For Some, There Is No Choice

July 22, 2006

So, making the job less stressful. Assuring that our personnel maintain their

sanity so that they may continue to perform their job to the best of their

ability. These are things we just don't need to worry about?

The original situation as described does not mention to me anything about not

being able to handle the job. It mentions that this one patient has brought back

memories of a devastating (shall we say traumatic) incident.

For those who have not witnessed this type of behavior, it is impressive to

observe.

wegandy1938@... wrote:

Dr. Krin makes some good points. I would be less appalled at the

refusals

of a medic to take a call that involved a patient or procedure that s/he had

some sort of moral allergy to, if there were reasonable alternatives.

But in most EMS systems, staffing is minimal, and you're worked to death

(courtesy of SSM) and there just isn't the opportunity to have a nice discussion

with your company's ETHICS MANAGER (ha ha ha) and have her or him say, " We

fully understand your difficulty with this assignment, and we support your

rights

to adhere to your personal moral principles. So just don't worry about it.

We'll call in another crew to take this call, and you can take the rest of

the day off, with pay, to recover from the stress that we put you through by

even suggesting that you transport a patient for a procedure that offends your

moral sensitivities. And we are going to write you a formal letter of

apology which will go into your personnel file, and also we're giving you a $150

voucher for dinner for yourself and a guest at the best restaurant in town.

Sincerely, we apologize for putting you through 17 minutes of hell. "

Um, Toto, I don't think we're in Kansas anymore.

GG

>

> In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

> wegandy1938@wegandy writes:

>

> There are times when people need to be true to themselves and take

> responsibility for their actions. If an EMS provider cannot in good

> conscience care

> for and carry out the transports of all patients that fall within their

> care,

> then perhaps that person ought not be in EMS. I have not known any

> physicians

> who wouldn't care for a certain kind of patient, even when they disagreed

> with

> that patient's lifestyle or religious philosophy. I'm sure there are some,

> but unless they can step aside and allow another physician to step in, they

> are going to be liable for any injury that might occur to a patient they

> refused

> to treat.

>

> I'm catching up after a couple of days on the road again... I do know of

> several situations where physicians have transferred care to an associate or

> competitor when the original physician could not in good conscious provide

> the

> care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

>

> In many cases, physicians and nurses who have this kind of objector status

> do have an out that a street medic does not...they can choose to associate

> themselves with facilities who follow the same kind of code that they

> profess to

> espouse...not something always possible for a medic.

>

> ck

>

> S. Krin, DO FAAFP

>

July 23, 2006

Why another paramedic? A taxi driver would suffice, who should have

been originally the person transporting this woman to the life

threatening emergency of an elective abortion.

I would any time trust more an employee who had the integrity to put

their job on the line for something they believed in (and I am not

talking about magical beliefs or delusions)no matter how much I

disagreed with them. Employees are people first. A good employer would

learn to get the best from their employee by understanding them as

individuals with individual needs. It is not a prudent decision to

force a worker to perform an act that would leave them in moral

quandry, no matter what.

The worse thing we could do to EMS would be to fill its ranks with

people with no conscience and no objections.

Shahla

>

> In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

> wegandy1938@... writes:

>

> There are times when people need to be true to themselves and take

> responsibility for their actions. If an EMS provider cannot in good

> conscience care

> for and carry out the transports of all patients that fall within

their

> care,

> then perhaps that person ought not be in EMS. I have not known any

> physicians

> who wouldn't care for a certain kind of patient, even when they

disagreed

> with

> that patient's lifestyle or religious philosophy. I'm sure there

are some,

> but unless they can step aside and allow another physician to step

in, they

> are going to be liable for any injury that might occur to a patient

they

> refused

> to treat.

>

> I'm catching up after a couple of days on the road again... I do

know of

> several situations where physicians have transferred care to an

associate or

> competitor when the original physician could not in good conscious

provide the

> care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

>

> In many cases, physicians and nurses who have this kind of objector

status

> do have an out that a street medic does not...they can choose to

associate

> themselves with facilities who follow the same kind of code that

they profess to

> espouse...not something always possible for a medic.

>

> ck

>

> S. Krin, DO FAAFP

>

July 23, 2006

Shahla:

Who decides what's a " magical belief or delusion " as opposed to sincerely

held beliefs?

If you asked Madalyn Murray O'Hair, she would've held that every religion

falls into those categories.

-Wes

In a message dated 7/23/2006 11:37:23 AM Central Daylight Time,

shah_emt@... writes:

Why another paramedic? A taxi driver would suffice, who should have

been originally the person transporting this woman to the life

threatening emergency of an elective abortion.

I would any time trust more an employee who had the integrity to put

their job on the line for something they believed in (and I am not

talking about magical beliefs or delusions)no matter how much I

disagreed with them. Employees are people first. A good employer would

learn to get the best from their employee by understanding them as

individuals with individual needs. It is not a prudent decision to

force a worker to perform an act that would leave them in moral

quandry, no matter what.

