Law and Ethics for Paramedics: An Essential Guide Authors: Georgette Eaton University of Oxford Abstract Providing a clear and concise overview of applied law and ethics to UK paramedic. Hamish Carver, Dominique Moritz, Phillip Ebbs, Research output: Contribution to journal Article peer-review. And even though the legal issues may have been covered, the ethical implications of the lack of healthcare provided are undoubtedly contrary to good clinical practice given it represents the deliberate concealment of a therapy (or lack of it) used in a given person. Practitioners must manage care that is least restrictive of the patient's rights (Mental Capacity Act 2005, section 1). This means that not only must they avoid doing harm - non-maleficence, they must also display active well-doing and an unselfish concern of the well being of others - beneficence. 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). For specific vulnerable groupssuch as children, older people, those with mental illness and persons with a disabilitythere are some consistent ethical considerations for clinicians. This expanded role builds on the skills and preparation of the Emergency Medical Technician (EMT) and Paramedic, with the intention of fulfilling the health care needs of those populations with limited access to primary care services. 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 . More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? 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. 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). They must also deliver care that is consistent with ethical. 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. 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). 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. Another important aspect when treating patients with mental illness is the stigma associated with mental ill health (Fink and Tasman, 1992). Paramedics interact with these patients every day, often during times of such vulnerability. 4 Conducting ethical research in paramedic practice. 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. Beneficence asks us to promote a course of action, but in practice, we also need to de-promote certain courses of action if there are better options available. At this time, using police powers seemed to be the last option available to ensure John's safety and treatment. This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. In the case of paramedicine, both ethics and law should remain unprejudiced and objective. One of the most important legal principles in paramedicine is the preservation of patients personal information and data. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. The ethics in paramedicine has become a field of interest for many scientists and researchers. 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 Some people with a disability may have mobility issues that do not affect their capacity to consent to treatment and decision-making, while others with a disability may not have decision-making capacity for numerous reasons, including communication difficulties or intellectual disability. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. 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). Legal & Ethical issues associated with paramedic practice during COVID19. 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. 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. 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]). It seems paramount that whichever decision is made and Act is used, should the patient receive any form of involuntary treatment, the principles of the MCA and the MHA are upheld, and any decision made is in the patients best interest (Department of Health, 2005). However, children's life experiences, maturity and understanding differ from one individual to the nextdepending on factors such as their age, culture, health, upbringing, background and environmentsand their ability to process healthcare-related information also varies. | From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover their sphere of professional activities. Therefore, John was detained under this section and transported to the nearest 136 suite for further assessment and treatment. Together they form a unique fingerprint. 153: The ethical responsibilities of a paramedic also include acting fairly and helping any patient who needs it, regardless of their race, age, gender, religion or another personal characteristic.. 105: 9 Using quantitative research methods in paramedic practice. The principles of non-maleficence and beneficence form an area of special interest for the paramedics since these ethical issues are of paramount importance to them. 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. This article "Legal and Ethical Aspects of Paramedic Practice" shall discuss one of these ethical issues. Therefore, where appropriate, the MHA is likely to take precedence over the MCA where a patient is being treated for a mental health disorder. 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). Samantha May Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. 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. 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. Introduction. A significant ethical consideration for clinicians when treating older patients is their capacity. 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. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. 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. 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. 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). It shall conclude with this student's position on the issue based on the discussions. 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 can be used by . N2 - Decision-making is central to the everyday practice of paramedicine. Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. This is not the case. doi = "https://doi.org/10.12968/jpar.2020.12.10.CPD1". A person's decision-making capacity is subject to change depending on circumstances such as the illness or injury being experienced at the time, the seriousness of the decision and various other factors. Because of older patients' vulnerability, a clinician's role in identifying and reporting elder abuse is crucial. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics . Methods 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. 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). Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. Vulnerable patients are at an increased risk of harm or exploitation in healthcare. When attending older people in the community, paramedics and other clinicians must be cognisant of the patient's life experiences, values and concerns. . 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. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. 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. NHS Research and Development Permissions were sought and granted. 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). This article addresses these questions by exploring the relationship between healthcare ethics, health law and evidence-based practice in paramedicine. In conclusion, ethical and legal principles are of great importance in paramedical practices. As with any patient, capacity can fluctuate, although this is more likely with older patients. Clinicians and families may become more involved in the decision-making process or take over that decision-making role in the vulnerable person's best interests. That said, given the earlier acknowledgment of paramedics feeling undertrained to assess mental health patients (Roberts and Henderson, 2009; Berry, 2014) it could be questioned how equipped paramedics would be to utilise this act. He is an intelligent and articulate 10-year-old boy, and also has leukaemia. 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. Despite this, there remain multiple barriers to their fully effective provision of such care. This CPD module will focus on some of the key ethical issues in relation to paramedic practice and prehospital care. 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. This principle refers to both physical and mental damage, which can be done to the clients. 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). Least restrictive option and maximising independence - Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. Paramedic practice must consider all of these factors to ensure ethically good care. MA Healthcare Ltd They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. In respecting older patients' choices, their vulnerability requires clinicians to take additional precautions to protect them. care passports). This study highlights how paramedics' values and communication skills influence their interactions with people with dementia. It affirms the supremacy of law and appreciation of human rights and freedom. Ethical dilemmas are in large part situational, and so it may be helpful to briefly describe the occupational nature of paramedic practice. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. 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. Legal and ethical practice in care. All of these actions may devaluate the positive results of treatment and harm patients health and well-being. 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.

Dallas Cowboys Director Of College Scouting, What Happens If You Break A Parking Gate, Brett Hamilton Isabel Wilkerson Wedding, Articles E