In a recent EMS1.com column, W. Ann Maggiore wrote about the declining ethics in EMS. In her article, she wrote, “Although 9/11 made us all heroes, we are making ourselves fools by our behavior.” One such example of what Maggiore is talking about is a La. EMT who allegedly stole money from an unconscious man while responding to an emergency call. The alleged act was caught on surveillance cameras and criminal charges have been filed. (Full Story)
With this issue once again front and center, EMS1.com asked its readers about the state of EMS ethics. We posed the question: Are things getting worse or are incidents like this inevitable?
Here are some of the replies we received:
Unless a review of news articles on ethical crimes in EMS reflect a scientific study, Maggiore’s article appears more to be a personal opinion on Public vs. Private EMS rather than a fact-based study on the decline of ethics.
What I read in her article reflects a “when I was young” syndrome and it surely does not represent what is going on in EMS today. Historically, only a small group of people become EMTs because they’re passionate about the profession. The majority seems to be attracted to it because of ulterior motives, be it the thought of driving fast or the prospect of getting to a profession where ambulances are of lower importance. Either way, these folks eventually fall by the wayside to be replaced by the next group. After a few cycles, the older professionals stop assuming that everyone else shares the same passion they have but fail to realize that their excitement in the beginning of their careers and their assumption that everybody else shared the same excitement prevented them from looking objectively at the field all along.
The same goes for the statement about the lack of new leadership. Not finding new leadership is strictly the result of not looking after the older folks retired. Major current forces like Brian Bledsoe and Nadine Levick are a few great examples of people who currently force us to take a good look at ourselves. Standards of medical care now include CPAP, 12 leads, pain management, PALS and data based review in care.
In our private company, where over 150 professionals hold an EMT or better certificate, high ethical standards are alive and well, thank you. People still fill out their own timesheets honestly, replace their own medications without sharing them amongst themselves and are entrusted with the care of over 40,000 patients a year. Accusations of stolen wallets, jewelry, glasses and dentures are quickly resolved. Patient advocacy is better than I can remember in the past, and although there have been cases of theft, falsification of timesheets and vandalism in the past, as can be expected in any large organization, incidents like these are few and far between and have actually decreased rather then gone up in the last five years, with nobody prosecuted in 2006 and the largest problems in the late 80s, when the company was a fraction of its current size, and I thought that everybody was as passionate about EMS as I was.
— Herb de la Porte, VP, LifeCare Ambulance, Inc
I have seen some EMSers do terrible things, but I teach quite a few really new ones, and I am seeing a ton of really special young people joining us. You can see their passion, and you can see the lights go on in some of them when you talk about serving people. But I do think there needs to be some selection process, even for students. I think when somebody is born with the right gifts, that transcends all the generational categories (Gen X, Gen Y, Tweeners and so on) we’ve applied in recent years.
I think it makes a big difference when we tell people the truth up front, though, about what EMS is really about and what they will really be doing as EMTs. I think the Pennsylvania State “Bad-ass” recruitment website is a pathetic and very clear example of why we get ourselves into trouble.
— Thom Dick
Anyone who steals or takes advantage of patients should be criminally charged and prosecuted to the full extent of the law. It’s absolutely disgusting and we as EMS professionals should not need to be having this discussion. The public puts their trust in us and we should not destroy that trust.
— Charles Phillips, REMT-P (Ret.), University of Missouri Health Care, SICU/BICU
Things are not getting worse. I do not believe that the members of the EMS community have changed. They are honest, caring and go out of their way to protect their patients. I believe that the media now has the power to spread the news farther and faster, and stories like this and other high profile crimes are used to sell media. Get attention. Nobody would read DULL.
— Joe Coren
I believe there have been major societal changes over the last 30 years that are affecting the workplace, not just EMS. Many of the things that used to be learned early in life are missing, especially social responsibility. In addition, supervisors in the past had some military background. This gave them an enormous advantage in providing leadership to young people and an understanding of espirit de corps and teamwork. The employee understood that how they performed their job would impact everyone, not just themselves.
— Joan Hillgardner, Paramedic, New York City
I don’t know if ethics are on the decline. I don’t know what it was like over 10 years ago. I DO know that some of us are very professional and proud of our jobs and ourselves. I DO know that ethics are not taught or even covered in my CE. So when the tired paramedic with the bad back comes across some Demerol in the dead person’s home and thinks, “Well, he won’t be needing these,” the medic only has his own ethics to lean on. We can simply hope that they’re enough.
— Abi Brown
Ethics in EMS are no different than in any other profession. Just look at the number of police officers charged and with crimes up to and including murder under the badge. Just check out the school teachers convicted of crimes against students. We need to remember one thing, “We all hire from the same human race,” and the best we can do is to make sure that background checks are done on everyone we hire.
— Louis Cox
Ethics in EMS starts at the top of any agency’s command structure. I believe that if field providers are treated with respect by their managers, they are more likely to show the same respect to their patients. I think that incidents of unethical behavior are more likely to occur in systems where $10.00 an hour paramedics are partnered with $7.00 an hour EMTs who must post at street corners between calls. They are also more likely to occur in fire based systems with EMTs who would rather be on a fire truck than an ambulance and have managers who communicate that fighting fire is more important than EMS.
As long as EMS workers are told that they are not as important as their public safety and healthcare counterparts, that they are only names on a schedule that can be replaced and that a company’s bottom line is more important than quality patient care, these incidents will continue to give our noble profession a black eye. The solution starts with government funding for EMS, working conditions that will retain enough good people so that the bad ones can be weeded out and to simply be told that we are doing a good job once in a while.
— Bob Sullivan, Wilmington, DE
I am a career firefighter paramedic and EMS instructor with 24 years of experience. While I believe any EMS professional caught stealing from a patient should be fired and prosecuted to the fullest extent of the law, you get what you pay for. Salary and benefits for EMS providers are horrible, considering the huge responsibility and complexity of the job. If you want well educated, motivated and ethical people, you have to offer pay and benefits that will attract them. While many see fire service EMS as possessing some of the best pay and benefits, trust me, these benefits are being attacked every day and in some cases successfully eroded or taken away.
— James Dunkle, Strongsville Ohio
I believe one of the biggest problems in EMS is the lack of professionalism and the true desire to help other human beings. There are far too many EMTs and paramedics judging the people we help and determining the treatment and care level based on their own personal bias and opinions.
There are a lot of professionals out there that would like to have the right to refuse to help the homeless person, the pregnant teen, the intoxicated patient, the overdose or anyone else that doesn’t fit their criteria for people worthy of their assistance.
I personally don’t like getting up in the middle of the night for the Not so emergent call, but I always treat all my patients with the same care and respect that I would give my own children, parents or grandparents. There are too many people in this field because of the thought of excitement, the chance to know the story before your neighbor or just plain job circumstances, like firefighters required to be paramedics to work as firefighters.
These types of people are in the profession for the wrong reasons, and therefore their ethics and morals toward their patients are already compromised. If the future EMTs and paramedics would take the time to understand that not all people enter into this life with the same amount of love, respect, family, opportunities, self esteem, money or education, I believe their job would be based on patient assessments and what’s the best way I can help this person, and not what side of town they live on, the color of their skin or whether they have the intelligence to understand what is not being done for them.
So to answer your question, yes this is a growing problem. Solution to the problem: The skills we perform in the field, IV, intubation, med administration etc., this is just the tip of the iceberg. The skill of patient interaction, respect, morals and ethics is not a pass or fail aspect and maybe it should be.
— Dawn, EMT-I future EMT-P, Charles City, Iowa