Ethics
Published (updated: ).
Ethics represents the moral code that guides a person’s choices and behaviors throughout their life. The idea of a moral code extends beyond the individual to include what is determined to be right, and wrong, for a community or society at large.
Ethics is concerned with rights, responsibilities, use of language, what it means to live an ethical life, and how people make moral decisions. We may think of moralizing as an intellectual exercise, but more frequently it’s an attempt to make sense of gut instincts and reactions. It’s a subjective concept, and many people have strong and stubborn beliefs about what’s right and wrong that can place them in direct contrast to the moral beliefs of others. Yet even though morals may vary from person to person, religion to religion, and culture to culture, many have been found to be universal, stemming from basic human emotions.
Applied ethics is the application of morals and beliefs to various subjects. Would it be ethical to assist a patient in suicide? The answer, as of today, is clearly no. However, could these values change in the future leading to the promulgation of an entire new ‘assisted suicide’ industry?
The EMS motto is ‘Do No Harm’. The motto comes from the Hippocratic Oath. In the past, doctors had to take the Hippocratic oath after completing medical school. As an important step in becoming a doctor, medical students must take the Hippocratic Oath. And one of the promises within that oath is “first, do no harm”.
The Hippocratic Oath
I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract:
To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others.
I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
In purity and according to divine law will I carry out my life and my art.
I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.
Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.
Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.
So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate.
Hippocrates
Dr. Charles Gillespie from Albany Georgia contributed greatly to the early days of EMS, and especially in Georgia when he wrote the Code of Ethics for EMS Practitioners and the EMT Oath:
Code of Ethics for EMS Practitioners
Professional status as an Emergency Medical Services (EMS) Practitioner is maintained and enriched by the willingness of the individual practitioner to accept and fulfill obligations to society, other medical professionals, and the EMS profession. As an EMS practitioner, I solemnly pledge myself to the following code of professional ethics:
To provide services based on human need, with compassion and respect for human dignity, unrestricted by consideration of nationality, race, creed, color, or status; to not judge the merits of the patient’s request for service, nor allow the patient’s socioeconomic status to influence our demeanor or the care that we provide.
To not use professional knowledge and skills in any enterprise detrimental to the public well being.
To respect and hold in confidence all information of a confidential nature obtained in the course of professional service unless required by law to divulge such information.
To use social media in a responsible and professional manner that does not discredit, dishonor, or embarrass an EMS organization, co-workers, other health care practitioners, patients, individuals or the community at large.
To maintain professional competence, striving always for clinical excellence in the delivery of patient care.
To assume responsibility in upholding standards of professional practice and education.
To assume responsibility for individual professional actions and judgment, both in dependent and independent emergency functions, and to know and uphold the laws which affect the practice of EMS.
To be aware of and participate in matters of legislation and regulation affecting EMS.
To work cooperatively with EMS associates and other allied healthcare professionals in the best interest of our patients.
To refuse participation in unethical procedures, and assume the responsibility to expose incompetence or unethical conduct of others to the appropriate authority in a proper and professional manner.
To conserve life, alleviate suffering, promote health, do no harm, and encourage the quality and equal availability of emergency medical care.
by Charles B. Gillespie, M.D.
EMT Oath
Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel. Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.
I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.
While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot.
So help me God.
by Charles B. Gillespie, M.D.
Another model for EMS behavior is ‘good faith’. Doing something in good faith implies that there is honest intent to act without taking an unfair advantage over another person or to fulfill a promise to act, even when some legal technicality is not fulfilled. The term is applied to all kinds of transactions. Similar to good faith, is doing something in the patients’ best interest. The main difference between doing something in good faith and in the best interest of the patient is a requirement to knowing what to do. In other words, sometimes bad things happen, but the EMS crew is defended by the idea that they were acting in good faith. When doing something in the best interest of the patient, small details that were not procedurally correct would be overlooked.
