Reflections on paramedic praxis

In Ancient Greek, 'praxis' (πρᾶξις) described an activity involving free people engaging in practical reasoning leading to wise action. Praxis is driven the moral disposition to act truly and rightly where a practical emphasis is placed on the end goal of action. Interpretation was pointless without it and theory had to result in practice.

The ambulance service I joined in 1989 may be considered a world away from today’s contemporary paramedic practice. A bitter national ambulance dispute was raging, there were no paramedics in our ambulance service at the time, the only drug available was Entonox and semi-automatic defibrillators had only recently been introduced. Despite the significant change over this time, many of the issues and challenges faced in 1989 remain in various forms. Our capacity to provide care has no doubt improved exponentially since this time, but on closer exploration of the case-mix presenting to paramedics today, widening health-related social inequalities dominate underlying patterns of disease and illness, revealing complex influences beyond our control and calling for continual change, reflection and adaptation.