Although ambulances have raced down Australian streets since the 1970s, paramedics have only been registered health care practitioners here since 2018. In the days before registration, ambulance services had the legal duty to ensure patients were treated ‘not negligently’ and this was achieved by directing vocationally trained ambulance officers to follow pre-written treatment protocols. Now, paramedics are university qualified with more clinical skills and a higher level of medical knowledge, and are better equipped to serve the acute health needs of our communities. However, as registered practitioners paramedics now have the additional legal duties to act in the patient’s ‘best interests’ and to conduct themselves ‘professionally.’

 

There are occasions where these duties conflict. For example, the duty owed by the paramedic to act in the patient’s best interests may conflict with the paramedic’s duty to comply with their employer’s treatment protocols.

 

The current study was designed to explore how paramedics perceive their various legal duties and how they approach the situations where they conflict. Richard interviewed ten registered paramedics from across Australia and compared their responses against the law as he interpreted it from legislation, regulations, codes of conduct, and case law. He found that participants universally expressed a desire to put the patient first, and the current legal framework supports this.

 

However, participants also described a culture within their services which so discouraged the idea of diverging from treatment protocols that many paramedics feared that doing so could cost them their job, or worse. This fear of adverse consequences has reportedly led many participants to put their duty to their employer above their duty to the patient. As the law currently supports the exercise of this discretion, the next step will be to shift Australian ambulance services towards a more supportive culture.

 

Richard Maddever has recently completed this project with the ANU College of Law as part of a Bachelor of Laws (Honours) program. His qualifications include a Diploma of Paramedical Science from a vocational training institution in Western Australia, and a Bachelor of Science (Human Biology) from the ANU. Richard is interested in exploring how effectively laws and regulations contribute to desired policy outcomes, with a particular focus on Australian health care and emergency services environments.