Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study

Abstract

BackgroundEmergency care providers regularly deal with ethical dilemmas that must be addressed. In comparison with in-hospital nurses, emergency medical service (EMS) personnel are faced with more problems such as distance to resources including personnel, medico-technical aids, and information; the unpredictable atmosphere at the scene; arriving at the crime scene and providing emergency care for accident victims and patients at home. As a result of stressfulness, unpredictability, and often the life threatening nature of tasks that ambulance professionals have to deal with every day, ethical decision-making (EDM) has become an inevitable challenge.MethodsThe content analysis approach was used to conduct the present qualitative study in Iran. The participants consisted of 14 EMS personnel selected through purposive sampling, which continued until the data became saturated. Data were collected using semi-structured interviews and analyzed concurrently with their collection through the constant comparison method.ResultsThe process of data analysis resulted in the emergence of 3 main categories “respecting client’s values”, “performing tasks within the professional manner”, “personal characteristic”, and the emergence of eight (8) sub-categories signifying participants’ experiences with regard to EDM.ConclusionAccording to the results, when EMS personnel are faced with ethical dilemmas, they consider the client’s values and professional dignity, and perform the assigned tasks within the framework of the regulation. The findings also suggest that pre-hospital care providers assess legal consequences before making any decision. Further studies should be conducted regarding the experiences of the subordinates and other related parties.

A Study of Pre-hospital Emergency Care Personnel's Perception of Ethical Dilemmas in the Field: a qualitative study

“…In the present study, one of the major ethical dilemmas, as perceived by pre-hospital emergency care personnel, is maintaining respect for the physical, sexual, and psychological privacy of the injured. A few other studies report similar results: showing respect for the physical, sexual, and psychological privacy of patients, including sick and injured individuals who are attended to by prehospital emergency care personnel in the eld, is a major ethical dilemma in providing care to this group [24,27,28].…”

“…These caregivers are the main source of support for the injured. Similarly, other studies point out that the healthcare personnel, including the pre-hospital emergency care personnel, overcome their uncertainty and follow professional ethics when confronted with dangerously infected patients [23,24].…”

Major Challenges and Barriers in Clinical Decision-making as Perceived by Emergency Medical Services Personnel: A Qualitative Content Analysis

“…Therefore, there is need for changes which will allow the employment of female personnel in emergency care. On a similar note, the results of the study of Torabi et al (2020) show that, from the viewpoint of pre-hospital emergency care personnel, maintaining the physical and sexual privacy of patients is among the key aspects of clinical and ethical decision-making [25].…”

The informational privacy of patients in prehospital emergency care—Integrative literature review

“…The data collection methods used were interviews (Bartlett et al, 2011;Kingswell et al, 2015;Tate et al, 2016;Torabi, Borhani, Abbaszadeh, & Atashzadeh-Shoorideh, 2018, observations (Adams et al, 1992;Mlinek & Pierce, 1997;Steele et al, 2016) and…”

“…Storing was good due to the electronic patient record system, although temporary storing of patient records required improvement (Koskimies et al, 2020). In addition, the patient's sensitive information was protected during consultations (Torabi et al, 2018;Valenzuela Espinoza et al, 2016…”