The worse thing we could do to EMS would be to fill its ranks with

people with no conscience and no objections.

Shahla

>

> In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

> wegandy1938@ wegandy193

>

> There are times when people need to be true to themselves and take

> responsibility for their actions. If an EMS provider cannot in good

> conscience care

> for and carry out the transports of all patients that fall within

their

> care,

> then perhaps that person ought not be in EMS. I have not known any

> physicians

> who wouldn't care for a certain kind of patient, even when they

disagreed

> with

> that patient's lifestyle or religious philosophy. I'm sure there

are some,

> but unless they can step aside and allow another physician to step

in, they

> are going to be liable for any injury that might occur to a patient

they

> refused

> to treat.

>

> I'm catching up after a couple of days on the road again... I do

know of

> several situations where physicians have transferred care to an

associate or

> competitor when the original physician could not in good conscious

provide the

> care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

>

> In many cases, physicians and nurses who have this kind of objector

status

> do have an out that a street medic does not...they can choose to

associate

> themselves with facilities who follow the same kind of code that

they profess to

> espouse...not something always possible for a medic.

>

> ck

>

> S. Krin, DO FAAFP

>

> [Non-text portions of this message have been removed]

>

July 23, 2006

Hmm! I would agree with her too.

Shahla

> Why another paramedic? A taxi driver would suffice, who should have

> been originally the person transporting this woman to the life

> threatening emergency of an elective abortion.

>

> I would any time trust more an employee who had the integrity to put

> their job on the line for something they believed in (and I am not

> talking about magical beliefs or delusions)no matter how much I

> disagreed with them. Employees are people first. A good employer would

> learn to get the best from their employee by understanding them as

> individuals with individual needs. It is not a prudent decision to

> force a worker to perform an act that would leave them in moral

> quandry, no matter what.

>

> The worse thing we could do to EMS would be to fill its ranks with

> people with no conscience and no objections.

>

> Shahla

>

> >

> > In a message dated 17-Jul-06 00:29:29 Central Daylight Time,

> > wegandy1938@ wegandy193

> >

> > There are times when people need to be true to themselves and take

> > responsibility for their actions. If an EMS provider cannot in good

> > conscience care

> > for and carry out the transports of all patients that fall within

> their

> > care,

> > then perhaps that person ought not be in EMS. I have not known any

> > physicians

> > who wouldn't care for a certain kind of patient, even when they

> disagreed

> > with

> > that patient's lifestyle or religious philosophy. I'm sure there

> are some,

> > but unless they can step aside and allow another physician to step

> in, they

> > are going to be liable for any injury that might occur to a patient

> they

> > refused

> > to treat.

> >

> > I'm catching up after a couple of days on the road again... I do

> know of

> > several situations where physicians have transferred care to an

> associate or

> > competitor when the original physician could not in good conscious

> provide the

> > care needed or requested by the patient, WHEN THE CARE WAS LAWFUL.

> >

> > In many cases, physicians and nurses who have this kind of objector

> status

> > do have an out that a street medic does not...they can choose to

> associate

> > themselves with facilities who follow the same kind of code that

> they profess to

> > espouse...not something always possible for a medic.

> >

> > ck

> >

> > S. Krin, DO FAAFP

> >

> > [Non-text portions of this message have been removed]

> >

>

July 23, 2006

So should I not transport an aetheist because I do not

agree with his beliefs or a mormon or a Jehova's

Witness? So now we should triage the call to see if

it is inline with my personal beliefs? This is

ridiculous at best. As long as I am not the one

performing the procedure I do not believe it would be

held against me. Try to talk the person out of it.

If you are shut down then just pray for the person

silently. Maybe the person was raped or something.

Last I checked we are here to perform the duties of an

EMT regardless of color, race, religion, or otherwise.

This is much like trying to have a religious

discussion. Everyone has their own beliefs. While I

do not support abortion, I am not going to lose my job

over a transport.

Salvador Capuchino Jr

EMT-Paramedic

--- shah_emt wrote:

>

> Why another paramedic? A taxi driver would suffice,

> who should have

> been originally the person transporting this woman

> to the life

> threatening emergency of an elective abortion.

>

> I would any time trust more an employee who had the

> integrity to put

> their job on the line for something they believed in

> (and I am not

> talking about magical beliefs or delusions)no matter

> how much I

> disagreed with them. Employees are people first. A

> good employer would

> learn to get the best from their employee by

> understanding them as

> individuals with individual needs. It is not a

> prudent decision to

> force a worker to perform an act that would leave

> them in moral

> quandry, no matter what.

>

> The worse thing we could do to EMS would be to fill

> its ranks with

> people with no conscience and no objections.

