Search results

With aging, the risk of requiring emergency care increases. Elderly patients who need Emergency Medical Services (EMS) are often vulnerable and dependent, especially when their decision-making ability is reduced, which may intensify the risk of important ethical values being violated. Studies about paramedics’ views on elderly people’s self-determination within EMS settings are scarce. The aim of this study was to explore the attitudes and perceptions of paramedics in a US context regarding self-determination in elderly patients who need emergency care provided by EMS.

The study had an exploratory design, and data were collected using a Delphi technique. A panel of experts consisting of US paramedics was recruited to answer a questionnaire sent out in three rounds. The questionnaire comprised 108 items, derived from a Swedish study on the same topic, rated with a five-point Likert scale ranging from agree to disagree with a predetermined consensus level of 70%.

In total 21 experts agreed to participate, 15 completed all three rounds, leaving a total response rate of 71%. Finally, 87 out of 108 items reached consensus, of which 60 were “agree” and 27 were “disagree.”

The paramedic–patient relationship is a core in assessing and handling ethical challenges within an advanced practice influenced by the paramedics’ educational level and/or the patient’s physical/mental status. Within a “find it fix it” modus operandi, there is a need to increase paramedics’ competence in understanding and handling advanced ethical challenges in relation to ethical values such as autonomy and self-determination in elderly patients.

All sorts of distinctions can be made concerning prestige goods: for instance, between the most durable like precious stones passed down from generation to generation and the ephemeral ones, or between those which seem to exert a universal fascination, like gold and others valued only in some places. The question of borrowings and possible syncretism is also most appealing for the comparatist and countless illustrations could be given here. In many cases, prestigious goods must be studied by taking both their symbolic and practical value into consideration. What I mean is that a ‘Veblenesque’ approach only paying attention to them as status symbols tends to underestimate their functional dimension. For example, limousines or jets must certainly be analyzed in terms of attributes of power and status enhancement. However, one cannot deny that they also have concrete functions of ‘comfortableness’ and rapidity for ubiquitous elites bound to do extensive traveling. Normally, in modern democracies, top political actors inherit or acquire all kinds of prestigious public assets, but these must be returned at the end of their mandate. Even presents officially given to them are supposed to be surrendered to a public museum. The famous affair of Emperor Bokassa's diamonds offered to Valéry Giscard d’Estaing no doubt discredited the French President and contributed to his defeat in the 1981 elections.