EMT-Is and the death penalty...

[JPINFV]

I guess everyone who said no also doen't believe in capital punishment for no matter the crime. Personally, if you're willing to take a life, then you should be willing to give your's (I don't care if it's death or life in a super-max where you see sunlight a hour a day. That hour is more then your victum got).

Furthermore, it doesn't matter what the mechanism of death is, an MD/DO would still need to be there to declare death (unless we want to return to the guillotine).

Furthermore, if the state is going to engage in capital punishment, then the convicted does deserve to feel the least amount of pain possible (I'm not talking about swabing with EtOH before putting the IV in).

Electricians never needed to take the Hippocratic Oath, and you don't need protocols to tie knots.

Every mechanism has its problems, and its protocol. If you tye the noose wrong or set the drop distance wrong then you end up strangling the person or snapping their head off instead of snapping their neck. Electric chair? Anyone else here seen Green Mile? Firing squad? Who says you can't miss?

[Rezq304]

OK, please forgive me. I had a link to aa story I wanted to share the other night but the sever was down. Now I can not find the story and it is driving me nuts.

Anyways, I can not recall which state it was, however they are proposing allowing/hiring EMT-Is to start the IVs and push the drugs on the inmate's death day. It seems they are having trouble hiring and keep anesthesiologists who have been doing it for years as required by the previous law. They will still have a doctor on hand to declare official death, but they think this will help by eliminating some of the docs ethical and moral dilemmas.

The quote was "they are trained to do IVs, so why dont we use them".

How do you feel about this...and if anyone finds the article, please post it.

Edit: I found the story..it was jems.com

http://www.jems.com/news/111464

So, do they not consider that EMT's have ethics & morals? This is a slap in the face. this would be the time I'd walk out and let the doctor do what he's technically there for.

[Andrewtx]

I agree with everyone else who has said that this is wrong and reflects the continuing perception of EMS as being an adjunct to, rather than an important part of, the medical profession.

The solution, as Scaramedic wrote, is for the state to train its own executioners to establish the IV if they wish to use lethal injections. They don't need to be trained as healthcare providers, as they won't be providing healthcare.

What about triage? I understand that not all will survive, in an attempt to [theoretically] save the most amount of lives, but why make exceptions now?

I disagree that these are contradictory positions. As I said in another thread, if a person already near death dies during an MCI triage situation because resources are diverted to those with a better chance of survival, than that person's death is a passive consequence of the actions of healthcare providers. That is, that person is dying just as they would had no healthcare provider made it to them at all. The death of someone who was administered a lethal dosage is an active consequence -- if nobody had showed up to kill the person, then that person would have lived.

[TechMedic05]

I think they would be under a doctors verbal and written directives. It would probably be only authorized by that state though as an expanded scope of practice.

As far as verbal or written directives, it is still outside of scope to administer such things. I guess there's the lengthy argument of what is in and out of scope. Technically, IV Medication administration is within the scope, so it is allowed. Until protocols come up for "Lethal Injection", it shouldn't be done by EMT's. Regardless of what a Doctor orders, we are still limited by protocols.

Every mechanism has its problems, and its protocol. If you tye the noose wrong or set the drop distance wrong then you end up strangling the person or snapping their head off instead of snapping their neck. Electric chair? Anyone else here seen Green Mile? Firing squad? Who says you can't miss?

I never said any other way was perfect. Sure, mistakes happen. The idea was to remove any aspect from an EMT's hands. Isolate and deny. Isolate those who do it [to on-healthcare providers], and deny entry to any EMT who wants to.

I disagree that these are contradictory positions. As I said in another thread, if a person already near death dies during an MCI triage situation because resources are diverted to those with a better chance of survival, than that person's death is a passive consequence of the actions of healthcare providers. That is, that person is dying just as they would had no healthcare provider made it to them at all. The death of someone who was administered a lethal dosage is an active consequence -- if nobody had showed up to kill the person, then that person would have lived.

Either way, it is still a consequence of the healthcare provider. And no one can say, 100% definitively, that any patient passed over in a MCI would be dead or not. So, is it safe to say that if the EMT is providing care to someone else, that it is acceptable to contradict the Hippocratic Oath, and cause further harm by not treating a patient?

I guess what I'm trying to point out is to watch your gatekeepers. Medicine, overall, will want to deny approval or isolate anything dealing with the death penalty. Why? We obviously don't want to be associated with death, and dealing death. It's dirty, people fear it, and we'd look bad. We already have enough of those issues. But change the taste to a MCI, and we openly admit that it's acceptable to allow people to die.

So, What is it?

I don't know. MCI is an essential tool. There's no changing that. Being active in the Death Penalty? That's something that would be incredibly easy to shove off onto someone else, and free the hands of medicine with.

[streetsmart]

Let's see, if doctors won't do it due to ethical standards (I seem to remember something about 'first do no harm...') then what would give an "I" or "P" the right to do it? Aren't we bound by the same ethical standards? If not, why not? If you aren't, then why are you working in this field? Don't we work for MDs...the same one's who are refusing to participate?

If it makes sense to let us do it because it falls within the scope of our training, they why not let an RN do it? Isn't starting an IV within the scope of their training? But oh! Wait! They won't do it either because RNs maintain ethical standards, too! What a coincidence!

Why is it that it is expected that MDs and RNs will be held to certain ethical standards but we won't?

-be safe.

I agree 100% - it's not within our scope of practice and we all better hope it never is.

Hire Professional Hangmen!

[emtkelley]

***Why is it that it is expected that MDs and RNs will be held to certain ethical standards but we won't?***

Because this same group of folks who are kicking this idea around are the same ones who still believe we are ambulance drivers. :evil:

[TechMedic05]

I agree 100% - it's not within our scope of practice and we all better hope it never is.

Hire Professional Hangmen!

Medication Administration is, in fact, within the scope of practice. It is that those medications are outside of protocols.

Unless you count "Murder" as a Scope of Practice Item.

[streetsmart]

Good point, I stand corrected!

I just find this inconceivable that anyone would even toss this idea around.

[TechMedic05]

Good point, I stand corrected!

I just find this inconceivable that anyone would even toss this idea around.

Much like the rest of healthcare, EMT's are cheap, dispensible, easy to come by, and most often readily willing to practice our skills. It's not our fault they throw these things at us, it's EMT's fault's that they accept it.

Many should be like Rezq304 and emtkelly, and aggrevated that others in this 'professional field' of 'medicine' would expect us to work against Hippocratic Oath, especially if done because they don't want to, or feel comfortable doing it.

We don't need to constatnly be the Bastard Child of medicine.

[paramedicmike]

Medication Administration is, in fact, within the scope of practice. It is that those medications are outside of protocols.

Unless you count "Murder" as a Scope of Practice Item.

Well, no. Those medications are out of our scope of pracatice as well. It's not a matter of protocols. EMS based protocols don't come into play here. (Even if they did it would be an issue of going against protocols as no medical director would have a protocol on how to kill someone. Do you want to pay the insurance on that?)

The meds that we push are described to be in our scope. All other meds are out of our scope which is why we don't use them. Don't confuse "scope of practice" with "protocols". They're two different concepts.

-be safe.