This paper examines the ethical responsibilities of Emergency Medical Technicians (EMTs), with particular focus on the tension between the duty to conserve life and the principle of informed consent. Drawing on the 1978 EMT Code of Ethics, the American Hospital Association's Patient's Bill of Rights, and relevant legal and medical literature, the paper explores how EMTs navigate consent in emergency situations where patients are unconscious, intoxicated, mentally ill, or otherwise unable to communicate their wishes. It considers whether a more standardized ethical code would improve decision-making or whether the current flexible framework remains the most practical approach for a rapidly evolving field.
The paper demonstrates ethical juxtaposition: it holds two legitimate but competing principles (the EMT's duty to conserve life and the patient's right to informed consent) in productive tension throughout the argument, showing why neither principle can simply override the other in practice. This technique prevents oversimplification and reflects the genuine complexity of applied professional ethics.
The paper opens by establishing the importance of EMTs as first responders and introducing the 1978 Code of Ethics. It then unpacks the Code's core responsibilities before pivoting to informed consent as the central ethical dilemma. Subsequent sections examine legal frameworks, edge cases involving mentally impaired patients, and the limits of standardized codes. The conclusion argues that the flexibility of the existing Code is its greatest practical strength.
The medical field is populated with professionals whom non-medical individuals rarely think about every day, yet these professionals profoundly affect the care received — and in many cases the life or death — of individuals being treated by the medical community. People such as a radiology technician, a dietician, or even the assistant who delivers medications to patients can be integral to a patient's treatment and survival. Emergency Medical Technicians are often the first responders to a trauma or sudden illness and, as such, may represent a patient's only interaction with the medical community. In emergency situations, these individuals become especially important and, as a result, have more complex roles to play.
The role of the Emergency Medical Technician, or EMT, is highly involved and constantly evolving. What is considered proper procedure one day may change the next with advances and discoveries in medical science. One example is the renewed emphasis on protecting medical personnel from body fluids after the discovery of how HIV and similar fluid-borne diseases can be transmitted via mouth-to-mouth resuscitation or accidental blood contact. Almost overnight, the job description for EMTs was radically changed; protocols regarding gloves and mucous membrane protections were added to shield medical professionals from contracting newly discovered blood-borne diseases. In order to address specific issues in this atmosphere, the EMT Code of Ethics was established in 1978 and subsequently approved to help deal with the ethical dilemmas of emergency treatment (Gillespie 1978).
This shift in emphasis on fluid contact is only one example of the ever-changing world of EMTs. The nature of the field requires that its members constantly remain aware of their behaviors and keep their decision-making and problem-solving skills sharp. This paper examines how these factors play into the ethics of the emergency medical technicians' field, the situations and persons involved in the implementation of the EMT Code of Ethics, and the overall effect the Code has had on EMTs. Specifically, it examines the ethics surrounding informed consent to treatment and to certain research participation by an injured or ill individual who is unable to consent in disaster situations.
The first part of an inquiry into the ethics involved in the professional behavior of EMTs concerns their decision-making and problem-solving duties, which naturally dictate an EMT's behavior. An early portion of the Code of Ethics establishes that a fundamental responsibility of the Emergency Medical Technician is to conserve life, to alleviate suffering, to promote health, to do no harm, and to encourage the quality and equal availability of emergency medical care (Gillette 1978).
It is significant that this tenet of ethical behavior does not specify for whom the EMT is to perform these actions. In today's world of medical advances, to "promote health and alleviate suffering" could be interpreted as performing an action that benefits research in terminally ill or mortally wounded patients; to "conserve life" might mean donating one patient's organs to another patient in need of a transplant when it becomes obvious that the trauma victim being treated will not survive. All of these interpretations are feasible. It is up to the individual decision-making and judgment skills of the EMT to make the lightning-fast choices required.
Another critical aspect of the decision-making and problem-solving skills needed by EMTs concerns informed consent. Informed consent requires that a patient understand and agree to the medical procedures being performed. In cases of trauma or other emergencies where the patient is unable to respond, the AHA Patient's Bill of Rights exempts this requirement:
Except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and/or treatments, the risks involved, the possible length of recuperation, and the medically reasonable alternatives and their accompanying risks and benefits (AHA 1998).
The principle of informed consent is vital to the role of an EMT. Without it, a technician would not be required to determine whether the patient has an allergic or other adverse reaction to certain medications that would preclude their use, nor to account for cases where a patient has a religious objection to certain procedures, such as a blood transfusion.
Informed consent requires that these considerations be explained to and approved by the patient before medical procedures take place. In an emergency, however, this is not always feasible or even possible. An unconscious patient obviously cannot convey his or her wishes regarding certain medical treatments. The ethics of treating such patients becomes most ambiguous in life-or-death situations where experimental procedures could be the only means of saving the patient. Such procedures require informed consent, but when consent is impossible to obtain, how does the individual EMT decide whether to proceed with or deny the treatment? In evaluating this decision, it is important to recall that the EMT Code of Ethics imposes a "fundamental responsibility" to "conserve life" (AHA 1978).
This ethical juxtaposition — between conserving life by every possible means and carrying out proper informed consent procedures — has become one of the central dilemmas in the field today. This question faces not just EMTs but all medical personnel involved in treating emergency patients and disaster victims. Standard procedure allows EMTs to make this decision individually and at the time of treatment (Richardson 2005). Congress has legislated that emergency medical treatment is a special situation in which informed consent is not a prerequisite to performing medical research or experimental procedures to save a patient's life (ibid.).
You’re 54% through this paper. Sign up to read the remaining 3 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.