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There are a lot of issues that face paramedics in their line of work and among them involve the cases of consent and also competence. There are also challenges of autonomy and informed decision making. Autonomy refers to making a decision on the treatment being offered. Paramedics are faced with challenges because at times they have to cater to children who by law might not be considered to be fully capable of making such decisions. Paramedics can sense a patient’s limited autonomy but are challenged on how to cater to such a patient due to their incapacity which might be permanent or temporary. In such instances paramedics are faced with a challenge on how to go about providing us with care. In the face of such challenges health care workers are committed to the integrity of their clients (Preston, 2001).
Competence on the other hand is quite a challenge to health care workers as they have to make sure that the patient fully understands his or her situation and is also informed on the options at hand. The assessment of competence is ethically critical as without competence one cannot give a valid consent. For consent to be a patient will have to have understood and made a decision concerning the matters that are to take place (Murdaugh, 2008). This is where voluntariness comes in and poses another ethical dilemma. If a patient is rushed into a hospital in a critical life situation then the consent of a relative will be required. In the course of the operation if there are other complications that arise, the consent of the surrogate decision maker will be sought though it might be against that of the patient before he or she was incapacitated. There are also challenges of who decides the best interest especially the obligation of children and quality of life decisions such as those faced by rehabilitation counselors (Westen, 2004).
Ethical dilemmas facing health care workers in the account of accountability include abortion, treatment in critical situations, suicide, euthanasia, suicide, personhood and beginnings and also genetic issues. Since the early philosophical thought, life and morals have been under significant debate as to ethical significance. IVF and other related technologies such as test tube babies’ onset the debate of ethics dilemma on the virtue of availability of viable and reproducible human cells. On genetic issues it involves the study of the composition of human race (Staunton & Chiarella, 2008).
The long term aim of human genetic issues is to improve on the health of all individuals but there arises questions and debates as there will be those who control other people. This will in the end undervalue the respect of dignity and rights regardless of generic characteristics. The issue of sexual activity, pregnancy and planning of children poses ethical convictions to people and especially health care workers (Eburn, 2010). Issues may raise the dilemma of preventing or aborting pregnancies. There are also ethical dilemmas that are faced by health care workers over treatment in critical situations. This mainly applies to those patients who may lapse into critical conditions. In some cases health care workers are discouraged to help children who may be born prematurely on the grounds of consequent suffering, futility of treatment and also the quality of life such as morbidity, disability and poor health outcomes (Lo, 2009).
Suicide is the act of ending one owns life and in some cases it offers ethical dilemma for healthcare workers who might aid people to end their lives as they should ensure the patient’s safety and help them to return to competent decision making (Kanoti, 2000). Euthanasia on the other hand poses dilemma as it might mean hastening a death of a patient. It poses an ethical dilemma as a patient may be in real pain and the health worker is not allowed to deliberate hasten that death (Nossiter, 2007).
An assault is the fundamental application of force to anther without their consent. The fundamental principle, plain and incontestable, is that every person’s body is inviolate. It has long been established that any touching of another person, however slight may amount to an assault. This may present a legal issue as paramedics would have to touch a person’s body if first aid which could be essential, to be administered (Eburn, 2010). There are cases when paramedics are faced with situations of people who are in deep pain or mental incapacitation that they cannot understand what the paramedic is trying to say or even to comprehend if the paramedic is trying to administer help to him or her (McFeely, 2006).
Many victims or patients may become physically violent and this may lead to the paramedic trying to hold the patient down. Many may have injuries but the point of view majority will have is that the person’s life has been saved. This however is not always the case. There are those who might file cases against the paramedics that they suffered assault while in the hands of those who are supposed to take care of them. It proves hard to understand such persons as what really matters is that their life has been saved and that they should be grateful in return. Should have the paramedics left him or her in their state of pain and not administered any help towards them? If yes what would have been the repercussions of such an action under the law. If the life was lost or the person developed other complications would the paramedic be questioned and accused of neglect. Where then is the balance in such case? What then are paramedics to do when faced by such legal issues in their line of work? (http://law.jrank.org/pages/11858/Euthanasia.html).
