"Humans Don't Do That to People": A Qualitative Study of the Experience of Paramedics Providing Care to a Patient Who Has Just Allegedly Committed a Violent Crime.

Abstract

Objectives: Every day across the world, paramedics make critical behavioral decisions that align with an expected standard of care, whilst also incorporating personal morals and values. The work of paramedics is inherently moral, however, the ability to do what is right can be impeded by multiple external factors. On occasion, paramedics are in the position where they are required to care for a patient who has just allegedly committed a violent crime. How does a paramedic perceive alterations to their behaviors regarding their personal morals, values and ethics, when caring for these patient types?

Methods: One-on-one, semi-structured interviews were conducted with 12 registered paramedics throughout Australia who had direct experience caring for a patient who had just allegedly committed a violent crime. These paramedics were diverse in their clinical levels, years of experience and working region. Interview questions detailed the paramedic's opinions, moral and ethical conflicts, prior specific training, effects on personal wellbeing, and coping strategies. Interviews were transcribed and subjected to inductive coding and examination through the reflexive thematic analysis framework.

Results: Four themes, comprising 11 sub-themes, were conceptualized: type of crime, coping strategies, impact, and support. The participants provided varying individual experiences with alleged violent crime, and thus differed in the opinions they held and the reactions and behaviors they faced. The participants were unanimous in their responses stating they received a severe lack of previous training or education pertaining to offender care. Participants referenced a desire for improvements to education, better recognition of these cases by the community and organizations, and incorporation of preventative measures for emotional distress, rather than focusing on coping with aftermath stress.

Conclusions: Paramedics experience profound impacts on their emotional, professional, and mental well-being when required to care for alleged perpetrators of violent crime. The innate role identity of the paramedic predisposes them to experiencing moral injury and distress. Paramedics call for action toward a greater level of training and education for upcoming paramedics, and qualified paramedics alike to ensure they are adequately prepared to make moral and ethical decisions.