By Chris McFadyen
I OFTEN hear criticism of court decisions proffered by people who have simply read a report in the media, and I feel that you can never truly criticise a decision unless you were in court for the whole of the proceedings.
In the recent case of the two paramedics I was not in court, so I will not comment on the verdict given, but I understand that many of their fellow crew were indeed in court. I feel that this case raises wider issues which should be carefully considered.
My sympathies go out to those who lost a family member and, in particular, for a reported two-year wait for this to come to court. My sympathies also go out in spades to the two paramedics, who were faced with an aggressive patient to the extent that they had to call on the police to attend before they could assess and treat him. Sadly, I understand that this is a daily occurrence.
The fact that those paramedics have now been found guilty of failing to provide “reasonable care” to a patient who later died must raise concerns for all staff in our emergency services, both paid, voluntary and indeed for the public in general. Our paramedics, hospital staff and all emergency-service employees cannot go about their daily jobs, or indeed think clearly, while they have concerns for their personal safety. A zero-tolerance policy towards aggression from those who they are trying to care for must be an appropriate policy, although I am sure that some receive more tolerance than they deserve.
Previously in the United States, if a doctor saw an accident or a person in distress it was anecdotally reported that they would often quietly walk the other way. At that time, the culture was such that, if a person died, the family would often question the actions of their attending doctor – and might possibly sue them.
This culture was even extended to those with some basic knowledge of first aid or even none. This became such a problem that in the US a “Good Citizens Law” was introduced, so that anyone going to the help of someone injured or in distress could not normally be sued. Are we edging towards the need for a similar law in 鶹?
A serious incident can be very fast moving, with decisions having to be made immediately on the information available at that time. That information may change quite rapidly, but in many cases a decision has already been made and may be difficult to reverse.
Most in the medical profession, both paid and unpaid, use the acronym Dr ABC when they go into an emergency situation to treat someone. Most will know what the ABC stands for – airway, breathing and circulation, but fewer will know what the Dr stands for – danger and response.
Consideration of the dangers involved is the first and paramount consideration. In other words: are you putting yourself into a dangerous situation, is the situation too dangerous for assistance to be given and can that danger be mitigated in some way?
A burning building is a prime example, as it would probably be too dangerous for a paramedic to immediately enter, but with the assistance of the Fire and Rescue Service the danger can be mitigated. The same would happen when a member of the emergency services is physically threatened, the mitigation is to retreat and wait for police backup.
Emergency services encourage hot debriefs to learn from any mistakes made, or to consider how systems and procedures could be improved. These are normally on a no-blame basis, so crews are able to speak freely and without fear of action against them.
How can our emergency services adopt a zero-tolerance policy and a no-blame culture when their actions could lead to possible civil, or as we have seen, criminal actions? Could the actions of a “good citizen”, perhaps someone with basic first aid knowledge, be similarly brought into a civil or criminal court?
I grew up in a family closely involved in St John Ambulance, and over 40 years ago I joined the RNLI and served as boat crew for about 13 years, before taking on shore-based roles.
During that time, I underwent extensive casualty-care training to the point that I held a certificate from the Royal College of Surgeons in pre-hospital care. My training time “expired” a couple of years ago, but I still keep a very extensive first-aid kit in my car. I now question whether I should take that kit out of my car, as I could be tempted to use it if I was first on scene at a serious accident. It was only the other day that I checked that everything was in date.
It would be inappropriate for me to comment in detail on the recent court action, indeed it may be that serious consideration will be given to an appeal to a higher court.
As mentioned earlier, should we be considering legislation to further protect our frontline services, both paid and voluntary, from civil and/or criminal action, except in the most extreme cases? In my opinion this would not be an easy law to draft.
-
Chris McFadyen was born and educated in 鶹 and qualified as a chartered accountant in the 1970s. He set up his own business and subsequently sat on many industry bodies advising on legislation which still governs practice in the sector today. He has been married to his wife, Caryll, for 45 years and has two children and two grandchildren.
