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Acceptable Limitations on Paramedic Duty to Treat During Disaster: A Qualitative Exploration

Published online by Cambridge University Press:  09 October 2018

Erin Smith ,
Frederick M. Burkle Jr. ,
Kristine Gebbie ,
David Ford  and
Cécile Bensimon
Erin Smith*
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, Joondalup, WesternAustralia James Cook University, College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, Cairns, Australia
Frederick M. Burkle Jr.
Affiliation:
Harvard Humanitarian Initiative, Harvard University and Harvard T.C. Chan School of Public Health, Cambridge, MassachusettsUSA Woodrow Wilson International Center for Scholars, Washington, DCUSA
Kristine Gebbie
Affiliation:
College of Nursing and Health Sciences, Flinders University, Adelaide, SouthAustralia
David Ford
Affiliation:
Edith Cowan University, School of Medical and Health Sciences, Joondalup, WesternAustralia
Cécile Bensimon
Affiliation:
Canadian Medical Association, Ottawa, Ontario, Canada
*
Correspondence: Erin Smith, PhD, MPH, MClinEpi School of Medical and Health Sciences Edith Cowan University 270 Joondalup Drive Joondalup, Western Australia, Australia 6027 E-mail: Erin.Smith@ecu.edu.au
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Abstract

Introduction

The Australian prehospital profession has not yet facilitated a comprehensive discussion regarding paramedic role and responsibility during disasters. Whether paramedics have a duty to treat under extreme conditions and what acceptable limitations may be placed on such a duty require urgent consideration. The purpose of this research is to encourage discussion within the paramedic profession and broader community on this important ethical and legal issue.

Methods

The authors employed qualitative methods to gather paramedic and community member perspectives in Victoria, Australia.

Results

These findings suggested that both paramedic and community member participants agree that acceptable limitations on paramedic duty to treat during disaster are required. These limitations should be based on consideration of the following factors: personal health circumstances (eg, pregnancy for female paramedics); pre-existing mental health conditions (eg, posttraumatic stress disorder/PTSD); competing personal obligations (eg, paramedics who are single parents); and unacceptable levels of personal risk (eg, risk of exposure and infection during a pandemic).

Conclusion

It is only with the engagement of a more broadly representative segment of the prehospital profession and greater Australian community that appropriate guidance on limiting standards of care under extreme conditions can be developed and integrated within prehospital care in Australia.

SmithE, BurkleFM Jr., GebbieK, FordD, BensimonC. Acceptable Limitations on Paramedic Duty to Treat During Disaster: A Qualitative Exploration. Prehosp Disaster Med. 2018;33(5):466–470.

Keywords

disastersduty to treatEmergency Medical Servicesparamedic
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 5 , October 2018 , pp. 466 - 470
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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References

1. Okie, S. Dr Pou and the hurricane – implications for patient care during disasters. N Engl J Med. 2008;358(1):1-5.Google Scholar
2. Gebbie, K, Peterson, PA, Subbarao, I, White, KM. Adapting standards of care under extreme conditions. Disaster Med Public Health Prep. 2009;3(2):111-116.Google Scholar
3. American Medical Association. Declaration of Professional Responsibility. Chicago, Illinois USA: American Medical Association. Adopted by the AMA House of Delegates, December 2001. http://www.ama-assn.org/ama/pub/category/7491.html. Accessed January 9, 2018.Google Scholar
4. Smith, E, Burkle, FM, Gebbie, K, Ford, D, Bensimon, C. A qualitative study of paramedic duty to treat during disaster response. Disaster Med Public Health Prep. April 2018.Google Scholar
5. Glaser, BG, Strauss, AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. New York, USA: Aldine; 1967.Google Scholar
6. Glaser, BG. The future of grounded theory. Qualitative Health Research. 1999;9(6):836-845.Google Scholar
7. Locke, K. Grounded Theory in Management Research. London, UK: Sage Publications; 2001.Google Scholar
8. Straus, SE, Wilson, K, Rambaldini, G, et al. Severe acute respiratory syndrome and its impact on professionalism: a qualitative study on physicians’ behavior during an emerging healthcare crisis. BMJ. 2004;329(7457):83.Google Scholar
9. Strauss, A, Corbin, J. Grounded Theory in Practice. Thousand Oaks, California USA: Sage Publications; 2007.Google Scholar
10. Emanuel, EJ. The lessons of SARS. Ann Intern Med. 2003;139(7):589-591.Google Scholar
11. Bensimon, CM, Tracy, CS, Bernstein, M, Shaul, RZ, Upshur, REG. A qualitative study of the duty to care in communicable disease outbreaks. Soc Sci Med. 2007;65(12):2566-2575.Google Scholar
12. Sokol, DK. Virulent epidemics and scope of healthcare workers’ duty of care. Emerg Infect Dis. 2006;12(8):1238-1241.Google Scholar
13. Bevan, JC, Upshur, RE. Anesthesia, ethics, and severe acute respiratory syndrome. Can J Anaesth. 2003;50(10):977-982.Google Scholar
14. Masur, H, Emanuel, E, Lane, HC. Severe acute respiratory syndrome: providing care in the face of uncertainty. JAMA. 2003;289(21):2861-2863.Google Scholar
15. Reid, L. Diminishing returns? Risk and the duty to care in the SARS epidemic. Bioethics. 2005;19(4):348-361.Google Scholar