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11/9/2008
Ethics, the philosophy of right and wrong
Morality, defined by society, religion, personal conscience
Oath of Geneva, 1948
Code of ethics for EMTs – 1978
Always, what is best for my pt
Patient Autonomy
- Right to direct own care
- Decide end of life issues
- Decide when care should be stopped
Advanced Directives
- Living wills
- Healthcare proxy
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DNR
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Vary from state to state
- NY – once started, do not terminate care
- Some states require bracelet
http://www.health.state.ny.us/nysdoh/ems/policy/99-10.htm
What procedures are and are not preformed if the patient presents a DNR?
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Do not resuscitate (DNR) means, for the patient in cardiac or respiratory arrest, NO chest compressions, ventilation, defibrillation, endotracheal intubation, or medications.
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If the patient is NOT in cardiac or respiratory arrest, full treatment for all injuries, pain, difficult or insufficient breathing, hemorrhage and/or other medical conditions must be provided.
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Relief of choking caused by a foreign body is usually appropriate, although if breathing has stopped, ventilation should not be assisted.
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CPR must be initiated if no Out of Hospital or facility DNR is presented. If a DNR order is presented after CPR has been started, stop CPR.
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For unusual situations or questions on individual patient circumstances, contact medical control.
Medics always accountable to;
- Patients
- Medical Director
- EMS system
Meet expectations of the community
