Paramedicine presupposes direct interaction with individuals. Not surprisingly, the paramedics encounter many ethical and legal dilemmas as a part of their professional activities. In some cases, it may be a confusing task to react properly to the emerged contradictory issues, preserving the legal implications and moral duties at the same time. It is important to remember that some dilemmas have no universally right solutions, and their consequences depend on every situation. In any case, the role of paramedics consists in the elimination of harmful aspects of patients’ ethical decisions as well as protection of their legal freedom and choice. From this standpoint, paramedics play a significant role in consideration of ethical issues and bear responsibility for the preservation of both legal and moral standards in every individual case of interaction with the patients. This paper aims to analyze the ethical and legal issues in paramedicine and examine the probable solutions.
The healthcare practices include many ethical dilemmas, and their solution influences both the personnel and patients. This is the main reason that explains the prominence of the ethical issues in health care and the necessity to respond to them appropriately. Among the most significant and complicated ethical dilemmas in nursing, it is possible to distinguish the problem of euthanasia, abortion, truth-telling as oppose to deliberate deception, and freedom contrary to control. All of these ethical issues represent significant dilemmas to consider for the sake of patients’ health as well as moral and legal justification (Bledsoe, Porter, Cherry, & Armacost, 2006).
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Nevertheless, it is important to understand that many ethical issues presented in health care have little to do with paramedicine as the latter focuses mainly on emergencies. From this point of view, paramedicine has to develop a distinct set of ethical standards and rules to cover its sphere of professional activities. The ethics in paramedicine has become a field of interest for many scientists and researchers. Stirrat, Johnston, Gillon, and Boyd (2010) suppose that paramedics should be aware of the ethical rules and follow them at the workplace. Such a position will help improve the system and lead to effective and fruitful results. Therefore, they suggest the introduction of ethical education for doctors and staff working in this sphere (Stirrat et al., 2010).
Modern paramedicine tends to use the ethical standards developed by scientists T. Beauchamp and J. Childress. The researchers have outlined four main ethical principles, which are important for consideration in paramedicine. Besides, their classification sets the right vision for development of paramedicine and provides it with the required tools and methods of acting and solving various dilemmas. Commonly, these four principles help the paramedics make the optimal decisions and protect the interests of clients, acting both morally and legally. The scientists regard those ethical principles as principles of respect, non-maleficence, beneficence, and justice (Beauchamp & Childress, 2008).
The ethical principle of respect for the patients’ autonomy presupposes the non-interference into the freedom of their decisions and choices (Steer, 2007). It also calls for the appropriate estimation of patients’ rights and a tolerant attitude to them. 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). Similarly, the principle of ethical justice refers to the necessity to provide all patients with equal care and treatment possibilities. For example, the patients who suffer from mental disorders have the same right to apply to different procedures as those who do not. The paramedics should consider every individual case and act fairly and objectively in every situation (Beauchamp & Childress, 2008).
The principles of non-maleficence and beneficence form an area of special interest for the paramedics since these ethical issues are of paramount importance for them. They identify and direct the work of the paramedical practices as well as determine all possible ways of interacting and communicating with patients (Bledsoe et al., 2006). Those two principles form the structure and responsibility of paramedicine and determine its credibility and prominence in contemporary society. Therefore, it is important to consider those principles more precisely.
The ethical principle of non-maleficence means that paramedicine practitioners should discuss the probable negative consequences of their decisions and prevent them in order not to harm the patients. This principle refers to both physical and mental damage, which can be done about the clients. The paramedics should take into account the health conditions of patients, the seriousness of their problem, their relations with relatives, and probable reactions to different types of treatment before making the final decision. The matter is that some spontaneous solutions or actions can negatively influence the patients and fail in the achievement of the desirable results (Beauchamp & Childress, 2008).
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). All of these actions may devaluate the positive results of treatment and harm patients’ health and well-being. Therefore, the personal attitudes and opinions of paramedicine practitioners should not be valued higher than the intentions and desires of patients. The primary task of paramedics is to provide opportune and unprejudiced services, correlating them with legal regulations. Therefore, they should consider the needs and requirements of patients and act correspondingly. In such a way, they will not violate the personal freedom and demonstrate respect to patients’ demands and plans (Blaber, 2012).
