Ethics and Law in Paramedical Practice - Principles of Capacity and Consent, Confidentiality and Data Protection - Case Study Example

Principles of ethics and law in paramedical practice Name: Course: Instructor: Date: Introduction Paramedics are personnel in the field of health that serves in a capacity that is auxiliary to a physician. In the UK, the entry level of a paramedic is the bachelors of Science degree in pre hospital or paramedic care. They provide emergency medical services which is a subspecialty in medical matters that is majorly concerned with the pre hospital emergency care which may include though not limited to stabilization, treatment and transportation in ambulances which are specially equipped (In Coln et al 2015). It is imperative that a paramedic have a well versed comprehension of the laws governing the practice so that they are conversant with the legal framework of their operations (Ruth and Morgan 2012). If the medics fail to comply with the laws governing their operations, they may be liable to compensate their aggrieved clients, dismissal or loss of the right to practice. The services of the paramedics are varied depending on the part of the world where the paramedic practices. They offer their services in diverse fields like firefighting ambulances, public ambulance service and hospital based services. In fact in all sectors where emergency services are likely to be required. Ethics may be referred to as the moral standards that govern the operations in a given field of professionals or the society as a whole In view of this, the principles that were proposed by Beauchamp and Childress (2001) provide the basis of starting point in ethical practices by the paramedics. The principles when considered by the paramedics will bolster a better ground for the medics to enact practices that are both ethically sound and in the better interest of the patients. The four principles are respect for autonomy, ‘do no harm’, Beneficence and justice. The principle of respect gives individuals the chance to wield control over them so that any decision that they make about their treatment has to be honored. The ‘do no harm’ principal on the other hand advocates for not causing undue harm to the patient. The principle of beneficence propagates that benefits be offered to the maximum while harm is diminished as low as possible to the patients. The principle of justice encourages the administration of what is fair in any given situation. For the sake of clarity and considering what is appropriate for the size of this work, I will narrow my work to the principle of respect for autonomy and that of beneficence. For the purposes of the law section I will discuss the principles of Capacity and consent then confidentiality and data protection. Autonomy The principle of autonomy advocates for the respect to any decision that a patient makes regarding their medication. A patient is deemed to own the right to medication and should not be influenced by the medical staff or their relatives (Ann and Sue 2012). Paramedics are encouraged to avail all the possible relevant information to the patient to facilitate their arrival to an autonomous decision. However in situations when a patient had appointed the power of attorney over their health decisions, the autonomy is in the hands of the appointee. The patient’s autonomy may be breached in favor of the decisions that are made by the appointee. The person to whom the decision is delegated to acts on behalf of the patient enjoys the autonomy even if the decision is not in line with the principle of ‘doing good’ to the patient. The power of attorney wielded by a second party is privy to blatant abuse and misuse (Beauchamp and Childress 2001). The person to whom the decision power is delegated may utilize it to deny the patient the right to medication, more so in situations that gaining stable health may contravene some of their interest. The patient’s state of the mind should be taken into account whenever they have to be left to make decisions on matters pertaining to their health (The Stationery Office 2005). If the person has proven mental disorder, which impairs their decision then the paramedic can exercise the principle of ‘doing good’ to overrule the opinion of the patient and administer medication that he can justify to be wholly in the best interest of the patient. Perpetuation of autonomy in decisions has very high chances of conflicting with the professionalism. While it is in the best interest of the patient that their opinions be respected and honored the medical practitioner may not be in a position to exercise his wits in saving the life of a patient. For instance, a paramedic can be called to the scene where a person suspected to have cardiac malfunction lies. While he is determined to resuscitate the patient who is elderly, unconscious and not able to breath, he realizes inscriptions on the body which states ‘do not resuscitate’ (Ruth & Morgan 2013). This is a dilemma for the paramedic partly because it is not clear who the author of the writings is and also considering the state of the patient he is supposed to act justly to the patient. Justice ‘do good’ principle The ‘do good’ principle envisages that the stuff that benefit the patient be maximized and those that impose harm to the patient be controlled as much as possible. It fosters the approach of best interests to patient care (Eburn 2010). It requires the practitioners be able to prove beyond doubt that their actions to patients is to the best interest of the patient. The principle does not allow letting die of patients who according to the judgment of the medical practitioner is in an irreversible end of life state. It is in the best interest of the ailing that offering them the best medication at whatever condition befits the principle of justice which encourages that only practices that benefit the sick be administered to them (Sanders et al., 2012). There is a wider general concern about minding the welfare of the patients with intentions of making sure that they are justly treated in the opinion of the medical practitioner as well as that of the patient. The dimension of justice is of very fundamental significance owing to the fact that it cannot be isolated from the other aspects of justice like the social, cultural and political dimensions. In medical practice there is no clear boundary between medication, morality and justice (Ann and Sue 2012). It is a great contravention of medical ethics if a patient fails to receive the deserved medication because of any situation that makes them vulnerable like being prisoners (Eburn 2010). All patients deserve the right to receive proper medical attention at equal measures, regardless of their social inclination. Legal principles The paramedics need to comprehend how cases in their field have been determined in the past on the basis of the doctrine of precedent. This may act as a defense tool in the event that they are caught up in similar incidences (Ann & Sue 2012). Michael Eburn (2010), states that in the context of Australia emergency