1. Presentation Title Presentation Subtitle

2. Lecture outlines 1. Ethics 2. Morals 3. Law 4. Advanced Directives

3. Introduction 1.Almost 15% of ALS calls in an urban system generated ethical conflicts. 2.EMS providers reported ethical problems regarding patient refusal of care, hospital destination and advance directives.

4. Ethics versus morals  Ethics and morals are closely related concepts but distinctly separate.  Morals: are the social, religious, or personal standards of right and wrong  Ethics: are the rules or standards that govern the conduct of members of a particular group or profession.

5. Medical ethics or bioethics  Medical ethics are also known as Bioethics.  Medical ethics : are ethics related to the practice and delivery of health care.  Your understanding of medical ethics Must Be consistent with the general codes of the health care professional.

6. Ethical codes of the EMS profession Many Ethical Codes for health care professionals have existed throughout history. 1.Oath of Geneva. 2.The Code of Ethics for Emergency Medical Technicians. 3.ICARE program.

7. The oath of Geneva  Drafted by the World Medical Association in 1948.  Taken by medical students upon completion of their studies, when they are about to enter the medical profession.

8. The Code of Ethics for Emergency Medical Technicians  Issued by the National Association of Emergency Medical Technicians in 1978  Still in use.  Under this code the paramedic is obligated to the following:

9. 1.Conserve life, alleviate suffering, and promote health. 2.Provide services based on human need, with respect for human dignity, unrestricted by considerations of nationality, race, creed, or status. 3.Not use professional knowledge and skill detrimental to the public good.

10. 4.Respect and hold in confidence all information obtained in the course of professional work unless required by law. 5.Understand and uphold the laws of citizenship, particularly when working with other citizens and health professionals in promoting efforts to meet the health needs of the public. 6.Maintain professional competence, and demonstrate concern for the competence of other members of the medical profession. 4.Respect and hold in confidence all information obtained in the course of professional work unless required by law. 5.Understand and uphold the laws of citizenship, particularly when working with other citizens and health professionals in promoting efforts to meet the health needs of the public. 6.Maintain professional competence, and demonstrate concern for the competence of other members of the medical profession.

11. 7.Assume responsibility: in defining and upholding standards of professional practice and education and for knowing and upholding laws that affect the practice of emergency medicine. 8.Have the responsibility to participate in the study of and action on matters of legislation affecting the profession and emergency service to the public. 7.Assume responsibility: in defining and upholding standards of professional practice and education and for knowing and upholding laws that affect the practice of emergency medicine. 8.Have the responsibility to participate in the study of and action on matters of legislation affecting the profession and emergency service to the public.

12. 9.Adhere to standards of personal ethics that reflect credit upon the profession. 10.May contribute to research in relation to a commercial product or service, but does not lend to professional status to advertising, promotion, or sales. 11.Advertise professional services within the conformity and dignity of the profession. 9.Adhere to standards of personal ethics that reflect credit upon the profession. 10.May contribute to research in relation to a commercial product or service, but does not lend to professional status to advertising, promotion, or sales. 11.Advertise professional services within the conformity and dignity of the profession.

13. 12.Does Not delegate a service to a person less qualified. 13.Work harmoniously with, and sustain confidence in, all members of the health team. 14.Refuse to participate in unethical procedures, and assume responsibility to expose incompetence or unethical conduct in others to the appropriate authority. 12.Does Not delegate a service to a person less qualified. 13.Work harmoniously with, and sustain confidence in, all members of the health team. 14.Refuse to participate in unethical procedures, and assume responsibility to expose incompetence or unethical conduct in others to the appropriate authority.

14. The ICARE program  Developed by a group of EMS students and educators  Incorporates many of the finest qualities of EMS professionals  ICARE: integrity, compassion, accountability, respect, and empathy  Incorporate “ICARE” into the care you provide to you patients.  Developed by a group of EMS students and educators  Incorporates many of the finest qualities of EMS professionals  ICARE: integrity, compassion, accountability, respect, and empathy  Incorporate “ICARE” into the care you provide to you patients.

15. Solving ethical dilemmas  Regardless of the ethical circumstances you may encounter, apply three basic ethical concepts when making a decision: 1.First to do no harm. 2.To act in good faith and act in the patient’s best interest 3.Paramedics must be accountable for their actions at all times.