Paramedical Science-Principles of Informed Consent - Term Paper Example

Paramedical Science---Principles of Informed Consent Insert your name here Insert name of your Institution here Insert Lecturers name here Introduction Safety and quality in healthcare remains central focus in the understanding of patient-centred care; not only in Australia but across other cultures. The conceptualization of patient-centred care means integration of a quality modern health service by introducing informed decision making process through informed consent. Contemporary studies have concentrated in comparative analysis regarding informed consent in healthcare; paying attention to similarities and differences in what can be seen as a two-way dialogue between healthcare practitioners and patients regarding the challenges, benefits, risks and alternative treatments to be adopted. However, there seems to be paucity of information, particularly evidence-based researches that have attempted to provide comparative analyses on principles of informed consent within paramedic science. Evidence-based studies such as Steer (2015) have noted that paramedic care is currently affected by the consequences of not considering patient’s personal beliefs, circumstances and priorities. As the scope of practice for paramedics in Australia continues to require the integration of safety and quality systems in healthcare, there is need to establish research based comparative analyses that focus on principles of informed consent as practiced in Australia and other parts of the world. The aim of this study is to critically outline different principles of informed consent relevant to Australian society comparing and contrasting these principles with other countries. Generally, there is a consensus among countries such as Canada, Australia and United States of America that one principle of informed consent is capacity and competency. To that extent, this principle holds that paramedics should engage patients in an informed decision making processes where patients are given an opportunity to make correct decisions regarding healthcare, paying attention to all circumstances of their life. Taking a case study of Australia, Townsend and Luck (2012) found that informed consent as premised in Queensland Health policy requires that paramedics provide patients with information they need so that they can make decisions. In such cases, the principle allows patients within Australia to decline the consent to the healthcare, in as much as paramedic could consider that the intended medical intervention will offer the best clinical outcome. This principle has been found to be similar in Canada and United States. During paramedic-defined end-of-life care period that was conducted among 473 adults Watson et al. (2012) showed that America considers capacity and competency and provision of information to patients as critical as far as informed consent is concerned. The research concluded that just like it is the case with Queensland Health policy, safety and quality systems in healthcare will be achieved if paramedic health practices encompass providing the needed information to patients so that they can make their decisions regarding the information provided. Different studies that have included non-oncology and oncology in Canada have noted provision of information to patients for their decision making is critical principle of informed consent that should part of paramedics’ practices especially in the wake of recent cases of paramedic errors in administration of look-alike drugs (Amblum, 2014). Secondly, the principle of voluntarily is another approach that Australian Commission on Safety and Quality in HealthCare have stressed on as far as informed consent among paramedics is concerned (Standard, 2012). The principle as outlined for paramedics provide a framework showing that the consent should be free from any manipulation or undue influence from paramedic staff, family or other social coercive influences where the paramedic works. This principle has also been captured by Australian Institute of Health and Welfare that noted that paramedics should make informed consent as voluntary as possible (Kreisfeld, Harrison and Pointer, 2014). This principle will allow a discussion between the paramedic and the patient to be transparent, balanced and involves two-way communication which is sensitive to the prevailing condition such that after these discussions, patients can make decisions voluntarily. Allowing processes to be voluntary is recognized in United Kingdom as one of the essential principles of informed consent (Bigham, Kennedy, Drennan and Morrison, 2013). Paramedics are supposed to give patients the needed time to consider options and voluntarily make well-informed decisions taking into consideration of different clinical situations and any long term emotional, physical, mental sexual, social and other unexpected outcome of the medical procedures. Bigham et al. further indicated that the principle of voluntarism stretches to countries such as Germany. Just like it is provided in Australia’s Consent to Treatment Policy for the Western Australian Health System, Bigham et al. argue that paramedics in Germany are bound to go with patient’s willingness to submit to healthcare. As a matter of policy, Kreisfeld et al. noted that paramedics should not coerce patient to provide information, in the process of investigation, examination, procedure, intervention or treatment when the patient in question is in the capacity to make their decisions voluntarily. Thirdly, the principle of disclosure of information has been found to be similar among different countries. According to O’Meara et al. (2016), the principle of disclosure of information refers to the situation where paramedics have a thoughtful dialogue with patients and in the process, disclose sufficient information to help patients make educated decisions. In United States of America, including District of Columbia, the term ‘disclosure to a reasonable person’ has been adopted to allow