As you may know, the Code of Ethics sets out the basic ethical commitments that guide all regulated members of the paramedic profession in Alberta. Each regulated member is required to understand and comply with this Code, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
The following scenario addresses responsibility to the public – respecting the rights and diversity of all individuals to access healthcare, regardless of demographic or socioeconomic factors, values, beliefs, gender identity and expression, and/or cultures.
2.1 Impartiality by respecting the rights and diversity of all individuals to access healthcare, regardless of their demographic or socioeconomic factors, values, beliefs, gender identity and expression, and/or cultures
Scenario:
A Primary Care Paramedic (PCP), Mark, is working an evening shift with his ACP partner, Julian, in Red Deer. They are dispatched to a public transit station for a patient experiencing dizziness and chest discomfort. When they arrive, they find Sam, an unhoused adult who is wearing soiled clothing and carrying several bags. A bystander tells the crew that Sam is often seen in the area and suggests that the patient is probably intoxicated and “just looking for a place to sleep.”
As Mark begins the assessment, Sam explains that they have not eaten much that day and are worried about the cost of going to the hospital. Sam also asks Mark to use they/them pronouns. Julian quietly suggests that they should keep the assessment brief because the call is likely related to substance use and the patient may not follow medical advice anyway.
Mark recognizes that assumptions about a person’s housing status, appearance, possible substance use or circumstances must not influence the care they receive. Mark uses Sam’s requested pronouns, speaks respectfully, explains the assessment and available care options, and asks questions without judgment. Mark completes an appropriate assessment, including vital signs and a focused history, and explains why further medical assessment at the hospital is recommended. Mark also explores Sam’s concerns about cost and access, provides clear information about the next steps, and supports Sam in making an informed decision.
When Sam initially hesitates to go to hospital, Mark does not dismiss the concern or pressure them through shaming language. Instead, Mark checks Sam’s understanding, explains the potential risks of declining transport, and follows the appropriate process for assessing and documenting an informed refusal if Sam continues to decline. Mark communicates the clinical findings and plan to his partner Julian, and ensures that Sam is offered the same respectful, clinically appropriate care that any other patient would receive.
After the call, Mark and Julian discuss the interaction. Mark explains that as a professional, we must not allow personal beliefs, stereotypes or assumptions about a person’s identity, culture, income, housing status or lifestyle to affect access to care. Julian reflects on how his initial assumptions could have led to an incomplete assessment or a dismissive response.
By providing respectful, impartial and clinically appropriate care, Mark demonstrates responsibility to the public. The scenario highlights that every person has the right to access healthcare without discrimination or judgment, and that a patient’s circumstances do not lessen a paramedic’s professional obligations.
Impartiality means:
- Treating each patient with dignity and respect, regardless of demographic or socioeconomic circumstances.
- Recognizing and challenging personal assumptions, stereotypes and biases that could affect care.
- Respecting a patient’s gender identity and expression, including using their stated name and pronouns where provided.
- Providing appropriate assessment, treatment options and explanations without judgment based on culture, beliefs, housing status, income or perceived lifestyle.
- Supporting informed decisions by communicating risks and options clearly and respectfully.
- Ensuring that concerns about a patient’s likely behaviour or willingness to follow advice do not replace an individualized clinical assessment.
- Maintaining professional boundaries and following applicable clinical, documentation and refusal-of-care processes.
This scenario demonstrates that responsibility to the public includes impartiality in every patient interaction. By setting aside assumptions, respecting the patient’s identity and circumstances, and providing appropriate care based on clinical need, a regulated member upholds the rights and dignity of the individual and supports equitable access to healthcare.