Another ethical principle in paramedicine is beneficence. It means that all actions taken by the practitioners should demonstrate positive effects on the patients and improve their health conditions. In other words, this principle requires minimizing the negative outcomes of treatment and maximizing its positive results. Very often, the patients’ points of view on the most suitable treatment do not correlate with the opinions of professionals. On the one hand, the paramedics should not neglect the interests and intentions of the patients. However, it is also essential to explain their view on the problem and prove the beneficence of their choice to reach the agreement with the patients (Aehlert, 2012).
The beneficence of paramedical practices includes not only the treatment and medicines but also relative education and informing. In other words, the paramedicine practitioners should inform the patients about all the probable effects of treatment as well as explain its moral and ethical issues. At the same time, the education should not be subjective, prejudiced, or convincing as the patients have to make their own decisions concerning their lives and health conditions. Moreover, the principle of beneficence involves the necessity to provide sufficient and professional communication and interaction with such patients, without demonstrating their subjective judgments and assessments of the situation. 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).
The question of justice is another part of the paramedical performance. While the moral or ethical side of paramedicine depends on various religious, cultural, and personal beliefs and views, its legal aspect has a strict definition. The tenet of justice presupposes that paramedicine practitioners should treat all patients equally, without showing personal evaluations and attitudes. Additionally, the measures taken by paramedics during the medical procedures should not contradict the existing laws and rules. Following the legal side of the treatment is a great step toward establishing qualitative and appropriate services. It affirms the supremacy of law and appreciation of human rights and freedom.
Speaking about the legal principles of paramedical practices, it is important to mention that legislative acts and rules are common for all individuals and organizations despite the scopes and directions of their activities. From this standpoint, the paramedics have to follow the same regulations and standards that are mandatory for the whole country. 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 means that all actions and decisions implemented by the paramedicine practitioners should not only comply with the moral aspect but also with the legislative laws and rules (Aehlert, 2012).
One of the most important legal principles in paramedicine is the preservation of patients’ personal information and data. In other words, paramedics need to adopt the principle of confidentiality and credence. Moreover, paramedics should respect the autonomy of patients and protect their privacy if needed. The disclosure of confidential information, as well as the announcement of personal data about patients, supposes administrative and even criminal responsibility (Steer, 2007). Therefore, paramedicine practitioners should take all measures to respect the privacy of patients and satisfy their demand for confidentiality.
Additionally, according to the current laws, all patients have the right to control their lives without any external interventions, control, and management. At the same time, the task of the paramedics is to improve their patients’ health conditions and choose the best way of treatment in every particular case. As a result, it is possible to observe a contradiction between the notion of personal autonomy and medical intervention. Nevertheless, paramedicine policies should encourage patients to follow the healthy way of life and apply to certain procedures, without intervening in their personal lives and decisions (Sharp, Palmore, & Grady, 2014).
Another legal principle in paramedicine calls for the demonstration of high competence and professional skills (Nixon, 2013). The practitioners should have the required level of education and work experience to deal with the patients in the most effective and quality manner. The insufficient competence or lack of basic knowledge can lead to harmful effects and negative consequences of treatment. Such a situation is irresponsible and dangerous in terms of not only morality and ethics but also legislation. Therefore, a set of laws regulates the requirements of paramedics’ competence and professional skills that are essential for successful and effective performance (Woollard, 2009).
In conclusion, ethical and legal principles are of great importance in paramedical practices. They help organize the work activities and solve various contradictions between the legal and moral aspects, professional and personal judgments, and cultural and social norms. The paramedics’ and patients’ views on treatments may vary as well as moral and legal explanations of different procedures are different according to the cultural, religious, and social backgrounds. Nevertheless, despite personal values and beliefs, paramedics should provide their patients with essential treatment, medicine, support, and instructions. In this case, both ethical and legal principles are important. While the ethical tenets apply to the moral aspect of practices, the legal ones help legally arrange them. In the case of paramedicine, both ethics and law should remain unprejudiced and objective.