Attitudes of prehospital emergency care professionals toward refusal of treatment

Erbay, Hasan; Alan, Sultan; Kadıoğlu, Selim

doi:10.1177/0969733013505311

Cited by 17 publications

(25 citation statements)

References 23 publications

(26 reference statements)

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“…The things that make it different from other areas of medical care include the necessity to react quickly, restricted time to consider medical and ethical aspects of the case or situation, and an absence of prior knowledge about the patients. [3] Obviously, it is very difficult to think through every aspect of the situation in a short period of time. Prehospital emergency medical care has many different characteristics, including unpredictable patient profiles, emergency conditions, and administration of care in a non-medical area.…”

Section: Introductionmentioning

confidence: 99%

Some Ethical Issues in Prehospital Emergency Medicine

Erbay

2014

Turkish Journal of Emergency Medicine

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SUMMARYPrehospital emergency medical care has many challenges including unpredictable patient profiles, emergency conditions, and administration of care in a non-medical area. Many conflicts occur in a prehospital setting that require ethical decisions to be made. An overview of the some of ethical issues in prehospital emergency care settings is given in this article. Ethical aspects of prehospital emergency medicine are classified into four groups: the process before medical interventions, including justice, stigmatization, dangerous situations, and safe driving; the treatment process, including triage, refusal of treatment or transport, and informed consent; the end of life and care, including life-sustaining treatments, prehospital cardiopulmonary resuscitation (CPR), withholding or withdrawal of CPR, and family presence during resuscitation; and some ambulance perception issues, including ambulance misuse, care of minors, and telling of bad news. Prehospital emergency medicine is quite different from emergency medicine in hospitals, and all patients and situations are unique. Consequently, there are no quick formulas for the right action and emotion. It is important to recognize the ethical conflicts that occur in prehospital emergency medicine and then act to provide the appropriate care that is of optimal value.

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Section: Introductionmentioning

confidence: 99%

Some Ethical Issues in Prehospital Emergency Medicine

Erbay

2014

Turkish Journal of Emergency Medicine

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“…In our results, men showed a higher proportion of non-urgent PEPs than women, which is inconsistent with reports showing that unmarried, less educated men present with more severe mental disorders to EDs [ 37 ]. The lower proportion of urgent PEPs among male patients in our study may be due to a higher rate of treatment refusal among males in emergency settings where the patient’s right to refuse treatment is often respected [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Validity and reliability of a novel Color-Risk Psychiatric Triage in a psychiatric emergency department

et al. 2016

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BackgroundClassification of Psychiatric Emergency Presentations (PEP) is not sufficiently clear due to their inherent high inter-subjectivity and lack of validated triage instruments. In order to improve current classification of psychiatric emergency presentations (PEP) at Emergency Departments, we implemented and validated the Color-Risk Psychiatric Triage (CRPT), an instrument for classifying PEP risk by sorting one to five color/risk levels and one to thirty-two possible conditions arranged by risk.MethodsUsers who visited the Emergency Department (ED) of a Mexican psychiatric hospital from Dec 1st, 2008 to Dec 1st, 2009 were included. One CRPT was assessed by an ED psychiatrist to each patient upon their arrival to ED. Some patients were randomly assessed simultaneously with an additional CRPT and a Crisis and Triage Rating Scale (CTRS) to test validity and reliability of the CRPT.ResultsA total of 7,631 CRPT assessments were included. The majority of PEP were non-urgent (74.28 %). For the validation phase n = 158 patients were included. CRPT score showed higher concurrent validity than CRPT color/risk. CRPT level/risk and score showed highest concurrent validity within dangerousness domain of CTRS (r = 0.703, p < 0.0001). CRPT and CTRS scores showed similar predictive validity (p < 0.0001). High intraclass correlation coefficient (0.982) and Cohen’s Kappa (0.89) were observed for CRPT score (r = 0.982, p < 0.0001).ConclusionsCRPT appeared to be a useful instrument for PEP classification due to its concurrent validity, predictive validity and reliability. CRPT score showed higher correlations than the CRPT color/risk. The five levels of risk provided by the CRPT appear to represent a simple and specific method for classifying PEP. This approach considers actual or potential risk, rather than severity, as the main factor for sorting PEP, which improves upon the current approach to emergency classification that is mainly based on the criterion of severity. Regardless of the triage procedure, emergency assessments should no longer classify PEP as “not real emergencies.”Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0727-7) contains supplementary material, which is available to authorized users.

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“…There are many studies in the literature about ethical dilemma and ethical conflict where the paramedics face in the field while giving prehospital care, [1], [9], [10]. In this context, it is expected that the ethical dilemmas and unethical behaviors can be fixed by a standardized and high quality ethical education.…”

Section: Ethical Codesmentioning

confidence: 99%

The importance of vocational ethics in paramedic education, vocational ethics course for paramedics

Pakdemirli

Koca

2016

SHS Web of Conferences

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Abstract. Ethics are rules of behaviors which morally good or bad. Bioethics is the study of ethics about by advances in biology and medicine. Health care providers should have knowledge about health professional ethics principles, public officials' ethical behavior principles and ethical principles concerned about other legislation. They should find the required information to make logical, objective and accurate decisions where they may face with ethical problems in their professional life. Unfortunately in our country there isn't any special vocational ethics course designed for paramedics. Our aim is to design a Vocational Ethics Course for Paramedics which includes all issues of bioethics.

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Attitudes of prehospital emergency care professionals toward refusal of treatment

Cited by 17 publications

References 23 publications

Some Ethical Issues in Prehospital Emergency Medicine

Some Ethical Issues in Prehospital Emergency Medicine

Validity and reliability of a novel Color-Risk Psychiatric Triage in a psychiatric emergency department

The importance of vocational ethics in paramedic education, vocational ethics course for paramedics

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