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As you may already know, the Standards of Practice set out the minimum standards in the provision of paramedic services. Each regulated member is required to understand and comply with these Standard but how does this translate in the day-to-day work of EMRs, PCPs, and ACPs?
In an effort to help regulated members understand and apply the Standards to real life situations, we will be launching a series of scenarios that give context to the Standard and ideas on how to implement this into practice.
The following scenarios will attempt to address Conflict of Interest:
1.2 Conflict of Interest
A conflict of interest may arise where a reasonable person could believe that a regulated member’s duty to act in the patient’s best interests may be affected or influenced by other competing interests, including financial, non-financial, direct, or indirect transactions with patients or others.
When a conflict of interest may reasonably be understood to exist, a regulated member must:
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- Identify situations that could lead to or be interpreted as a conflict of interest.
- Not engage in situations where a conflict of interest can be avoided.
- Disclose to the patient any identified conflicts of interest and offer options to resolve the conflict where the conflict cannot be avoided.
- Ensure the resolution of any real, potential or perceived conflicts of interest are in the best interest of the patient.
Example A – Patient Care:
Paramedics Mel and Sandy are working a shift together in Airdrie, a suburb of Calgary. They are nearing the end of a busy shift when they get a call an hour before their shift ends. The patient has suffered a possible stroke, and the transport protocol for stroke patients is to transfer the patient to the Foothills hospital, which is near the centre of Calgary, and it is rush hour traffic.
Both Mel and Sandy have family commitments after work, and they know taking this patient to the Foothills hospital will definitely result in overtime, and they would be unable to meet their familial obligations. They decide to downplay the patients’ symptoms and transport to the Airdrie Urgent Care Centre.
Without going into the potential violation of employer policies and the College’s Code of Ethics, we can see that there is a conflict of interest between the paramedics’ desire to meet their familial commitments and their obligation to the patient’s specific needs.
Example B – Employment Responsibilities:
Joe works for EMS Ambulance which has a contract to provide medical coverage at an arena for sporting events and concerts. After working a few of these events, Joe strikes up a relationship with the Director of Operations at the arena and they begin to talk about the current contract with EMS Ambulance. Joe divulges that EMS Ambulance has had numerous issues related to staff turnover, keeping equipment in working order and maintaining the appropriate level of supplies. Joe also divulges that the owner of EMS Ambulance often brags about how lucrative the arena contract is.
Over the course of a few months, Joe convinces the Director to go to market for the contract to provide medical coverage for the arena events. Meanwhile, Joe has formed a company and places a lower bid to provide the same services as EMS Ambulance. Ultimately Joe’s company wins the bid.
While this example doesn’t relate to patient care, it does present an alternative situation where a conflict may exist or be perceived. Joe’s role as an employee of EMS Ambulance is to professionally represent EMS Ambulance while covering these events, but conversations with the Director undermined the credibility of EMS Ambulance. Joe’s decision to form a company to place a competing bid creates a clear conflict of interest where Joe’s financial interest is positioned against the duty to professionally represent their employer.