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. title = "Ethics and law in paramedic practice: Boundaries of capacity and interests". Confusions surrounding said laws have been extracted from the case report and discussed in more generic terms in order to be more readily applicable to other similar cases. The complexity of mental illness means a person's capacity can fluctuate so they may lose or regain capacity at different stages of their illness. Overview This CPD module aims to outline, describe and explain some of the key ethical-legal issues in paramedic practice, and their relation to the concept of consent, a duty of care and negligence. Determining the scope of decision-making required is crucial because a person's vulnerability should not automatically equate to a loss of autonomy. 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. Notify the family that once CPR has been initiated, you are required to transport the patient. At this point, healthcare professionals (for example paramedics) are likely to question and subsequently assess the person's ability to make this decision. 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. 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. A complex range of personal, medical, social and environmental factors may contribute to older people being vulnerable. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. It concerns the application of four principles: autonomy, beneficence, non-maleficence and justice. 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. The Mental Health Act (1983) The MHA can be used to provide treatment for mental health disorders without consent (Department of Constitutional Affairs, 2007). They must also deliver care that is consistent with ethical standards and respectful of the expectations, preferences and beliefs of the patient. Paramedics must be aware of their own personal biases or preconceived ideas of disability; these are sometimes referred to as unconscious biases. 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). Autonomy is an important healthcare principle because it ensures a person maintains control over decisions relating to their healthcare. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. The crew's assessments and thought processes surrounding the management of John will be discussed. Conclusion The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. Gillick competence empowers children to exercise autonomy over their own medical decisions. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. Non-maleficence is the sister to beneficence and is often considered as an inseparable pillar of ethics. More specifically, how should they navigate these situations in the presence of complexities such as diminished mental capacity and end-of-life care? By midday, his ability to communicate was largely diminished and his friend, unable to help John, had phoned for emergency services. There are a numbers of texts in other areas, such as nursing and medicine, but not exclusively in relation to paramedics. Paramedics must deliver appropriate clinical care within the boundaries of the law, clinical guidelines and evidence-based standards. It doesn't seem clear yet within the literature, whether the addition of extra powers under legislation is of benefit or not. On closer inspection of the literature, it seems that John could have been treated (or in this case transported for treatment) using the MCA, as he wasn't currently detained under the MHA, nor did it seem likely he was going to be at that time (due mainly to a lack of access to the relevant health care professionals required to perform a MHA assessment) in order to receive the treatment he appeared to require in his best interest. In contrast, family discordance was reported by nine studies as a significant barrier to paramedic practice of palliative and end-of-life care. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Every job a paramedic enters, the risk of getting injured is always prominent; But with the correct approach, that risk is minimised. 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. Harris and Millman (2011) highlight the importance of ruling out a physical cause for the patient presenting with altered mental status such as hypoglycaemia, head injuries, infection and alcohol or drug use. Decision making in this environment is intended to provide care and treatment in the best interests of the patient. Our researchers and research supervisors undertake their studies within a wide range of theoretical frameworks and models relating to the development of policy and practice that takes account of: lived experiences of health and social issues, health and social care use, and, service delivery by the nursing, midwifery and paramedic professions . Once an allegation is made, the HPC will arrange for it to be reviewed by paramedics, other allied health professionals, and, most importantly, members of the public, to determine if In such circumstances, clinicians have the added consideration of not only treating the patient but also ensuring the other vulnerable party is protected. 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). @article{6040c026e1e34bd9b7239761b13480e7. The priorities of the medical director C. The wishes of the general public D. Locally accepted protocols, During your monthly internal quality improvement (QI) meeting, you review several patient care reports . 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. 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). They must also deliver care that is consistent with ethical. Legal and ethical practice in care. 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. Unfortunately, in this case, it was wrongly thought by the crew that the MCA could not be used to enforce treatment plans for mental health conditions. This was because of current UK law and a lack of access to a GP respectively. MA Healthcare Ltd Insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. 105: 9 Using quantitative research methods in paramedic practice. Furthermore, the HCPC (2016) standards of conduct place a responsibility on paramedics that they must take reasonable actions to this end. It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. 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. Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. 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. Ethics National Health Service (NHS) ethical approval was deemed unnecessary during proportionate review, as interviews were with existing staff and no changes to their practice were planned, nor was any contact made with patients. 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. 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. 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. It is important to remember that capacity is not a binary state; it exists on a continuum and depends upon the patient's circumstances and the potential consequences of the decision being made. 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 Abstract. Allowing a 16-year-old person to make healthcare decisions yet restricting a person one month before their 16th birthday from doing the same seems arbitrary and illogical.

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