In addition to the foundational ethical principles that guide EMS providers in delivering patient care, there are several other key ethical concepts that are equally important in the practice of prehospital medicine.
These concepts focus on ensuring fairness, respect, honesty, integrity, and advocacy in all interactions with patients.
EMS providers frequently encounter diverse populations and situations that require a deep commitment to ethical standards, reinforcing the importance of treating every individual with dignity and fairness, while also advocating for those who cannot speak for themselves.
Part Two explores five additional ethical principles that are vital for EMS providers to uphold in their daily practice.
6. Justice
As it pertains to healthcare, justice refers to the level of fairness by which medical services are distributed.
In EMS, medical care is provided on an emergency basis equally to all persons in need regardless of race, sex, religion, or socioeconomic status.
Systems of triage also observe the ethical principle of justice when determining each patient’s priority for care depending on the urgency of their needs.
7. Respect For Persons
Simply tending to an emergency medical need is not enough; patients must be afforded dignity and respect. In our often dark and gloomy profession, it is easy to fall into the trap of viewing our patients as cargo to be transported.
This is a natural psychological self-defense reaction that EMS providers must guard against in order to maintain ethical healthcare practices.
8. Honesty
EMS providers must be truthful in all dealings. Lying can at best destroy any trust built between EMS and the public, and at worst result in legal ramifications for the provider and the agency.
Honesty must be exercised in our documentation, and in our direct communication with our patients and other healthcare providers.
9. Integrity
An EMR with integrity adheres to ethical principles despite any pressures or temptations to do otherwise.
The provider must be always stalwart in the face of challenges to their ethics, and make only decisions that they know to be good and true.
10. Advocacy
One of the best ways we can care for our patients is to be their advocate. Advocating for a patient may simply entail making phone calls to coordinate assistance for them, or contacting their primary care physician to help clarify any confusion the patient may have about their doctor’s instructions.
In some situations, the patient may be unable to advocate for themselves at all, such as in cases of child or elder abuse, and it becomes the legal and ethical responsibility of the EMS provider to advocate for the patient’s safety and well-being.
Conclusion
EMS practice is inherently complex and challenging, demanding not only clinical skills but also a steadfast commitment to ethical principles. By upholding justice, respect for persons, honesty, integrity, and advocacy, EMS providers can ensure they are delivering care that is fair, respectful, and protective of patient rights.
These ethical principles are crucial in fostering trust, maintaining professional standards, and advocating for the well-being of all patients, especially those who are most vulnerable.
As EMS professionals continue to serve on the front lines of healthcare, their adherence to these ethical guidelines is essential in upholding the integrity of the profession and ensuring that all patients receive equitable and compassionate care.
Further Reading:
Alexander, M. & Belle, R. (2017) Advanced EMT: A Clinical Reasoning Approach (2nd Ed). Hoboken, New Jersey: Pearson Education
Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023) Paramedic Care: Principles and Practice (6th Ed) Boston, Massachusetts: Pearson
Brown, J. F. (1999) Ethics, Emergency Medical Services, and Patient Rights: System and Patient Considerations. Topics in Emergency Medicine 21 (1): 49-57 Accessed August 9, 2024
Harris, D. (2014) Contemporary Issues in Healthcare Law and Ethics (4th Ed). Illinois: Health Administration Press.
Iserson, K. V. (2006) Ethical Principles - Emergency Medicine. Emergency Medicine Clinics of North America 24(3): 513 - 545 Accessed August 9, 2024
Larkin G. L. & Fowler, R. L. (2002) Essential Ethics for EMS: Cardinal Virtues and Core Principles. Emergency Medicine Clinics of North America 20 (4): 887-911. Accessed August 9, 2024
Mistovich, J. J. & Karren, K. J. (2014) Prehospital Emergency Care (11th Ed). Hoboken, New Jersey: Pearson Education
Moskop, J. C. (2006) Informed Consent and Refusal of Treatment: Challenges for Emergency Physicians. Emergency Medicine Clinics of North America 24 (3): 605-618. Accessed August 7, 2024
National Association of Emergency Medical Technicians (2013) Code of Ethics for EMS Practitioners. Accessed August 7, 2024
Winston, B. & Moskop, J. C. (2014) A Review of the Updated NAEMT Code of Ethics. Journal of Emergency Medical Services 39 (6): 50-53 Accessed August 9, 2024
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