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The Ethics of Real-Time EMS Direction: Suggested Curricular Content

Published online by Cambridge University Press:  14 February 2018

Jay M. Brenner*
Department of Emergency Medicine, SUNY-Upstate Medical University, Syracuse, New York USA
Andrew L. Aswegan
Department of Emergency Medicine, Union Hospital, Elkton, Maryland USA
Laura E. Vearrier
Department of Emergency Medicine, Drexel University, Philadelphia, Pennsylvania USA
Jesse B. Basford
Department of Emergency Medicine, Louisiana State University, Shreveport, Louisiana USA
Kenneth V. Iserson
Department of Emergency Medicine, University of Arizona, Tucson, Arizona USA
Correspondence: Jay M. Brenner, MD Department of Emergency Medicine SUNY-Upstate Medical University Syracuse, New York USA E-mail:


Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR). This requires a strong foundation in the principles and theories underlying sound ethical decisions that EPs and prehospital providers make every day in good faith, but will now also make with more awareness and conscientiousness.

BrennerJM, AsweganAL, VearrierLE, BasfordJB, IsersonKV. The Ethics of Real-Time EMS Direction: Suggested Curricular Content. Prehosp Disaster Med. 2018;33(2):201212.

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© World Association for Disaster and Emergency Medicine 2018 

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Conflicts of interest: none


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