law is designed to provide a clear insight to issues which are involved in the planning and responding to emergencies. Emergency law should elucidate with clarity and concisely the laws that are related to civil emergency duties and also the rights and obligations of both the affected as well as the emergency service providers. The paramedics should be familiars with the peculiarities of the laws that govern their field of practice. Most of the laws regarding the practice of the paramedics are held with the employing authorities. Confidentiality and Data protection Confidentiality and data protection requires the paramedic to hold in confidence the information that is disclosed to them by the patients. This is embedded in the case law, professional codes of conduct as well as in the employment contracts of the paramedics. It is anticipated that the information about the service users be kept confidentially and only used for the purpose for which they were revealed. The paramedics are therefore bound by this law not to reveal information about the service seekers unless they prove beyond doubt the identity of the people who are inquiring to be provided with such information and the justification for release of the information (HPC UK 2008). The JRCALC (2006) has a host of UK ambulance service clinical practice guidelines as per the ethical issues of confidentiality. At times excitement may push a paramedic to narrate his experience with a patient to colleagues, this may be healthy for purposes of sharing work experiences. However caution should be exercised so that descriptions that may reveal the identity of the patients remain concealed. It does not amount to breach if there is no disclosure of data that can lead to ease of identification. Identifiable data does not include only names and addresses but includes any unique features that can be easily attributed to the patient (Lord 2007). The information revealed to the paramedic is commonly of very sensitive nature and the concerned persons anticipate highest levels of confidentiality. Revelation should only be to fellow health workers since medication does not stop with the paramedics only. This revelation should be professionally conducted like in situations when the paramedics hand over patients to other levels to perpetuate continuation in the field of care. It is not always the case that through acceptance to taken to hospital then by default the patients have accepted that the information be revealed to other medical staff (In cone et al 2015). Capacity and Consent Capacity and consent require a paramedic to seek a valid consent of the patient in most of the encounters. If this is not observed then the paramedic is liable to being accused of assault or battery. Validity of consent requires that a patient has access to information and must be able to understand the procedures and interventions to be administered on them and the consequences thereof (HPC 2007). This awareness facilitates the process of making informed consent (Beauchamp and Childress 2001).Validity of consent is dependent on the capacity of the patient which involves the understanding of procedures as they are explained. The paramedic is required to understand the Mental Capacity Act of 2005. They are required to refer to this act when handling patients. The act stipulates that adults who are aged 16 and above own full legal capacity to arrive at decisions. The code of practice to the act states that evaluating the capacity starts with the assessment of impairment or disturbance in the functioning of the brain followed by ascertaining the level of effect that the impairment has on the patient (Lord 2007).The act remains obscure in the event of emergency operations because a paramedic is expected to take time before declaring a patient incapacitated. Those given the lasting power of attorney are supposed to make decisions only after those who handed them the power are declared incapacitated. Paramedics are required to know when and how to make applications to the court of protection and court appointed deputies. Succinct knowledge to the power of the court is alls significant to the paramedic. If a patient demonstrates capacity then the paramedic is under obligation to comply with their decision to the means and kind of treatment. If the paramedic compels them, then there is likelihood of being accused of assaulting the patient. The paramedic’s dilemma arises when the patient refuses to consent medication and more so when they are deemed to have the capacity. The situation of refusal is easier to handle when the patient refuses but is not fit in their capacity (Lord 2007). In this case the paramedic may treat the patient without consent if it is in the best interest of the patient. Conclusion Ethical standards are extremely subjective in the way they are perceived and interpreted. In most instances the paramedics are faced with the dilemma as per the course of action to pursue to resolve certain emerging conditions. At times paramedics are compelled to make very sudden critical decisions such that it may be viewed that ethical considerations are suspended to arrive at appropriate clinical judgments. The challenge is emanating from the fact that there exist very comprehensive clinical guidelines to follow for the paramedics without proper ethical decision making processes that correspond to them. References Ann, G. and Sue, H., (2012). Ethics, law and professional issues; a practice based approach for health professionals. Palgrave Macmillan UK. Beauchamp, T.L. and Childress, J.F. (2001). Principles of Biomedical Ethics, 5th edn. New York: Oxford University Press. Eburn, M. (2010). Emergency law: Rights, liabilities and duties of emergency workers and volunteers. Leichhardt, N.S.W: Federation Press. Hampton, O.P (1970). The systematic approach to emergency medical services, arch environ health. HPC (Health Professions Council) (2007). Standards of Proficiency for Paramedics. London: Health Professions Council. In Cone, D. C., In Brice, J. H., In Delbridge, T. R., & In Myers, J. B. (2015). Emergency medical services: Clinical practice and systems oversight. Cambridge: New York. JRCALC (Joint Royal Colleges Ambulance Liaison Committee) (2006) United Kingdom Ambulance Service Clinical Practice Guidelines. London: Joint Royal Colleges Ambulance Liaison Committee. The Ambulance Service Association (ASA). Lord Chancellor (2007) Mental Capacity Act 2005 Code of Practice. Issued by the Lord Chancellor on 23 April 2007 in accordance with sections 42 and 43 of the Act. London: The Stationery Office. Ross, L. (2013). Applied Paramedic Law and Ethics .Australasian Journal of Paramedicine, 10(1).Retrieved from http://ro.ecu.edu.au/jephc/vol10/iss1/8. Ruth, T. and Morgan, L. (2012). Applied Paramedic Law and Ethics: Australasia and New Zealand. Chatswood, Elsevier Australia. Sanders, M. J., Lewis, L. M., Quick, G., & McKenna, K. (2012). Mosby's paramedic textbook. St. Louis, Mo: Elsevier/Mosby Jems. The Stationery Office (2005) The Mental Capacity Act. London: The Stationery Office. Read More