The Ethics of Real-Time EMS Direction: Suggested Curricular Content

Abstract

Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR). This requires a strong foundation in the principles and theories underlying sound ethical decisions that EPs and prehospital providers make every day in good faith, but will now also make with more awareness and conscientiousness. Brenner JM , Aswegan AL , Vearrier LE , Basford JB , Iserson KV . The ethics of real-time EMS direction: suggested curricular content. Prehosp Disaster Med. 2018;33(2):201-212.

Keywords: AD advanced directives; AHA American Heart Association; ALS Advanced Life Support; AMA against medical advice; CPR cardiopulmonary resuscitation; DNI do not intubate; DNR do not resuscitate; ED emergency department; EM emergency medicine; EMR electronic medical record; EMS Emergency Medical Services; EMT emergency medical technician; EP emergency physician; HIPAA Health Insurance Portability and Accountability Act; PHI protected health information; POLST physician orders of life-sustaining treatment; TOR termination of resuscitation; ePOLST electronic POLST; DNR; EMS; ethics; medical direction; refusal of treatment.