Open AccessEthical Dilemmas with Little Time for Reflection: A Discussion of the Ethics of Out-of-Hospital Refusals
Author(s) -
Bryson Galozo,
Blair J. MacDonald
Publication year - 2021
Publication title -
australasian journal of paramedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.177
H-Index - 15
ISSN - 2202-7270
DOI - 10.33151/ajp.18.909
Subject(s) - beneficence , autonomy , paternalism , ethical dilemma , context (archaeology) , dilemma , psychology , ethical decision , impartiality , engineering ethics , social psychology , epistemology , political science , law , philosophy , paleontology , biology , engineering
In this article, we consider an approach for ethical decision-making for refusals in the out-of-hospital environment. Autonomy and beneficence are discussed as the two ethical principles central to guiding paramedic decision-making in this context. We describe some situations where the two principles may come into conflict and where the working paramedic may be faced with an ethical dilemma. These cases may involve temptations of medical paternalism, which we argue ought to be avoided if possible. A discussion on navigating between autonomy and beneficence will be presented in order to help paramedics sort through dilemmas when these principles conflict. We argue that when these principles are in conflict, autonomy should primarily be respected – however, we will examine situations where the principle of autonomy cannot be applied and the paramedic should either attempt to rectify the patient’s capacity for autonomous decision-making, or, if not possible, proceed with the principle of beneficence.