>

> Shahla

>

> >

> > In a message dated 17-Jul-06 00:29:29 Central

> Daylight Time,

> > wegandy1938@... writes:

> >

> > There are times when people need to be true to

> themselves and take

> > responsibility for their actions. If an EMS

> provider cannot in good

> > conscience care

> > for and carry out the transports of all patients

> that fall within

> their

> > care,

> > then perhaps that person ought not be in EMS. I

> have not known any

> > physicians

> > who wouldn't care for a certain kind of patient,

> even when they

> disagreed

> > with

> > that patient's lifestyle or religious philosophy.

> I'm sure there

> are some,

> > but unless they can step aside and allow another

> physician to step

> in, they

> > are going to be liable for any injury that might

> occur to a patient

> they

> > refused

> > to treat.

> >

> > I'm catching up after a couple of days on the

> road again... I do

> know of

> > several situations where physicians have

> transferred care to an

> associate or

> > competitor when the original physician could not

> in good conscious

> provide the

> > care needed or requested by the patient, WHEN THE

> CARE WAS LAWFUL.

> >

> > In many cases, physicians and nurses who have

> this kind of objector

> status

> > do have an out that a street medic does

> not...they can choose to

> associate

> > themselves with facilities who follow the same

> kind of code that

> they profess to

> > espouse...not something always possible for a

> medic.

> >

> > ck

> >

> > S. Krin, DO FAAFP

> >

> > [Non-text portions of this message have been

> removed]

> >

>

July 24, 2006

The discussion is not at all about the background of the patient,

i.e., is he/she gay, hindu, baptist or transvestite. The discussion

is about what the provider feels about the procedure he or she is

participating in.

The ethical question is not about whether or not Hitler's doctors

liked jews or not, but about what they felt about the procedures they

performed on them. If they thought that the job they were ordered to

perform was not morally right, then the question would arise whether

they should refuse it or not. The same question arises when

anesthetists are employed to give the injection at the execution of a

death sentence. The moral dilemma has nothing to do with whether you

like the inmate's mug or not. (You may argue that it is our duty to

kill everyone without regard to race, religion or sexual orientation)

This moral dilemma can arise even for an atheist, because whether or

not they indulge in the insanity of religion, they too have a sense

of right or wrong.

The position I am taking is, if you feel in your bones that something

is just not right, however wrong you may be, refuse. The only thing

you have to lose is your job.

> > Why another paramedic? A taxi driver would suffice,

> > who should have

> > been originally the person transporting this woman

> > to the life

> > threatening emergency of an elective abortion.

> >

> > I would any time trust more an employee who had the

> > integrity to put

> > their job on the line for something they believed in

> > (and I am not

> > talking about magical beliefs or delusions)no matter

> > how much I

> > disagreed with them. Employees are people first. A

> > good employer would

> > learn to get the best from their employee by

> > understanding them as

> > individuals with individual needs. It is not a

> > prudent decision to

> > force a worker to perform an act that would leave

> > them in moral

> > quandry, no matter what.

> >

> > The worse thing we could do to EMS would be to fill

> > its ranks with

> > people with no conscience and no objections.

> >

> > Shahla

> >

> > >

> > > In a message dated 17-Jul-06 00:29:29 Central

> > Daylight Time,

> > > wegandy1938@ writes:

> > >

> > > There are times when people need to be true to

> > themselves and take

> > > responsibility for their actions. If an EMS

> > provider cannot in good

> > > conscience care

> > > for and carry out the transports of all patients

> > that fall within

> > their

> > > care,

> > > then perhaps that person ought not be in EMS. I

> > have not known any

> > > physicians

> > > who wouldn't care for a certain kind of patient,

> > even when they

> > disagreed

> > > with

> > > that patient's lifestyle or religious philosophy.

> > I'm sure there

> > are some,

> > > but unless they can step aside and allow another

> > physician to step

> > in, they

> > > are going to be liable for any injury that might

> > occur to a patient

> > they

> > > refused

> > > to treat.

> > >

> > > I'm catching up after a couple of days on the

> > road again... I do

> > know of

> > > several situations where physicians have

> > transferred care to an

> > associate or

> > > competitor when the original physician could not

> > in good conscious

> > provide the

> > > care needed or requested by the patient, WHEN THE

> > CARE WAS LAWFUL.

> > >

> > > In many cases, physicians and nurses who have

> > this kind of objector

> > status

> > > do have an out that a street medic does

> > not...they can choose to

> > associate

> > > themselves with facilities who follow the same

> > kind of code that

> > they profess to

> > > espouse...not something always possible for a

> > medic.

