For Whom the Sirens Toll: A Study on an Ethical Challenge in Prehospital Emergency Medicine

Abstract

Aim: The main responsibility of an emergency medical dispatcher (EMD) is to determine the situation and location of an emergency and allocate emergency resources to the scene. However, in some cases, there might be more than one emergency calls at one time forcing an EMD to decide which call should be given priority. Triage, prioritization, and choosing are issues that may be influenced by the EMD’s personal values and thus raise ethical challenges. The aim of the present study was to determine (theoretically) the triage decisions of dispatchers in equal emergency care situations and the factors influencing their thinking and decisions.Materials and Methods: A questionnaire containing two emergency scenarios was applied to 92 students who were candidate ambulance dispatchers in training. The distribution of the participants’ response was analyzed and the Chi-square and Fisher's exact tests of independence were performed.Results: Most of the participants chose to direct the ambulance to the orphanage. Results showed that the number of victims was the main factor influenc-ing priorities and resource allocation in an emergency. In the second survey, age of the injured person influenced the choices.Conclusion: In triage decisions, EMD students prioritize the age and the number of the victims while deciding the allocation of emergency resources. It includes many individual values that might influence the decision. The ethical conflict of principles in a triage decision is between justice and beneficence.