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. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. 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. 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. Dominique Moritz, Phillip Ebbs, Hamish Carver

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