> > >

> > > ck

> > >

> > > S. Krin, DO FAAFP

> > >

> > > [Non-text portions of this message have been

> > removed]

> > >

> >

July 24, 2006

So if I am a Jehova's Witness I should not transport a

patient to a facility for a blood transfusion because

it's against my religion? If it ever comes to this it

is time to find another profession. So if I am a

nurse and a Jehova's Witness I should refuse to

administer a blood transfusion to a patient. This is

why there is a separation between church an state. We

have too much time on our hands to even worry about

whether I should transport a patient to an elective

procedure. Like I said I may not support some

abortions, but as humans we all have the right to

choose. God has given us this ability to choose life

or death, heaven or hell. If you don't care about

losing your job over refusing to transport a patient,

THEN KNOCK YOURSELF OUT. It's no sweat off my back.

I can already see a patient suing a medic for refusal

of transport!!! I'd say let's find another topic as

this one is going to cross the line in the rules of

this list. I do not feel like being moderated again.

Salvador Capuchino Jr

EMT-Paramedic

--- shah_emt wrote:

> The discussion is not at all about the background of

> the patient,

> i.e., is he/she gay, hindu, baptist or transvestite.

> The discussion

> is about what the provider feels about the procedure

> he or she is

> participating in.

>

> The ethical question is not about whether or not

> Hitler's doctors

> liked jews or not, but about what they felt about

> the procedures they

> performed on them. If they thought that the job they

> were ordered to

> perform was not morally right, then the question

> would arise whether

> they should refuse it or not. The same question

> arises when

> anesthetists are employed to give the injection at

> the execution of a

> death sentence. The moral dilemma has nothing to do

> with whether you

> like the inmate's mug or not. (You may argue that it

> is our duty to

> kill everyone without regard to race, religion or

> sexual orientation)

>

> This moral dilemma can arise even for an atheist,

> because whether or

> not they indulge in the insanity of religion, they

> too have a sense

> of right or wrong.

>

> The position I am taking is, if you feel in your

> bones that something

> is just not right, however wrong you may be, refuse.

> The only thing

> you have to lose is your job.

>

> > > Why another paramedic? A taxi driver would

> suffice,

> > > who should have

> > > been originally the person transporting this

> woman

> > > to the life

> > > threatening emergency of an elective abortion.

> > >

> > > I would any time trust more an employee who had

> the

> > > integrity to put

> > > their job on the line for something they

> believed in

> > > (and I am not

> > > talking about magical beliefs or delusions)no

> matter

> > > how much I

> > > disagreed with them. Employees are people first.

> A

> > > good employer would

> > > learn to get the best from their employee by

> > > understanding them as

> > > individuals with individual needs. It is not a

> > > prudent decision to

> > > force a worker to perform an act that would

> leave

> > > them in moral

> > > quandry, no matter what.

> > >

> > > The worse thing we could do to EMS would be to

> fill

> > > its ranks with

> > > people with no conscience and no objections.

> > >

> > > Shahla

> > >

> > > >

> > > > In a message dated 17-Jul-06 00:29:29 Central

> > > Daylight Time,

> > > > wegandy1938@ writes:

> > > >

> > > > There are times when people need to be true

> to

> > > themselves and take

> > > > responsibility for their actions. If an EMS

> > > provider cannot in good

> > > > conscience care

> > > > for and carry out the transports of all

> patients

> > > that fall within

> > > their

> > > > care,

> > > > then perhaps that person ought not be in EMS.

> I

> > > have not known any

> > > > physicians

> > > > who wouldn't care for a certain kind of

> patient,

> > > even when they

> > > disagreed

> > > > with

> > > > that patient's lifestyle or religious

> philosophy.

> > > I'm sure there

> > > are some,

> > > > but unless they can step aside and allow

> another

> > > physician to step

> > > in, they

> > > > are going to be liable for any injury that

> might

> > > occur to a patient

> > > they

> > > > refused

> > > > to treat.

> > > >

> > > > I'm catching up after a couple of days on the

> > > road again... I do

> > > know of

> > > > several situations where physicians have

> > > transferred care to an

> > > associate or

> > > > competitor when the original physician could

> not

> > > in good conscious

> > > provide the

> > > > care needed or requested by the patient, WHEN

> THE

> > > CARE WAS LAWFUL.

> > > >

> > > > In many cases, physicians and nurses who have

> > > this kind of objector

> > > status

> > > > do have an out that a street medic does

> > > not...they can choose to

> > > associate

> > > > themselves with facilities who follow the

> same

> > > kind of code that

> > > they profess to

> > > > espouse...not something always possible for a

> > > medic.

> > > >

> > > > ck

> > > >

> > > > S. Krin, DO FAAFP

> > > >

> > > > [Non-text portions of this message have been

> > > removed]

> > > >

> > >

July 24, 2006

Yes, this seems to be the confusion that is abounding. Those who argue the

medic has the right to refuse are arguing that they are being asked to perform

an immoral action (in this case, participating in murder). Those arguing on the

other side seem to make it an issue of 'what type of person' is being

transported.

