The Research

Working in the out-of-hospital environment, paramedics have to make fast, complex decisions, often with minimal information available to them when they are confronted with a patient in cardiac arrest.

Decisions to commence or forego resuscitation have complex and wide-ranging effects on patients, their loved-ones, the rescuers and society. This project seeks to explore the distinctive ethical and practical challenges that can arise, and to gain an ethical understanding of paramedic decision-making in these cases.

The Researcher

The researcher is Iain Campbell, a paramedic who is undertaking his Masters by research at the Centre for Ethics in Medicine, in the Medical School at The University of Bristol. This study is funded by the Wellcome Trust, via the Centre for Ethics in Medicine Wellcome Trust Masters programme in Humanities and Social Science (Bioethics).

The research is supervised by Professor Richard Huxtable and Professor Jonathan Ives.

The Research Questions

The primary research question is: On what basis or bases should paramedics decide not to attempt resuscitation of out-of-hospital adult patients experiencing a non-traumatic cardiac arrest?

In order to answer this question, the research will also ask:

• On what bases do paramedics say they decide not to attempt resuscitation of out-of-hospital patients experiencing a non-traumatic cardiac arrest?
• On what bases do paramedics report they should be making decisions not to attempt resuscitation of out-of-hospital patients experiencing a non-traumatic cardiac arrest?
• What, according to the literature, are the ethical bases underpinning decisions not to attempt resuscitation of out-of-hospital patients experiencing a non-traumatic cardiac arrest?

The Approach

This study will involve interviewing paramedics about their decision-making in out-of-hospital cardiac arrest. A narrative literature search will also be conducted to find the main theoretical texts, scientific studies, laws, and guidelines which inform practice in this area. The various findings will then be used to inform the ethical analysis (using the approach “reflexive balancing”) that seeks to answer the research questions.

Would you like to participate?

Recruitment for this project has now closed.

Ethical Approval

This project has been reviewed and approved by the University of Bristol Health Science Student Research Ethics Committee (Ref: 114705).