Medics with guns: The cost of a pulled trigger

What is the cost of a pulled trigger?

In part one of this article, I explored the background of the increasing violence involving EMS responders and raised the issue of whether the time has come to consider arming, or allowing EMS providers to carry a firearm. Let's now talk about what this might all mean.

The cost of a pulled trigger
The issue of liability was addressed in the Dayton Daily News article and the response was simple enough: the agency could wind up in court at any time for their actions and this is no different.

Well, legally speaking, it's a little different.

Where an armed EMS provider pulls the trigger in the face of an actual, verified grave and imminent threat to himself (or herself), the provider will likely prevail in the inevitable lawsuit.

However, to most people and certainly to most juries, "grave," "imminent," and "threat" are rather subjective.

What happens when a provider pulls the trigger because the subject was "going for his waistband"? What happens when the gun was actually a detached hose nozzle? And heaven help the Caucasian provider who pulls the trigger on any non-Caucasian kid with a toy.

These are the kinds of issues and lawsuits that police departments face all the time and they pay for it through extortionate insurance premiums, exorbitant legal fees, and abysmal public image problems; problems most EMS agencies are not equipped or funded to manage.

The duty vortex
Two armed, rural-area paramedics are called to a private residence for a man complaining of abdominal pain. The next closest ambulance is 45 minutes away. They arrive, enter the home and find it was a ruse; the two are held at gunpoint and the man demands free satellite TV for the three women whom he has held captive in the basement for that last five years. At an opportune moment, one of the paramedics draws his concealed weapon and double-taps the man center mass. The man drops to the floor, gasping for air and bleeding out.

  • Do the paramedics, now reeling from the experience, have a duty to perform advanced life-saving treatment for the man one of them just shot?
  • Or do they secure the suspect and the crime scene for law enforcement?
  • If they treat the man and contaminate the scene, are they liable for a subsequent inability to prosecute?
  • If they withhold treatment are they liable for circumventing the duty to act?
  • If they provide harmfully improper treatment because of the PTSD, are they liable for negligence?

As you can see, the simple idea of arming EMS providers is rife with perils, pitfalls, complications, and unintended consequences – both legal and ethical.

The solution
The world has changed; maybe it seems that the time for armed EMS providers may very well be upon us.

This will require careful, deliberate, and extraordinarily thoughtful reflection on what adding this new tool would mean to your agency and to your community, not just emotional knee jerk reactions.

In some places, maybe a simple response policy alteration is the answer. In others, maybe combining services – police & EMS – is the way to go. In others still, maybe it is finally time to lock and load and reshape EMS.

No matter where you are, the world is changing and you, we, must change with it. As your advocate, I ask only this: change only that which requires changing and only for reasons of advancing and improving EMS. Change for the sake of change has always been a recipe for failure.

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