Primary Care Paramedic Ethics
Published 15 Feb 2017
The issue on the ethics on life in medical terms is a long topic to debate on, for one, it conflicts with morality, religion and the law. Morality and religion speak the same language on the issue of life, while the medical side tries to separate morality from the law. It is hard to separate the two considering there are things that have to be aptly considered (Brock 124). How does ethics come into play in the decision making of the paramedic practitioner in the out-of-the hospital environment? Morals relate to the standards of the society, while the standards of ethics relate to the standards of the individual.
Ethics, according to Haskeu (22) “involves the construction of a personal code, it also implies a measure of self examination and reflection of one’s practice”. That is why if there should be issues or questions that need to be answered, it must be answered on the basis of reason.
There are three questions of ethical tests in health care, the first one is, What is it in the patient’s best interest? Second, what does the patient want? Third, what role does good faith play in making an ethical decision? This aims to provide patient benefit, avoiding harm and respecting the patient’s autonomy. But the ultimate question for ethics is what makes human life valuable? In particular, why is it more valuable than any other form? How can we determine value? There is no doubt in the essence or significance of the human being. Given the dilemma between a dog and man, we choose to save man because we think it is the right thing to do. I agree with Harris, who wrote “The value of life” when he said that there is no prejudice in the preference for human life, it is just that we know that it is the right thing to do.
But in the case of the choosing between two human beings, this is quite hard to decide upon, the predicament involved here are two supreme beings that is either bound to die or to live. Harris points out also, that abortion (to some countries may be legal) may be tolerable given that the mother would be free of harm and the fetus might be considered as less of the human adult. What is pointed out is that, adults in our society will be of value (in the wider sense of productivity) than the fetus that’s why it is rational to choose the adult rather than the fetus. What makes the human life valuable are the features that “both incline us and entitle us to value ourselves and one another and which license our belief that we are more valuable (and not just to ourselves) than humans, fish or plants” (Haskeu 8) .
We are looking for the basis of the belief that it is right to save the life of the person rather than a dog which both cannot be saved for instance and in which this isn’t a form of unfair dislike or preference but is capable of a justification for the belief. The features possessed by human beings will not catalogue the difference between the human and other creatures, rather it will be pointed out of the features of their moral relevance, which only supports the belief of our preference of ourselves and the belief that it is right to treat people as the equivalent of the other and most specially the supreme being. But it is widely accepted for any medical person to do no harm.
“In order for someone to follow even this apparently unexceptional directive, it is important to have a lively sense of the ways in which his or her conduct may affect others. Although in many circumstances the scope of our individual or collective impact on the world is entirely unproblematic, there is an important dimension of conduct where this is not so. The problem is precisely whether or not we have two equally effective ways of determining the state of any world in which we are able to intervene. One is to intervene and to change the state of the world, the other is to refrain from intervention and leave everything as it is”. This is what I am pointing out that it is really hard to debate on the ethical stand of medical people regarding for example killing, letting people die and acts and omissions. The difference between positive and negative ways of influencing the society can be seen in many ways and in each case, the obvious thrust of the distinction and the definition of the terms might be slightly different. We can sometimes choose to make things happen and sometimes we tolerate to let them occur. A simple “omission to act may bear a different construction than an empathic neglect of an action. To make things complicated it is always possible to re-formulate any action description or any omission description so that each becomes the other. On the negative side, Harris (8) cites an example that suppose a person can save your life by telling a lie, for example saving you from a capital crime, then saving your life is something that person has done and for which he must take responsibility. On the other hand, if that person told the truth and as a result became the cause of your death, that person is still similarly responsible. But if that person knew his silence can save you and knowing this he keeps quiet, then “those who deny the existence of negative responsibility must believe that I have not in these circumstances saved you at all” (Haskeu 72).
Then conversely, if that person could save your life by speaking but still chooses to remain silent, he cannot be held morally responsible for your death. Those who deny negative responsibility would have to recommend lying to those who wish to save others in such circumstances; and needlessly, since keeping silent and telling a lie are both equally effective ways of saving lives.
Harris (9) used the term person in lieu of human being in his book “The value of life”. He sees the importance of having a word or a term for beings “which is not simply anthropocentric or species-specific” Person for him, would stand for any being who has what it takes to be of value in the sense described and to refer to as species neutral. On the contrary, another author conversely debates on the exact opposite of what Harris is saying. Brock (123), says that “on the aspect of taking lives, it is by now familiar to distinguish moral theories according to whether their basic principles are formulated in term s of rights, goals and duties. He takes the fundamental principle of morality to be “impermissible not to respect every human being, one’s self or any other, as a rational creature”.
Brock (124) stretches the importance of the necessity of looking at issues more broadly and also to the areas of research that often explicitly address the quality of life but nevertheless has an important bearing on it. There are two main areas of work in the medical ethics. The first is the ethical framework for medical treatment decision making in the clinical context. The second is the development of valuation measures of outcomes of health care treatments and programs.
But what do we consider in saving a man’s life? Does he need to be good guy? The smart and talented guy? The famous? The weak? The old? In the case of the two patients in a remote highway, I think that the person to be saved is the 17 year old delinquent. One because he is young and that he has a lot to do in this world after the incident, Two because there is the chance of his character transformation or a chance for change in a narrower sense and Third, there a lot of lessons that he needs to learn.
After the incident, the chances might be crucial for change but at least, he has been given the chance to live his life. There are still a lot to be traveled by and like what I have pointed out earlier lessons that should be considered. While the 92-year old retired police officer also deserves the right to live, we must remember that it is important also to know whether the patient wants to be resuscitated. The police officer has done a lot of great things for his country but he is old and therefore weak. I am confidently claiming that with him is a hero’s heart (based on the given information). He has done several advocacies, thatis why it may be open to scrutiny also if he does accept resuscitation. Surely, he has completed his life, his dreams and goals in life have been achieved and he feels satisifed over what he has attained.
Moreover, my decision is influenced by Harris’ (124) idea of the basis of value. We value something based on the features of the being/person and what it can offer to society. The dilemma between the juvenile and the old man is like the dilemma on choosing between a dog and the man. Apparently, the old man has a lot more importance to society than the dog, thus, it is necessary to chose the old man rather than the dog. The existence of the juvenile after the accident (may or may not) result positively but his existence may be given a chance for change and to direct his life into more possibilities.
Therefore, by choosing to revive him, we not only give him the chance of having another life ahead of him, but also looking at the possibility of him sharing and touching other’s lives, by probably sharing what he could share to either co-delinquent or his experiences may serve as a lesson and an inspiration to all. Unlike the old man, we all know that his life might anytime come into an end most specially after the incident, just in case he was revived, we are uncertain of the result since he may be weak. His life then might be useless (objectively speaking) and might not be of help to other people though he has a good heart and we might be certain of his character after. The lesson that we should all remember here is not the issue on the value of a person as we are all equally given the chance to live. Rather, on the issue that we cannot debate on the ethics on morality, the ethics on medical treatment, religion and the law, all these aspects are all correct in different perspectives, it is all up to us on how to react and which aspect to espouse to. It is just a matter of respect for opinions and which concern to adhere to.
- Brock, Dan W. (2005) Life and Death. Cambridge University Press, p. 123-124
- Harris, John (2007) The value of Life: an introduction to medical ethics, p. 8-9
- Haskeu, Guy H. (1975) Paramedic Pearls of Wisdom, p. 8,22-23,72