I would argue this distinction is precisely where the line should be drawn. No

one should be required to perform a non-emergency transfer to perform murder.

And no one should refuse to transport someone they merely 'don't like' or even

'disagree with' on some moral issue. Hopefully none of us would be willing to

perform a transfer to a Euthenasia clinic, or a Nazi/Stalinist 'hospital'.

Hopefully none of us would refuse to transport 'one of them'.

Vaughn

EMT, SVN

Re: For Some, There Is No Choice

The discussion is not at all about the background of the patient,

i.e., is he/she gay, hindu, baptist or transvestite. The discussion

is about what the provider feels about the procedure he or she is

participating in.

The ethical question is not about whether or not Hitler's doctors

liked jews or not, but about what they felt about the procedures they

performed on them. If they thought that the job they were ordered to

perform was not morally right, then the question would arise whether

they should refuse it or not. The same question arises when

anesthetists are employed to give the injection at the execution of a

death sentence. The moral dilemma has nothing to do with whether you

like the inmate's mug or not. (You may argue that it is our duty to

kill everyone without regard to race, religion or sexual orientation)

This moral dilemma can arise even for an atheist, because whether or

not they indulge in the insanity of religion, they too have a sense

of right or wrong.

The position I am taking is, if you feel in your bones that something

is just not right, however wrong you may be, refuse. The only thing

you have to lose is your job.

> > Why another paramedic? A taxi driver would suffice,

> > who should have

> > been originally the person transporting this woman

> > to the life

> > threatening emergency of an elective abortion.

> >

> > I would any time trust more an employee who had the

> > integrity to put

> > their job on the line for something they believed in

> > (and I am not

> > talking about magical beliefs or delusions)no matter

> > how much I

> > disagreed with them. Employees are people first. A

> > good employer would

> > learn to get the best from their employee by

> > understanding them as

> > individuals with individual needs. It is not a

> > prudent decision to

> > force a worker to perform an act that would leave

> > them in moral

> > quandry, no matter what.

> >

> > The worse thing we could do to EMS would be to fill

> > its ranks with

> > people with no conscience and no objections.

> >

> > Shahla

> >

> > >

> > > In a message dated 17-Jul-06 00:29:29 Central

> > Daylight Time,

> > > wegandy1938@ writes:

> > >

> > > There are times when people need to be true to

> > themselves and take

> > > responsibility for their actions. If an EMS

> > provider cannot in good

> > > conscience care

> > > for and carry out the transports of all patients

> > that fall within

> > their

> > > care,

> > > then perhaps that person ought not be in EMS. I

> > have not known any

> > > physicians

> > > who wouldn't care for a certain kind of patient,

> > even when they

> > disagreed

> > > with

> > > that patient's lifestyle or religious philosophy.

> > I'm sure there

> > are some,

> > > but unless they can step aside and allow another

> > physician to step

> > in, they

> > > are going to be liable for any injury that might

> > occur to a patient

> > they

> > > refused

> > > to treat.

> > >

> > > I'm catching up after a couple of days on the

> > road again... I do

> > know of

> > > several situations where physicians have

> > transferred care to an

> > associate or

> > > competitor when the original physician could not

> > in good conscious

> > provide the

> > > care needed or requested by the patient, WHEN THE

> > CARE WAS LAWFUL.

> > >

> > > In many cases, physicians and nurses who have

> > this kind of objector

> > status

> > > do have an out that a street medic does

> > not...they can choose to

> > associate

> > > themselves with facilities who follow the same

> > kind of code that

> > they profess to

> > > espouse...not something always possible for a

> > medic.

> > >

> > > ck

> > >

> > > S. Krin, DO FAAFP

> > >

> > > [Non-text portions of this message have been

> > removed]

> > >

> >

July 24, 2006

Medical Ethics is an emerging body of knowledge. It is a legitimate

area of research. This kind of discussion would only allow us to share

our viewpoints and knowledge. If we manage to do so without getting

emotional or personal and calling names there would be no earthly

reason to get moderated.

Nurses already have succeeded in getting safe harbor laws passed that

protect them from being fired in case of refusal. The decision is

deferred till a comittee of their peers evaluates their case and makes

recommendations. The current acceptable reason for refusing an

assignment is jeopardy to 'patient safety', but in time it will

encompass more and more areas, giving them more power and hospitals

and doctors lesser and lesser.

Wake up and smell the cofee! The days of 'there is not to make reply;

There is not to reason why; There is but to do and die' are over even

in the armed forces. We are trying to be recognized as professionals

who provide pre-hospital medical care.

> > > > Why another paramedic? A taxi driver would

> > suffice,

> > > > who should have

> > > > been originally the person transporting this

> > woman

> > > > to the life

> > > > threatening emergency of an elective abortion.

