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Perceptions of ethical dilemmas in Australian paramedicine

02 August 2021
Volume 13 · Issue 8



Paramedics experience a range of ethical dilemmas in the course of their work. To date, ethical dilemmas by Australian paramedics have not been documented. With the scope of practice becoming increasingly complex, paramedic education may not have evolved to meet holistic professional demands.


To describe the ethical dilemmas experienced by contemporary Australian paramedics.


An online survey, based on a previous instrument, was used to explore a range of ethical dilemmas.


Paramedics face a range of ethical dilemmas in their everyday practice. While several demographic variables were associated with different perceptions, the results of this study highlight that a paramedic's years of experience is most consistently associated with their perception of ethical dilemmas.


Australian paramedics experience a range of ethical dilemmas consistent with previous international findings. Years of experience in the profession features heavily and is relied upon more so than education, suggesting that educational approaches to ethics education in paramedicine need to be reconsidered.

Paramedicine is evolving in Australia, and has transitioned from providing rudimentary care and transport to delivering advanced prehospital and out-of-hospital care by highly trained professionals (O'Meara and Grbich, 2009). As this evolution continues, paramedics have to address increasingly complex situations that require not only astute clinical and operational knowledge but also a deep understanding of how to apply judgement in what are often ethically complex cases.

An expert practitioner involved in the intricacies of complex clinical care requires a range of capabilities in addition to clinical knowledge and well-honed skills (Tyreman, 2000). The development of expertise occurs via several stages; all of these must be progressed through but some can occur concomitantly. The Dreyfus model of development, which is often adopted in health education, encompasses the novice, advanced beginner, competent, proficient and expert stages (Persky and Robinson, 2017: 73). These stages involve progressive problem-solving so individuals must engage in increasingly complex problems consciously aligned with their stage of development (Persky and Robinson, 2017: 72).

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