Background: Professional ethical codes are an important part of healthcare. They are part of the professionalisation of an occupation, are used for regulation of the professions and are intended to guide ethical behaviour in healthcare. However, so far, little is known about the practical use of professional codes in healthcare, particularly in paramedicine. Objective: The aim of this scoping review was to determine what is known in the existing literature about health professionals’ knowledge, awareness and use of their professional codes. (...) Method: A scoping review was performed based on a six-stage framework as described by Levac et al. Six databases were searched: OVID Medline, EMBASE, EMCARE, CINAHL, ProQuest and Scopus, in September 2020. Google Scholar, Trove and Google using.gov and.org websites were also searched for grey literature. Two reviewers independently assessed study eligibility. Results: The search yielded 1162 results after duplicate removal. Thirty-nine studies remained after title and abstract review. Twenty-five articles were included after full-text review. Sixteen examined nursing, eight examined medicine and one examined both nursing and medicine. No studies were identified that examined paramedicine. Twenty-one studies were of a cross-sectional design and four studies were of a qualitative design. Conclusion: Most health professionals know the codes exist, but do not think they know the content. Despite valuing professional codes highly, healthcare professionals do not use them regularly in clinical practice. Further research is needed, and professional codes should be made useful for practice and consideration given to how codes can be written, communicated and implemented to increase their actualisation in healthcare. Research should also begin in paramedicine to identify clinician’s knowledge and use of codes in this profession. Review registration: Open Science Framework – doi:10.17605/OSF.IO/NKBY4 Ethics Statement: This article does not contain any studies involving human participants performed by any of the authors. The review followed good scientific conduct. (shrink)

Paramedics encounter ethical dilemmas at work, and while previous research has improved ethics education and practice, more can be learned from the lived experience of paramedics facing ethical challenges. This paper explores the lived experience of two paramedics, one with five years’ experience, the other twenty, presented with comparable cases. The participants, who were interviewed in a broader qualitative study exploring practical wisdom, were asked to select a case involving ethical decision-making from their own practice experience. Semi-structured interviews employed the (...) five-step Critical Decision Method as a framework to explore various aspects of the decision-making process. The two cases were identified as exemplars of prominent themes suitable for discussion. The findings highlighted several factors that influence paramedic ethical decision-making, including practical wisdom, communication and teamwork, clinical support, and education. This case comparison identifies a greater need to focus education on the fostering of practical wisdom, and the development of non-technical skills such as communication and teamwork, supported by interprofessional education endeavours. Furthermore, greater access to support for paramedics must be available to further evolve practical wisdom. The combination of improved education and support will likely cater for the full spectrum of ethical challenges faced by paramedics in their work. (shrink)

Background Paramedicine is a newly regulated profession in Australia and with the introduction of regulation in 2018 for this profession came increased responsibilities – including the introduction of a professional code of conduct. Several countries now have regulation of paramedicine and associated professional codes to guide ethical and professional behaviour. Despite this, there has been no published research into paramedic understanding and use of their professional codes. Objectives To explore Australian paramedics’ use and understanding of their professional code of conduct. (...) Research design: This study used a qualitative descriptive design, underpinned by hermeneutic theory. Reflexive thematic analysis was used to analyse the interview data and identify Australian paramedic perceptions surrounding the use of their code of conduct. Results 11 Registered Paramedics from several states and territories were interviewed. Participants were invited to interview by advertisement on social media and the Australasian College of Paramedicine Web site. Participants had varied professional backgrounds including clinical work, education providers and policymakers/managers. Four themes were identified as follows: Theme 1 – ‘You don’t know, what you can’t know’; Theme 2 – ‘I don’t need the code – the code is for others’; Theme 3 – ‘It’s about time’; Theme 4 – ‘Navigating the new profession’. Ethical considerations: Ethics approval was granted by the Monash University Human Research Ethics Committee (MUHREC) Project ID: 28921. All participants provided informed consent. Conclusions The results of this study suggest that paramedics’ knowledge and use of their code is limited, and participants appeared to mostly rely instead on ‘common sense’ morals. Participants did appear to want to understand the broad concepts of the code more and have this better integrated into the profession. The code was also interpreted as important to the paramedic profession and its new professional status, helping to legitimise it as a health profession in Australia. (shrink)

In Australia, paramedics are obliged to practice ethically. Graduates of baccalaureate degrees in paramedicine should therefore possess a common grounding in ethics to meet the professional capabilities expected of registered paramedics. However, there is a lack of clarity regarding ethics education for paramedicine students, including what is taught, how it is taught, and how it is assessed. This paper explores ethics education for paramedicine students in Australia, how it aligns with current professional expectations, and how it may be enhanced. Point-in-time (...) data regarding ethics education was collected from websites of fifteen Australian universities offering undergraduate baccalaureate degrees in paramedicine. Data collection was supported by consultation with academics from several institutions. Content analysis was utilised to categorise and analyse data to explore similarities and differences in curricula. Similarities included approaches to learning and teaching and the use of case-based learning, with variability found across teaching staff profiles and content areas. Findings suggest it is time for collaboration to develop a model ethics curriculum for paramedicine students in Australia. (shrink)