EMT-B Ethics question

[emtannie]

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You expect to need to treat a patient who killed one of your family members?

Unfortunately, it may be a possibility if you live in a rural or remote area. If you work in those kinds of areas, where a number of your calls are people who are known to you, you may end up on a call that is a family member, or in the case of Tyler's question, the patient may be the person who killed your family member. Tyler hasn't specified HOW this patient killed your family member.... it could be violence, or it could be an mvc, or some other method....

I have had the unfortunate experience of having family members as patients, and close friends as patients, and family members of my partner as patients, and in some of these situations the patient has died from their illness or injuries. It isn't nice... but being in a rural area, sometimes there aren't enough other people to step in and for you to step back.... like mike said, you just have to detach yourself and do your job and deal with the emotions later. (and, for clarification, because someone will probably ask me - my closest backup is 30 miles away). I'm not saying it doesn't suck... it does... but it is something you have to be willing to deal with depending on what service you work for.

[Lone Star]

Obviously, if you roll up on a scene where the pt has harmed one of your family members, I would think that you would be too 'close' to the call. Some might (note the key word 'might' used here), be willing to provide less than 'adequate' care to this pt. I don't see a problem of having your partner attend.

The cause of the family members death is irrelevant. If the pt was found to be the cause of the death, some would be tempted to exact some form of revenge, be it either poor care, gross negligence, or pt abuses (making the required treatments as painful or uncomfortable as possible).

In some cases, you may not have the luxury of being able to pass the pt off to your partner, or someone of equal or higher licensure. In these cases, you have but one option available to you. Detach yourself from the situation, treat the pt, and do your job.

[KSEMT122]

Sure in a perfect world you wouldn't and shouldn't have to care for this piece of crap. However if he just killed your family member I suspect this isn't a perfect world. Rural services you might well have to do something like that. I would be doing everything possible not to have to treat that person, such as calling another unit. But when the cards are dealt, there is no turning back, and I darn sure don't want a criminal and civil charge. I would do everything in my power to make the bastard live so I could torment him daily while he lives in prison being bubba's bitch.

[Richard B the EMT]

At higher level of medical authority, doctors are not allowed to take care of their own family members. I have no knowledge how this affects those of us at BLS and ALS levels.

If a crew member recognizes a family member's address as the pickup point, I would think the dispatch center should be notified of this, and dispatch a secondary unit, so the crew who's family member is injured or killed can be taken off service, and the member can attend to their own family.

Within the FDNY EMS EMD center, it is possible to request "location histories" be programmed into the computer assisted dispatch (CAD) system, like notification of persons hostile to EMS thereat, or family member of member of service. This might give dispatch a heads up of possible MOS family at a location, complete to some medical history, if the MOS feels it needed. I have my own address so noted for household of MOS and family of MOS (my mother).

I do realize this is not available within all systems, but most supervisors, on being advised that a MOS family member might be involved, will bend over backwards to get a second unit to this type situation, as well as responding themselves.

[Just Plain Ruff]

actually, if you get dispatched to your house for a violent call, then I can guarantee you that everyone here would advise their dispatch that they are responding to their own home.

I think that if the medic or emt notified dispatch then a 2nd unit should and could be dispatched.

I for one have had to treat two of my own family members and it is not fun. It wasn't an immediate relative but it was my aunt. She suffered a stroke and it was not a good call nor a good outcome. I did all that was expected of me and more.

I also took care of the wife of my uncle(great) and it was a transfer from our ICU to a cardiac center 75 miles away. She was very very sick. She arrested in the ambulance and we shocked her, we brought her back and made it to the cardiac center. She received immediate open heart which is what she was being brought up to have anyway. She survived and lived another 8 years.

So taking care of family members are a definate possibility but a higher probablility in a small rural area than a large urban area.

The possibility of taking care of someone who hurt your family member is a distinct possiblity if you live in a rural area and if you are the highest level of provider and the patient needs your level of skill then you will need to take care of the scumbag if there's no-one else available. Usually in every service there is someone available to spell you but sometimes not.

[spenac]

If the person killed your family member on purpose, I bet there are many on here that are actually thinking he would not be a patient long that if anything he would need funeral home instead of ambulance, so no concern as to who works him as a patient. But thats just me playing guess that feeling, but could be wrong I guess.

[Just Plain Ruff]

You know I was thinking about this a little bit more and I think the chances of this happening are so remote unless you work in a small rural area that this might be a moot point

But it could happen so it's good to discuss but I think it's statistically insignificant.

[whit72]

I am guessing if someone intentionally hurt a family member of mine. I wouldn't be expected to render care, as you probably wouldn't want me anywhere near this person. No one would expect you too or hold you liable for not rendering care. There are plenty of people on my scene where this wouldn't be an issue.

In some remote areas where your the only game in town, this could be an issue.

[ladyfirefighter36]

I don't know how I would feel about treating someone who injured or killed one of my family members. I'm sure I would prefer not to, because, like some have said, I would be thinking of causing THEM bodily harm.

I have had to treat my family. We are in a very rural area and sometimes daytime help is hard to find because of swing shift schedules. Just recently had to transport my husband. He fell 10 feet from a ladder. Was doing OK, but landed head first in angle iron. Entire crew was family members. Didn't want to do this, but circumstances warranted transport and I was it.

A few years ago my father was run over by a tractor. Again, all family crew with medic from nearby dept. to transport.

Again, not by choice, buy by circumstance. I think that if at all possible we should not treat or transport family members. Call for backup.

[spenac]

If I understand OP he is asking if we should treat the person that killed our family member, not if we should treat our own family. I have no problem working on my own family, been there, done that got the t-shirt, was happy I knew what to do.

I would have a problem working on the person that killed my family. You should not treat the person that killed your family as you would be dealing with to many emotions and things could happen.