> > > >

> > > > I would any time trust more an employee who had

> > the

> > > > integrity to put

> > > > their job on the line for something they

> > believed in

> > > > (and I am not

> > > > talking about magical beliefs or delusions)no

> > matter

> > > > how much I

> > > > disagreed with them. Employees are people first.

> > A

> > > > good employer would

> > > > learn to get the best from their employee by

> > > > understanding them as

> > > > individuals with individual needs. It is not a

> > > > prudent decision to

> > > > force a worker to perform an act that would

> > leave

> > > > them in moral

> > > > quandry, no matter what.

> > > >

> > > > The worse thing we could do to EMS would be to

> > fill

> > > > its ranks with

> > > > people with no conscience and no objections.

> > > >

> > > > Shahla

> > > >

> > > > >

> > > > > In a message dated 17-Jul-06 00:29:29 Central

> > > > Daylight Time,

> > > > > wegandy1938@ writes:

> > > > >

> > > > > There are times when people need to be true

> > to

> > > > themselves and take

> > > > > responsibility for their actions. If an EMS

> > > > provider cannot in good

> > > > > conscience care

> > > > > for and carry out the transports of all

> > patients

> > > > that fall within

> > > > their

> > > > > care,

> > > > > then perhaps that person ought not be in EMS.

> > I

> > > > have not known any

> > > > > physicians

> > > > > who wouldn't care for a certain kind of

> > patient,

> > > > even when they

> > > > disagreed

> > > > > with

> > > > > that patient's lifestyle or religious

> > philosophy.

> > > > I'm sure there

> > > > are some,

> > > > > but unless they can step aside and allow

> > another

> > > > physician to step

> > > > in, they

> > > > > are going to be liable for any injury that

> > might

> > > > occur to a patient

> > > > they

> > > > > refused

> > > > > to treat.

> > > > >

> > > > > I'm catching up after a couple of days on the

> > > > road again... I do

> > > > know of

> > > > > several situations where physicians have

> > > > transferred care to an

> > > > associate or

> > > > > competitor when the original physician could

> > not

> > > > in good conscious

> > > > provide the

> > > > > care needed or requested by the patient, WHEN

> > THE

> > > > CARE WAS LAWFUL.

> > > > >

> > > > > In many cases, physicians and nurses who have

> > > > this kind of objector

> > > > status

> > > > > do have an out that a street medic does

> > > > not...they can choose to

> > > > associate

> > > > > themselves with facilities who follow the

> > same

> > > > kind of code that

> > > > they profess to

> > > > > espouse...not something always possible for a

> > > > medic.

> > > > >

> > > > > ck

> > > > >

> > > > > S. Krin, DO FAAFP

> > > > >

> > > > > [Non-text portions of this message have been

> > > > removed]

> > > > >

> > > >

July 24, 2006

I'll buy your argument, but to compare it to the anesthetist administering

(or refusing to administer) a lethal dose is apples to oranges. When the

anesthetist applied for the job, he/she knew what was expected. It would be

ludicrous to think that they applied for it, knowing what would be expected,

then, when push came to shove, he/she suddenly claims moral beliefs don't

allow him/her to do it.

If at any time during your employment, you feel as though you will not be

able to meet the expectations of your employer, discuss it with them, or

leave.

If you are hired as a Medic for football games, and are told that you will

only cover 'football games' only to find yourself sent to cover a pro choice

rally at an abortion clinic, I can see an argument for a sudden onset of

moral conscious. If you are hired to cover 'various events', I think it is

pushing it a bit too far.

The argument with regards to nurses being allowed to refuse orders plays

only when the order will have a detrimental impact on the patient. I don't

see that going much further than that. Where does it end? I can 'what if'

this one till the cows come home.

What if you are a Christian and the patient is a Satanist? What if I am a

Jew and my patient is a known Nazi war criminal? What if....

If you cannot meet the expectations of your employer, it's time to move on.

My religious beliefs are held near and dear to my heart, but I differentiate

between what is 'right' to me, and what is 'right' to others.

This has nothing to with 'ours is but to do or die', if you don't want to do

the job as your employer lays it out, then move on.

It will be interesting to see how this case draws out

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

www.michaelhatfield.net

(updated 6.15.06)

Re: For Some, There Is No Choice

Medical Ethics is an emerging body of knowledge. It is a legitimate

area of research. This kind of discussion would only allow us to share

our viewpoints and knowledge. If we manage to do so without getting

emotional or personal and calling names there would be no earthly

reason to get moderated.

Nurses already have succeeded in getting safe harbor laws passed that

protect them from being fired in case of refusal. The decision is

deferred till a comittee of their peers evaluates their case and makes

recommendations. The current acceptable reason for refusing an

assignment is jeopardy to 'patient safety', but in time it will

encompass more and more areas, giving them more power and hospitals

and doctors lesser and lesser.

