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). Sections 182 (1) a-e, 184 and 162 c-d of the Children, Youth and Families Act 2005 (Vic.) 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). 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. 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). Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. 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 appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. 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 . Perceptions and concerns about receiving treatment at hospital may arise for a number of reasons, such as fear of not returning home, an experience of relatives dying in hospital, worry about pets, stoicism and beliefs about not wanting to bother others. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions. Reflective practice is undertaken for a variety of reasons. With the exception of life-threatening situations (where a paramedic will often act in the patient's best interests to protect the patient's wellbeing), the preference is for clinicians to restore capacity or to wait for capacity to resume before intervening in the care of the patient. 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). While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. John had arrived at a friend's house during the night, behaving in a strange, confused manner. Confidentiality, capacity and consent. Within this, confusion and limitations surrounding both the MCA and the MHA will be explored, as well as how these may affect patient care and any key areas that could be developed in the future. Chat. 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. If a person is then deemed to have capacity and continues to refuse care, paramedics are forced to balance their duty to protect life against the patient's right to make autonomous decisions (Hodgson, 2016). Elder abuse can encompass neglect, financial duress, psychological threats and violence. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. 2011). Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. The ethical and legal dilemmas paramedics face when managing a mental health patient | Journal Of Paramedic Practice Features The ethical and legal dilemmas paramedics face when managing a mental health patient The ethical and legal dilemmas paramedics face when managing a mental health patient Samantha May Monday, January 2, 2017 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. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. A major concern in healthcare ethics (including within paramedicine) is the protection of vulnerable persons within the realms of patient-practitioner interactions (Moritz, 2017; Townsend, 2017; Ebbs and Carver, 2019). The paramedics and patients views on treatments may vary as well as moral and legal explanations of different procedures are different according to the cultural, religious, and social backgrounds. @article{6040c026e1e34bd9b7239761b13480e7. 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. Paramedicine presupposes direct interaction with individuals. 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). A recent topic of concern has been the extent to which paramedics and other health and care professionals are required to report instances of known or suspected child abuse or neglect (Foster, 2020). Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. 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. The COVID-19 pandemic and the paramedic response to it, has raised a raft of legal, ethical and professionalism questions for paramedic clinicians and managers. AB - Decision-making is central to the everyday practice of paramedicine. Discussing Beneficence At Interview When you're talking about ethical issues, you need to consider beneficence. Like the abuse of children, the abuse of older people is a significant community concern. For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. 3 The ethical and legal frameworks within paramedic practice, and relevant to legislation. Purpose and effectiveness - Decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines. John's speech was also disordered; he regularly halted sentences mid-flow and appeared confused, completely losing fluidity and continuity of his passages. 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. 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. Download Free PDF View PDF 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. At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. 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. 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 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. Paramedics interact with these patients every day, often during times of such vulnerability. Capacity can fluctuate over time or as a health condition changes. Although provider judgment plays a large role in the . It shall conclude with this student's position on the issue based on the discussions. Children are individuals so, although they have not reached adulthood, they should not be excluded from participating in healthcare decisions that affect them. / Carver, Hamish; Moritz, Dominique; Ebbs, Phillip. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". 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). Due to this misconception, the crew then considered the MHA (1983). 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). Purpose of the fitness to practise process. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. A. In the case of paramedicine, both ethics and law should remain unprejudiced and objective. Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). For example, the patients who suffer from mental disorders have the same right to apply different procedures as those who do not. 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. In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. This may be necessary to protect a person from harm or to prevent a deterioration in their condition (Department of Health, 2005). 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. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. The authors have faced all eight of the clinical scenarios in this paper in their routine clinical practice. Assessing a person's capacity at every attendance is crucial because capacity is fluid, affected by numerous personal, medical, social and environmental factors. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. People with mental illness may also be vulnerable because their illness may sometimes render them unable to make some decisions or, like older patients, their decision-making ability fluctuates. In other words, the paramedicine practitioners should inform the patients about all the probable effects of treatment as well as explain its moral and ethical issues. 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. 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. 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. Utilizing a priority dispatch system allows dispatchers to send response . There are many ethical issues that are encountered during the prehospital care of children and adults. Notify the family that once CPR has been initiated, you are required to transport the patient. Undergraduate students who study ethics in nursing have an opportunity during their clinical practice, to discuss and reflect on a range of ethical and moral actions. Major incident clinical . Ethical dilemmas comprise an important non-technical aspect of paramedicine but have not received significant research attention. 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. MA Healthcare Ltd Paramedicine occurs in the social fabric of society. It is particularly important for clinicians to assess patient capacity every time they attend a person rather than relying on past experiences that because the person lacked capacity owing to their mental illness during a previous attendance, they will somehow lack capacity on all future presentations. Having considered the probability of causes for John's symptoms, the crew suspected John may have been suffering from psychosis. This was because of current UK law and a lack of access to a GP respectively. 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. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010). This course is made up of a number of paramedic specific units and additional health care units. 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. Study with Quizlet and memorize flashcards containing terms like As an EMT, the standards of emergency care are often partially based on: Select one: A. Abstract Principlism is arguably the dominant recognised ethical framework used within medicine and other Western health professions today, including the UK paramedic profession. The Iserson Model for ethical decision making in emergency medicine was used as the conceptual framework. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. | Mental illness can be a challenging vulnerability for clinicians to navigate. People with a disability may have difficulty advocating for themselves because of communication issues or their disability may affect their understanding of healthcare considerations. 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. 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). 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. The ethics in paramedicine has become a field of interest for many scientists and researchers. A consensus among paramedic supervisors B. For example, a person presenting with suicidal thoughts may score higher on the JRCALC tool, and thus be at high risk of self injury, but at a lower risk of being involved in an accident, a risk which may be higher in a person suffering from psychosis.