Thomas Meyer, BS EMS Former Regional Training Coordinator Southern - - PowerPoint PPT Presentation

Thomas Meyer, BS EMS Former Regional Training Coordinator Southern Region EMS Council

Define EMS Ethics Evaluate examples for their ethical merit Talk about Sex Talk about Drugs Talk about Rock and Roll Discuss the concept of gratuity and its ethical implications

Principles or habits with respect to right and wrong conduct. Defines how things should work according to an individual’s ideals and principles. Simply put, morality and moral actions come from inside each of us.

The rules of conduct recognized in respect to a particular class of human actions or a particular group, culture, etc… It defines how things are according to the rules. Ethics and ethical actions are defined by the social system that is present.

ETHICAL

We are ethical because

• ur society demands us to

be ethical. If we fail to be ethical we face:

Peer/Societal disapproval Losing our job Going to jail

MORAL

We are moral because we believe in something being right or wrong. If we fail to be moral we face:

Self‐recrimination Depression Moral Crisis

The following movie clip contains profanity. If you are offended, I am sorry. I did not alter the content of this clip. It is how it appears in the film.

When viewed in the extremes of the heroin

• verdose from “Bringing out the Dead” or the

Tiananmen Square video, ethics and morality tend to be in alignment. The patient with the DNR tattoo, not so much Morals tend to be consistent and stable Ethics are determined by the masses and can be fluid.

You can be completely ethical and be totally amoral. A moral person may choose to follow a looser code of ethics to be socially accepted.

Who determines the moral character of an individual? Who sets the EMS morals of an EMT? What social system exists to set EMS ethics?

There are great examples of moral/ethical conflicts in your everyday practice

Working a “full code” on a 99 year old elder Talking people out of going to the hospital by ambulance Not completing mandatory reporting incidents or suspicions of such How about hazing the new guy?

Known link between traumatic situations and sex drive. Florence Nightingale effect Transference

It is generally considered unethical to engage in a relationship with a patient. This is less of a problem for EMS than for clinical providers. What about after they are done being a patient? If you are doing your job right, you already have their phone number, address, medical history…

Who needs Eharmony?

It’s poor form to ask out the daughter of the heart attack patient you just treated.

This is more flexible Fraternization Success = good, Failure = real bad However, there are many examples of successfully starting a relationship

Partnerships in EMS are incredibly powerful bonds. Be careful muddying the waters. Can cause huge, huge conflicts. Not to mention conflicts of interest.

NO GUNS NO STETHOSCOPES NO HOSES

Cigarettes Alcohol Diversion

I really wanted to show you a picture of an EMT in uniform smoking. I have no right to talk. Hypocrisy. Why do we smoke?

It’s fun? It’s stress relief? It’s expected?

Drinking allows some to blow off steam Drinking to excess is rampant Alcohol abuse vs. Dependence

Abuse is drinking to excess that causes an issue Dependence is problem drinking AND withdrawal symptoms

You are treating a patient with chest pain. You have given NTG with no relief. You administer Morphine IV, as a result the patient’s BP spikes, CP increases, ST elevation increases. What’s going on?

Diverting drugs is a big deal Betrayal:

Fellow providers Patient Management Medical director Public trust

Someone who uses drugs or alcohol and it interferes with their practice No impaired provider program in Alaska No reporting or tracking

Except MICP

Transporting a 94 y/o Male with a complaint of urinary retention. History of invading Iwo Jima. Patient is placed on gurney, in unit and patient’s wife is placed in the passenger seat of the ambulance. Where she is met with…

How about when cruising around? How about when in the station? We are basically walking, driving billboards.

The local movie theater, as an act of appreciation, gives two free movie tickets to each licensed/certified EMT, once a month. You and your buddy and your significant others, (4 people total) approach the ticket booth and collect your four free tickets. The person behind you states “I wish I were cool enough to get free movie tickets for doing my job.”

Is accepting free things right? Is accepting discounts right? Does it matter if you are paid or volunteer?

To be nice? To “graciously accept the goodwill of the giver?” For yourself? Harford County Maryland –

Bel Air VFC

The Baltimore Sun, Colin Campbell –

“Such freebies are as old as jokes about police and doughnuts — and cups of complimentary coffee. Many restaurants and convenience stores give uniformed police and firefighters discounts to thank them for their service — and even encourage them to frequent the establishments and provide unofficial security. Some have store policies that guarantee the perks. But police and fire supervisors say public servants must walk a narrow line to ensure that such courtesies don’t create an expectation of preferential treatment on either side.”

EMS has difficulty doing research, why? Star Trek hypothesis? EMS Driven Refusal.

Author, Father of Emergency Medicine

Am I doing this for my patient OR Am I doing this to my patient

Define EMS Ethics Evaluate examples for their ethical merit Talk about Sex Talk about Drugs Talk about Rock and Roll Discuss the concept of gratuity and its ethical implications

Star Trek: The Next Generation, Episode 109, “A Matter of Time” Paramount Television “Bringing out the Dead” Paramount Pictures “The Tank Man” CNN Further references available on request.