Wake up and smell the cofee! The days of 'there is not to make reply;

There is not to reason why; There is but to do and die' are over even

in the armed forces. We are trying to be recognized as professionals

who provide pre-hospital medical care.

July 24, 2006

Medical Ethics Groups have proliferated in hospitals, but how many EMS

services have an ethics process? I don't know of any. Should every EMS

service

have an ethics committee to exercise oversight over ethical and moral decisions

to perform job requirements by the service's employees? Of course not.

That's so idiotic and absurd that even the most flaky medic would see that it

wouldn't work. That's because we do our things within time frames that do not

afford delays for contacting committees.

As I have firmly stated, I do not believe that any EMS provider has the

prerogative to refuse treatment or transport of any patient at any time.

The provider's personal ideas about morality must be subjugated to the

patient's needs.

EMS is not a forum for personal decisions about what patients to transport.

Maybe EMS services ought to have a hiring application that would require an

applicant to list her or his moral allergies and to state which patients they

would agree to transport and which they would refuse.

Of course, that's so absurd that everybody but a certain group of idealogues

would recognize it as such.

In the real world, if you are an " Amlance driver " you drive that Amlance from

X to Y and take that patient where he needs to go. You don't have a say in

what the reason for the transfer is or what's going to happen to him when he

gets there.

Only the effete, silly, selfish, and self-important EMT would interpose his

personal moral requirements between himself and the emplolyer. The employer

doesn't give a ratz ass about that, and he shouldn't have to. The employer

can, and should, fire any EMT who refuses to take a transport based upon a

problem with what might happen to the patient at the receiving faclilty. The

EMT

isn't involved in the hated procedure at all. He's only involved in

transport. It's beyond nitwit silly to refuse.

Transporting a patient from one place to another to receive a legal procedure

shouldn't involve the personal morals or ethics of the employee at all.

Do your job or quit. Period. If you won't quit, and you refuse to do your

job, and you get fired, live with it.

Understand that most people in These United States of America don't agree

with you. They think that when you take a job, you agree to do it, When you

take a job, your employer sets the work rules, and you follow them. If you

have a union contract, then that comes into play, but if you don't have one, you

serve at the pleasure of your employer.

Few employers are interested in the philosophical musings of their employees.

Some people have tried to use the Nazi experience to try to elevate the

refusal to transport a patient for an abortion to the equivalent of resistance

of

The Third Reich. What drivel. It's nowhere near that.

Cowboys have a saying, " Ride for the brand. " That means, if you work for a

man, be loyal to him and give him your best efforts.

Somehow we've got this idiotic notion that employees have the right to

dictate to their employer what tasks they will do and what they will not.

If you can't " Ride for the brand, " then quit and go down the road and find

another job.

Quit being silly.

Gene G.

July 24, 2006

>

> Hopefully none of us would be willing to perform a transfer to a Euthenasia

clinic, or a

> Nazi/Stalinist 'hospital'.

Where would I find a euthanasia clinic or a Nazi and/or Stalinist Hospital?

FWIW, Many of us do transfers to euthanasia centers every day...

they're called hospices. Their sole point is to make the process of

(painful) death easier for all involved - patients, families, etc.

Mike

July 25, 2006

Mike,

Perhaps you are unclear as to the meaning of 'euthenasia'. From answers.com:

euthanasia (yooh-thuh-nay-zhuh)

Painlessly putting someone to death â€” usually someone with an incurable and

painful disease; mercy killing.

This practice is currently illegal in Texas, altho legal in Oregon and overseas

(the Netherlands, for example). I doubt many hospice workers would be thrilled

at your putting them in that class.

As for a Nazi hospital... might I suggest that is what this thread is about.

Vaughn

Re: Re: For Some, There Is No Choice

>

> Hopefully none of us would be willing to perform a transfer to a Euthenasia

clinic, or a

> Nazi/Stalinist 'hospital'.

Where would I find a euthanasia clinic or a Nazi and/or Stalinist Hospital?

FWIW, Many of us do transfers to euthanasia centers every day...

they're called hospices. Their sole point is to make the process of

(painful) death easier for all involved - patients, families, etc.

Mike

July 25, 2006

" What a prick! " is what some will say. I say " Hail to you " O " mighty

Gandy.

Henry

wegandy1938@... wrote:

> Medical Ethics Groups have proliferated in hospitals, but how many EMS

>

> services have an ethics process? I don't know of any. Should every EMS

> service

> have an ethics committee to exercise oversight over ethical and moral

> decisions

> to perform job requirements by the service's employees? Of course not.

>

> That's so idiotic and absurd that even the most flaky medic would see

> that it

> wouldn't work. That's because we do our things within time frames that

> do not

> afford delays for contacting committees.

