Submited on: 10 May 2013 02:33:02 PM GMT
Published on: 11 May 2013 07:42:32 AM GMT
 
Ethics in Prehospital Emergency Medicine
Posted by Dr. William J Maloney on 05 Feb 2014 08:23:24 PM GMT Reviewed by Interested Peers

  • What are the main claims of the paper and how important are they?

    The aim of this paper is to discuss the ethical dilemma surrounding consent and patient autonomy from prehospital services.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    No


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    Yes- this would be a great seminar at a hospital.


  • Other Comments:

    This article presents an ethical case in a very detailed fashion.  The author provides a well-structured analysis of the ethical diemma presented in the case.  The author suggests that ethical diemmas receive more systematic attention in basic and further education programs.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:

    None

  • Experience and credentials in the specific area of science:

    Clinical associate professor

  • How to cite:  Maloney W J.Ethics in Prehospital Emergency Medicine[Review of the article 'Ethics in Prehospital Emergency Medicine: An Ethical Dilemma in Patient Communication ' by Nordby H].WebmedCentral 2014;5(2):WMCRW002944
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Who is the Patient?
Posted by Dr. Russell Searight on 17 Jun 2013 08:50:48 PM GMT

  • What are the main claims of the paper and how important are they?

    A married woman was being transported to the hospital via EMS. Her husband did not want to go and the EMTs believed that he might be overwhelmed caring for his wife and need a break. The wife indicated she would not go, despite cardiac symptoms, unless her husband went. The EMTs stressed the wife's fragile health state and essentially told the husband to come in the ambulance--diminishing his choicefulness


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes and No--See Hardwig in the Hasting Center Report. He has had several articles in which the well-being of the family and the patient may be in conflict.

     

    What is unique about this paper is the context--Ambulance crew: Do they have a relationship and duty to the patient ? Is it acceptable to be coercive on a short-term basis to a family member to assure the well being of the patient. Many ethical decisions are made in these "on the street" settings and raise unique issues


  • Are the claims properly placed in the context of the previous literature?

    There could be more background literature provided--see comment above. Does use Kant's categorical imperative as the ethical model for this case; the case could be examined from other ethical perspectives such as principlism, Virtue ethics, Utilitarianism, etc.


  • Do the results support the claims? If not, what other evidence is required?

    Yes--this is a case report and not research study


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No applicable


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    More discussion of the issue regarding who is primary patient ?; Whose well-being is the ambulance crew chiefly responsible for? As noted above, analysis from other ethical perspectives


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    It is an interesting and a somewhat unique ethical dilemma.  I could use a case like this to teach medical ethics


  • Other Comments:

    No

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Searight, H.R. (2012). Ethics and the practice of primary care psychiatry. In O. Capelli (Ed.), Primary Care at a Glance: Hot Topics and New Insights (pp. 389-406). Rijeka, Croatia: Intech. Searight, H.R., & Pound, P. (1994). The HIV-positive psychiatric patient and the duty-to-protect: Ethical and legal issues. International Journal of Psychiatry in Medicine, 24, 263-274.

  • Experience and credentials in the specific area of science:

    I teach and write in this area

  • How to cite:  Searight R .Who is the Patient?[Review of the article 'Ethics in Prehospital Emergency Medicine: An Ethical Dilemma in Patient Communication ' by Nordby H].WebmedCentral 2014;4(6):WMCRW002765
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