04/16/2025
From Douglas Wolfberg, EMS Attorney, Page, Wolfberg & Wirth: ๐ช๐ฒ ๐ฎ๐ฟ๐ฒ ๐ณ๐ฎ๐ถ๐น๐ถ๐ป๐ด ๐๐ผ ๐ฎ๐ฑ๐ฒ๐พ๐๐ฎ๐๐ฒ๐น๐ ๐ฝ๐ฟ๐ฒ๐ฝ๐ฎ๐ฟ๐ฒ ๐ป๐ฒ๐ ๐๐ ๐ง ๐ฎ๐ป๐ฑ ๐ฝ๐ฎ๐ฟ๐ฎ๐บ๐ฒ๐ฑ๐ถ๐ฐ ๐๐๐๐ฑ๐ฒ๐ป๐๐ ๐ณ๐ผ๐ฟ ๐๐ต๐ฒ ๐น๐ฒ๐ด๐ฎ๐น ๐ฟ๐ฒ๐ฎ๐น๐ถ๐๐ถ๐ฒ๐ ๐๐ต๐ฒ๐ ๐ณ๐ฎ๐ฐ๐ฒ ๐ถ๐ป ๐ฒ๐๐ฒ๐ฟ๐๐ฑ๐ฎ๐ ๐๐ ๐ฆ ๐ฝ๐ฟ๐ฎ๐ฐ๐๐ถ๐ฐ๐ฒ.
Initial EMT and paramedic courses have a "medicolegal" module, and virtually all the ones I've seen are woefully outdated and insufficient. The content is also largely inaccurate, harkening back to the "conventional wisdom" about topics like ๐ฝ๐ฎ๐๐ถ๐ฒ๐ป๐ ๐ฎ๐ฏ๐ฎ๐ป๐ฑ๐ผ๐ป๐บ๐ฒ๐ป๐, ๐ป๐ฒ๐ด๐น๐ถ๐ด๐ฒ๐ป๐ฐ๐ฒ ๐ฎ๐ป๐ฑ "๐ฟ๐ฒ๐ณ๐๐๐ฎ๐น๐." These topics are important, but they need to be taught accurately and with an eye toward the practical realities of today's EMS practice. I still see slides saying things like "๐ช๐ต'๐ด ๐ฑ๐ข๐ต๐ช๐ฆ๐ฏ๐ต ๐ข๐ฃ๐ข๐ฏ๐ฅ๐ฐ๐ฏ๐ฎ๐ฆ๐ฏ๐ต ๐ช๐ง ๐บ๐ฐ๐ถ ๐ฅ๐ฐ๐ฏ'๐ต ๐ฉ๐ข๐ฏ๐ฅ ๐ฐ๐ง๐ง ๐ข ๐ฑ๐ข๐ต๐ช๐ฆ๐ฏ๐ต ๐ต๐ฐ ๐ด๐ฐ๐ฎ๐ฆ๐ฐ๐ฏ๐ฆ ๐ฐ๐ง ๐ฆ๐ฒ๐ถ๐ข๐ญ ๐ฐ๐ณ ๐ฉ๐ช๐จ๐ฉ๐ฆ๐ณ ๐ต๐ณ๐ข๐ช๐ฏ๐ช๐ฏ๐จ," which is not only legally inaccurate, but fails to reflect modern EMS clinical practice.
We are also coming up short in educating our EMT and paramedic students about the new realities of ๐ฐ๐ฟ๐ถ๐บ๐ถ๐ป๐ฎ๐น ๐น๐ถ๐ฎ๐ฏ๐ถ๐น๐ถ๐๐ ๐ณ๐ฎ๐ฐ๐ถ๐ป๐ด ๐ต๐ฒ๐ฎ๐น๐๐ต๐ฐ๐ฎ๐ฟ๐ฒ ๐ฝ๐ฟ๐ผ๐๐ถ๐ฑ๐ฒ๐ฟ๐, and the unique medicolegal challenges that arise when sick or injured people are in law enforcement custody.
Teaching "consent" and "refusals" as if they are binary choices is also outdated and inadequate. We should be teaching new EMTs and paramedics about the process of collaborative informed decision making ๐ข๐ญ๐ฐ๐ฏ๐จ ๐ต๐ฉ๐ฆ ๐ธ๐ฉ๐ฐ๐ญ๐ฆ ๐ค๐ฐ๐ฏ๐ต๐ช๐ฏ๐ถ๐ถ๐ฎ of a patient interaction, from assessment to treatment to transport to destination choices. We should also be educating new clinicians about both the the ๐น๐ฒ๐ด๐ฎ๐น ๐ฎ๐ป๐ฑ ๐ฝ๐ต๐๐๐ถ๐ฐ๐ฎ๐น ๐๐ฟ๐ฎ๐ป๐๐ณ๐ฒ๐ฟ ๐ผ๐ณ ๐ฐ๐ฎ๐ฟ๐ฒ ๐ฑ๐๐ฟ๐ถ๐ป๐ด ๐๐ต๐ฒ ๐ฝ๐ฎ๐๐ถ๐ฒ๐ป๐ ๐ต๐ฎ๐ป๐ฑ๐ผ๐ณ๐ณ ๐ถ๐ป๐๐ฒ๐ฟ๐๐ฎ๐น ๐ถ๐ป๐๐ถ๐ฑ๐ฒ ๐๐ต๐ฒ ๐.๐., and defining when those occur. And we need to do better than simply repeating platitudes like "EMS providers practice under a physician's license" -- we need to more a๐ฐ๐ฐ๐๐ฟ๐ฎ๐๐ฒ๐น๐ ๐๐ฒ๐ฎ๐ฐ๐ต ๐๐ต๐ฒ ๐ฐ๐ผ๐ป๐ฐ๐ฒ๐ฝ๐๐ ๐ผ๐ณ ๐ถ๐ป๐ฑ๐ฒ๐ฝ๐ฒ๐ป๐ฑ๐ฒ๐ป๐, ๐ฐ๐ผ๐น๐น๐ฎ๐ฏ๐ผ๐ฟ๐ฎ๐๐ถ๐๐ฒ ๐ฎ๐ป๐ฑ ๐ฑ๐ฒ๐น๐ฒ๐ด๐ฎ๐๐ฒ๐ฑ ๐ฝ๐ฟ๐ฎ๐ฐ๐๐ถ๐ฐ๐ฒ and how they apply in different situations.
These challenges present opportunities for our nationally respected voices of leadership in EMS education - including groups and agencies like the National Association of EMS Educators (NAEMSE) and the National Highway Traffic Safety Administration NHTSA - to help lead our profession in updating the medicolegal content for new EMTs and paramedics. This is a worthy and urgent challenge that will benefit our profession and better prepare our clinicians to face today's EMS legal realities.