>

> As I have firmly stated, I do not believe that any EMS provider has

> the

> prerogative to refuse treatment or transport of any patient at any

> time.

>

> The provider's personal ideas about morality must be subjugated to the

>

> patient's needs.

>

> EMS is not a forum for personal decisions about what patients to

> transport.

>

> Maybe EMS services ought to have a hiring application that would

> require an

> applicant to list her or his moral allergies and to state which

> patients they

> would agree to transport and which they would refuse.

>

> Of course, that's so absurd that everybody but a certain group of

> idealogues

> would recognize it as such.

>

> In the real world, if you are an " Amlance driver " you drive that

> Amlance from

> X to Y and take that patient where he needs to go. You don't have a

> say in

> what the reason for the transfer is or what's going to happen to him

> when he

> gets there.

>

> Only the effete, silly, selfish, and self-important EMT would

> interpose his

> personal moral requirements between himself and the emplolyer. The

> employer

> doesn't give a ratz ass about that, and he shouldn't have to. The

> employer

> can, and should, fire any EMT who refuses to take a transport based

> upon a

> problem with what might happen to the patient at the receiving

> faclilty. The EMT

> isn't involved in the hated procedure at all. He's only involved in

> transport. It's beyond nitwit silly to refuse.

>

> Transporting a patient from one place to another to receive a legal

> procedure

> shouldn't involve the personal morals or ethics of the employee at

> all.

>

> Do your job or quit. Period. If you won't quit, and you refuse to do

> your

> job, and you get fired, live with it.

>

> Understand that most people in These United States of America don't

> agree

> with you. They think that when you take a job, you agree to do it,

> When you

> take a job, your employer sets the work rules, and you follow them. If

> you

> have a union contract, then that comes into play, but if you don't

> have one, you

> serve at the pleasure of your employer.

>

> Few employers are interested in the philosophical musings of their

> employees.

>

> Some people have tried to use the Nazi experience to try to elevate

> the

> refusal to transport a patient for an abortion to the equivalent of

> resistance of

> The Third Reich. What drivel. It's nowhere near that.

>

> Cowboys have a saying, " Ride for the brand. " That means, if you work

> for a

> man, be loyal to him and give him your best efforts.

>

> Somehow we've got this idiotic notion that employees have the right to

>

> dictate to their employer what tasks they will do and what they will

> not.

>

> If you can't " Ride for the brand, " then quit and go down the road and

> find

> another job.

>

> Quit being silly.

>

> Gene G.

>

July 25, 2006

In a message dated 7/25/2006 1:17:18 P.M. Central Daylight Time,

ExLngHrn@... writes:

Benford's Law of Controversy also applies: Passion is inversely proportional

to the amount of real information available.

Now that one I was unaware of but god is it not a true statement!

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

July 25, 2006

>

> Perhaps you are unclear as to the meaning of 'euthenasia'. From answers.com:

> euthanasia (yooh-thuh-nay-zhuh)

>

> Painlessly putting someone to death â€” usually someone with an incurable and

painful disease; mercy killing.

What's the *real* difference in painlessly putting someone to death

and taking their pain away while they die? End result for *both* is a

painless death, and one that ethically is " due to " an intractable

condition in which treatment would be of no value, and the only other

option for the patient is a painful death (i.e. death is inevitable,

the patient is already suffering). The only real difference is

timeframe - short or long - and control - " nature " vs. practitioner.

> This practice is currently illegal in Texas, altho legal in Oregon and

overseas (the Netherlands, for example). I doubt many hospice workers would be

thrilled at your putting them in that class.

I don't know that many would mind, but I'm not asserting that they're

actually doing any of the killing - just providing pallative care (the

" long term " scenario). Of course, I can't speak for all hospice

workers - but I'd imagine that most of them would agree that the

primary motivator in their job is pain reduction, patient comfort,

etc. leading to a " more dignified " death than writhing around in pain

soiling themselves as a horrified, stricken family watches on (i.e.

the " old west " ).

> As for a Nazi hospital... might I suggest that is what this thread is about.

No. I don't remember anything about a " Nazi " hospital any earlier in

this thread. The invoking of " Nazi " -ism in the discussion, however,

follows Godwin's Law, which says that " As an online discussion grows

longer, the probability of a comparison involving Nazis or Hitler

approaches one. "

See http://en.wikipedia.org/wiki/Godwin's_law for more information.

Accordingly, I think we should declare this thread closed.

Mike

July 25, 2006

Not only does Godwin's Law apply, Benford's Law of Controversy also applies:

Passion is inversely proportional to the amount of real information available.

In other words, all we have is one news story that only tells one side, yet

somehow Naziism and Stalinism are invoked by some. Does anyone really know

what happened based on that one news article?