For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not.
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. 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. Elder abuse can encompass neglect, financial duress, psychological threats and violence. A clinician's role in supporting vulnerable people and reporting abuse and neglect is crucial to protecting patients and allowing them to continue exercising the greatest possible level autonomy over their own healthcare. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Paramedics play a crucial role to protect vulnerable children using the principles of beneficence and non-maleficence. The principles of the Mental Capacity Act 2005 and the Mental Health Act 1983. Older people, persons with disabilities or mental illness, or even those who have poorer social and economic standing (such as people who are homeless) may experience periods of substantial vulnerability. It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. Principles of consent, autonomy, beneficence, malfeasance 4 Current UK law that relates to . 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 .
In some cases, it may be a confusing task to react properly to the emerged contradictory issues, preserving the legal implications and moral duties at the same time. 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 1 The ethical, legal and professional issues that inform and shape paramedic practice. 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. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. B. crew control. 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 concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. However, what should paramedics do when their intended, evidence based course of treatment is different from the patients own wishes? Nevertheless, it is important to understand that many ethical issues presented in health care have little to do with paramedicine as the latter focuses mainly on emergencies. 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). 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. 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. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Elder abuse is often perpetuated by family members, friends and care workers (Biggs et al, 2009). 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. 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. Legal & Ethical issues associated with paramedic practice during COVID19. However, it's unclear whether the MCA would have been the best act to utilise to provide treatment without consent in this case. The use of the other sections of the MHA can require much more time (Hawley et al. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". Many with intellectual or communication disabilities are able to live independently in the community and make autonomous choices about their healthcare. Together they form a unique fingerprint. 122: 10 Researching paramedic clinical practice a practical guide. Ethical practice forms a fundamental aspect of paramedic care, and not only is the of model 2 paramedic expected to meet standards of ethics as laid down by the HPC, but more importantly paramedics Following attendance to a call, a reflective account was completed using model 2. are required to treat patients in a way that is humane The @article{6040c026e1e34bd9b7239761b13480e7. B. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. 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). Abstract. Putting in place a safety net for all parties is thus an important component of the paramedics' ethical practice. The ability to do the above forms key elements of an MCA assessment and suggests that John lacked capacity at that time (Department of Constitutional Affairs, 2007). They may need to consider whether community rapid response services or home GP visits are appropriate, whether additional support services should be organised or if they may need to ensure family members or friends visit the patient in a timely manner. While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. 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. While clinical information should always be held in confidence, the stigma associated with mental illness means that most patients value their privacy more so in this regard, and paramedics have a duty to ensure they do not share this information, even inadvertently. 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. 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. Methods Thompson et al (2011) highlight that frequent callers (also known as frequent users) are known to clinicians because they regularly require paramedic support, usually as a result of a mental illness. 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. For example, in England and Wales under section 74 of the Serious Crimes Act 2015, health professionals have a legal duty to notify the police if they discover female genital mutilation. Our paramedic test questions are listed below. The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and information. However, while parental responsibility involves exercising legal decision-making authority for children, children do have the ability to make some healthcare decisions for themselves in certain circumstances.
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). One of the most important legal principles in paramedicine is the preservation of patients personal information and data. On the one hand, the paramedics should not neglect the interests and intentions of the patients. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Gillick competence addresses children's understanding and provides paramedics and other health professionals with a means to determine the extent of involvement a child should have in decisions that affect their healthcare. Continuing Professional Development: Ethical issues in paramedic practice Continuing Professional Development: Ethical issues in paramedic practice Friday, August 5, 2011 OverviewThis CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. This will also help you learn important concepts for the exam. 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). Separate to the MCA (2005), the Mental Health Act (1983) (MHA) may also be used to provide treatment without consent in case of a mental health disorder (Department of Constitutional Affairs, 2007). Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. A person must be presumed to have capacity unless it is established that he lacks capacity. Paramedicine presupposes direct interaction with individuals. Empowerment and involvement - Patients should be fully involved in decisions about care, support and treatment. Vulnerable patients are no exception. In any case, the role of paramedics consists in the elimination of harmful aspects of patients ethical decisions as well as protection of their legal freedom and choice. A key assumption of the Mental Capacity Act (MCA, 2005), is that a person has capacity until proved otherwise. 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. Ethics, bioethics and legal issues in paramedic practice. 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. Vulnerable patients may not have the capacity to consent to their own healthcare, or their vulnerability may mean their interests need protection. Practical decision-making strategies are provided and illustrated by brief examples. While restraint and sedation may be an option for patient treatment, those options are invasive, contravene autonomy and can perpetuate mental health stigma. This guidance helps you to explore and understand the issues of trust in the doctor-patient relationship and looks at factors affecting patients' vulnerability. This situation will hopefully alter over time, so this module attempts to present the four ethical contexts common in other health disciplines and discuss them in relation to paramedic practice.Learning OutcomesAfter completing this module you will be able: To provide an overview of the four key ethical principles that underpin current clinical practice in the UK To explore these four ethical principles in relation to specific prehospital and clinical issues To encourage the practitioner to reflect on their own ethical practice To begin to develop the ability to share, discuss and debate the four ethical principles with colleagues and friends, in relation to your own clinical practice. It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". Children are largely understood to be vulnerable and adult patients may also be considered vulnerable. N2 - Decision-making is central to the everyday practice of paramedicine. This principle refers to both physical and mental damage, which can be done to the clients. A significant ethical consideration for clinicians when treating older patients is their capacity. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . 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 . |
All rights reserved, The ethical and legal dilemmas paramedics face when managing a mental health patient. 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. 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. A legal concept important in understanding the extent to which children have autonomy in making their own healthcare decisions is Gillick competence, named after a landmark UK case (Gillick v West Norfolk and Wisbech Area Health Authority [1985]). MA Healthcare Ltd
8 Quantitative research in paramedic practice an overview. The ethics in paramedicine has become a field of interest for many scientists and researchers. Efficiency and equity - Providers commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. 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. To assist paramedics in navigating these complex issues, the London Ambulance Service NHS Trust (2019) provides guidance on how to refer vulnerable people to services which may investigate the circumstances and ensure the safety and welfare of the patient). 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.