OK, fellow forumites - I need some help.

At EMS TODAY, someone who heard my presentation on leadership said "You should do a talk on ethics in EMS - not the medical stuff, but the other stuff."

What do you think "the other stuff" involves? What are the non-clinical ethical issues that are important in the EMS industry, as it stands today?

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I guess we're talking about purchasing and business management?

- Choosing equipment/drugs because of cost rather than clinical benefits, retaplase over tenectaplase 

- System Status Management - Deciding which ambulance goes where, why is one neighbourhood more than the other

- Employee's: Recruitment of/meal breaks...physical safety - lone workers

I am very intrigued, it would be a very interesting lecture and discussion on issues like these

Hiring and firing practices.  There are a lot of ethical issues that involve HR.  And as I type this, two words come to mind that I know you are passionate about: background checks.

nepotism, favoritism in hiring processes, and after, poorly qualified leader/manager promotions, just to name a few

The primary goal, I think, is to treat patients the way we would want our families treated. The challenge is to itemize the steps needed to accomplish that, then determine how we can best implement those steps safely and cost-effectively.

For me to embrace that goal, I should come to work alert, on time, in a service-oriented frame of mind, knowing what I'm supposed to know to deliver any aspects of care within my scope of practice. I won't be able to achieve the latter without effective primary and continuing education, an element of which is appropriate reinforcement. Such reinforcement should be based on objective evaluation of my performance.

I can encourage others to achieve the primary goal by demonstrating, through my practice, the importance of that goal to me.

Ethical treatment of employees comes to mind, I believe that as administrators we tend to focus so much on the mission and the patient (obvious reasons) that we tend to forget those who carry out that mission.

The phrase "Mission First, People Always" (Tim Holman) says it best

Just a thought, maybe off base.

I don't think off base at all, Eric.  But could you amplify and clarify?  How might EMS employees be treated unethically?


We all have personnel that challenge the status quo (for the good), and in some cases i have witnessed that those individuals get black balled. For what ever reason; they did not propose an idea in the correct format , they are pushy with the ideas, their personality rubs the leader the wrong way etc. (that by the way make perfect sense) thus they are dismissed as trouble makers and ignored, this gives the appearence that the administrator or first line supervisor is threatened and there for treats the individual with disparity and discontent, extreme cases isolation with out cause (unethical)

Now there are alot of variables, was policy for proposing inovations followed etc. My opinion is reardless of a leaders personal opinion of an individual, it is that leaders (administrator) responsibility, oblgation to treat all personnel with respect.

Question? do you feel that ethics ar generational? (what was viewd as being ethical by say baby boomers is different for gen. exers?

Does this make sense?

Thanks, Eric.

I think that there are generational differences in ethics, at least the way they seem to play out.  I'm not sure why that is, but it's interesting to observe and ponder.....

Regardless of how generational differences in ethics might be perceived, there have always been issues where egos get in the way of an open-minded look at doing the right thing, and there have always been non-clinical ethical EMS issues by any yardstick by which eithics are measured.


One example us the chronic bouncing paychecks on which I was supposed to support myself when I worked for a particular private EMS provider.  I consider paying your employees with worthless checks to be an ethical issue, since the employer is not keeping the promise to actually pay the employee for value received.



Ethics in EMS is a very interesting topic because it is rarely addressed. There is a code of ethics you are supposed to honored for medical issues, but nothing has never being attended properly regarding management, leadership, commradship, and so on, ever, which is also important for the industry and ourselves as human beings and professionals. It is related to our day to day life in our jobs, and the way we might feel and perform as an outcome of management and leadership issues. The success of a whole organization is based upon it´s ability to perform according to it´s people, the way it is managed, it´s ressources, planning, and how the leadership uses it all. Motivation may come as a way of doing things, right or wrong, and ethics should rule as a standard to motivate people in the right pad.  

This is a great discussion. I feel the one question we should all be asking is simply "how do we best serve the public?" One example I like to ponder is what are the ethical implications of say 24-48 hour shifts? Is it bad for  the public for us to be constantly sleep deprived and overworked for the sake of our own schedule. That's just an example, there are countless other issues (fire based services, billing, etc.) where we make decisions based on what the agency down the street is doing, or what makes life easier for us rather than whats best for the public.

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