week 9

Question 1

5 Legal and Ethical considerations

Answer 1

• Dignity
• Autonomy
• Beneficence
• Privacy
• Duty of care

Question 2

Dignity

Answer 2

Dignity: It is essential to ensure patients who are
dying or deceased retain their dignity as human
beings.

8 components of dignity:
honesty
kindness
compassion
courtesy
understanding
confidentiality
privacy
communication

Question 3

Autonomy/ consent

Answer 3

It is important that we recognise a patients right to autonomy, even in death, a patient has the right to choose the care they receive.

Question 4

Beneficence

Answer 4

Refers to an act of charity, mercy, and kindness. It infers that it is a moral obligation to ensure that you do good by others.

Question 5

Privacy

Answer 5

In this context, the notion of privacy may refer to physical privacy or that of medical history etc.

Question 6

Duty of Care

Answer 6

A requirement that a person act toward others in a manner that a reasonable person in the circumstances would to avoid foreseeable harm.

Question 7

Negligence

Answer 7

Negligence is a concern for healthcare workers when
withholding or ceasing resuscitation without the correct
documentation.

Question 8

End of life care

Answer 8

The priorities of care in those who are dying are often
difficult for paramedics to decide on.

It is important that we work within the law and our protocols. This protects us from charges of negligence, assault, battery or even manslaughter.

Question 9

Attending a deceased patient

Answer 9

It is important that paramedics prepare to resuscitate until there is reason to withhold efforts.

Question 10

What to do when paramedics withhold or cease resuscitation

Answer 10

• Let the family/ friends on scene know.
• Offer to contact other support for the family.
• Contact the police- police attend all deaths that are unexpected. If the death was expected call the local GP and/or follow local protocols
• Conduct a verification of death (optional).
• Ensure all of the patients details are recorded for paperwork.
• Ensure the patient is dressed/ appropriately presented (e.g. perhaps put them in bed)/ covered.

Question 11

Cultural considerations

Answer 11

Ensure you consult with the family prior to moving the body.

Question 12

Reportable Death

Answer 12

A ‘reportable death’ is the term used for all deaths that
are:
• Unexpected, unnatural or violent death (e.g. suspected suicide or homicide).
• Death following a medical procedure
• Death of a person held in custody or in alcohol or
mental health care.
• A person who is under care of the mental heath act
but independent.

Question 13

Reviewable Death

Answer 13

Death of a child (<18) where the death is the second or subsequent death of a child of the parent or guardian or foster parent.

Question 14

Expected deaths

Answer 14

In the case that a patient who was under palliative
care, or had been terminally ill/ deteriorating in health
and was under the care of a GP for this condition
police may not be required.

Question 15

Paediatric Deaths

Answer 15

In all cases of paediatric deaths the paramedics
should consider transportation to the major paediatric
hospital if possible. This is because counselling and
support is available for parents in large hospitals such
as the Royal Children’s Hospital. So the family has
immediate access to professional help. It also
separates the process from the home.

Question 16

SIDS

Answer 16

Sudden Infant Death syndrome is associated with unexpected, unexplained death of children, usually within the first year/s of life.
• All SIDS cases should be transported to a major paediatric hospital.
• Paramedics usually transport these children and their parents via ambulance.
• Cooperation with police is essential. Explain to family why police are attending (e.g. it is policy/standard process)

Question 17

Crime Scenes

Answer 17

• In suspicious circumstances it is important that the paramedic try not to contaminate the scene.
• Patient care should come first, but once death has been verified the paramedics should take care not to move, touch or even step on anything if possible.
• Take note of what you saw, who was on scene and what you moved as you may be required to give evidence in court.

Question 18

Supporting the family

Answer 18

• In the case of a death- unexpected or not it is
important you consider the family, friends and bystanders on scene – essentially they become the
patient.

• Take your time- explain what is happening to the
family and why.

• If the police are required it is really important that you
explain why- as many people feel that they are being
accused of wrongdoings and can get upset when they
arrive.

• Consider the different reactions people have to grief- allow people to express themselves- but also be
aware that people can become aggressive/ angry if
they expected a different outcome.