paramedics engage in consent discussion with patient (O’Meara et al., 2016 p. 26). The principle of disclosure of information has also been adopted for paramedics in Australia. The National Health and Medical Research Council (NHMRC) have provided guideline for medical practitioners including paramedics on ways in which they should provide information to patients as far as informed consent is concerned (Steer, 2015). One of the guidelines that NHMRC has suggested for paramedics is to provide essential information to patients before asking them to make some decisions. Essential to note is that the guideline outlines the need to engage Indigenous Hospital Liaison Officer in information disclosure in cases where paramedics are handling patients with Torres Strait Islander and/or Aboriginal origin. Just like it is the case with India, the information paramedics provide in the Queensland Health procedure specific consent forms as well as patient information documents take into consideration different factors that are likely to influence the outcome for specific patient (Steer, 2015). Both cultures (India and Australia) have presented these factors to be the age of the patient, number of co-morbidities the patient is having and complexity of the disease. Contrariwise, there are considerable numbers of informed consent principles that are different when Australia’s case is compared with other cultures or countries. In particular, Australia’s approach to invasive treatment and healthcare with significant risks has different informed consent principle when compared with Canada, Japan and Unites States. Taking a case study of Queensland Health policy for paramedics, informed consent entail autonomous authorization principle where paramedics, upon completing dialogue with the patient will be expected to retain the consent documentation. Steer (2015) argues that all health practitioners in Australia, including paramedics and Visiting Health Officers are expected to retain all copies of consent forms as part of patient’s clinical records. This principle has been applied differently in Australia and a good example is the guideline provided by Queensland Health Retention and Disposal of Clinical Records Policy that upon the authorization of the patient, details of consent form will have to be retained for record purposes. This principle is not applicable in other cultures such as United States where patients’ retention of consent form or documents is considered necessary. In most cases, paramedics and patients will have copies of the consent for their separate records. American College of Obstetrics and Gynecology comprehensive guidelines for retention of informed consent provides that blood transfusions, methadone and chemotherapy medical interventions should allow patients to retain a copy of informed consent (Vanopdenbosch and Rincon, 2015). This practice is a reflection of what is taking place in other cultures such as Canada and Japan especially in cases where paramedics are dealing with patients with the ability to make well-informed decision regarding healthcare procedures (Vanopdenbosch and Rincon, 2015). Specifically, paramedics in Japan will not be operating against any code of practice by refusing to provide patients with informed consent documentations if it is ascertained that the paramedic dealt with a patient who was: Able to understand the basic medical situation and processes involved Able to communicate their decisions voluntarily and effectively Conclusion This study sought to provide succinct understanding of informed consent as an important aspect of safety and quality systems among paramedics. To conceptualise this point, case studies on different cultures/countries have been reviewed with an aim of comparing and contrasting principles of informed consent relevant to Australian society. The study concludes that principles of informed consent relevant to Australian society compare and differ with other cultures on the basis of decision making and safety and quality systems. That is, principles that were found to be similar to those applied to Australian society were based on patient’s healthcare decisions. Researches and guidelines that have been consulted regarding principles of informed consent provide paramedics with different approaches in understanding the link between outlined principles and quality of care. This report concludes that principles of informed consent are essential in enhancement of quality of care especially when paramedics are dealing with cases or situations where healthcare is required to meet imminent risks to patient’s health or life. References Amblum, J. (2014). A critical appraisal of the impact of Section 3 of the Mental Capacity Act (2005). Journal of Paramedic Practice• Vol, 6(8), 423. Bigham, B. L., Kennedy, S. M., Drennan, I., & Morrison, L. J. (2013). Expanding paramedic scope of practice in the community: a systematic review of the literature. Prehospital Emergency Care, 17(3), 361-372. Kreisfeld, R., Harrison, J. E., & Pointer, S. C. (2014). Australian Institute of Health and Welfare. Canberra, Australia: Australian Institute of Health and Welfare. O’Meara, P., Stirling, C., Ruest, M., & Martin, A. (2016). Community paramedicine model of care: an observational, ethnographic case study. BMC health services research, 16(1), 1. Standard, Q. I. G. (2012). Australian Commission on Safety and Quality in Health Care. Steer, B. (2015). Paramedics, consent and refusal–are we competent?. Australasian Journal of Paramedicine, 5(1). Townsend, R., & Luck, M. (2012). Applied Paramedic Law and Ethics: Australia and New Zealand. Elsevier Health Sciences. Vanopdenbosch, L. J., & Rincon, F. (2015). Ethics in the Neuro-ICU. In Neurointensive Care (pp. 327-336). Springer International Publishing. Watson, D. L. B., Sanoff, R., Mackintosh, J. E., Saver, J. L., Ford, G. A., Price, C., ... & Murtagh, M. J. (2012). Evidence from the scene: paramedic perspectives on involvement in out-of-hospital research. Annals of emergency medicine, 60(5), 641-650. Read More