A while back, when I wrote about the duty to act, I emphasized the idea that the duty to act only extends to “on-duty” medical personnel. In fact, my exact words were,
“If you are a trained medical professional and you are acting with an expectation of compensation you have a duty to act appropriately and within the scope of your training when called to assist with an emergency situation.”
I figured I should emphasize the idea that trained EMTs don’t have a duty to act when they aren’t being compensated for their services. This seemed to be the point of greatest confusion. I never thought much about making it clear that while you are on duty, working as an EMT, you are required to act.
I know … it seems painfully obvious. I thought so too. But over the past few weeks, there have just been a slew of stories that seem to fly in the face of the obvious.
First, there was the strange story of the UK paramedic who watched his EMT partner deliver a non-breathing child, didn’t call for any assistance, then watched her try to resuscitate the child. To his credit, he did drive her to the hospital while she continued the resuscitation attempt in the back.
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Steve Valdez only wanted to cash a check. In retrospect it seems so simple. The check was written to him from his wife’s account at Bank of America. He had two forms of ID, both with photos. The address on the drivers license was the same as the ID on the check (printed by Bank of America.) Bank of America thought differently.
Here’s the rub. B of A has a written policy that states if you don’t have an account at their bank you need to leave a thumbprint. You’ve probably seen those by now. Either you dab your thumb in an ink blotter or you use the fancy thumb scanner. But Steve Valdez doesn’t have any arms. And based on his inability to make a mark with his non-existent thumb, B of A refused to cash the check.
Clearly the bank representative thought that following the rules was the safest option. Instead of considering the needs of the customer, interjecting common sense into the matter, taking on a wee bit of personal risk on behalf of the individual being served and making a simple accommodation, the bank manager stuck to her guns. Rules are rules. And now the story has been picked up by the AP news wire and it’s everywhere.
Don’t laugh. It could happen to you. We all operate under multiple sets of rules and regulations from our written protocols to our national scope of practice to our organizations policy manual. We all are expected to apply a set of pre-established rules to our jobs in EMS. The question is how we perceive those rules. Do they trump basic common sense?
Do the prohibit us from acting in the patients best interest? When are we allowed to forgo the rules? If we decide it’s only in emergencies … well, were bound to encounter a lot of those.
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Did you know you had a code of ethics? You do.
It was writen by Dr. Charles Gillespie and adopted by the National Association of EMT’s in 1978. It probably 
appeared somewhere near the front of your EMT textbook. It may have been touched upon by your instructor during your medical / legal lecture. It’s less likely that you were ever ask to raise your hand and recite its words (or accompanying oath.)
Consider what it means to be ethical. Ideas regarding what it means to act ethically in the practice of medicine have been handed down from hard won lessons of human history. From the sacred pledge of the Hippocratic Oath to the tenants of the Declaration of Helsinki and the Nuremberg Code, medical ethics has evolved to deepen our understanding of what it means to be a moral provider of medical care.
Your patients place great trust in you because your authority rests on the honor and tradition of a code of medical ethics. In case you haven’t read it in a while, here is the EMT Code of Ethics.
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