2. Refusal of consent other people than the patient
This looks into both the children and non-competent adults who have to rely on other people to make the decision for them. The legal dilemma in children comes in when the child requires treatment to save his or her life but the parent or guardian refuses. On the case of non-competent adults, the common law states that no one can make a medical decision on behalf on another adult. In this case it becomes a legal dilemma if the appointed guardian refuses to allow the patient get medical assistance while the rescuer thinks it is right to save the person’s life and prevent serious harm (Eburn, 2010).
Negligence is among the many legal issues faced by paramedics in their day to day work. In Australia there is a rule of “no fault” in which case one has to prove that there was someone’s negligence that led to the injury in order for compensation to be allowed. Many of the paramedics who also include volunteers may face injuries in their line of work (Schrage, 2001).
The issue of damage holds a lot of ground under negligence but a plaintiff has to show proof of how negligence led to loss on his behalf. As in the case of Neal v ambulance of New South West Wales, he refused to have himself transport to hospital and ended up suffering damage (Jenkins, 2008).
Duty to treat
The common law states that it is not a duty to go to the aid of others as a rescuer. This however poses a questionable debate as shown in the Lown v Woods case. When approached to help the victim who was having a fit, he declined in which case it is right with the law (Hurlimann, 2003). He was however found guilty of failing in his duty to treat the victim as he was within proximity to the victim and he was preoccupied treating any other patient. it should however be stressed as to when it is legally right for a health care worker to retreat from providing duty to treating a patient or victim (Sorrell, 2008).There was equitable and ethical distribution of labor in the group and it did not create any ethical dilemmas. My contribution to the group work was in the research of legal issues that face health care workers in their line of work. I researched on the Katrina hurricane disaster and came up with the following crimiminal law case.
Criminal law - In July 2006, The Attorney General launched an investigation and arrested Dr. Anna Pou and two nurses, Cheri Landry and Lori Budo. A grand jury considered possible murder charges in the deaths of these four patients (Morrow, 2006). The evidence against Dr Puo included a summary of evidence that was released by the Louisiana Department of Justice. Statements by LifeCare employees included Susan Mulderick, Therese Mendez, Steven Harris, Kristy Johnson, and Diane Robichaux.
In the Toxicology and autopsies report it was found that Morphine and midazolam were found. Results of this substance were not accurate due to body decay. Autopsies report could not classify the cause of death (Wright & Pamela, 2002).
Civil law, as opposed to criminal law, refers to the branch of law dealing with disputes between individuals and organisations where remedy can be sort by an action for compensation, which often takes the form of monetary damages. An amount of money is intended to make up for the loss or damage suffered by the victim and restores the victim to the position they were in before the offence was committed. In the scenario of Dr Pou and Hurricane Katrina, Dr Pou and the Nurses owed a duty of care to their patients. The standard of care cannot be determined in this case because of the extreme conditions in the hospital. Dr Pou and her colleagues were initially charged with administering lethal amounts of medication to help suffering patients die. This is referred to as euthanasia. Euthanasia means ending one’s life with the intention of relieving pain and suffering. Euthanasia is illegal in Australia and many states in the US (Hoffman, 2007).
Law and medicine can easily intersect in civil arenas of malpractice litigation, health law, or regulation. Criminal prosecutions have been reserved for intentional activities such as assisted suicide/ euthanasia. This is evident in the case of Dr Pou. While her and her colleagues could not be charged under Civil Law as a duty of care could not be established, she and her colleagues and still be charged with a Criminal offence (Griffin & Johnston, 2005).
To health care providers, there is a very thin line in the dilemmas they face between legal and ethical. One course of action could be making them face legal charges while taking another course of action would make them face ethical dilemmas such as the case of Dr. Pou and her colleagues.