Legal
Writing a prescription: the law and good practice
Paramedic independent prescribing offers an opportunity to improve patient access to medications. However, incomplete, unclear or incorrectly written prescriptions can cause harm to patients. This article in the Prescribing Paramedic series considers: the legal requirements a prescription must meet for prescription-only medicines and controlled drugs; common errors that may occur during prescription writing and potential solutions; and best practice recommendations for prescribers to follow when...
Respecting an autonomous decision to refuse life-saving treatment: a case study
Background: Autonomy is a key ethical principle in healthcare, giving patients the right to be involved in their own care. Allowing patients to make decisions based on their own values and beliefs is a fundamental aspect of evidence-based practice. Professional autonomy allows paramedics to make critical decisions around patient care in an emergency, enabling them to provide life-saving treatment. A patient's autonomy can conflict with that of a paramedic, leading to complex ethical situations...
A human rights perspective on the use of social media by the ambulance services
Social media use on behalf of ambulance services by paramedics, student paramedics and ancillary staff—‘corporate tweeting’, as it has become known—has in recent times been the subject of much debate in the paramedic profession. It has been argued that social media use is an unstoppable tide and a necessary means of imparting information to members of the public about the work the ambulance service performs. Conversely, others have argued that by tweeting about their patients, the ambulance...
Medical negligence insurance for paramedic professionals
Medical negligence insuranceThe cover is generally described as Medical Malpractice insurance—but can often be referred to as Medical Liability insurance, Medical Indemnity, Clinical Negligence cover or Professional Indemnity. Its overriding objective is to insure the health professional against claims arising from wrongful advice or negligent treatment.
Does precedence trump in the origins of confidentiality?
Good clinical practice has to be entwined with good ethical practice. Therefore, it follows that the clinical acumen of a modern paramedic develops at the same rate as their moral and ethical practice. As a newer profession, paramedics have relied on rules and codes from others to help maintain this balance, but their ancient and basic structure fails to address the nuances of modern practice. The paramedic profession has required a heuristic approach, as well as relying on the precedent of...
Amended police powers under the MHA 1983
Paramedics are frequently called to people with acute mental health problems and often assist in caring for and transporting individuals subject to police powers under the Mental Health Act 1983, sections 135 and 136. Those powers will change when Chapter 4 of the Policing and Crime Act comes into force this autumn. In this short article featured for World Mental Health Day, Richard Griffith considers the impact of amendments to police powers on paramedic practice under the Mental Health Act...
Emotional labour in paramedic practice: student awareness of professional demands
Purpose:The purpose of this study was to explore student paramedics' awareness of the emotional demands of their future role, particularly regarding the delivery of compassionate care.Problem:There is a dominance of nursing literature in the discourse around compassionate care and emotional labour, and a paucity of research in the paramedic literature.Methods:A survey was issued to a small convenience sample of paramedic students. Excel was used to organise data collected, which was then...
Live tweeting by ambulance services: a growing concern
Despite advances in technology being a driver of paramedic professional development, particularly over the past decade, the introduction of new forms of technology appears to have presented paramedics with some professional challenges. Paramedics, pre-hospital clinicians, and ambulance service providers in both the United Kingdom and Australia, have begun using social media technology to communicate what they do to the general public. Unfortunately some of the material that has been communicated...
Future of digital technology in paramedic practice: blue light of discernment in responsive care for patients?
This discussion explores the significance of digital technology to responsive patient care in applied paramedic practice. The authors' previous research identified the relative ambiguity of the role of digital technology in facilitating and supporting patients in practice, and the findings revealed the relative transferability of this finding to wider allied healthcare clinical and professional practice. The discussion encompasses two key debates, namely a) How best the quality of the digital...
Community paramedics: need of legal education specific to the pre-hospital non-emergency environment (discussion based on Texas)
Emergency medical services (EMS) have responded to the Affordable Care Act's target to reduce healthcare spending and focus on preventative health by developing community paramedicine programmes in the USA. Currently in their infancy, these community paramedicine programmes aim to utilise existing skills and knowledge to combat patient readmission to the emergency department, and empower the public to take control of their healthcare path. Paramedics are taken out of the pre-hospital emergency...
Patient confidentiality and safety: a classic conundrum
Paramedics frequently have to balance patient confidentiality and patient safety. Patient information is subject to legal, ethical and professional obligations of confidentiality and should not be disclosed to a third party for reasons other than healthcare, without consent. Whilst there is an imperative to preserve the professional/patient relationship, there are occasions where this is not possible. This article considers circumstances when confidential patient information may be disclosed...
Principlism: when values conflict
To ensure morally justified decisions, clinicians are encouraged to apply ethical theories and frameworks. Beauchamp and Childress’ ‘Four Principles’ approach to medical ethics, or ‘Principlism’ for short, is highly regarded as a simple methodology for considering ethical dilemmas, and is common to many undergraduate clinical programmes. On occasion, ethical dilemmas are complex and one or more of the four principles come into conflict with each other. Critics of the approach have suggested that...