Ethical Principles and Professional Code of Conduct for EMTs

Ethics guides what an EMT ought to do when values, safety, law, limited resources and patient wishes meet. Technical skill without ethics can still harm a patient. Professional conduct makes ethical care visible in daily actions.

• Explain autonomy, beneficence, non-maleficence and justice.
• Apply the principles to common EMS situations.
• Describe professional conduct, confidentiality, consent, boundaries and accountability.

Consent is valid when the patient has capacity, receives understandable information and agrees voluntarily. In a life-threatening emergency, a patient who lacks capacity may need immediate necessary treatment under emergency principles and local law/protocol. Continue to explain care, involve the patient when capacity returns and document why urgent action was required.

• Capacity may be impaired by unconsciousness, shock, severe hypoxia, intoxication, delirium, head injury or severe mental illness.
• Refusal: assess capacity, explain risks/alternatives, involve senior support where available, document carefully and give safety advice. Do not use force except where legally and clinically justified.
• Children: involve parent/guardian where possible, act in the child’s best interests and follow local safeguarding/referral procedures.

1. Ensure immediate safety and treat ABCDE threats.
2. Identify the ethical issue and who may be affected.
3. Gather relevant facts: capacity, wishes, risks, law/protocol and available resources.
4. Consider autonomy, benefit, harm and justice.
5. Consult a senior/medical control where time allows.
6. Act, communicate respectfully and document the reasoning.
7. Review afterwards and learn from the case.

• Ethics is part of every assessment, treatment, transport and handover.
• Autonomy does not mean abandoning a patient; it means supporting informed choice and capacity assessment.
• Confidentiality, respectful communication and accurate documentation are professional duties.
• Uganda’s health-worker ethical guidance emphasises access to emergency care, privacy, integrity, customer care and non-discrimination.

1. Define the four ethical principles.
2. How would you manage a competent adult who refuses ambulance transport?
3. State five rules of professional conduct for an EMT.
4. Why is accurate documentation an ethical duty?

Study sources: Uganda Joint Code of Conduct and Ethics for Health Workers; WHO health ethics guidance.

An Emergency Medical Technician (EMT) is a trained pre-hospital care provider who assesses, treats, monitors and transports people with illness or injury within an authorised scope of practice. The EMT links the community, emergency response and receiving health facility.

• Describe the core role of an EMT.
• Explain clinical, safety, communication and professional responsibilities.
• Apply EMT responsibilities to scene care, transport and handover.

1. The EMT's Role
2. Core Responsibilities
3. Patient-care Workflow
4. Professional Conduct
5. Exam Focus

The EMT is not simply a driver or a person who carries patients. The EMT brings organised emergency care to the patient, identifies immediate threats, starts indicated treatment, decides on safe transport and communicates essential information to the receiving team. The exact procedures permitted depend on national policy, service protocols, training level, equipment and medical direction.

Before approaching, the EMT assesses traffic, fire, electricity, violence, unstable structures, hazardous materials, crowds and infection risk. Use personal protective equipment and request police, fire, rescue or additional clinical resources when needed. A rescuer who becomes injured cannot help the patient.

Use a systematic primary assessment such as ABCDE: airway, breathing, circulation, disability and exposure. Treat life-threatening problems first. A focused history, vital signs and secondary assessment follow when the patient is stable enough. Identify patients needing urgent transport and a specific facility.

Responsibilities include protocol-authorised care such as airway positioning, ventilation support, oxygen where indicated, bleeding control, shock management, glucose assessment, seizure protection, splinting, positioning and medicine administration only when trained and permitted. Never perform a procedure merely because it is requested or has been seen elsewhere.

Select safe lifting methods and equipment, protect the patient from falls, use stretcher straps and consider trauma, pregnancy and respiratory needs. During transport, reassess vital signs, continue treatment, record changes and balance speed with road safety.

Clear communication prevents dangerous delay. Report location and resource needs, explain care calmly to patients and relatives, alert a receiving facility for critical patients and give concise handover. ATMIST or SBAR can include the problem, history or mechanism, assessment, vital signs, treatment, response and concerns.

Every case record should include times, findings, vital signs, treatment, response, destination and handover. Before and after each shift, check vehicle safety, oxygen, suction, monitoring equipment, PPE, medicines, consumables, communication devices and stretcher function. Report defects and stock gaps promptly.

1. Receive information and prepare the correct equipment.
2. Approach only when the scene is safe.
3. Identify and treat immediate life threats using ABCDE.
4. Gather focused history and repeat vital signs.
5. Decide destination and request additional help or early facility notification.
6. Move and secure the patient safely.
7. Continue care, reassessment and documentation during transport.
8. Give structured handover and restock or report after the case.

An EMT team reaches a rider after a collision. Traffic is active and a crowd is gathering. The team first establishes a safe working area, uses PPE and requests traffic control. The patient has major leg bleeding and is confused. The EMT controls bleeding, assesses airway and breathing, checks circulation and consciousness, prepares the patient for safe transfer, communicates with the receiving facility and reassesses throughout transport. On arrival, the crew provides a structured handover.

• Work within training, scope of practice and service protocols.
• Respect patient dignity, privacy, culture and confidentiality.
• Seek consent when possible; act in the patient's best interests when emergency incapacity applies under authorised practice.
• Remain calm, honest and respectful; never promise outcomes that cannot be guaranteed.
• Do not abandon a patient after taking responsibility unless care is transferred appropriately.
• Avoid discrimination, unsafe driving and careless social-media use.
• Participate in debriefing, skills updates and quality-improvement review.

The EMT must recognise when a patient needs a higher level of care, more resources or medical consultation. Good practice includes requesting help early, communicating limitations, choosing an appropriate destination and documenting decisions. Working beyond scope or improvising unsafe care can harm the patient and the team.

• An EMT is a pre-hospital clinician, not only a transport worker.
• Scene safety comes before patient contact.
• ABCDE guides management of immediate life threats.
• Care continues during transport and ends after a safe handover.
• Scope, protocol, documentation and confidentiality are professional duties.

1. List six responsibilities of an EMT at an emergency scene.
2. Explain why care in transit is an EMT responsibility.
3. Describe a structured clinical handover.
4. State four professional limits or ethical duties of an EMT.
5. Apply the EMT workflow to a road traffic crash.

• WHO Emergency Care Toolkit
• Uganda Ministry of Health: National Emergency Medical Services Policy